More than 3,500 patients in the United States -- and 700 in Europe -- are being treated for drug dependency with a medicine called ORLAAM (levomethadyl acetate). However, in recent years, several young people being treated have suffered life-threatening heart rhythm disorders.

Because of the high incidence of these serious side effects, the European Agency for the Evaluation of Medicinal Products (EMEA) has issued warnings about the drug. The agency has instructed doctors not to start treating any new patients with it.

Besides the U.S., ORLAAM is marketed in Denmark, Germany, the Netherlands, Portugal, Spain and the United Kingdom and is used to treat addiction to opiate drugs, such as heroin.

According to the EMEA, ORLAAM has been linked to 10 cases of "life-threatening cardiac rhythm disorders" since July 1997. Three patients required a pacemaker.

"This raises a major concern given the fact that these life-threatening cases occurred in young patients...a population at low risk of developing these cardiac disorders, and given the relatively low exposure to the product. Furthermore, these cardiac disorders might have been under-recognized or under-reported," the agency noted in a public statement issued December 19, 2000.

Many addiction experts have argued that treating drug dependency with more drugs is counter-productive and seldom effective. Instead, research is beginning to look at alternatives to medical treatment, including chiropractic.

The use of chiropractic for addicted patients is not a new concept. B.J. Palmer, the developer of the profession, was the first to discuss the possibility of the application of subluxation correction for drug- dependent patients.

Chiropractic has already been shown effective in a randomized placebo-controlled clinical trial and The Journal of Psychoactive Drugs, a world leading peer-reviewed medical journal, is due to publish a paper on Reward Deficiency Syndrome, which introduces the role of subluxation correction in addiction and compulsive disorders.

According to the American College of Addictionology & Compulsive Disorders (ACACD) Program Coordinator Michael Davis, "Addiction is a multifactorial disease having psychological, genetic, metabolic and spiritual components. The most significant mechanism of this disease process is manifest through neurophysiological insult within the dorsal horn of the spinal cord as expressed in the 'Brain Reward Cascade Model,' which aligns itself with the known causes of the vertebral subluxation."

In order to promote research into this area, the World Chiropractic Alliance has established a Council on Addictionology, headed by Jay Holder, D.C., M.D., Ph.D.

SOURCES: Public statement, European Agency for the Evaluation of Medicinal Products (EMEA), London, December 19, 2000.

"Addiction certification program achieves new level of accreditation," The Chiropractic Journal, Vol.14, No.5, February 2000.