Baclomania: The Cult Of A Cure For Alcoholism - Page 2

By Benjamin Plackett 03/24/14

Could a cure for one of the most destructive addictions have been lying dormant on the shelves of the FDA?

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Rolland is right, the story does revolve around Ameisen, you can’t talk to anyone about baclofen and alcoholism without his name popping up at some point—and everyone has their opinions about him. 

Some are grateful and admire his courage; “He absolutely deserves a Nobel Prize for his work, he tested the drug on himself!” says Dr. Fred Levin, a Chicago based physician who prescribes baclofen.

Others are less certain of the value that Ameisen can bring to the baclofen debate. “Sometimes he speaks like a physician and other times like a patient,” says Rolland, “We don’t know if he’s a lobbyist or a scientist.” 

Ameisen says that his past experiences as an alcoholic and a baclofen pioneer make him all the more qualified to speak on the matter because “it is very degrading for a patient to hear 'I understand what you are going through' from a non-alcoholic,” he says.

WHERE IT CAME FROM

In reality, the story began before Ameisen put pen to prescription pad 12 years ago; it began with a researcher called Dr. Dave Roberts in a Carleton University lab during the late 90s. Roberts says it was a student of his who suggested they look into the possibility that baclofen might help fight addiction, but he says they “had no theoretical axe to grind, we were just throwing all the drugs in the cabinet at the problem to see what might work.”

They realized they had hit something with their stab in the dark when they started to test the effects of baclofen in cocaine addicted mice. The mice on baclofen no longer had the drive to seek out a hit of cocaine compared to the mice not given a dose of baclofen. 

It was after reading Roberts’ research that Ameisen decided in his desperation to give baclofen a try. “I tried every medication on the market and found that they didn’t work at all. I chose myself as a guinea pig because I knew I was going to die,” he says.  

The French trial is expected to come to a conclusion in early June of this year, but it could be significantly longer before its results are known. In the mean time, a number of doctors in the U.S. are prescribing baclofen to alcoholism sufferers. Levin says that each day his phone rings with new people asking him to write a baclofen prescription and he accepts almost all of them. “This isn’t something that I hesitate to prescribe, you have to give [patients] the opportunity,” he says. Levin adds that his success rate with baclofen is extremely high, “if you’d had the experience that I have, you wouldn’t refuse baclofen.”

It takes Levin about two to three months to find the right dose for each patient, gradually increasing the prescription until the patient no longer has a desire to drink. 

Willenbring doesn’t see the point in requesting a label change. “More drugs in the U.S. are prescribed ‘off-label’ than for FDA indications … so FDA indication is largely meaningless in terms of what doctors prescribe,” he says. 

He’d be right if there were a large number of doctors in the U.S. prescribing off-label baclofen. But there isn’t, they’re just a handful in reality, and a label change would almost certainly empower patients to inquire about baclofen therapy. Online message boards are a flurry with recovering alcoholics offering each other tips on how to get hold of baclofen and how to get your doctor to consider writing a prescription. 

Fields says that it isn’t easy to convince a physician in the U.S. to prescribe baclofen for alcoholism and it took her some time to find one who was willing to help her. This difficulty has driven alcoholism suffers, through their desperation, to buy baclofen online rather than seek a legitimate prescription from a physician. 

Fields is a somewhat active member of one of the online message boards, which lists the contact details of physicians who are known to prescribe the drug as well as websites where you can illegally buy baclofen without a prescription. She says that she begun her baclofen treatment with pills she bought online and self medicated before finding a doctor that wrote her an off label-prescription. “I’ve never heard of anyone complaining that the baclofen they ordered online wasn’t good,” she says. But clinicians and experts universally and strongly advise against buying online. Gardner says that you never really know what you’re getting: “They could be sugar pills or worse, something sinister.”

Where’s all this going? What function will the clinical trials present if there isn’t going to be a label change by the FDA? They would tell us a little more about the safety of the drug, and more comprehensively prove or disprove that baclofen works as an addiction treatment. 

“My end goal is for any doctor to treat alcoholism with baclofen in the same way they treat other diseases with drugs,” says Ameisen. Other experts are less optimistic and think there remains a huge distance to travel to reach Ameisen’s end goal.  

“Where we are right now is like where we were 60 years ago with depression,” says Willenbring—comparing depression patients, who were institutionalized, with alcoholism patients who are today sent to rehab. 

“What’s going to be the Prozac moment for alcohol dependence?” Willenbring asks, unable to answer. But, he predicts that the way we treat alcoholism is going to look radically different within a decade, and he thinks drugs like baclofen are needed to bring about that change. “We need to change the addiction treatment system to one of science rather than ideology,” he says, adding that the “time is ripe” for such a change.

Benjamin Plackett is a New York based science and health journalist. His work has appeared in Wired, CNN and Business Insider.

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Benjamin Plackett is a New York based science and health journalist. He especially enjoys covering moral quandaries within the world of research. His work has appeared in Wired, CNN and Business Insider. Benjamin holds a B.Sci in biology from Imperial College, London and an M.A. in journalism from New York University. Benjamin can be found on Linkedin and Twitter.