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At least 19 recordsLinked to original sources
PubMed1984

Alternative induction and crossover schedules for methadyl acetate.

Various schedules exist for inducting heroin addicts newly admitted to treatment into methadyl acetate maintenance and crossover schedules for the transition from methadone maintenance to methadyl acetate maintenance. A sample of 255 street addicts was randomized to three induction schedules: methadyl acetate three times a week (tiw) with placebos on alternate days; methadyl acetate tiw supplemented with decreasing doses of methadone on alternate days; methadyl acetate six days a week with diminishing doses on three days. Treatment was double-blind for four weeks and single-blind for six. All schedules were considered feasible, but supplementation with methadyl acetate or methadone had no advantage. A sample of 310 patients receiving methadone maintenance was randomized to comparable supplementation groups, except that the group receiving supplementary methadyl acetate received it along with the regular dose. This schedule was not successful. Supplementing with methadone had no advantage.

Adolescent↗
PubMed1978

Mass fragmentographic determination of methadyl acetate in urine using stable isotope labeled analog as internal standard.

A quantitative GLC-mass spectrometric assay was developed for the determination of methadyl acetate in urine. The assay utilized selective ion focusing to monitor, in a GLC effluent, the M--15 ion generated by electron-impact ionization of methadyl acetate. Methadyl acetate-d4 was used as an internal standard. The assay can measure 10 ng of drug/ml with about 6% precision. The curve relating the amounts of drug added to control urine versus the amounts experimentally found over a large concentration range is a straight line with a slope of 0.98 +/- 0.02 and a nearly zero intercept. Assay specificity was confirmed by complete identity of the mass spectrum of methadyl acetate in the biological extract with that of the authentic material. The method was used for the urinary analysis of methadyl acetate in a rabbit given a single intravenous dose. The animal excreted less than 1% of the intact drug with a half-life of approximately 15 hr. Consequently, the long-acting characteristic of methadyl acetate must be attributed to its metabolism into active metabolites.

Animals↗
PubMed1977

Methadyl acetate and methadone. An open comparison.

Heroin addicts were recruited for a 14-week open clinical comparison of methadone hydrochloride and methadyl acetate. Patients were randomly assigned to a methadyl acetate clinic in which methadyl acetate was dispensed to patients three times per week or to a methadone clinic in which methadone was dispensed six days per week. No statistically significant differences were observed between groups in retention rates, illicit drug use, employment rates, or arrest rates. The group treated with methadyl acetate had more dropouts in the first seven weeks than the second seven weeks: this pattern was reversed for the methadone-treated group. The differences were significant (P = .01). Spontaneously reported symptoms suggest that induction with methadyl acetate may be a more clinically variable phenomenon than induction with methadone. The reduction of number of clinic visits in the group treated with methadyl acetate was not a source of variance in treatment effectiveness.

Adult↗
PubMed1980

A cooperative clinical study of methadyl acetate. II. Friday-only regimen.

We conducted an open clinical trial of the feasibility of maintaining heroin addicts by administering methadone hydrochloride on Monday through Thursday, methadyl acetate on Friday, and no drug at all on Saturday or Sunday. Sixty-five patients from four participating clinics were randomly assigned to this schedule and another 71 to a daily methadone comparison group. The patient sample consisted of heroin addicts previously stabilized on a maintenance regimen of methadone. The starting dose of methadyl acetate was identical to the previously established dose of methadone but was flexible within limites thereafter. A greater number of patients in the methadyl acetate group failed to complete the full 40 weeks of the study, particularly because they claimed the medication was not holding. Although this particular use of methadyl acetate on Friday to provide a drug-free weekend does not appear to be widely applicable clinically, the fact that at least some patients in the methadyl acetate group tolerated the schedule with little or no illicit drug use or obvious discomfort suggests that the strategy is viable and should not be discarded.

Adult↗
PubMed1976

Methadyl acetate and methadone as maintenance treatments for heroin addicts. A veterans administration cooperative study.

This was a double-blind comparison of methadyl acetate and two dose levels of methadone hydrochloride in the maintenance of 430 street heroin addicts from 12 Veterans Administration hospitals. The starting sample consisted of 146 patients receiving low-dose methadone, 142 patients receiving methadyl acetate. Patients were first given 30 mg of both drugs, and doses were incremented by 10 mg/week until they stabilized at methadyl acetate, 80 mg three times a week, and methadone hydrochloride, 50 mg daily or 100 mg daily. Dosage was fixed for the balance of the 40-week treatment period. Safety was evaluated by clinical and laboratory observations conducted at frequent intervals throughout the study. Relative efficacy was evaluated by illicit drug use, program retention and attendance, and global staff judgments. It is concluded that methadyl acetate is as safe a drug as methadone and that it compares favorably with highdose methoadone in terms of efficacy. Both methyadyl acetate and high-dose methadone appear to be better maintenance regimens than low-dose methadone under the conditions of this study.

Adolescent↗
PubMed1978

A cooperative clinical study of methadyl acetate. I. Three-times-a-week regimen.

This was an open clinical trial of methadyl acetate (LAAM) compared with methadone in the maintenance of 636 heroin addicts who had previously been stabilized on a maintenance regimen of methadone. The starting sample assembled by the 13 cooperating clinics were randomly assigned to continued maintenance on methadone (= 308) or crossed over to methadyl acetate (= 328) for a period of 40 weeks. The starting dose was identical to the previously established dose of methadone, but beginning with the second visit, dosage was flexible. Safety was evaluated by clinical and laboratory observations conducted at four-week intervals throughout the study. Relative efficacy was evaluated by illicit drug use, program retention and attendance, and global staff judgments. It is concluded that methadyl acetate is as safe as methadone and, when given three times a week, is an acceptable and effective maintenance drug for many heroin addicts.

Adult↗
PubMed1980

Restabilization with methadone after methadyl acetate maintenance.

Sixty-eight heroin addicts maintained for 40 weeks on a regimen of methadyl acetate or methadone hydrochloride in a double-blind study were transferred to a uniform dose of 60 mg of methadone daily at the end of their tenure in the study. They were observed for the ensuing six weeks, during which their daily methadone doses were adjusted according to their clinical needs. Patients were observed for symptoms and signs of discomfort and for the amount of illicit drug use during this period of transition. The results indicate that patients maintained on a regimen of methadyl acetate can be readily restabilized with methadone and that sudden decrease of the methadone dose tends to result in the patient's supplementing with illicit heroin. Conversely, increasing methadone doses resulted in a corresponding reduction in illicit drug use. It is suggested that a chronic covert abstinence syndrome may exist in some patients receiving long-term methadone maintenance therapy, and that while it may contribute to their continued illicit drug use, it may have a different pathophysiologic basis and require different therapeutic considerations.

Adult↗
PubMed1977

Methadyl acetate versus methadone: the experience of one hospital.

Sixty subjects participated in a double-blind study comparing methadyl acetate (80 mg) with two dosages of methadone (50 mg and 100 mg) in the maintenance of opiate addicts. The safety of all three regimens was supported and methadyl acetate was as effective as methadone in the retention of subjects.

Adult↗
PubMed1978

Chromosomes in patients receiving methadone and methadyl acetate.

Chromosomes of peripheral leukocytes were examined in 28 addicts participating in a Veterans Administration-Special Action Office for Drug Abuse Prevention (SAODAP) cooperative study of methadyl acetate vs methadone. Blood samples for 72-hour leukocyte cultures were drawn after nearly 40 weeks of maintenance therapy while subjects were receiving active medication. For comparison, ten nondrug users were also studied. The frequency of chromosome damage was not greater in subjects maintained on methadyl acetate or methadone than in nondrug users.

Adult↗
PubMed1982

Withdrawal from heroin in three or six weeks. Comparison of methadyl acetate and methadone.

A randomized clinical trial compared four methods of outpatient withdrawal from heroin. Sixty-one subjects were assigned in a double-blind manner to treatment with either methadone or methadyl acetate. Within each drug group, subjects were assigned to detoxification programs either within the standard three-week period or in an extended six weeks of treatment. Outcome measures included retention to the end of the dosing schedule, use of illicit drugs during treatment, subjective discomfort, satisfaction, staff ratings of global progress, and durability of change at a three-month follow-up. Methadyl acetate performed similarly to methadone in most respects. Six-week withdrawal showed some temporary benefits over standard treatment, but these advantages should be weighed against the greater cost of the longer treatment and similarity of follow-up outcome.

Adult↗
PubMed1978

Acceptability of methadyl acetate (LAAM) as compared with methadone in a treatment program for heroin addicts.

Heroin addicts who had been maintained for at least three months on LAAM (levo-alpha-acetylmethadol, methadyl acetate) and at least three months on methadone were asked to compare the two drugs on a number of criteria. The responses were highly selective, indicating that a desire to please the investigators was not an important factor. Overwhelmingly, the majority of patients reported that LAAM provided better heroin "blockade", that it was more effective in reducing craving, and that actual use of heroin was less on LAAM than on methadone. In other respects, such as sexual performance, sleep, and appetite, most patients perceived no difference between the drugs. In no respect was methadone preferred by a majority, although methadone was viewed more favorably on some criteria by some patients. These findings indicate that for most heroin addicts LAAM will be an acceptable maintenance drug.

Heroin Dependence↗
PubMed1983

Methadyl acetate (LAAM) in the treatment of heroin addicts. II. Double-blind comparison of gradual and abrupt detoxification.

One hundred nineteen patients were admitted to a six-month (26-week) prenaltrexone detoxification program comparing abrupt and gradual withdrawal from methadyl acetate (LAAM) therapy. All patients were brought to a maintenance level of 50, 50, and 65 mg (Monday, Wednesday, and Friday). Patients randomly assigned to the gradual group (group G) began 4-mg/wk reduction the Monday of week 9 and reached zero dosage (placebo) the Monday of week 23; patients in the abrupt group (group A) continued to receive 50, 50, and 65 mg until the Monday of week 23, when their dosage was dropped to zero (placebo). All patients were given placebo for four weeks. This study showed the superiority of abrupt withdrawal over this gradual-withdrawal schedule. Forty-six percent of group P compared with 28% of group G made the transition to naltrexone treatment. Severity of withdrawal problems was in no case significantly greater in group A.

Adolescent↗
PubMedDate not supplied

Symptom complaints of patients maintained on methadone, LAAM (methadyl acetate), and naltrexone at different times in their addiction careers.

In this study, side effect complaints were compared between methadone patients on a stable dose with no heroin use for at least 3 months and matched non-drug-using controls; between methadone patients when using and not using heroin; and between patients in treatment (stable dosage, no heroin use for at least one month) and at follow-up, when not using any opiates and no longer in treatment. This last comparison was done for methadone, LAAM (l-alpha-acetylmethadol, methadyl acetate), and naltrexone patients. Methadone patients had more complaints than did non-drug-using controls; patients in methadone treatment felt worse when using heroin than when not using heroin; methadone, LAAM, and naltrexone patients felt worse while in treatment than when they left treatment and stopped using all opiates; the level of complaints for patients abstinent from opiates at follow-up was not different from that reported by non-drug-using controls. The difficulty of ascribing the symptom complaints to the drugs, in the absence of placebo-treated control groups, is discussed.

Constipation↗