A randomized trial comparing levo-alpha acetylmethadol with methadone maintenance for patients in primary care settings in Australia.
AIMS: The present study aimed to compare the efficacy of levo-alpha-acetylmethadol (LAAM) and methadone, as measured by retention in treatment and heroin use, in a randomized trial conducted under naturalistic conditions. SETTING: This study is the first randomized trial comparing LAAM with methadon...
| Publicado en: | Addiction Vol. 98; no. 11; pp. 1605 - 1614 |
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| Autores principales: | , , , , , |
| Formato: | clinical trial research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Nov2003
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106714919&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106714919 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09652140 AIO jtl: Addiction issn: 09652140 maglogo: Y pubinfo: dt: Nov2003 vid: 98 iid: 11 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 106714919 106714919 2004047261 10.1046/j.1360-0443.2003.00529.x NLM14616187 106714919 ppf: 1605 ppct: 9 formats: fmt: @attributes: type: P tig: atl: A randomized trial comparing levo-alpha acetylmethadol with methadone maintenance for patients in primary care settings in Australia. aug: au: Ritter AJ Lintzeris N Clark N Kutin JJ Bammer G Panjari M affil: Turning Point Alcohol and Drug Centre, Fitzroy, VIC 3065, Australia; alisonr@turningpoint.org.au sug: subj: Methadone Therapeutic Use Substance Dependence Drug Therapy Adult Australia Chi Square Test Clinical Trials Female Funding Source Heroin Heroin Urine Male Methadone Adverse Effects Middle Age Primary Health Care Research Instruments Rural Areas Self Report Survival Analysis Urban Areas Human Adult: 19-44 years Middle Aged: 45-64 years Female Male ab: AIMS: The present study aimed to compare the efficacy of levo-alpha-acetylmethadol (LAAM) and methadone, as measured by retention in treatment and heroin use, in a randomized trial conducted under naturalistic conditions. SETTING: This study is the first randomized trial comparing LAAM with methadone in the primary care setting. Participants were recruited through 29 medical practitioners working in specialist and generalist settings in Australia. PARTICIPANTS: Existing methadone maintenance patients, aged 18 years and over and able to give informed consent, were randomized to receive either LAAM or methadone. A total of 93 patients participated. INTERVENTION: After being trained in the use of LAAM, existing methadone prescribers were then able to determine an individually tailored treatment regimen for each patient. The trial was an open-label study. Methadone and LAAM dosing was supervised through local community pharmacies. Participation in ancillary services (e.g. counselling) was optional for all patients. The treatment period for the trial was 12 months. MEASUREMENTS: Baseline, 3-, 6- and 12-month interviews were conducted. Outcome measures were retention in treatment, self-reported heroin use and serious adverse events. FINDINGS: There were no significant differences between LAAM and methadone on retention in treatment, nor heroin use. There was a trend for LAAM patients to have lower heroin use than methadone patients. Of the seven serious adverse events in the LAAM group, three were not drug-related. There were two dosing errors. CONCLUSIONS: This study demonstrates (a) the efficacy of LAAM as a treatment for heroin dependence, and (b) the capacity for LAAM to be effectively delivered in primary care settings by trained general practitioners and pharmacists. The next challenge is to resolve outstanding safety concerns with LAAM. pubtype: Academic Journal doctype: clinical trial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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