Levo-Alpha Acetyl Methadol (LAAM). Its advantages and drawbacks

[smfadmin (OP)]

https://pubmed.ncbi.nlm.nih.gov/9437627/

Levo-Alpha Acetyl Methadol (LAAM). Its advantages and drawbacks

1997 Nov-Dec

Abstract

Levo-Alpha Acetyl Methadol, or LAAM, is a medication therapy for individuals addicted to opiates that provides an alternative to methadone.

Because it is administered only three times a week and, therefore, requires fewer clinic trips, patient acceptance can be higher than with methadone.

While blocking the effects of other opiates and preventing withdrawal, LAAM does not produce a subjective high.

However, because most patients are not familiar with LAAM, they may be initially more anxious and need more counseling and support when receiving the medication than they would with the more familiar methadone medication.

On balance, LAAM enables clinic administrators and counselors to offer an alternative medication to methadone that some clients prefer once they become adjusted to it because of LAAM's even, stable effect.

Through hypothetical but true-to-life case studies of LAAM use, it is possible to gain a clearer understanding of the advantages and drawbacks of using LAAM.

Levacetylmethadol^Wiki

LAAM is indicated as a second-line treatment for the treatment and management of opioid use disorder.

https://pubmed.ncbi.nlm.nih.gov/12076441/

LAAM maintenance vs methadone maintenance for heroin dependence

N Clark et al. Cochrane Database Syst Rev. 2002

Abstract

Background:

LAAM and methadone are both full mu opiate agonists and have been shown to reduce dependence on heroin when given continuously under supervised dosing conditions.

LAAM has a long duration of action requiring dosing every two or three days compared to methadone which requires daily dosing. LAAM is not as widely available internationally as methadone, and may be withdrawn from the market following ten cases of life-threatening cardiac arrhythmias and an association with QT prolongation.

Objectives:

To compare the efficacy and acceptability of LAAM maintenance with methadone maintenance in the treatment of heroin dependence.

Search strategy: We searched MEDLINE (January 1966 to August 2000), PsycINFO (1887 to August 2000), EMBASE (January 1985 to August 2000), and the Cochrane Controlled Trials Register (Issue 2 2000). In addition we hand searched NIDA monographs until August 2000 and searched reference lists of articles.

Reviewer's conclusions:

LAAM appears more effective than methadone at reducing heroin use. More LAAM patients than methadone ceased their allocated medication during the studies, but many transferred to methadone and so the significance of this is unclear. There was no difference in safety observed, although there was not enough evidence to comment on uncommon adverse events.