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Problems of methadone diversion and implications for control.

R B Resnick

    The International Journal of the Addictions
    |October 1, 1977
    PubMed
    Summary

    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.

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    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.

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