THE EFFICACY OF L-METHADONE AND RACEMIC METHADONE IN SUBSTITUTION TREATMENT FOR OPIATE ADDICTS - A DOUBLE-BLIND COMPARISON

In a two-week double-blind trial l-methadone and racemic methadone wer e compared for efficacy in substitution treatment for opiate addicts. Before the trial the twenty-six participants had been on stable doses of l-methadone. Patients with evidence of current serious psychologica l problems were excluded. Patients were evaluated twice a week using a modified FSUCL, physician's withdrawal checklist, self-rating withdra wal scale, and the Beschwerden-Liste (complaint list) according to von Zerssen. Between addicts continuing on l-methadone(n = 13) and those now receiving racemic methadone (n = 13) there were no statistically s ignificant differences. In particular, patients receiving racemic meth adone did not complain more frequently of withdrawal symptoms. In a fo llow-up period of nine weeks after replacement of l-methadone with rac emic methadone, there was also no significant increase in complaints a bout withdrawal symptoms, although six patients needed an elevation of their daily dosage by at least 20 mg racemic methadone.