Heroin addict responses to six weeks of detoxification with LAAM

This paper describes the range of experience of 28 heroin addicts who received LAAM instead of methadone over six weeks in an outpatient detoxification program. Four patients are singled out to illustrate the variety of response during withdrawal, temporary abstinence from drugs, and social adjustment. The paper explores the motivation of patients and both their physical and subjective responses to the detoxification attempt. By describing a variety of patients, the paper documents clinical responses that cannot be communicated in statistical summaries or single-case reports. Overall, the cases illustrate the difficulties of brief-stay outpatient detoxification from heroin. Clinicians should expect to see only small steps toward rehabilitation during a patient's attempt to taper from opiates, but even minimal progress may justify the use of detoxification programs as a link between "street life" and the decision to enter long-term treatment.