The ABC interview is great, wish it was longer or on 60 minutes soon. For those that missed the Dr. Ameisen's website link. I am going to post his FAQ here in this thread. Its a bit long but think there is very important information in it.
olivier ameisen responds to questions about baclofen and addiction
Q Medical dogma says that addiction is incurable and that abstinence is the only answer. What has changed?
A There is a generic prescription medicine with a proven safety record, a muscle relaxant called baclofen, that can completely eliminate the symptoms and consequences of addiction and bring rapid, effortless relief to the millions of sufferers from addiction and their families. Baclofen ends the daily struggle to remain abstinent and makes the patient indifferent to alcohol or another addictive substance or behavior. Baclofen produces these results within a few weeks of beginning to take it, and the results do not fade over time.
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Q Is addiction a real disease?
A The consensus of medical science and medical authorities such as the World Health Organization (WHO) and the American Medical Association (AMA) is that addiction is not a problem of willpower or morality, but a biological disease like cancer, diabetes, or heart disease. All drug and nondrug addictions (such as gambling addiction, binge eating, compulsive shopping, and sex addiction) have been shown to produce the same general pattern of imbalanced neurotransmission in the brain.
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Q What makes people vulnerable to addiction?
A Anxiety disorders, mood disorders such as depression, post traumatic stress disorder (PTSD), and impulse and control disorders also produce the same general pattern of imbalanced neurotransmission seen in addiction, and the likeliest explanation of vulnerability to addiction is a preexisting imbalance in neurotransmission from such a disorder. The National Institute of Health’s National Epidemiological Survey on Alcohol and Related Conditions (NESARC) found that “associations between most substance use disorders and independent mood and anxiety disorders were overwhelmingly positive and significant.”
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Q Is taking baclofen substituting one drug for another?
A Baclofen has been confirmed to be non-addictive and non-euphoric. There is no craving for baclofen. Daily use of baclofen for addiction is not substituting one drug for another, but is exactly like daily use of beta blockers for hypertension.
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Q What makes baclofen different from other medications for addiction?
A Other medications at best slightly reduce the symptoms and consequences of addiction. Baclofen can stop them completely.
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Q Does medical science know why baclofen acts differently from other medications for addiction?
A Baclofen is one of only two substances known to affect the GABA-B receptor in the brain, and the only one that is itself non-addictive. Through the GABA-B receptor, baclofen has a beneficial effect on three neurotransmitters — dopamine, glutamate, and GABA — that are part of the brain’s reward system and are involved in all addictive and compulsive behaviors, as well as in disorders such as anxiety and depression. More research is needed to discover exactly how baclofen does this.
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Q What is the evidence for baclofen’s effectiveness against addiction?
A Multiple animal studies have shown that baclofen suppresses the motivation to consume addictive substances at doses in the range of 1 to 5 milligrams per kilogram (2.2 pounds) of body weight. Laboratory animals addicted to alcohol, amphetamine, cocaine, heroin and other opiates, and nicotine lose all interest in them when given baclofen in this dosage range.
I was the first person to transpose these findings to human addiction, completely freeing myself from severe alcoholism as described in my book. Since then, a growing number of patients have found that following the protocol I established for baclofen therapy has completely freed them from their addictions (see below).
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Q Is baclofen safe?
A Baclofen is established as a safe, non-addictive medication with no limiting side effects. It was originally approved by the FDA to treat muscle spasms and similar problems. Neurologists have used it for long term comfort care of both adults and children since the 1960s. A comfort care drug has to meet the highest standard of safety, because you are not trading off the side effects of the drug in order to have a chance of survival from a lethal condition, but simply taking it to improve your quality of life.
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Q Has baclofen been specifically approved for addiction?
A Prescribing baclofen for addiction is what is known as an “off-label” use. Once the FDA has approved a medicine for a specific purpose, physicians can prescribe it off-label for other conditions they think it can help. The AMA says the deciding factor in off-label prescribing is “the best interest of the patient.” Off-label prescriptions are very common. Over 23% of all prescriptions, and over 60% in cancer care, are off-label.
Among the commonly prescribed medications for addiction, topiramate has been approved by the FDA for epilepsy and is prescribed for addiction off-label. Naltrexone has been specifically approved for addiction at a dose of up to 50 milligrams a day, but it is often prescribed at higher doses off-label. Neither medication has been shown to be as effective against addiction as high-dose baclofen.
Prescribing baclofen for addiction is a legitimate off-label use of the medication. According to Markus Heilig, M.D., Ph.D., clinical director of the National Institute on Alcohol Abuse and Alcoholism at the National Institutes of Health (NIH), “there is certainly nothing wrong with physicians prescribing [baclofen] off-label.”
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Q Are there problems getting used to taking baclofen?
A When you first take baclofen or an increased dose, which like all prescription medicines should only be done as prescribed and supervised by a physician, it can make you feel sleepy or induce muscular weakness for a day or two. This passes, and you can then increase the dose again, until you find the level that frees you from craving and other symptoms and consequences of addiction. Based on what I have seen in myself and other patients, temporary sleepiness on baclofen is a sign that the medication is beginning to work. Other side effects may include headache or vertigo. In the majority of patients who have tried high dose baclofen for muscular problems or addiction, the side effects pass in a day or two, and in all cases they are completely reversible. At my maintenance dose I have no side effects.
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Q How much baclofen does a patient need?
A It varies from patient to patient, depending probably on physical size, extent of dependency, and other factors. Studies have shown that animals lose all motivation to consume addictive substances when they are given baclofen in the range of 1 to 5 milligrams per kilogram (2.2 pounds) of body weight.
The evidence from my case and other patients is that the threshold dose needed to break the cycle of addictive craving, preoccupation, and obsessive thoughts is higher than the maintenance dose needed to keep a patient completely free from addiction.
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>Q To stay free from addiction, does a person need to keep taking baclofen?
A Yes, it’s like taking insulin for diabetes or medicines for other chronic conditions like hypertension.
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Q How did you find out about baclofen?
A I was a desperate alcoholic, and my physicians and I thought I was going to die from drinking. A friend who had often heard me say that I suspected my chronic muscular tension and anxiety were connected with my later addiction to alcohol, noticed a story in The New York Times about baclofen, which said that a paraplegic cocaine addict who was taking baclofen to control his muscle spasms complained that the baclofen blunted his cocaine “high,” but that baclofen also limited his craving when he couldn’t get cocaine. The newspaper story set me on a long journey, between binges, to learn more about baclofen. Because the conventional treatments for addiction weren’t helping me – unfortunately, they do not help most people with severe addiction to stop for good – I eventually decided to experiment on myself with baclofen, something I was able to do because I am a physician and could self-prescribe the medication. Through trial and error I found the dose that completely ended my craving for alcohol, and I have been disease-free since then – five years and counting!
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