The Use of L-α-Acetylmethadol in Treatment of Heroin Addiction: An Open Study

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Abstract
There was no apparent difference in social adjustment, occupational participation, clinic attendance or drug abuse patterns of heroin addicts treated with LAAM [L-.alpha.-acetylmethadol] as compared to methadone. LAAM had a mild, amphetamine-like effect most marked in the early phase of treatment. This effect was manifested by increased motor activity, irritability, tenseness and restlessness. LAAM may exaggerate a loss of impulse control in hysterical and explosive personality patterns. Increased aggressive behavior was observed in people with these personality patterns throughout the study. At least 2/3 of our methadone maintenance population would accept this drug on a long-term basis. Of those who participated in the methadone maintenance program prior to LAAM, all felt less comfortable on weekend dosages of LAAM. The drug effect of LAAM and methadone was not completely interchangeable. Other side-effects reported by participants in the LAAM study included anorexia, an alteration of eating patterns, gastrointestinal discomfort, constipation, decreased libido and mood changes. These side-effects were generally well tolerated by the patients. There was a major physiological problem in shifting from daily dosage of methadone to a 3 times/wk dosage of LAAM. Of those started on LAAM from the beginning of treatment, all seemed to accept and adjust to the 3 times/wk dosage schedule as readily as did those placed on daily methadone maintenance schedules. The conditioning of people to require a drug dosage on a particular schedule was an important factor in either methadone or LAAM acceptability.

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