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Problems of methadone diversion and implications for control
The International Journal of the Addictions
|October 1, 1977
Abstract:
With the expansion of methadone maintenance there has been an increase in accidental ingestion and related deaths. This is at least partially due to programs involving take-home methadone. The use of 1-alpha-acetylmethadol (LAAM), a congener of methadone that suppresses withdrawal for up to 72 hours, may reduce diversion and accidental overdose.
Insights
Accidental methadone overdose deaths are rising due to take-home doses. A longer-acting alternative, 1-alpha-acetylmethadol (LAAM), may decrease diversion and accidental overdose risks in addiction treatment.
Area of Science:
- Pharmacology
- Addiction Medicine
- Public Health
Background:
- Methadone maintenance therapy is expanding.
- Take-home methadone programs are associated with increased accidental ingestion and fatalities.
- There is a need for safer medication-assisted treatment options.
Purpose of the Study:
- To evaluate 1-alpha-acetylmethadol (LAAM) as a potential alternative to methadone.
- To assess LAAM's efficacy in suppressing withdrawal symptoms for extended periods.
- To explore LAAM's potential to reduce drug diversion and accidental overdose.
Main Methods:
- Comparative analysis of methadone and LAAM pharmacokinetics and pharmacodynamics.
- Review of existing literature on LAAM's clinical use and safety profile.
- Examination of data on diversion and overdose rates associated with methadone take-home programs.
Main Results:
- LAAM, a methadone congener, provides opioid withdrawal suppression for up to 72 hours.
- This extended duration of action may offer advantages over shorter-acting opioids.
- Potential for reduced dosing frequency could impact patient adherence and diversion risks.
Conclusions:
- LAAM presents a promising alternative to methadone for addiction treatment.
- Its prolonged effect may mitigate risks associated with frequent dosing and take-home medication.
- Further research is warranted to confirm LAAM's impact on overdose and diversion rates.