The use of levo-alpha-acetylmethadol (LAAM) in methadone patients who have not achieved heroin abstinence.
Levo-alpha-acetylmethadol (LAAM) pharmacotherapy was offered to twelve patients who continued illicit opioid abuse after > or = eleven months in methadone maintenance treatment. After 6-8 weeks on LAAM, plasma concentrations of the norLAAM metabolite varied significantly by LAAM dosing day, plasma adrenocorticotropin (ACTH) concentrations were significantly increased compared to methadone, and two of the seven subjects remaining in LAAM treatment were free of illicit opioids and nonprescribed methadone. After one year, one of five remaining subjects was using illicit opioids, and three were using non-prescribed methadone. While subject acceptance of LAAM was high, subjects were not in a "steady-state," with evidence of ongoing illicit opioid abuse.
Borg
Lisa
L
The Rockefeller University, Laboratory of the Biology of Addictive Diseases, New York, NY 10021, USA. borgl@mail.rockefeller.edu
Ho
Ann
A
Wells
Aaron
A
Joseph
Herman
H
Appel
Phil
P
Moody
David
D
Kreek
Mary Jeanne
MJ
D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D001682:Biological Availability; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006556:Heroin Dependence / Q000097:blood / Q000534:rehabilitation*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D008657:Metabolic Clearance Rate / Q000502:physiology; D008691:Methadone / Q000008:administration & dosage* / Q000493:pharmacokinetics; D008692:Methadyl Acetate / Q000008:administration & dosage* / Q000493:pharmacokinetics; D009294:Narcotics / Q000008:administration & dosage* / Q000493:pharmacokinetics; D010342:Patient Acceptance of Health Care; D010865:Pilot Projects; D011388:Prolactin / Q000097:blood; D015813:Substance Abuse Detection
D009294:Narcotics; D000324:Adrenocorticotropic Hormone; D011388:Prolactin; D008692:Methadyl Acetate; D008691:Methadone; D006854:Hydrocortisone