Debating, Debating...Antabuse or Baclofen?
I know that meds can be very difficult to obtain from some doctors, but concerning the Antabuse or baclofen question, I think both could be used at the same time, at least at the beginning. That is what I am planning, now that I'm in touch with an addiction specialist who admits there is evidence for high-dose baclofen treatment.
In my own experience, even though Antabuse doesn't reduce the direct cravings, it can be valuable in stopping internal mental anguish caused by the fight between the part of me that wants to be sober and the part that wants to drink. I don't have cravings for alcohol until late afternoon or evening, so taking Antabuse in the past (during the morning) has allowed me to get some sober time. It has stopped that internal mind debate about whether to drink or not at night, and stops all the excuse-making my "drinking side" makes up to over-ride my decisions not to drink. There is no point making excuses to drink or having an internal mind debate when you know you simply cannot drink. However, I must also point out that this has only ever been a short-term, intermediate step, between the end of detox and the start of other treatment. Taking Antabuse and doing nothing else is likely to just cause desperation and craving to build up over days or weeks like rising pressure in a gas cylinder, until a person can't stand it and deliberately stops taking the Antabuse so they can drink again after a week or so. I have found myself so desperate while on Antabuse that I have smoked cannabis at night for emotional relief, even though I don't normally use it. I have considered hard drugs for relief, even though I never take any of them. I have used prescription drugs, and even drank once after only having quit Antabuse for 3 days.
When used with baclofen, however, the situation could be very different. The Antabuse could prevent impulsive drinking while waiting for the baclofen dose to increase enough to start reducing alcohol cravings. The promise of strong anti-craving effects from the baclofen could prevent the urge to give up on the Antabuse. And taking Antabuse would allow the baclofen to be taken while completely alcohol-free, avoiding any potential interactions between alcohol and baclofen, and maybe also allowing the effects of baclofen to be felt and appreciated more than if it was being used with alcohol still in the system. Maybe baclofen could actually work better at a lower dose than when taken while still drinking??
Of course, to do this would require admittance to a detoxification facility or an outpatient detox program, which usually means taking a benzodiazepine for a week or so, usually at a high dose to begin with. Just suddenly stopping alcohol is very dangerous for anyone who drinks on a daily basis at a substantial daily intake, as I'm sure everyone knows (I'm just pointing it out again to ensure my post is responsible...I'm not trying to sound like a know-it-all). Of course baclofen itself has been used as a detox drug instead of benzos, but I can't recommend do-it-yourself home detox. In my own case, if I actually get prescribed high-dose baclofen and Antabuse from the specialist I've been in touch with, I still intend to undertake detox using a benzodiazepine (diazepam aka Valium is the one normally used here in Australia) either as an inpatient or a fully-supervised outpatient. Only after the detox will I start the baclofen and titrate it upwards (as fast I can handle, by the way). The Antabuse could be started even during the detox.
As baclofen dosage is increased and real anti-craving effects are experienced, to the point of not wanting to drink at all or feeling able to resist urges to drink, the Antabuse could be discontinued altogether, carried as an emergency drug to be taken immediately if a serious urge to drink was noticed, or just continued to be taken as a back-up. If discontinued, and a return to drinking happened despite baclofen being effective, then the Antabuse could be restarted again as a back-up against urges as soon as the latest alcohol was out of the body.
Anyway this is my plan, after trying baclofen up to 75 mg per day without success, and also having tried Antabuse without a reliable long-term anti-craving solution. If all goes well with the latest specialist I will post my results at some stage in the future.
Sorry for the long post. I hope it has been of some help.
I know that meds can be very difficult to obtain from some doctors, but concerning the Antabuse or baclofen question, I think both could be used at the same time, at least at the beginning. That is what I am planning, now that I'm in touch with an addiction specialist who admits there is evidence for high-dose baclofen treatment.
In my own experience, even though Antabuse doesn't reduce the direct cravings, it can be valuable in stopping internal mental anguish caused by the fight between the part of me that wants to be sober and the part that wants to drink. I don't have cravings for alcohol until late afternoon or evening, so taking Antabuse in the past (during the morning) has allowed me to get some sober time. It has stopped that internal mind debate about whether to drink or not at night, and stops all the excuse-making my "drinking side" makes up to over-ride my decisions not to drink. There is no point making excuses to drink or having an internal mind debate when you know you simply cannot drink. However, I must also point out that this has only ever been a short-term, intermediate step, between the end of detox and the start of other treatment. Taking Antabuse and doing nothing else is likely to just cause desperation and craving to build up over days or weeks like rising pressure in a gas cylinder, until a person can't stand it and deliberately stops taking the Antabuse so they can drink again after a week or so. I have found myself so desperate while on Antabuse that I have smoked cannabis at night for emotional relief, even though I don't normally use it. I have considered hard drugs for relief, even though I never take any of them. I have used prescription drugs, and even drank once after only having quit Antabuse for 3 days.
When used with baclofen, however, the situation could be very different. The Antabuse could prevent impulsive drinking while waiting for the baclofen dose to increase enough to start reducing alcohol cravings. The promise of strong anti-craving effects from the baclofen could prevent the urge to give up on the Antabuse. And taking Antabuse would allow the baclofen to be taken while completely alcohol-free, avoiding any potential interactions between alcohol and baclofen, and maybe also allowing the effects of baclofen to be felt and appreciated more than if it was being used with alcohol still in the system. Maybe baclofen could actually work better at a lower dose than when taken while still drinking??
Of course, to do this would require admittance to a detoxification facility or an outpatient detox program, which usually means taking a benzodiazepine for a week or so, usually at a high dose to begin with. Just suddenly stopping alcohol is very dangerous for anyone who drinks on a daily basis at a substantial daily intake, as I'm sure everyone knows (I'm just pointing it out again to ensure my post is responsible...I'm not trying to sound like a know-it-all). Of course baclofen itself has been used as a detox drug instead of benzos, but I can't recommend do-it-yourself home detox. In my own case, if I actually get prescribed high-dose baclofen and Antabuse from the specialist I've been in touch with, I still intend to undertake detox using a benzodiazepine (diazepam aka Valium is the one normally used here in Australia) either as an inpatient or a fully-supervised outpatient. Only after the detox will I start the baclofen and titrate it upwards (as fast I can handle, by the way). The Antabuse could be started even during the detox.
As baclofen dosage is increased and real anti-craving effects are experienced, to the point of not wanting to drink at all or feeling able to resist urges to drink, the Antabuse could be discontinued altogether, carried as an emergency drug to be taken immediately if a serious urge to drink was noticed, or just continued to be taken as a back-up. If discontinued, and a return to drinking happened despite baclofen being effective, then the Antabuse could be restarted again as a back-up against urges as soon as the latest alcohol was out of the body.
Anyway this is my plan, after trying baclofen up to 75 mg per day without success, and also having tried Antabuse without a reliable long-term anti-craving solution. If all goes well with the latest specialist I will post my results at some stage in the future.
Sorry for the long post. I hope it has been of some help.
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