LAAM has advantages over methadone specifically with respect to thrice-weekly dosing, the potential to reduce the risk of HIV and AIDS, possible cost savings, and possible improved relations between the clinic and the community. Some clients prefer LAAM to methadone because it produces less sedation, allows them to function more effectively, and permits them to develop lives that are less tied to the clinic than is possible with methadone. The effective and cost-effective implementation of LAAM as a new treatment for opioid addiction requires attention to a number of issues. These include LAAM as an HIV prevention measure through its potential risk-reduction effects, the use of LAAM with specific high-risk subgroups, and the causes of differential rates of treatment dropout and their amenability to intervention. Additional issues include the role of client choice in long-term maintenance treatment, the impact of LAAM on clinic operations, the potential for LAAM as a take- home medication, and the costs of implementing and sustaining LAAM maintenance services. 58 references (Author abstract modified)