SPAIN'S OPIATE ADDICTS TO BE GIVEN ANOTHER CHOICE

The Spanish Ministry of Health approved dispensation of
levo-alpha-acetyl-methadol (LAAM) to opioid addicts as a therapeutic
alternative to methadone on March 30.

This decision comes after encouraging results from a 3-month pilot
study by the National Commission of Agonists (NCA) in 224 opioid
addicts from 13 autonomous communities.

NCA president, Guillermo Guigou said "LAAM offers some clear
advantages over methadone", namely: "higher comfort levels since
patients have to go to the dispensing centres only two or three times
a week and not on a daily basis; fewer physical withdrawal symptoms;
fewer desires for consuming opioids; and a lack of significant side
effects."

"LAAM treatment shows an 80% efficacy thus, it is fairly feasible that
methadone-treated patients switch to LAAM", added Guigou.

The disadvantages of LAAM include contraindication during pregnancy
and in patients with severe liver abnormalities, such as liver
cirrhosis or chronic viral hepatitis.

LAAM is also very expensive: it is estimated that 500 mL of LAAM costs
US$330-500, about US$2 per dose. During the XVI Jornadas Nacionales
Socidrogalcohol, a national symposium on drugs, alcohol, and society
(Canary Islands, Spain; March 29-30) Walter Ling, from the University
of California (Los Angeles, USA) emphasised the importance of LAAM. As
a therapeutic alternative, LAAM gives patients a greater chance of
social integration and offers an improved quality of life to the
addicts and their families, he said.

Ling explained that once given, each LAAM dose is metabolised into two
compounds, one of them having a potency six-fold greater than
methadone. LAAM, a long-lasting opioid agonist which blocks the
effects of other opiates and prevents withdrawal, has effects which
last 48-72 hours.

The longer efficacy means the addict can undergo a quicker
rehabilitation by being able to spend more time on activities, such as
occupational workshops and psychotherapy classes.

The Ministry of Health is providing training courses from May to raise
awareness of LAAM amongst 500 health-care professionals who care for
drug addicts. Currently about 58,000 people are receiving
opiate-replacement treatment with methadone in Spain.