This old pill could take the pain out of battling alcoholism

No matter how many months he had been sober, no matter how, objectively, he knew that drinking was the road to hell, the visceral craving for alcohol overcame his resolution and he repeatedly relapsed.

The relapses destroyed his relationships

He was a cardiologist in one of the most admired cardiology teams in the world. And an alcoholic. His binge drinking started during his student days, when, as a high achiever, he was constantly anxious, permanently on edge. Prescription anti-anxiety drugs helped. A bit. But the complete intellectual extinction provided by a non-prescription dose of alcohol helped even more. The hangover wasn’t great, but it was worth it.

As junior doctor, he admitted grey-faced patients into alcohol detox treatment. He knew the signs. He knew the symptoms. He knew better than any layman the dangers. But he continued to binge-drink.

Because he was a clever, insightful man, he eventually acknowledged that he was an alcoholic, went through treatment and faithfully attended Alcoholics Anonymous meetings. He had exceptionally good “sponsors” within AA, sponsors being the individuals who serve as supportive buddies to recovering alcoholics like themselves.

Yet no matter how many months he had been sober, no matter how, objectively, he knew that drinking was the road to hell, the visceral craving for alcohol overcame his resolution and he repeatedly relapsed. The relapses destroyed relationships. The woman he loved quietly withdrew from the disaster area he had become. Part of that disaster was physical: once he was drunk, he would fall, cutting himself, concussing himself and breaking bones.

He experienced plenty of “tough love” from friends and relatives. On one occasion, a group of them incarcerated him in a treatment centre against his will. They felt so strongly that this brilliant man had to be helped that they went further than friendship allowed in order to make sure he got the help he needed. He sobered up. Went back to AA. Went back to drinking. Lost his job. Hit bottom. Continued to drink.

One binge put him in hospital with several agonisingly broken ribs, one of which punctured his lungs, causing them to collapse. After his lungs had been re-inflated, he went home. Labouring with the pain of the fractured ribs but still sober and craving alcohol, he remembered a cutting from The New York Times his former girlfriend had sent him a year earlier. The cutting had dealt with some medication which seemed to offer some hope to even the most chronic drinkers. He contacted her and asked her to find the information for him and send it to him again. She did. In shivering sobriety, he opened up the document.

“I read with fascination how positron emission tomography (PET) scans conducted by the psychologist Dr Anna Rose Childress, an addiction researcher at the University of Pennsylvania’s Treatment Research Centre, showed a remarkable quieting of brian activity in a cocaine addict who was taking baclofen, a muscle relaxant, to control spasms. The addict said that this medication reduced his craving substantially. I did not want to get my hopes up too much, but I did have to wonder: could baclofen help me stop drinking?”

The doctor — Olivier Aemisen — was excited by the possibility that a medication might reduce his constant physical rigidity and the panic to which that tension led. That panic, in turn, led to a craving for alcohol to damp it down. Now, he was reading, in a prestigious newspaper, that scientific evidence existed which suggested one drug might at the same time relax muscular tension and reduce cravings, even in the seriously addicted.

He continued to attend AA meetings, do yoga and heal from his alcohol-inflicted wounds while he read, obsessively, about this possibility. Unlike valium and other similar preparations, baclofen, according to the information he found, did not make the patient groggy. However, a single study of one cocaine-addicted individual proved little, so before he talked to his doctors, he bought a computer and an internet connection and checked out every possible link to the drug. He discovered another study which had found that baclofen, administered to anxious or depressed alcoholics, was as effective as valium or anti-depressants, with the added advantage that it didn’t have the side effects or complications of either.

Then he hit gold. An Italian study of alcoholics on whom baclofen had been tried, albeit a study of a relatively small cohort, nonetheless showed the drug had promise.

“Craving was significantly reduced from the first week of the drug administration and remained so throughout the entire treatment period,” the clinical report stated. “Participants also reported that obsessional thinking about alcohol disappeared.”

The doctors to whom he brought the study were dismissive. It was one small investigation of a tiny number of alcoholics, they said. Because Ameisen was no longer a practising medical man, he could not prescribe baclofen for himself. He persuaded a medical friend to prescribe it for him. Not for alcoholism, but for muscle spasms.

The friend said it was an old drug, now manufactured by several pharmaceutical companies, and pretty safe. Amiesen should, however, begin the treatment slowly and tape off carefully.

He did. The initial results were positive. He slept better, woke up refreshed and felt calmer, even on low initial doses. He no longer did compulsive shopping, which was just as well, since he was broke.

Several months later, having built up the daily dose of the drug considerably, he found himself in a mountain resort in France, dining with friends and drinking water. He’d done that countless times before, fighting, every second, the craving for drink created by the presence, on every side, of alcohol. On this occasion, he absently watched a stranger in a nearby armchair drinking a glass of “something dark”. It could have been cognac or whiskey.

Amiesen realised that for the first time in decades, he was a) sober and b) neutral about someone else drinking alcohol.

“The spell didn’t break,” he remembers. “The dream didn’t end. That evening, for the first time since my alcoholism began, I had no craving for alcohol.”

Amiesen quickly began to look better and his friends, relieved, began to compliment him on his courage in staying off the drink. He explained to them that there was no virtue in his abstinence. It wasn’t just that he was calm and sober and wasn’t in the grip of overwhelming cravings for alcohol. He wasn’t trying hard. He was completely indifferent to alcohol.

Thanks to baclofen, Amiesen retrieved his life and his career. His account of his experience with the drug, published as The End of My Addiction, led to alcoholics talking to their doctors about it. Prescriptions were written and sobriety attained. More studies ensued.

“A large number of cures and a very high success rate have been documented by specialists,” he claims.

The success rate led to his appointment as visiting Professor of Medicine at State University of New York Downstate Medical Centre. The use of baclofen to reduce craving for cocaine and alcohol may be the first step — it’s now being speculated that the muscle relaxant may also reduce carbohydrate cravings.

For many alcoholics, sobriety is found in treatment and in the constant support provided by AA. But the possibility that an old drug may have a new role to play in this area has to be good news.

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