phr
Bluelighter
The One-Step Program
Nate Penn
GQ
March 2010
Thirty years of heavy drinking will erode your fine motor skills, so even when Martin's sober, he moves with the exaggerated deliberateness of someone who's not. Right now he's concentrating hard to insert his keys into the ignition of his Pontiac Grand Am. The car's upholstery is stained brown and yellow and smells, as Martin himself does, like rancid-sweet beer. It's a Saturday in March, 4 p.m. By this time of day, Martin is normally buying his first twelve-pack of ice beer. But his wife, Sally, has unexpectedly been called into work, and she's asked him to look in on their daughters, who live five miles away from his studio apartment downtown. If he doesn't start drinking within an hour, Martin will go into withdrawal. His hands will begin to tremble; his temples will throb; his stomach will be gripped by cramps so excruciating that three times, in ER detoxes, he's been given morphine for the pain. When you've been an alcoholic for as long as Martin has, with- drawal can also lead to fatal seizures, heart attack, and stroke, all of which he prefers not to think about, concentrating instead on that one thing, getting his beer.*
The streets of this small North Carolina town slide past us, steep avenues of white magnolias in blossom. "I can go home whenever I want," Martin announces, "as long as I'm sober."
He's 45 years old and hasn't lived with his family since the Sunday morning in November 2007 when he retreated to the basement with forty-eight beers and announced to his eldest daughter that he wanted to die. Sally called 911, and as the neighbors gawked, cops arrived and escorted him out of the house in his underwear, handcuffed and shackled and shouting, "Go ahead, motherfuckers! Shoot me!" This was the second and final time Sally kicked him out, and Martin tells the story smoothly, having honed it at four separate rehabs and hundreds of twelve-step meetings.
In the living room, Erika, who's 10, is sitting in an armchair with Harry Potter and the Chamber of Secrets. "You're reading Harry Potter now?" Martin says.
"Dad, I've had this book for like a month," she responds. Olivia, 12, is on the phone with a friend and tilts her head to allow Martin to kiss her cheek. Then he excuses himself, and the three of us listen to a series of dry, heaving coughs coming from the bathroom. A moment later, Martin is standing at the front door. "Call me if you need anything, okay?" His visit has lasted all of five minutes.
"We're gonna get some beers!" Martin exclaims once we're back in the car. At the counter of a mini-mart, he struggles to remove his wallet from the front pocket of his jeans. "I hate when my hands start shaking when I'm doing something precise like this," he mutters. "It's very embarrassing." As he leaves the store with his twelve-pack propped on his shoulder, he exchanges a sharp glance with a guy who's scratching lottery tickets. Back behind the wheel, he's practically livid. "That guy is the leader of my AA group. Did you see the look he gave me?" He wipes his sweating forehead (it's forty-five degrees today). "I'm an alcoholic, and I'm drinking! Nothing abnormal about that."
Martin's studio looks like a dorm room: hot plate, folding table, futon. Its single window overlooks railroad tracks. Carefully, Martin hangs his coat on the back of a chair, then walks slowly to the kitchen, where he pours two cans of beer into two tall glasses. His movements have the feel of ritual now. He carries the glasses to a low coffee table and downs one in seconds. "You see that I don't shake anymore, after just one beer?" he says, a little out of breath. "My stomach doesn't hurt anymore. And I've stopped losing my mind."
Every weeknight, Martin comes home from his IT job, cooks dinner on his hot plate, works on the German crosswords his mother mails him, drinks around a dozen beers, then blacks out. Some nights, he drinks everything he's got and goes out to buy more. "I'm only driving five minutes," he says. "I know the road, and I'm not driving fast." On the folding table, along with several traffic tickets for driving with an expired registration, are valentines from his daughters cut out of red construction paper. Erika's reads: "Thank you for being a very lovable Dad." "She put on her Christmas list, 'I want my Daddy back home,'" Martin says. The kids don't visit him, not since the night Olivia, who'd come downtown to see a movie with friends, dropped in on him unexpectedly. "I'd had about ten beers," Martin says. "I guess I said hello to her. I don't really remember."
I ask him if he ever wonders if it would be better for his kids not to see him at all.
"Your periods of sobriety, you're not very operational," he says. "You're just waiting for the time you're gonna start drinking. I'm not drunk most of the time I'm with them, but I'm not available." He seems eerily undisturbed by what he's saying. "My girls are doing very well in school."
With three beers in his stomach, another in his hand, and eight more chilling in his refrigerator, Martin looks happy for the first time all day. "When I'm sober, I'm terribly fearful and anxious," he says. "You don't know exactly of what, but you feel it—that something's gonna happen to me."
Years ago, Martin contracted hepatitis C, which makes him vastly more vulnerable to cirrhosis, fibrosis, pancreatitis, and various cancers. Alcohol has also begun to cause irreversible damage to his brain; he complains of problems with his concentration and memory. His addiction has cost him a job and his place in his own home and may yet cost him his marriage. Now his therapist is warning him that if he doesn't stop drinking, he will die within two years. "I said, 'What do you mean, stop drinking? No more?' And he said, 'Yeah, no more.' I looked at him and I said, 'That's not gonna work with me.'"
The Hotel Lutetia in Paris is a Belle Epoque landmark and a frequent setting for occasions of state. In 2000, Dr. Olivier Ameisen was made a Chevalier of the Légion d'honneur here for his rayonnement de la France à l'étranger—his "radiating of French culture abroad" as a distinguished physician and composer-pianist in New York City. The ceremony had originally been scheduled to take place a year earlier but had to be postponed because Ameisen was on a drinking binge. "The emotion of it was huge, and I relapsed," he says as we sit talking in the hotel's brasserie. "Nobel Prize winners and government ministers were going to be there. People had to be disinvited at the last moment."
White-haired and dapper, Ameisen is the image of the prosperous Upper East Side cardiologist he once was, though his grayish complexion speaks to his history of bodily abuse. In multiple drunken falls and blackouts, he says, "I broke bone after bone after bone. I was hospitalized I don't know how many times. Every time, I thought I had hit bottom. But my bottom would have been death."
He's been sober for five years, ever since he self-prescribed massive doses of baclofen—an obscure forty-year-old muscle relaxant—and, he says, "cured" himself of his alcoholism. A year ago he published The End of My Addiction, a strange, fascinating book that's equal parts tour-of-hell drug confessional, scientific investigation, and public-health manifesto.
The book caused a sensation in France, where in the months after its publication patients reportedly besieged their doctors for prescriptions. But many European addiction experts assailed the book, calling its claims "extremely irresponsible" and "woefully premature" and insisting that Ameisen had "misunderstood the nature of alcoholism." One eminent physician suggested he be stripped of his license for having self-prescribed the medication in the first place.
From childhood, Ameisen, who was born into a prominent Parisian family, was primed for a brilliant career. He says that at age 16 he performed privately for the legendary pianist Arthur Rubinstein; had a volume of poems accepted for publication, until he refused to revise it ("I would have been the youngest person in France ever to publish a book of poetry," he tells me with disarming immodesty, "younger even than Rimbaud"); and became the first Frenchman ever to take and pass the baccalaureate exam two years early. Later, he served as personal physician to the prime minister before moving to New York in the mid-'80s and becoming a cardiology professor at Cornell Medical Center. He began drinking, he says, to deal with acute social anxiety. "I had a lot of patients who were diplomats or businessmen or artists, who would invite me to parties and ask me to perform. It was painful to do this in front of people. But when I drank scotch, I felt great, and people liked me. If it didn't cause tremendous collateral damage, alcohol would be one of the best medications around."
When he left teaching to open a private practice, a risky financial move, he had frequent panic attacks. He began to binge-drink. There were falls and fractures, seizures, bleeding in his lungs, rehabs, hundreds of AA meetings, di`erent kinds of behavioral therapy, and the full spectrum of medications, none of which quenched his desire for alcohol. There was also what he calls the "brutalization" of a medical establishment totally unsympathetic to his condition. "Not only do you have one of the deadliest diseases, but in addition people say, 'Well, it's your fault!'"
Finally he shuttered his practice, put his bills on auto-pay, and retreated to his apartment. "I was going to my psychiatrist three times a week, to a cognitive-behavioral therapist at least once a week, to a psychopharmacologist, to one or two AA meetings a day. Basically, I was spending my day trying not to drink. " Several rehabs did provide relief, but "they were cocoons. When I left, I saw liquor stores and bars, and I relapsed that very same day."
He credits AA for giving him desperately needed fellowship, but he calls twelve-step methodology "torture." "The DSM-IV defines complete remission as a year of abstinence," he says. "But telling somebody they're in complete remission from alcoholism when the person is craving on a daily basis, he's miserable, he spends all his time going to AA—it's extraordinarily cruel. Abstinence ruined my life."
One day a friend sent him a New York Times clipping about a paraplegic drug addict who, after being prescribed baclofen for acute muscle spasms, reported that the medication also seemed to reduce his cravings for cocaine, alcohol, and nicotine. That a medication might work by reducing craving—not by blocking a high—was a new idea. Between binges, Ameisen immersed himself in the National Institutes of Health's vast online archive. Baclofen's primary indication was for muscle spasms, but as far back as 1976 a study had mentioned in passing that it might be useful in treating alcoholism.
Ameisen was generally familiar with the neuroscience of alcoholism. He knew that the illness hinges in part on the yin-yang relationship between two neurotransmitters: GABA, a sedative, and glutamate, a stimulant. Keeping them in balance is the hopeless task at the heart of alcoholism, because drinking not only incites the brain to release the neurotransmitters but also builds new receptors that demand more of both. The onset of withdrawal is like being trapped in a room that's slowly flooding. Minute by minute, an alcoholic searches wildly for a way out, even as he su`ers inexorable, finally unbearable physical discomfort. To counteract the glutamate he craves more GABA, so he drinks to relieve the symptoms of drinking.
Baclofen, Ameisen learned, is the only nonaddictive drug that stimulates a particular GABA receptor. Taking baclofen, he believed, might bring about the neuro-chemical calm an alcoholic pursues at such terrible cost.
"I began self-prescribing fifteen milligrams in March 2002, and on that same day I noticed something strange," he says. "As I was returning from my weekly appointment with my therapist, I stopped o`, as I always did, at a nearby music store. As I was leaving, I thought, Where are my bags? Then I realized I hadn't bought anything. I used to buy $80 to $100 worth of CDs on my way home. I had been a compulsive shopper, and baclofen, even at a low dose, completely suppressed it." But even at 180 milligrams, he found that his craving for alcohol, while diminished, was still "overwhelming." He feared that a higher dose might so relax his respiratory system that he'd su`ocate in his sleep. For eighteen months, he endured still more relapses and hospitalizations.
Then he happened upon a 1997 study that described rats completely losing interest in cocaine as their baclofen dose was slowly increased. "I thought, Can that be transposed to humans? Can I write a protocol in which I increase the dosage gradually, as neurologists do, to see if I can reach a stage at which my cravings are not reduced but completely suppressed?"
He consulted with various physicians in Paris. "Nobody would prescribe it to me," he says, so again he self-prescribed. Thirty-seven days later, having reached a dose of 270 milligrams, he was having tea with a friend in a mountain resort. "All of a sudden, I saw a man drinking Cognac, and it did nothing to me. I looked at the bottles behind the bar, and they were neutral to me, like a vase. I thought I was dreaming and that I'd wake up from the beautiful dream. But the next day was the same, and the next and the next."
Ameisen began field-testing: "At a gathering, I drank three gin-and-tonics to see what would happen. Nothing. So I thought, Let me try five, which is the definition of when you drink abnormally. After that I actually experienced craving. I took more baclofen, and it was over. Normally either experiment would have activated the whole cycle of craving and thrown me into an emergency room within a couple of days.
"I knew that what I was feeling had never been described before. I thought, How do I break the news to the medical community? I'm the only one on the planet living this. And how credible am I as an alcoholic? People won't even believe me."
In August 2004, he wrote up a formal self-case report, which was published by the British journal Alcohol & Alcoholism (but only after its editor received a written statement from Ameisen's personal physician confirming Ameisen's version of events). He rented a post-oce box in anticipation of a flood of inquiries from addiction physicians, but none came. What came instead were hundreds of urgent e-mails from patients unable to find a doctor to prescribe them the medication.
"When doctors say, 'I don't believe, so I won't try it,' that's obscurantism," Ameisen says now, the blood rising in his face. "It's not science. People's lives are at stake."
For the past five years, making the case for high-dose baclofen has been Ameisen's full-time job. He goes so far as to predict that baclofen—which acts on a pathway of the brain involved in many different addictions—will cure dependence not only on alcohol but also on "cocaine, heroin, nicotine, and methamphetamine. Plus, I've treated three binge eaters and a cannabis addict and suppressed it all. One could of course imagine that along with compulsive shopping, it would also suppress compulsive gambling and compulsive sex. It also treats PTSD, and my hunch is that it has antidepressant properties, too." In breathless, outraged bulletins e-mailed from his apartment in the Sixth Arrondissement, he has promoted the medication to practitioners and researchers around the world, urging them to do the full-scale study that he's convinced will validate his experiences. There's been little interest from Big Pharma, largely because baclofen, which has been around since the '60s, is out of patent. Absent the exclusive right to manufacture it, no drug company will invest money in formal trials.
Nate Penn
GQ
March 2010
Thirty years of heavy drinking will erode your fine motor skills, so even when Martin's sober, he moves with the exaggerated deliberateness of someone who's not. Right now he's concentrating hard to insert his keys into the ignition of his Pontiac Grand Am. The car's upholstery is stained brown and yellow and smells, as Martin himself does, like rancid-sweet beer. It's a Saturday in March, 4 p.m. By this time of day, Martin is normally buying his first twelve-pack of ice beer. But his wife, Sally, has unexpectedly been called into work, and she's asked him to look in on their daughters, who live five miles away from his studio apartment downtown. If he doesn't start drinking within an hour, Martin will go into withdrawal. His hands will begin to tremble; his temples will throb; his stomach will be gripped by cramps so excruciating that three times, in ER detoxes, he's been given morphine for the pain. When you've been an alcoholic for as long as Martin has, with- drawal can also lead to fatal seizures, heart attack, and stroke, all of which he prefers not to think about, concentrating instead on that one thing, getting his beer.*
The streets of this small North Carolina town slide past us, steep avenues of white magnolias in blossom. "I can go home whenever I want," Martin announces, "as long as I'm sober."
He's 45 years old and hasn't lived with his family since the Sunday morning in November 2007 when he retreated to the basement with forty-eight beers and announced to his eldest daughter that he wanted to die. Sally called 911, and as the neighbors gawked, cops arrived and escorted him out of the house in his underwear, handcuffed and shackled and shouting, "Go ahead, motherfuckers! Shoot me!" This was the second and final time Sally kicked him out, and Martin tells the story smoothly, having honed it at four separate rehabs and hundreds of twelve-step meetings.
In the living room, Erika, who's 10, is sitting in an armchair with Harry Potter and the Chamber of Secrets. "You're reading Harry Potter now?" Martin says.
"Dad, I've had this book for like a month," she responds. Olivia, 12, is on the phone with a friend and tilts her head to allow Martin to kiss her cheek. Then he excuses himself, and the three of us listen to a series of dry, heaving coughs coming from the bathroom. A moment later, Martin is standing at the front door. "Call me if you need anything, okay?" His visit has lasted all of five minutes.
"We're gonna get some beers!" Martin exclaims once we're back in the car. At the counter of a mini-mart, he struggles to remove his wallet from the front pocket of his jeans. "I hate when my hands start shaking when I'm doing something precise like this," he mutters. "It's very embarrassing." As he leaves the store with his twelve-pack propped on his shoulder, he exchanges a sharp glance with a guy who's scratching lottery tickets. Back behind the wheel, he's practically livid. "That guy is the leader of my AA group. Did you see the look he gave me?" He wipes his sweating forehead (it's forty-five degrees today). "I'm an alcoholic, and I'm drinking! Nothing abnormal about that."
Martin's studio looks like a dorm room: hot plate, folding table, futon. Its single window overlooks railroad tracks. Carefully, Martin hangs his coat on the back of a chair, then walks slowly to the kitchen, where he pours two cans of beer into two tall glasses. His movements have the feel of ritual now. He carries the glasses to a low coffee table and downs one in seconds. "You see that I don't shake anymore, after just one beer?" he says, a little out of breath. "My stomach doesn't hurt anymore. And I've stopped losing my mind."
Every weeknight, Martin comes home from his IT job, cooks dinner on his hot plate, works on the German crosswords his mother mails him, drinks around a dozen beers, then blacks out. Some nights, he drinks everything he's got and goes out to buy more. "I'm only driving five minutes," he says. "I know the road, and I'm not driving fast." On the folding table, along with several traffic tickets for driving with an expired registration, are valentines from his daughters cut out of red construction paper. Erika's reads: "Thank you for being a very lovable Dad." "She put on her Christmas list, 'I want my Daddy back home,'" Martin says. The kids don't visit him, not since the night Olivia, who'd come downtown to see a movie with friends, dropped in on him unexpectedly. "I'd had about ten beers," Martin says. "I guess I said hello to her. I don't really remember."
I ask him if he ever wonders if it would be better for his kids not to see him at all.
"Your periods of sobriety, you're not very operational," he says. "You're just waiting for the time you're gonna start drinking. I'm not drunk most of the time I'm with them, but I'm not available." He seems eerily undisturbed by what he's saying. "My girls are doing very well in school."
With three beers in his stomach, another in his hand, and eight more chilling in his refrigerator, Martin looks happy for the first time all day. "When I'm sober, I'm terribly fearful and anxious," he says. "You don't know exactly of what, but you feel it—that something's gonna happen to me."
Years ago, Martin contracted hepatitis C, which makes him vastly more vulnerable to cirrhosis, fibrosis, pancreatitis, and various cancers. Alcohol has also begun to cause irreversible damage to his brain; he complains of problems with his concentration and memory. His addiction has cost him a job and his place in his own home and may yet cost him his marriage. Now his therapist is warning him that if he doesn't stop drinking, he will die within two years. "I said, 'What do you mean, stop drinking? No more?' And he said, 'Yeah, no more.' I looked at him and I said, 'That's not gonna work with me.'"
The Hotel Lutetia in Paris is a Belle Epoque landmark and a frequent setting for occasions of state. In 2000, Dr. Olivier Ameisen was made a Chevalier of the Légion d'honneur here for his rayonnement de la France à l'étranger—his "radiating of French culture abroad" as a distinguished physician and composer-pianist in New York City. The ceremony had originally been scheduled to take place a year earlier but had to be postponed because Ameisen was on a drinking binge. "The emotion of it was huge, and I relapsed," he says as we sit talking in the hotel's brasserie. "Nobel Prize winners and government ministers were going to be there. People had to be disinvited at the last moment."
White-haired and dapper, Ameisen is the image of the prosperous Upper East Side cardiologist he once was, though his grayish complexion speaks to his history of bodily abuse. In multiple drunken falls and blackouts, he says, "I broke bone after bone after bone. I was hospitalized I don't know how many times. Every time, I thought I had hit bottom. But my bottom would have been death."
He's been sober for five years, ever since he self-prescribed massive doses of baclofen—an obscure forty-year-old muscle relaxant—and, he says, "cured" himself of his alcoholism. A year ago he published The End of My Addiction, a strange, fascinating book that's equal parts tour-of-hell drug confessional, scientific investigation, and public-health manifesto.
The book caused a sensation in France, where in the months after its publication patients reportedly besieged their doctors for prescriptions. But many European addiction experts assailed the book, calling its claims "extremely irresponsible" and "woefully premature" and insisting that Ameisen had "misunderstood the nature of alcoholism." One eminent physician suggested he be stripped of his license for having self-prescribed the medication in the first place.
From childhood, Ameisen, who was born into a prominent Parisian family, was primed for a brilliant career. He says that at age 16 he performed privately for the legendary pianist Arthur Rubinstein; had a volume of poems accepted for publication, until he refused to revise it ("I would have been the youngest person in France ever to publish a book of poetry," he tells me with disarming immodesty, "younger even than Rimbaud"); and became the first Frenchman ever to take and pass the baccalaureate exam two years early. Later, he served as personal physician to the prime minister before moving to New York in the mid-'80s and becoming a cardiology professor at Cornell Medical Center. He began drinking, he says, to deal with acute social anxiety. "I had a lot of patients who were diplomats or businessmen or artists, who would invite me to parties and ask me to perform. It was painful to do this in front of people. But when I drank scotch, I felt great, and people liked me. If it didn't cause tremendous collateral damage, alcohol would be one of the best medications around."
When he left teaching to open a private practice, a risky financial move, he had frequent panic attacks. He began to binge-drink. There were falls and fractures, seizures, bleeding in his lungs, rehabs, hundreds of AA meetings, di`erent kinds of behavioral therapy, and the full spectrum of medications, none of which quenched his desire for alcohol. There was also what he calls the "brutalization" of a medical establishment totally unsympathetic to his condition. "Not only do you have one of the deadliest diseases, but in addition people say, 'Well, it's your fault!'"
Finally he shuttered his practice, put his bills on auto-pay, and retreated to his apartment. "I was going to my psychiatrist three times a week, to a cognitive-behavioral therapist at least once a week, to a psychopharmacologist, to one or two AA meetings a day. Basically, I was spending my day trying not to drink. " Several rehabs did provide relief, but "they were cocoons. When I left, I saw liquor stores and bars, and I relapsed that very same day."
He credits AA for giving him desperately needed fellowship, but he calls twelve-step methodology "torture." "The DSM-IV defines complete remission as a year of abstinence," he says. "But telling somebody they're in complete remission from alcoholism when the person is craving on a daily basis, he's miserable, he spends all his time going to AA—it's extraordinarily cruel. Abstinence ruined my life."
One day a friend sent him a New York Times clipping about a paraplegic drug addict who, after being prescribed baclofen for acute muscle spasms, reported that the medication also seemed to reduce his cravings for cocaine, alcohol, and nicotine. That a medication might work by reducing craving—not by blocking a high—was a new idea. Between binges, Ameisen immersed himself in the National Institutes of Health's vast online archive. Baclofen's primary indication was for muscle spasms, but as far back as 1976 a study had mentioned in passing that it might be useful in treating alcoholism.
Ameisen was generally familiar with the neuroscience of alcoholism. He knew that the illness hinges in part on the yin-yang relationship between two neurotransmitters: GABA, a sedative, and glutamate, a stimulant. Keeping them in balance is the hopeless task at the heart of alcoholism, because drinking not only incites the brain to release the neurotransmitters but also builds new receptors that demand more of both. The onset of withdrawal is like being trapped in a room that's slowly flooding. Minute by minute, an alcoholic searches wildly for a way out, even as he su`ers inexorable, finally unbearable physical discomfort. To counteract the glutamate he craves more GABA, so he drinks to relieve the symptoms of drinking.
Baclofen, Ameisen learned, is the only nonaddictive drug that stimulates a particular GABA receptor. Taking baclofen, he believed, might bring about the neuro-chemical calm an alcoholic pursues at such terrible cost.
"I began self-prescribing fifteen milligrams in March 2002, and on that same day I noticed something strange," he says. "As I was returning from my weekly appointment with my therapist, I stopped o`, as I always did, at a nearby music store. As I was leaving, I thought, Where are my bags? Then I realized I hadn't bought anything. I used to buy $80 to $100 worth of CDs on my way home. I had been a compulsive shopper, and baclofen, even at a low dose, completely suppressed it." But even at 180 milligrams, he found that his craving for alcohol, while diminished, was still "overwhelming." He feared that a higher dose might so relax his respiratory system that he'd su`ocate in his sleep. For eighteen months, he endured still more relapses and hospitalizations.
Then he happened upon a 1997 study that described rats completely losing interest in cocaine as their baclofen dose was slowly increased. "I thought, Can that be transposed to humans? Can I write a protocol in which I increase the dosage gradually, as neurologists do, to see if I can reach a stage at which my cravings are not reduced but completely suppressed?"
He consulted with various physicians in Paris. "Nobody would prescribe it to me," he says, so again he self-prescribed. Thirty-seven days later, having reached a dose of 270 milligrams, he was having tea with a friend in a mountain resort. "All of a sudden, I saw a man drinking Cognac, and it did nothing to me. I looked at the bottles behind the bar, and they were neutral to me, like a vase. I thought I was dreaming and that I'd wake up from the beautiful dream. But the next day was the same, and the next and the next."
Ameisen began field-testing: "At a gathering, I drank three gin-and-tonics to see what would happen. Nothing. So I thought, Let me try five, which is the definition of when you drink abnormally. After that I actually experienced craving. I took more baclofen, and it was over. Normally either experiment would have activated the whole cycle of craving and thrown me into an emergency room within a couple of days.
"I knew that what I was feeling had never been described before. I thought, How do I break the news to the medical community? I'm the only one on the planet living this. And how credible am I as an alcoholic? People won't even believe me."
In August 2004, he wrote up a formal self-case report, which was published by the British journal Alcohol & Alcoholism (but only after its editor received a written statement from Ameisen's personal physician confirming Ameisen's version of events). He rented a post-oce box in anticipation of a flood of inquiries from addiction physicians, but none came. What came instead were hundreds of urgent e-mails from patients unable to find a doctor to prescribe them the medication.
"When doctors say, 'I don't believe, so I won't try it,' that's obscurantism," Ameisen says now, the blood rising in his face. "It's not science. People's lives are at stake."
For the past five years, making the case for high-dose baclofen has been Ameisen's full-time job. He goes so far as to predict that baclofen—which acts on a pathway of the brain involved in many different addictions—will cure dependence not only on alcohol but also on "cocaine, heroin, nicotine, and methamphetamine. Plus, I've treated three binge eaters and a cannabis addict and suppressed it all. One could of course imagine that along with compulsive shopping, it would also suppress compulsive gambling and compulsive sex. It also treats PTSD, and my hunch is that it has antidepressant properties, too." In breathless, outraged bulletins e-mailed from his apartment in the Sixth Arrondissement, he has promoted the medication to practitioners and researchers around the world, urging them to do the full-scale study that he's convinced will validate his experiences. There's been little interest from Big Pharma, largely because baclofen, which has been around since the '60s, is out of patent. Absent the exclusive right to manufacture it, no drug company will invest money in formal trials.