From: Subject: *LAAM* reduces heroin addiction Date: 1997/06/26 Newsgroups: alt.drugs.hard LAAM (levomethadyl acetate hydrochloride) reduces heroin addiction From URL: http://www.yahoo.com/text/headlines/970625/health/stories/drug_1.html _________________________________________________________________ Drug Reduces Heroin Addiction NEW YORK (Reuters) -- People addicted to heroin may be able to reduce their use of the drug by up to 90% with a medication that lasts longer than treatment with methadone, a new study shows. Earlier tests of the medication, called LAAM (levomethadyl acetate hydrochloride), confirmed that it needs to be taken only three times a week. Methadone, the most widely used medication for heroin addiction, must be taken daily, which can mean a daily trip to a clinic or unsupervised use of take-home dosages. LAAM was first approved by the Food and Drug Administration in 1993 for use in treating heroin addiction. Studies showed it to be as effective as methadone but with longer-lasting effects. According to study co-author Dr. George Bigelow, director of the Behavioral Pharmacology Research Unit at Johns Hopkins University School of Medicine in Baltimore, LAAM has not been widely adopted in many states because of regulatory hurdles governing drug-abuse treatment. "And some of the most important states are getting around to finally approving it," he says. "So this study is still very early in the clinical availability of this medication." This study is the first clinical trial comparing the effectiveness of different LAAM doses. Results show the medication can reduce heroin use when taken three times a week at either low-, medium-, or high-dose regimens, with effectiveness increasing substantially at the highest dose. This was also the first carefully controlled study of LAAM to include women. It showed that men and women respond equally well to the medication, and that high doses are safe for both male and female heroin addicts. "This study reinforces the fact that heroin addiction can be treated effectively," says Dr. Alan I. Leshner, director of the National Institute on Drug Abuse in Bethesda, Maryland. "When higher doses of LAAM are used in combination with other drug abuse treatment methods, such as behavioral therapies and psychosocial care, we may see even more positive outcomes for persons who are opioid dependent." "It's one of the benefits of the psychosocial counseling aspects of treatment," Bigelow says. "It's important for people to know that it's not just medications that are beneficial but that psychosocial aspects of counseling are very important also." The 17-week study was conducted with 180 heroin-dependent volunteers (70 women, 110 men). None of the participants were concurrently in a drug treatment program. Upon entering the study, they were assigned to either a high-, medium-, or low-dose LAAM treatment group. Three days a week, on Mondays, Wednesdays, and Fridays, the groups received a liquid LAAM dosing regimen -- either 25/25/35 milligrams, 50/50/70 milligrams, or 100/100/140 milligrams. Each participant was also offered counseling. LAAM reduced heroin use in a dose-related pattern. Before assignment to a LAAM group, addicts reported using heroin an average of 29 of the past 30 days. After 16 weeks of high-dose LAAM treatment, addicts reported using heroin an average of 2.5 of the past 30 days, a reduction of nearly 90%. For addicts in the medium-dose group, heroin use declined an average of 4.1 days, and to an average of 6.3 days among low-dose LAAM users. These self-report findings were corroborated through urine testing. The study also found that heroin addicts taking high-doses of LAAM were twice as likely to achieve four weeks of full abstinence compared with those taking lower doses. "This study is important because the effectiveness of the most widely used heroin-dependence medication, methadone, has not been fully realized because of a lack of information regarding effective doses," says Bigelow. He says the completion of this dose-comparison study of LAAM will allow doctors to base their dosing decisions on research data "and may help increase LAAM's therapeutic effectiveness." The researcher also notes that cocaine users in the study reduced their cocaine use by almost two-thirds. However, this degree of reduction was not found to be related to the dose of LAAM used. According to government figures, in 1993 about 586,000 Americans reported using an illicit opioid drug at least once a week. SOURCE: The Journal of the American Medical Association (1997;277:1945-1951) _________________________________________________________________ ==================================================================== From: (Peter McDermott) Subject: Re: *LAAM* reduces heroin addiction Date: 1997/06/26 Newsgroups: alt.drugs.hard In article <5ot2mc$cuq$1@vnetnews.value.net>, wrote: > "This study is important because the effectiveness of the most widely > used heroin-dependence medication, methadone, has not been fully > realized because of a lack of information regarding effective doses," > says Bigelow. What total and utter nonsense. There's all manner of studies from the USA and Australia that show that methadone is extremely effective at doses of 80mg and over.