EHB will offer new heroin substitute from next year
By Nuala Haughey

An alternative treatment to methadone for heroin addicts will be made
available next year by the Eastern Health Board.

The treatment, which was pioneered in the US and used successfully in
several EU countries, is not yet licensed in Ireland. The board will
introduce LAAM, Levo Alpha Acethyl Methadol, on a limited basis next year.

LAAM will be cheaper to administer than methadone because it needs to be
given to patients in clinics only every two days, rather than daily like
methadone. It is a clear, bittertasting liquid, which is taken orally.

Because patients will receive the treatment only every other day, there
will also be fewer opportunities for them to sell LAAM on the street,
according to Dr Brion Sweeney, a consultant psychiatrist with the EHB.

Dr Sweeney said LAAM was a "good and very safe alternative" to methadone.

Both LAAM and methadone are synthetic opiates. Methadone's effects last for
24 hours whereas LAAM's last for 48 hours.

There are about 2,512 registered methadone clients in the EHB region.

The High Court yesterday ordered that the number of addicts attending the
drug treatment centre at Trinity Court, Pearse Street, Dublin, cannot
expand beyond the numbers for July last, in an action taken by local traders.

Dr Sweeney, who is based parttime at Trinity Court, said the "major
advantage" of LAAM was that it took longer to clear the body than
methadone. "The advantage is that it cuts down on the amount of clinic
attendance and also costs," he said.

Because of its slower release time, LAAM does not give users the same
"high" as methadone. According to Dr Sweeney, this means that some patients
would prefer methadone.

"It's a cleaner form of methadone in the sense that you get less euphoria
than with methadone . . . It's more useful for fairly highlymotivated
patients who want to be clear in their minds."

Portugal was the first European country to use LAAM in an organised
treatment programme, according to Dr Luis Patricio from the Taipas Centre
in Lisbon, which runs both a methadone and a LAAM programme. Dr Patricio
said LAAM has been more suitable for some longterm heroin addicts than
methadone.

He said: "Some patients say that with methadone I feel good. With LAAM I
feel normal. People who are more settled in their lives prefer LAAM. They
don't have the daily ups and downs of methadone and basically they are more
stabilised than methadone because they don't have to visit the clinic as
often."

A recent survey of patients on the Taipas Centre's LAAM programme showed
that 50 per cent had stopped using other "street drugs" such as heroin or
cocaine.