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Cochrane Database of Systematic Reviews

LAAM maintenance vs methadone maintenance for heroin dependence

Overview of attention for article published in Cochrane database of systematic reviews, April 2002
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Title
LAAM maintenance vs methadone maintenance for heroin dependence
Published in
Cochrane database of systematic reviews, April 2002
DOI 10.1002/14651858.cd002210
Pubmed ID
Authors

Nicolas C Clark, Nicholas Lintzeris, Alan Gijsbers, Greg Whelan, Adrian Dunlop, Alison Ritter, Walter W Ling

Abstract

LAAM and methadone are both full mu opiate agonists and have been shown to reduce dependence on heroin when given continuously under supervised dosing conditions. LAAM has a long duration of action requiring dosing every two or three days compared to methadone which requires daily dosing. LAAM is not as widely available internationally as methadone, and may be withdrawn from the market following ten cases of life-threatening cardiac arrhythmias and an association with QT prolongation. To compare the efficacy and acceptability of LAAM maintenance with methadone maintenance in the treatment of heroin dependence. We searched MEDLINE (January 1966 to August 2000), PsycINFO (1887 to August 2000), EMBASE (January 1985 to August 2000), and the Cochrane Controlled Trials Register (Issue 2 2000). In addition we hand searched NIDA monographs until August 2000 and searched reference lists of articles. All randomised controlled trials, controlled clinical trials and controlled prospective studies comparing LAAM and methadone maintenance for the treatment of heroin dependence and measuring outcomes of efficacy or acceptability were included. Data on retention in treatment, heroin use, side-effects and mortality were collected by two reviewers independently. A meta-analysis was performed using RevMan. Discrepancies were resolved by consensus. Eighteen studies, (15 RCTs, 3 Controlled prospective studies) met the inclusion criteria for the review. Three were excluded from the meta-analysis due to lack of data on retention, heroin use or mortality. Cessation of allocated medication (11 studies, 1473 participants) was greater with LAAM than with methadone, (RR 1.36, 95%CI 1.07-1.73, p=0.001, NNT=7.7 (or 8)). Non-abstinence was less with LAAM (5 studies, 983 participants; RR 0.81, 95%CI 0.72-0.91, p=0.0003, NNT=9.1 (or 10)). In 10 studies (1441 participants) there were 6 deaths from a range of causes, 5 in participants assigned to LAAM (RR 2.28 (95%CI 0.59-8.9, p=0.2). other relevant outcomes, such as quality of life and criminal activity could not be analysed because of lack of information in the primary studies. LAAM appears more effective than methadone at reducing heroin use. More LAAM patients than methadone ceased their allocated medication during the studies, but many transferred to methadone and so the significance of this is unclear. There was no difference in safety observed, although there was not enough evidence to comment on uncommon adverse events.

Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 117 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 2 2%
United States 1 <1%
Unknown 114 97%

Demographic breakdown

Readers by professional status Count As %
Student > Master 19 16%
Student > Ph. D. Student 15 13%
Student > Bachelor 15 13%
Researcher 12 10%
Other 6 5%
Other 13 11%
Unknown 37 32%
Readers by discipline Count As %
Medicine and Dentistry 37 32%
Nursing and Health Professions 13 11%
Psychology 13 11%
Social Sciences 5 4%
Agricultural and Biological Sciences 3 3%
Other 7 6%
Unknown 39 33%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 04 December 2012.
All research outputs
#8,571,053
of 25,457,858 outputs
Outputs from Cochrane database of systematic reviews
#9,070
of 11,499 outputs
Outputs of similar age
#43,006
of 127,658 outputs
Outputs of similar age from Cochrane database of systematic reviews
#20
of 36 outputs
Altmetric has tracked 25,457,858 research outputs across all sources so far. This one is in the 43rd percentile – i.e., 43% of other outputs scored the same or lower than it.
So far Altmetric has tracked 11,499 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 40.0. This one is in the 15th percentile – i.e., 15% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 127,658 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 5th percentile – i.e., 5% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 36 others from the same source and published within six weeks on either side of this one. This one is in the 13th percentile – i.e., 13% of its contemporaries scored the same or lower than it.