LAAM has recently been approved by the FDA for treatment of opiate addiction. A number of implementation issues will be important in determining the extent to which LAAM will be used in standard clinical practice. This project will investigate two of these issues: (1) the option of using take-home LAAM; and (2) the use of LAAM with medically compromised opiate addicts. Study 1 investigates the therapeutic benefit and feasibility of take-home LAAM. One-hundred fifty (150) subjects will be randomly assigned to a nine-month period of LAAM treatment with either: (1) standard LAAM treatment with no take-home LAAM (n=75); or, (2) a treatment condition that provides LAAM with take-home privileges (n=75). Diversion of LAAM will be monitored and deterred using a random recall procedure. Study 2 investigates the feasibility of using LAAM with opiate addicts who are medically compromised by a number of medical conditions common to opiate addicts. Approximately 100 subjects will be admitted to a six month period of treatment with LAAM. Subjects will be eligible for this study who have compromised hepatic or renal function and subjects in treatment for medical disorders requiring chronic administration of medication. Outcome for subjects in both studies will be evaluated using physical measures of drug use, behavioral measures of treatment involvement, self- report of drug use (including Addiction Severity Index), AIDS risk behaviors and clinical global impression ratings. In addition, in study 2 the effects of the medical conditions upon LAAM effectiveness will be assessed along with the effects of LAAM on the concurrent medical conditions or concurrent medications.
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