LAAM is an opiate agonist that helps reduce the cravings for opioids. It is a long-acting medication that requires dosage once every two to three days. LAAM is a Schedule II drug (a controlled substance) sold under the name of Orlaam.
LAAM blocks the euphoric effects of heroin and other opiates if they are used while a patient is taking LAAM and prevents opiate withdrawal symptoms from occurring. Like methadone, LAAM has addictive qualities. It is not to be used to help with long-term or short-term opiate detox. There are disagreements about dosage levels and effectiveness of LAAM and its use has not grown in popularity as some had hoped. It is rarely used in the United States. However, when a person on methadone maintenance suffers from cardiac problems such as irregular QT, LAAM can be substituted for methadone. LAAM, unlike methadone, must be taken under the supervision of a licensed physician. It cannot be given in three day supplies to be taken at home.
There are, as with methadone substitution treatment, drawbacks to LAAM use. Clients using the drug can be more difficult to manage and have a range of needs that differ from those who go through conventional drug rehabilitation treatment without switching drugs.
People tend to resist using LAAM as it must be administered by a professional and is not allowed to be taken home. Patients who abuse sedatives, tranquilizers, propoxyphene, antidepressants, benzodiazepines or alcohol should not take LAAM, as these substances can increase its sedating effects.
LAAM can induce withdrawal symptoms in persons regularly taking opiates, those on methadone maintenance, and those using drugs to treat alcohol cravings such as naltrexone. LAAM can be used with Antabuse (disulfiram).
- Muscle and joint pain
In order to ensure LAAM is used safely, a level of dosage needs to be established and symptoms of dose accumulation should be monitored. These symptoms include:
- Jumpiness or feeling wired
- Poor concentration
The protocol for stopping treatment with LAAM is patient-specific. Because LAAM has a long half-life, withdrawal symptoms will have a delayed onset and will probably not be as severe as with opiate medications. Use of LAAM is being phased out because of safety concerns.
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