During MMT* *Methadone Maintenance Treatment

The medical community and government agencies have raised concerns about medications associated with prolongation of the QT interval on the electrocardiogram (ECG). This alter-ation in cardiac repolarization may result in a serious and poten-tially fatal arrhythmia known as torsade de pointes (TdP; see Side Box for a review of the QT and TdP). Particular concerns relating to medications used in the treat-ment of opioid addiction surfaced in 2001 and focused on 10 patients administered LAAM (levacetylmethadol or Orlaam®) who developed cardiac electrophysiologic disturbances: QT interval prolongation and/or TdP. LAAM was subsequently withdrawn from European markets (EMEA 2001). In the United States, the FDA strengthened warnings about this arrhythmo-genic potential (FDA 2001) and screening ECGs were recom-mended prior to and during LAAM titration (AATOD 2001)