Relationship between LAAM-methadone preference and treatment outcomes

Relationship between LAAM-methadone preference and treatment outcomes

Studies of relative LAAM-methadone preference have indicated that a significant proportion of patients prefer levo-alpha-acetylmethadol (LAAM). The present study was designed to determine whether this preference is associated with better treatment outcomes. Sixty-two stable methadone patients partic...

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Bibliographic Details
Published in:Drug and alcohol dependence Vol. 66; no. 3; pp. 295 - 301
Main Authors: WHITE, Jason M, DANZ, Cath, KNEEBONE, Joanne, LA VINCENTE, Sophie F, NEWCOMBE, David A. L, ALI, Robert L
Format: Journal Article
Language:English
Published: Shannon Elsevier Science 01-05-2002
Subjects:
Adult
Australia
Biological and medical sciences
Chi-Square Distribution
Cross-Over Studies
Drug addictions
Drug addicts
Female
Heroin
Heroin Dependence - drug therapy
Heroin Dependence - rehabilitation
Humans
Levo-alpha-acetylmethadol
Male
Medical sciences
Methadone
Methadone - therapeutic use
Methadyl Acetate - therapeutic use
Middle Aged
Narcotics - therapeutic use
Outcomes
Patient Satisfaction - statistics & numerical data
Preferences
Statistics, Nonparametric
Toxicology
Treatment
Treatment Outcome
Human
Drug addiction
Replacement therapy
Prognosis
Treatment efficiency
Opiates
Methadone
Drug compliance
Chemotherapy
Randomization
Treatment
Preference
Clinical trial
Evolution
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Summary:Studies of relative LAAM-methadone preference have indicated that a significant proportion of patients prefer levo-alpha-acetylmethadol (LAAM). The present study was designed to determine whether this preference is associated with better treatment outcomes. Sixty-two stable methadone patients participated in a randomised crossover clinical trial. They received LAAM (alternate days) and methadone (daily) for 3 months each, followed by a further 6-month period during which they were free to choose between the drugs. LAAM maintenance was associated with a lower rate of heroin use than methadone maintenance based on analysis of morphine concentration in hair and equivalent health outcomes. The majority of subjects showed a preference for LAAM (n=27, 69.2%) rather than methadone (n=12, 30.8%). The main reasons given for the LAAM preference were that it produced less withdrawal (39.3%), fewer side effects (28.5%), less craving for heroin (17.9%), and entailed fewer pick-up days (14.3%). Those who chose LAAM had lower levels of heroin use during LAAM maintenance, significantly better outcomes on two sub-scales of the SF-36 (Vitality and Mental Health), and reported that they felt more normal and that they were 'held' better when on LAAM. For those who chose methadone, there were no differences in outcomes between the LAAM and methadone maintenance periods. Preference for LAAM is associated with treatment outcomes as good or better than those with methadone.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:0376-8716
1879-0046
DOI:10.1016/S0376-8716(02)00007-8