View Full Version : The One-Step Program (Baclofen used to treat addiction)

15-04-2010, 01:29
The One-Step Program
Nate Penn
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.

15-04-2010, 01:29
Ameisen's pleas to academia and government have been met by a similar skepticism—indeed, by a kind of cure fatigue. "The alcohol and drug-abuse field has a long history of things that are promising that haven't panned out," explains Dr. Roger Weiss, a Harvard psychiatrist who directs the rehab program at McLean Hospital. For instance, there's Prometa, a cocktail of three ordinary, widely available drugs that Hythiam, Inc., introduced in 2006. Without ever subjecting the regimen to a controlled trial, Hythiam announced that 80 percent of patients would become abstinent after a single monthlong treatment costing $12,000 to $15,000. (The Los Angeles Times later demolished those claims.) The case of ibogaine, a psychedelic that was thought to bring about long-term sobriety after just a single dose, is even more extreme. "A clinical director at the National Institute on Drug Abuse called it the most promising medication he had ever seen," says Dr. Stephen Ross, an NYU psychiatry professor who directs Bellevue Hospital's rehab program. "The problem is, ibogaine's killed like eighteen people since 1990."

Dr. Mark Willenbring, who at the time of our conversation was the director of the treatment-and-recovery-research division of the NIH's National Institute on Alcohol Abuse and Alcoholism, laughs when we discuss Ameisen's claims for the drug. "That's what's called anecdotal evidence, right? I'm glad he's better, but that doesn't tell us much about anything." Dr. Richard Pops, chairman of Alkermes, a biotech company that makes the injectable alcoholism drug Vivitrol, can barely hide his disdain. "That isn't science," he says. "You have to publish your results in JAMA,, and the data set has to be vibrant and robust so it's not bullshit."

But other physicians, even those skeptical of the "magic bullet" claims Ameisen makes for baclofen, do see a future shaped by a single medication. Alcoholism treatment, says Willenbring, "is about where we were with depression treatment fifty years ago. And then along came Prozac in 1987. We haven't had the right drug at the right time. In ten years, maybe five, most people who receive treatment for alcohol dependence will go to their primary-care doctor or psychiatrist and they'll get a medication and some brief support. Just like they do right now for depression."

The medical establishment's temporizing infuriates Ameisen. "Nobody wanted to prescribe baclofen to me, so I had to self-prescribe," he says. "Had I been a lawyer or a bartender, I'd be dead."

AlcoholIcs relapse at a rate of at least 75 percent, with or without the three FDA-approved medications for alcoholism—naltrexone, acamprosate, and disulfiram. "You cannot get cured," Martin tells me, "so doctors look at you as a danger for their job. 'Go to AA.' That's all they can tell me." Neither disulfiram nor acamprosate has prevented him from drinking, and he can't take naltrexone because of his damaged liver.

Around the world, at least ten doctors are now prescribing high-dose baclofen to more than 300 patients, and their reports suggest that well above 50 percent of those patients are getting sober, from Ann Arbor to Glasgow to Geneva to Berlin, where psychiatrist Andreas Heinz has received so many calls from patients seeking baclofen that his sta` now refers to the oce line as the "baclophone." In Chicago, Dr. Fred Levin, a clinical associate professor of psychiatry at Northwestern, contacted eleven former patients after reading Ameisen's book and put them on baclofen. "As the dose gets higher and higher, they suddenly realize they're no longer interested in alcohol," he says. "I don't think I've seen anything like this in my lifetime. Baclofen absolutely stops addiction in its tracks. I think this is going to be a revolution."

In November 2008, at Ameisen's urging, Dr. Renaud de Beaurepaire, director of psychiatry at HUpital Paul Guiraud near Paris, agreed to try high-dose baclofen with his patients. Today he has prescribed it to more alcoholics—over a hundred—than any other doctor in the world.

"I was very skeptical," he told me when I visited him at his bunkerlike clinic in the ugly suburb of Vitry. "Thirty years of treating patients with never any success, you become skeptical." Within a couple of weeks, though, he realized he was witnessing something unprecedented. "In every patient, there is a dosage for which they say, 'I'm not interested in drinking anymore.' For all patients. It's quite miraculous." He continues, "We have seen a series of patients this morning who have been alcoholics for ten, twenty, thirty years. They take baclofen and they don't drink anymore. One said, 'I don't understand what has happened to me. I'm not the same person. What happened?'"

Martin's mother, who still lives in Berlin, told him about baclofen after reading a newspaper article about Ameisen in late 2008. "I thought it was bullshit," Martin remarked over lunch last spring. "I have fought my alcoholism so hard. This pill is going to stop it?" He said he doubted he could even get a prescription: To oblige Sally, he'd already given copies of Ameisen's book to both his GP and his psychiatrist, but neither would prescribe to him. At the time of our conversation, only five doctors in the United States were prescribing high-dose baclofen, and none within 400 miles of his home.

Ameisen had told me about a New York addiction psychiatrist who had just begun treating patients with baclofen. I proposed to Martin that I put him in touch, and he said he'd think it over. "I don't think I've hit bottom yet," he insisted. "And Sally has always sent me… What is that thing you send to somebody who's sinking?"

"A life preserver?"

"Yeah. I don't know how many times she's gonna do it, but… And my children are not hostile. One of my daughters said I was the best friend of the month on Facebook." For a minute he went elsewhere in his head, as if he were considering whether or not he was deserving of such an honor. "They love me," he said. Rather than grateful, though, he sounded weary.

A few days later, he e-mailed me his answer: "I'm trying this only because Sally asked."

Two weeks laTer, on a rainy afternoon in early May, Martin emerges from the psychiatrist's Fifth Avenue oce. (The psychiatrist asked that I not name him, saying his corporate clients wouldn't appreciate his association with an "experimental medication.") This morning he flew up from North Carolina; tomorrow he'll fly home. "I was worried I might say something wrong and he wouldn't give me the medication," he says.

The psychiatrist starts Martin out on a low dose with the possibility of further increases, if necessary. Having read about Ameisen and his 270 milligrams, this isn't what Martin had anticipated. Still, his first e-mails from home are excited and hopeful. "My craving during the daytime has now disappeared," he writes. "When Sally calls me to ask if I can help with anything after I leave the oce, I don't feel the stress I used to feel about postponing my first drink. Today I stayed with the girls until 7 p.m."

On day fifteen, he writes, "Last night I bought eight beers and only drank seven. I do not have a memory of doing that in all my years of drinking. The following morning I saw the beer in the fridge. Having something to drink in the morning is one of my highest triggers, but I decided not to drink it. Something new definitely happened."

It's hard, reading his updates, not to feel hopeful, too. I've seen what Martin's drinking has done to him and his family. At the same time, common sense says that this all seems way, way too easy.

On a Sunday in April, I'd visited Sally at her house. "When I first met Martin, I was blown away by how sweet and nice and smart he was," she said. "I was royally happy with him for years. And he was a great dad. Even up until the last few months, he never declined an invitation to play cards or a board game." Her voice went up a few keys, optimistically. "Everything is workable if he can stop drinking. But he has no feelings of self-preservation. Olivia came to me last year and asked, 'When is Daddy going to die?' I keep telling them, 'He doesn't want to be like this. No one wants to be like this. Obviously he loves you more than anything. He's doing something that hurts you—we don't know why he can't stop.'"

I asked how she's managed to stay with someone so self-destructive. "I can really compartmentalize things," she said, and laughed. "If you have something with someone, it's precious and you can't just throw it out, even if the other person was totally out of it the whole time. But I'm no fool. I've mentioned divorce to him. I don't think he believed me, though." She fell silent. "Do you think I'm the world's biggest pushover?"

By day thirty, Martin is taking 140 milligrams of baclofen, but his optimism is gone. "I haven't seen any improvement for about three weeks now," he writes. "I drank 14 beers on Saturday and 12 on Sunday. I am not doing very well."

A week later, he stops e-mailing me altogether. When I finally get him on the phone, he says, "I'm quite depressed about the treatment. My cravings are weaker, but I've been drinking at least six beers every day." He's asked for a higher dose, but the psychiatrist has refused to prescribe more than 140 milligrams because of the side effects—"speeding," Martin says—he's been experiencing.

Ameisen, when I fill him in, pronounces the psychiatrist's dose "absurd" and declares that Martin needs more baclofen, not less. He offers to speak with Martin, and they decide he should fly to Chicago, where Fred Levin of Northwestern will give him a prescription for a higher dose.

Levin prescribes 200 milligrams to Martin, but within days Martin reports no improvement, and in consultation with Ameisen he begins to combine the New York and Chicago prescriptions for a total of 300 milligrams. But it's unclear whether he'll be able to cobble together that amount indefinitely, since his local pharmacist will likely refuse to fill two concurrent identical prescriptions.

Martin tells me he's heartened by Ameisen's interest but troubled by one thing: "Dr. Ameisen didn't take my side effects seriously," he says. "He's so passionate about his cause that he ignores anything bad about it."

"Maybe I've been blind," Ameisen concedes when I relay Martin's comments. "If so, I apologize." A few weeks earlier, in a staggeringly premature declaration of victory, he had e-mailed me to announce: "Martin is completely cured and will remain so." I remind Ameisen of that e-mail, and he replies, "I prefer side e`ects to Martin stopping the treatment and being in the gutter or his wife leaving him or him dying in a car crash. What I meant was: Bear with it; I know it's hard, but what's your alternative?"

In late July, Martin and I drive to the house to pick Sally up for dinner. As we walk to the front door, he shows me the slate walkway he's building, one of several home-improvement projects he's embarked on. He's been at it every weekend after working fifty-to-sixty-hour weeks at his job. "Baclofen gives me a lot of energy," he says. He's also been swimming—the first exercise he's done in years.

A neighbor passes in her car, and he waves to her, flagstone in hand, the picture of a wholesome suburban dad. "In AA, if you're sober, you're going to meetings every day, seeing your sponsor, rebuilding your personality, working on your triggers. I don't have to do that anymore. I don't have to fight the force of the universe."

Pleased though he is with the results of the treatment, he doesn't seem to want to talk about it. How much baclofen is he taking now? Three hundred forty milligrams, he says somewhat grudgingly. Is he still drinking? Four beers a day. "But just to get relaxed," he assures me. "I don't really have cravings. If someone told me six months ago that one day I will drink four beers and not need more, I would smile, thinking that this guy doesn't know how strong my disease is."

I ask about side effects, and lowering his voice, he says he's been having trouble sleeping, so a local doctor prescribed Xanax.

Sally comes into the kitchen, dressed up for dinner, smiling. "Now she's talking about when I move back home." Martin says, gazing at her. " 'We can do this.' 'We can do that.' She never talked about that before."

I start to tell her how glad I am that Martin's nearly overcome his side e`ects, but he brusquely says, "We'll meet you in the car, Sally, all right?" I follow him onto the front lawn, where he tells me, "Sally doesn't know I'm taking Xanax. She'll get very upset if she finds out: 'You're an addict!' But Ameisen says baclofen prevents you from acquiring dependency. He said the Xanax is okay."

The three of us eat dinner at a restaurant downtown. Martin pours the wine and drinks two glasses. "It won't affect my craving," he says. "Wine never has." (Later, Sally will tell me she was "bummed about the wine.") He and Sally taste each other's food, but there's no physical contact between them, and it occurs to me that I've never seen either of them touch the other. Martin has told me that he and Sally haven't slept together in almost two years.

"Moving back home will not be a major change," Martin says at one point. His confidence—that it's a fait accompli, that problems won't linger—is surprising, and I try to read Sally's reaction, but whatever she's feeling, she doesn't reveal it.

Afterward, at her car, Sally o`ers Martin a ride home. "I'm fine, I'll walk," he says. We're only a few blocks from his studio.

Sally watches him make his way along the quiet industrial street. "I don't think he understands what it's like being around someone who's really drunk," she says. "That is the one part that I find unforgivable." What do you mean? I ask.

"One night, when Erika was a baby, I was cooking something with hot pepper, and I got it in my eye. It was burning, and Erika was at the table…and I thought I was gonna have to be rushed to the hospital. Martin just kept eating. He didn't seem to care at all." She opens the car door. "That sort of thing happened many times. Maybe he owns up to his responsibility for that with someone else, but he hasn't done that with me yet, and I don't know that he ever will."

The fIrst time Sally kicked him out, in the fall of 2006, Martin tried to kill himself. He was living at the time in a house that an AA buddy was renovating, on a steep, crumbling street in a rough section of town. He'd just been fired from a job for calling in sick for two straight weeks during a binge.

The day after our dinner, Martin takes me to see the house. Together we mount a weed-smothered stone staircase. "There was no hot water, no furniture, no heat," he says. "I was sleeping on the floor with all this dust. Forty years old, I lost my family, I lost my job. I just said, 'Okay, that's it.'"

He bought gin, vodka, and tequila and swallowed every prescription pill he had. Finally he phoned Sally. "I was like, 'I'm gonna die, this is your fault.' Crazy stuff." Sally called an ambulance. He was in a coma for two days, then in a psychiatric hospital for ten more.

He went to rehab as an outpatient from January to May 2007. "Then I got a nice new job," he says as we reach the top of the stairs. "I don't know why I started drinking again." During the ten-minute drive to work, he would pull over and drain a couple of beers. Within weeks, two cans a day turned into thirty, and not long after that the cops came and dragged him out of his basement in his boxers.

At the top of the staircase we discover that the AA buddy, three years on, hasn't gotten very far with the renovations. Shingles are missing, and paint is peeling in long, thin strips. "Do you want to look inside?" Martin asks. As we approach the windows, a Doberman the size of a deer silently appears. It stands there looking at us, not moving, waiting for us to take one more step. Martin and I immediately head back down the hill. At the bottom, panting—he's still in terrible physical shape—he says, "When I look at everything I've done to destroy my life—and what I still have? I feel I am a very lucky person."

In September, Olivier Ameisen ew to New York to deliver a lecture entitled "Addiction: A Cure at Last" at three prestigious addiction centers. One evening, I met him at a bar in Brooklyn. He was glowing. "It's night and day from when we first spoke," he said. "Then I was screaming in the desert. The doors have finally opened." He mentioned that he'd also been invited to speak at Harvard's McLean Hospital but that he'd had to decline, reluctantly ("I've dreamed of teaching at Harvard," he said), so that he could fly to Berlin to appear on television.

In December, The End of My Addiction was published in paperback with a new title: Heal Thyself. By then the recovery community had discovered the book, and people around the world were comparing notes online, many reporting that baclofen suppressed their urges for alcohol. Meanwhile, Ameisen and de Beaurepaire had submitted a paper for publication—the first-ever clinical trial of high-dose baclofen as a treatment for alcohol abuse. A confidentiality clause prevented Ameisen from discussing his data on the record, but he told me, "It's our hope that the paper will convince more and more physicians to prescribe baclofen."

In mid-January, Martin e-mailed me his latest progress report. "I just want to let you know I am not sober yet," he wrote. "Worse, my drinking increased from October through New Year's. I am now back to six beers a day. I plan to stop drinking in the next few weeks."

Link! (http://www.gq.com/news-politics/mens-lives/201003/one-step-program)

15-04-2010, 01:34
yeah i read this in GQ. ok article, but as it points out, there is still a pretty high relapse rate, and no one stopped drinking...they just drank less. kinda overblown IMO

15-04-2010, 04:33
My thoughts exactly.

I can't help but wonder what this guy Ameisen's motivations are. Something about it, and I don't know if it's just the way it's written, leads to be believe he has ulterior motives. Maybe just an ego boost, I don't know...

The sad thing is that he could have said vitamin c delivered the same results -and considering a potentially strong placebo effect, it may!- and addicts would have jumped all over it. That's just how desperate things get with addiction. :\

15-04-2010, 11:28
too long for me :/

15-04-2010, 22:21
I remember hearing about baclofen on an addiction speacial on HBO which showed suboxone maintainance, a couple of different drugs used to treat alcoholism, and then baclofen used for cocaine craving reduction.
The test had a crack/cocaine addict have his brain activity monitored as pictures of triggers were flashed in front of him. The test showed a lot of brain activity. After he took the baclofen, the same test was administered and his brain activity was significantly lower which was interpreted as him not craving the drug as much after taking baclofen.


15-04-2010, 23:51
I don't know how conclusive just reading brain activity is. I'm sure other drugs cause the same drop. The question is if it causes long term remission, or at least temporary remission to allow the patient to explore and settle just exactly what the reason for the addiction was.
As much as a magic addiction bullet in pill form would be nice, addiction is such a complicated and personal affliction, that I don't think such a thing exists.

16-04-2010, 00:07
Well the meds that will make you extremely sick if you drink on them will keep people from drinking. High doses of suboxone will keep people from getting high on other opiates. But this is only successful if the person takes the medication daily. Sure the keep you from getting drunk/high and reduce cravings when you take them, but you can stop taking them at anytime and go back to using.
I guess the nalaxone implant thing can ensure one doesn't get high, but people go crazy on those things, and some people have contemplated removing the implant themselves.

16-04-2010, 00:20
What a horribly written article. I don't know why, this syle seems to be popular with journalists covering stories that relate to drugs. They basically spend half of the article in a more or less gloomy introduction that I really don't care much to read. Cut to the fucking chase for fuck's sake!

Anyway, I skimmed through the article, so pardon me if I missed something, but Ameisen seems to ignore the fact that Baclofen itself is physically-addictive, as is its newer analogue, Phenibut. If it makes people drink less, then it is basically doing exactly what benzos would have done: get you drunk with less alcohol. Being as addictive as benzos, baclofen doesn't really offer much of an advantage...

18-04-2010, 17:30
^I didn't get past the gloomy part

thanks for the most depressing beer of the day... at 10:30am

19-04-2010, 17:44
I've been put on baclofen for alcohol abuse in the past. It definitely did reduce my cravings, though I find that alcoholism is not just driven by cravings, but also the perceived reward of the drug, as well as all of it's associations, such as the social events it accompanies etc, which baclofen does not address. The ritual of using a drug can be just as addictive as the physical dependence it creates. As such, I don't ever believe there will be a magic cure for addiction.

Also, even a low dose of baclofen had me so drowsy I felt like I was nodding out all the time, falling asleep at work, with food in my mouth, etc.

22-04-2010, 14:25
^ See, that's what I mean, the benzo effect.

In fact, I had never been alcoholic to begin with, yet in periods when I quit benzos I went through bouts of binge-drinking.

This really IS nothing more than substituting one addiction for another, or in the case of Ameisen above, substituting one addiction for half of it and half of another.

Still, byzantine as it is, I would applaud this as a harm-reduction technique. Baclofen or Benzos are less toxic than alcohol, both in their action and in their withdrawal symptoms. One is addicted anyway, so here, at least, is the option of still being addicted while suffering less damage.

24-08-2010, 14:53
I get Baclofen for what it's for, which is lower spinal pain. It has several side effects, or some may say benefits. for one thing, it never creates a self tolerance. for another, it lowers over all body temperature as against body raising agents like MDMA. it's somewhat likely that the cooling action of the drug as against other drugs prevents their spread through the body, plus the full spinal antinflammation can provide relief, like as with other aitiinflammatories like dexamethasone, to any amount of inflammation which reduces pain and craving. also putting so much of a chem into your body and you start to taste it. 40 mgs a day. treat your alcoholism more slowly. watch it go away more slowly if this works. don't look to magic, what will happen when you're a trick short?

24-08-2010, 15:14
I've been on baclofen twice for back pain, I never found it to reduce cravings for opiates (except in the sense that reduced pain meant I had less of a reason to crave the drug, since my use of opiates is as much self medication as recreational these days)/meth, but I've never been one to crave alcohol so I can't comment in that regard.

Both times I had to stop because by the time I was taking a high enough dose to even partially reduce pain, I was getting all sorts of unusual nasty side effects, side effects totally out of line with what you'd expect from that class of drug as well.

31-01-2011, 10:37
What a horribly written article. I don't know why, this syle seems to be popular with journalists covering stories that relate to drugs. They basically spend half of the article in a more or less gloomy introduction that I really don't care much to read. Cut to the fucking chase for fuck's sake!

Anyway, I skimmed through the article, so pardon me if I missed something, but Ameisen seems to ignore the fact that Baclofen itself is physically-addictive, as is its newer analogue, Phenibut. If it makes people drink less, then it is basically doing exactly what benzos would have done: get you drunk with less alcohol. Being as addictive as benzos, baclofen doesn't really offer much of an advantage...

Baclofen is NOT addictive and patients do not develop tolerance. Saying that baclofen is addictive is spreading misinformation. People all over the world are being cured of addictions (right now, it's mainly being used for alcoholism, but it is apparently effective for other addictions, as well -- not just substance addictions, either). If you google it yourself, you will probably be astounded.

If you visit the MWO forum, you will find an exhaustive amount of information, mostly sharing of experiences with baclofen (for alcohol), but there are reams of information and links to relevant sites, scientific papers, protocols, etc.

Try starting here:


31-01-2011, 18:45
wow that was really interesting. Thanks for sharing

31-01-2011, 19:15
Baclofen is NOT addictive and patients do not develop tolerance. Saying that baclofen is addictive is spreading misinformation.

Baclofen is a GABA agonist, and like all GABA agonists it *is* addictive.

Claiming it isn't addictive is spreading misinformation.

31-01-2011, 20:28
I think he means addictive in the sense that it spurs its own consumption. Baclofen doesn't do this. It does cause fairly strong physical dependence but it is much easier to manage than benzo dependence. It less likely to cause persistent symptoms after discontinuation as well.

I think it's a much better harm reduction drug than using benzos to replace alcohol. It's far less toxic to the body and if makes people drink less without being psychologically addictive then its should be used.

31-01-2011, 20:38
I see what you are saying and I agree Baclofen treatment may very well be the less of two evils when compared to alternatives..

However claiming that a drug which has a well known withdrawal syndrome is not addictive is far from the truth and does not help anyone make an informed decision about the treatment.

10-06-2012, 22:54
See, that's what I mean, the benzo effect.
If I fully understood her post: No- that's not what footscrazy was getting at whatsoever. Yes, it is a replacement therapy of sorts, akin to benzodiazepines. But this statement completely ignores & disregards baclofen's unique pharmacologicaly which directly acts on the (quite poorly understood) portions of the brain responsible for neurological dependency (& obsessive compulsivity, within the context of addictive behavior as a whole. Although not all people respond positively of course--just like w/ any medication or medical procedure).

This really IS nothing more than substituting one addiction for another
As you eluded to further on, that is precisely the point--to a degree. If one is killing his or herself via chronic alcohol abuse, or by injecting a black-market drug like heroin (the many contaminates/cut in heroin--due to its illegality--being the main causes of stroke, heart attack, amputation, & vein degradation associated w/ its IV use)... Seems there is superior worth in replacing one substance for another safer[/I substance; even if the drug acts in the same area of the brain, if the addict cannot get sober otherwise [I]there is value there. Be it buprenorphine, benzodiazepines, methadone, or baclofen- you cannot take away the vital role these drugs have in reducing addict-related behavior, which is otherwise detrimental to the addict!