***TASK*** the task is to summarize an input biomedical literature in six sentences 
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    Input: Sixty subjects participated in a double-blind study comparing methadyl acetate ( 80 mg ) with two dosages of methadone ( 50 mg and 100 mg ) in the maintenance of opiate addicts . The safety of all three regimens was supported and methadyl acetate was as effective as methadone in the retention of subjects Abstract 1-Alpha-acetylmethadol ( LAAM ) maintenance treatment has been proposed as a favorable alternative to methadone maintenance . With an un-obtrusive actometer we recorded two successive 24-h cycles of spontaneous motor activity from 12 patients receiving LAAM  every other day , and from five receiving methadone  every day . LAAM  patients were about 50 % more active on days of drug administration than on no-dose days ( P<0.001 ) . There were no significant day-to-day differences in motility of  methadone patients .  LAAM administered every other day may significantly modify the human circadian rhythm of spontaneous motility ; further research is thus needed before this treatment is widely akopted Thirty-four drug addicts , aged 20 - 24 years , with a history of 4 - 8 years of intravenous heroin abuse , were r and omly assigned either to a methadone maintenance treatment ( MMT )  ( 17 ) or to an untreated group ( 17 ) . The untreated controls could not apply for entrance to the program until two years later . It was found that after two years 12 MMT patients had ab and oned their drug habits and begun work , whereas 5 had recurrent drug abuse problems . Of the controls , one was drug-free and gainfully employed , 12 were continuously abusing heroin ( 3 of these had incurred potentially fatal diseases in consequence ) , 2 were in prison and 2 had diet . Two to seven years after their first visit to the Psychiatric Research Center 8 of the original control group have been accepted into the program . At present 19 ( out of 25 admitted ) are gainfully employed and no longer abusing drugs . Among the remaining controls 4 are dead , 3 are in prison , one in spite of a serious heart condition abuses heroin and one is drug-free . The rehabilitation rate was thus 76 per cent in the program as compared to 6 per cent among the control group . In addition , MMT obviously reduced the high morbidity and mortality rates found in a selection of heroin addicts who fulfilled the admittance criteria of the Swedish program The authors conducted a 16-week study with nine opioid-dependent individuals ( six male ; four white/two African American/three Hispanic ; age 36.8 + /- 2.2 years ) . Participants were assigned to either a low-dose ( 165 mg/week ; n = 5 ) or high-dose ( 330 mg/week ; n = 4 ) Levo-alpha-acetylmethadol ( LAAM ) condition according to a r and omized , double-blind , within-subjects crossover design , such that they were inducted onto one maintenance dose for 4 weeks and then were crossed over to receive the converse for 4 weeks . Subsequently , individuals underwent detoxification from LAAM .  Eight of nine participants completed the study protocol . The proportion of urine sample s positive for opiates was 0.22 + /- 0.08 and 0.53 + /- 0.12 , under the high- and low-dose conditions , respectively ( F = 11.8 ; P = 0.01 ) . These results show that LAAM dose regimen affects the degree of abstinence from opioids Heroin addicts were recruited for a 14-week open clinical comparison of methadone hydrochloride and methadyl acetate .  Patients were r and omly assigned to a methadyl acetate  clinic in which methadyl acetate was dispensed to patients three times per week or to a methadone clinic in which methadone was dispensed six days per week . No statistically significant differences were observed between groups in retention rates , illicit drug use , employment rates , or arrest rates . The group treated with methadyl acetate had more dropouts in the first seven weeks than the second seven weeks : this pattern was reversed for the methadone-treated group . The differences were significant ( P = .01 ) . Spontaneously reported symptoms suggest that induction with methadyl acetate may be a more clinical ly variable phenomenon than induction with methadone . The reduction of number of clinic visits in the group treated with methadyl acetate was not a source of variance in treatment effectiveness Heroin addicts who had been maintained for at least three months on LAAM ( levo-alpha-acetylmethadol , methadyl acetate ) and at least three months on methadone  were asked to compare the two drugs on a number of criteria . The responses were highly selective , indicating that a desire to please the investigators was not an important factor . Overwhelmingly , the majority of patients reported that LAAM provided better heroin " blockade " , that it was more effective in reducing craving , and that actual use of heroin was less on LAAM than on methadone . In other respects , such as sexual performance , sleep , and appetite , most patients perceived no difference between the drugs . In no respect was methadone preferred by a majority , although methadone was viewed more favorably on some criteria by some patients . These findings indicate that for most heroin addicts LAAM will be an acceptable maintenance drug This was an open clinical trial of methadyl acetate ( LAAM ) compared with methadone in the maintenance of 636 heroin addicts who had previously been stabilized on a maintenance regimen of methadone .  The starting sample assembled by the 13 cooperating clinics were r and omly assigned to continued maintenance on  methadone (= 308 ) or crossed over to  methadyl acetate (= 328 ) for a period of 40 weeks . The starting dose was identical to the previously established dose of methadone , but beginning with the second visit , dosage was flexible . Safety was evaluated by clinical and laboratory observations conducted at four-week intervals throughout the study . Relative efficacy was evaluated by illicit drug use , program retention and attendance , and global staff judgments . It is concluded that methadyl acetate is as safe as methadone and , when given three times a week , is an acceptable and effective maintenance drug for many heroin addicts In a double-blind study carried out between 1972 and 1975 in Hong Kong 100 heroin addict volunteers were initially admitted to hospital for two weeks for stabilisation on 60 mg of methadone before being assigned at r and om to two groups : one group received methadone ( range 30 - -130 mg , average 97 mg/day ) ; those in the other group had their dose of methadone reduced at the rate of 1 mg/day and were then maintained on placebo . All subjects were provided with a broad range of supportive services . After thirty-two weeks 10 % of the controls were still on treatment , compared with 76 % of those receiving methadone . At the end of the three-year project , only 1 of the original 50 placebo subjects still turned up for treatment ( 2 % ) , whereas the retention-rate ( proportion still on treatment ) for methadone subjects was 56 % . Subjects who had dropped out of the study and were readmitted for methadone treatment under known conditions had the same retention-rate as the original treatment group The authors r and omly assigned 95 male narcotic addicts to one of four treatment conditions : either methadone or LAAM maintenance and one of two drug-appropriate clinic attendance schedules . Although no differences were observed among treatment conditions on any of the outcome measures employed , the conclusion that the drugs and attendance regimens were equally efficacious and acceptable was made cautiously due to the relatively small sample size and to the observed trend ( p = . 10 ) in favor of methadone maintenance combined with the 3-day ( LAMM-appropriate ) attendance schedule . There was no evidence of untoward physical effects associated with any of the treatment approaches BACKGROUND Opioid dependence is a chronic , relapsing disorder with important public health implication s. METHODS In a 17-week r and omized study of 220 patients , we compared levomethadyl acetate ( 75 to 115 mg ) , buprenorphine ( 16 to 32 mg ) , and high-dose ( 60 to 100 mg ) and low-dose ( 20 mg ) methadone as treatments for opioid dependence . Levomethadyl acetate and buprenorphine were administered three times a week . Methadone was administered daily . Doses were individualized except in the group assigned to low-dose methadone . Patients with poor responses to treatment were switched to methadone . RESULTS There were 55 patients in each group ; 51 percent completed the trial . The mean ( + /-SE ) number of days that a patient remained in the study was significantly higher for those receiving levomethadyl acetate ( 89+/-6 ) , buprenorphine ( 96+/-4 ) , and high-dose methadone ( 105+/-4 ) than for those receiving low-dose methadone ( 70+/-4 , P<0.001 ) . Continued participation was also significantly more frequent among patients receiving high-dose methadone than among those receiving levomethadyl acetate ( P=0.02 ) . The percentage of patients with 12 or more consecutive opioid-negative urine specimens was 36 percent in the levomethadyl acetate group , 26 percent in the buprenorphine group , 28 percent in the high-dose methadone group , and 8 percent in the low-dose methadone group ( P=0.005 ) . At the time of their last report , patients reported on a scale of 0 to 100 that their drug problem had a mean severity of 35 with levomethadyl acetate , 34 with buprenorphine , 38 with high-dose methadone , and 53 with low-dose methadone ( P=0.002 ) . CONCLUSIONS As compared with low-dose methadone , levomethadyl acetate , buprenorphine , and high-dose methadone substantially reduce the use of illicit opioids This was a double-blind comparison of methadyl acetate and two dose levels of methadone hydrochloride in the maintenance of 430 street heroin addicts from 12 Veterans Administration hospitals . The starting sample consisted of 146 patients receiving low-dose methadone , 142 patients receiving methadyl acetate .  Patients were first given 30 mg of both drugs , and doses were incremented by 10 mg/week until they stabilized at methadyl acetate , 80 mg three times a week , and methadone hydrochloride , 50 mg daily or 100 mg daily . Dosage was fixed for the balance of the 40-week treatment period . Safety was evaluated by clinical and laboratory observations conducted at frequent intervals throughout the study . Relative efficacy was evaluated by illicit drug use , program retention and attendance , and global staff judgments . It is concluded that methadyl acetate is as safe a drug as methadone and that it compares favorably with highdose methoadone in terms of efficacy . Both methyadyl acetate and high-dose methadone appear to be better maintenance regimens than low-dose methadone under the conditions of this study Sixty-eight heroin addicts maintained for 40 weeks on a regimen of methadyl acetate or methadone hydrochloride in a double-blind study were transferred to a uniform dose of 60 mg of methadone daily at the end of their tenure in the study . They were observed for the ensuing six weeks , during which their daily methadone doses were adjusted according to their clinical needs . Patients were observed for symptoms and signs of discomfort and for the amount of illicit drug use during this period of transition . The results indicate that patients maintained on a regimen of methadyl acetate can be readily restabilized with methadone and that sudden decrease of the methadone dose tends to result in the patient 's supplementing with illicit heroin . Conversely , increasing methadone doses result ed in a corresponding reduction in illicit drug use . It is suggested that a chronic covert abstinence syndrome may exist in some patients receiving long-term methadone maintenance therapy , and that while it may contribute to their continued illicit drug use , it may have a different pathophysiologic basis and require different therapeutic considerations Ten volunteer patients participating in a methadone hydrochloride maintenance program were assigned r and omly to experimental ( five patients ) or control ( five patients ) groups . These patients had been in treatment for several months and had been stabilized ( had no change of dose for at least three weeks ) with methadone prior to inclusion in the study . Patients in the experimental group were given l-methadyl acetate ( l-α acetylmethadol ) on weekends and methadone on weekdays . Patients in the control group were given methadone each day . Clinic attendance , requests for change in medication , and scores on an opiate-withdrawal test instrument did not reveal differences between groups . Clinical observers blind to the experiment were unable to discriminate experimental and control patients . No untoward reactions were observed in either group . These preliminary observations suggest that l-methadyl acetate can be interchanged repeatedly with methadone without difficulty A r and omized clinical trial compared four methods of outpatient withdrawal from heroin . Sixty-one subjects were assigned in a double-blind manner to treatment with either methadone or methad 
    Output:
    
REVIEW ER 'S CONCLUSIONS LAAM appears more effective than methadone at reducing heroin use .
There was no difference in safety observed , although there was not enough evidence to comment on uncommon adverse events