Source: Irish Times Pubdate: Sat, 08 Nov 1997 Contact: Letters to Editor, The Irish Times, 1115 D'Olier St, Dublin 2, Ireland Fax: ++ 353 1 671 9407 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.