So here we are again, back at the baclofen question. My Dutch friend sends me a link to a news story (in Dutch!) about the University of Amsterdam starting a study of baclofen as a treatment for alcoholism and drug addiction. Managed to cobble some sense out of the story, which begins:
Is this the wonder pill which will bring rescue to, among others, alcoholics, junkies and smoke-drug addicts?
“Smoke-drug addicts”—very much like that one. My mother, a die-hard smoker for 30 years before she died at 58 of lung cancer, was definitely a “smoke-drug addict.”
(Another interesting tidbit: the Dutch word for “addiction” is “verslaving”—which, my friend says, means “a slave to a substance.”)
Baclofen is a derivative of gamma-aminobutyric acid (GABA) and is a GABA-receptor agonist—just like, as it happens, alcohol. Surprise, surprise! they work in the same way. … Baclofen is prescribed as a muscle-relaxant for spasticity in conditions such as multiple sclerosis. It is also prescribed off-label to reduce addictive cravings. And it’s dependency-producing. You can’t just quit baclofen—it must be tapered up and down when getting on or off it; stopping use suddenly leads to the same kind of (prolonged, painful) detox that benzos induce.
So they’re gonna study us alcoholics, junkies and smokers, BUT: not gamblers, because apparently there’s no medical evidence that gambling addiction actually exists. The researchers are, according to the story, somehow really hoping it works for drug-addicts. Leading us to believe “junkies” are maybe worse than the other types?
The story quotes a guy from a drug-rehab who has administered baclofen to 100 patients addicted to alcohol, cocaine, cannabis, GHB and benzos, and, apparently, about half of them no longer use their (other) drugs.
The best part of the story: the researchers are speculating that baclofen works better on addicts who use out of “angst.” The story reads (according to my Dutch friend–thanks P):
“With people who use substances from a more positive emotion we do not believe baclofen to be very effective,” according to [Professor Reinout] Wiers [of Amsterdam University]. One assumption of the researchers is that the muscle relaxer also has a calming effect on addicts who try to mask and conquer their fear.
Which would make sense. I mean, what real alcoholic doesn’t drink out of conscious or unconscious “angst”?
Also: I was not fully aware of this, but angst is the Germanic word for fear. So, take a pill, and my fear is relieved. … This brought back the words of my first sponsor, a deeply spiritual woman and former “junkie” who once advised me, as I detoxed off fentanyl and started work on my Fourth Step only to discover that I had a few bits of “angst” going on:
DON’T call it “anxiety.” It’s plain old fuckin fear, OK? If you call it “anxiety,” you can go to the doctor and get a pill for it. It’s OK to medicate “anxiety.” But nobody goes to the doctor and says, “I’m having some FEAR, I need a pill.”
I took her point.
But maybe now, with baclofen, you’ll be able to do that.
Olivier Amiesen, M.D., who controls his alcoholic cravings with Baclofen
The whole baclofen business started with Olivier Ameisen, a French cardiologist who for 15 years practiced in New York and taught medicine at Cornell’s Weill Medical College. Unable to stay sober despite following up on all his practitioners’ recommendations, going to rehab, and sitting in two AA meetings per day for seven years, Ameisen experimented on himself: he started taking high doses of baclofen, which, he wrote in his 2008 book The End of My Addiction, eradicated his cravings and allowed him to become a social drinker. Ameisen called for randomized studies of baclofen’s effectiveness—of which, presumably, the Amsterdam study is one.
One wonders if it would even be OK to become a social drinker while taking high-dose baclofen. Though not classified as a benzo, baclofen basically has a benzo profile and the same kinds of OD risks. In addition, though it seems not to have any tolerance effect (unlike alcohol), dosages have to be closely monitored, because over 80mg/day baclofen can interfere with functioning and cause drowsiness. Ameisen uses baclofen at doses of 200mg+.
I once brought my questions about baclofen up at a meeting early in my sobriety. I got a number of very interesting responses. One was from a young man, maybe 28 or 29, who had been clean for about a year or so. Smart guy and very physically fit. His face lit up like a torch when I mentioned baclofen. After the meeting he said:
It’s funny when people talk about using baclofen to get rid of cravings. My experience was, when I used baclofen WITH alcohol, the combination was juuuuust right. If you know what I mean.
I knew what he meant.
For me, using a chemical to fight chemical addiction is like using water to avert a flood.
Ameisen’s statistic sounds so disappointing: 5,000 meetings over seven years failed to keep him sober. Another friend, a former heroin addict who got sober the way I did, bristled when I mentioned this statistic:
For an addict like me, sitting in two AA meetings per day for seven years ISN’T the solution.
What this person meant was, for an addict like her, the solution = taking the steps. Meetings alone don’t keep her sober.
I can buy, along with Gabor Maté (one of my true addiction-treatment heroes), that some people just can’t get sober with the steps and may need to take “maintenance” drugs to escape the “junkie” lifestyle. That’s cool. In Stephen King’s words, there’s more than one way to de-fur a feline. But if they want to research the addiction-treatment possibilities of baclofen, on which the patent has expired and from which ain’t nobody gonna make no big bucks, why don’t they also research the effectiveness of other cheap and non-patentable “solutions” that have worked for millions of people for much longer?