Study: Alternatives to Methadone Work

Nov. 1, 2000 -- — The first head-to-head comparison of treatments for heroinaddiction found that two newer, easier-to-take medicines work justas well as methadone, the standard drug since the 1960s.

Unlike methadone, which has to be taken daily, the two otherdrugs are longer-acting and can be taken only three times a week.

Previous studies have shown all three medications — methadone,Orlaam and buprenorphine — to be effective in treating heroinaddiction. This study looked at them together for the first time.The findings were published in Thursday’s New England Journal ofMedicine.

Two Rather Than One

The two newer drugs could improve treatment of heroin addictionby giving doctors more options, said researcher Rolley E. Johnsonof Johns Hopkins University School of Medicine, who led the study.

“There are some patients who perhaps have tried methadone anddidn’t think it was the thing that could help them. They maybenefit from [Orlaam] or they may benefit from buprenorphine. Maybewe can get those people back into treatment,” said Johnson, whohas worked as a consultant for makers of all three medications.

Methadone, a synthetic narcotic, has been used for more than 30years to treat heroin addiction. It suppresses withdrawal symptomsand curbs the craving for heroin.

Orlaam, another synthetic narcotic known generically aslevomethadyl acetate, was approved in 1993 but has not been widelyused. Buprenorphine, also a synthetic narcotic, is awaitingapproval from the Food and Drug Administration for use as ananti-addiction drug. It causes weaker narcotic effects.

Methadone and Orlaam are liquids, while buprenorphine will bemarketed as a tablet. But all three drugs were given in liquid formduring the study so that participants would not know what they weregetting.

Different Options for Treatment

There are about 1 million chronic heroin users by governmentestimates, said Alan I. Leshner, director of the National Instituteon Drug Abuse, which paid for the research. He said the findingspoint to more options for doctors and ways of treating morepatients.