Anti-Levo-Alpha-Acetylmethadol polyclonal antibody

Background: Buprenorphine is a promising alternative to methadone or levo-acetyl alpha methadol for opioid agonist maintenance treatment, and thrice-weekly dosing would facilitate its use for this purpose. Methods: After a 3-day induction, opioid-dependent patients (n = 92) were randomly assigned to daily clinic attendance and 12-weeks maintenance treatment with sub-lingual buprenorphine administered double blind either daily (n = 45; 16 mg/70 kg) or thrice weekly (n = 47; 34 mg/70 kg on Fridays and Sundays and 44 mg/70 kg on Tuesdays). Outcome measures include retention, results of 3X/week urine toxicology tests, and weekly self-reported illicit drug use. Results: There were no significant differences at baseline in important social, demographic and drug-use features. Retention was 71% in the daily and 77% in the 3X/week conditions. The proportion of opioid-positive urine tests decreased significantly from baseline in both groups and averaged 57% (daily) and 58% in 3X/week, There were no significant differences between groups in self-reported number of bags of heroin wed for any day of the week, including Thursdays (48-72 hours following the last buprenarphine dose for subjects in the 3X/week condition), or in medication compliance (92%, 91%) and counseling attendance (82%, 82%), Conclusions: At art equivalent weekly dose of 112 mg/70 kg, thrice-weekly and daily sublingual buprenorphine appear comparable in efficacy with regard to retention and reductions in illicit opioid and other drug Else. These findings support the potential for utilizing thrice-weekly buprenorphine dosing in novel settings. (C) 2000 Society of Biological Psychiatry.

Aims Despite their potential advantages, many of the pharmacological interventions available to treat substance misuse are controversial and their acceptability within the United Kingdom (and other countries) has only recently begun to be investigated. Design A questionnaire mailed to British National Health Service (NHS) alcohol and drug treatment services asked respondents to rate the acceptability and availability of 11 pharmacological interventions for substance misuse employed to relieve withdrawal, reduce the likelihood of relapse and opiate overdose and substitute pharmaceuticals for illicit drugs. Participants A sample of NHS substance misuse services (n = 265) listed in one or more directories of services in England, Wales and Scotland. Findings Substitute methadone for opiate addiction, substitute benzodiazepines for benzodiazepine-dependent patients, lofexidine for opiate detoxification, naltrexone for opiate relapse prevention and acamprosate for alcohol relapse prevention were widely acceptable and available interventions. Another subset of medications-buprenorphine for opiate detoxification, take-home naloxone for overdose prevention and substitute prescribing of levo-alpha-acetyl-methadol (LAAM), heroin and dexamphetamine-garnered less support. but the majority of participants rated even these therapies as acceptable. Ultra-rapid detoxification under sedation was the intervention rated as least acceptable to, and was one of the two least frequently available from, responding NHS services. Conclusions Differences among specific medications notwithstanding, a wide range of harm-reduction and abstinence-orientated interventions were acceptable to and available from NHS services. Acceptance and availability are probably limited by a combination of practical, economic, safety, efficacy and theoretical considerations.