Baclofen doc in Austin, TX?

[coverto]

Baclofen doc in Austin, TX?

Thanks, Otter and RedThread!!!

Interestingly enough, my gf, who signed up first on mwo looking for help for me, and who started this thread, is a public-interest attorney (gasp!).

We're both successful professionals and know that, unfortunately, pursuing my case could be a sisyphean (pointless) task. I am proverbially "mad as hell and don't want to take it anymore" ...completely pissed off at the status quo we alcoholics are dealt... and yet would not jump into such a thing lightly.

Such a suit would be viewed by many as frivolous, and seen at best serve to further hobble the already short supply of "qualified" psychiatric care we enjoy.

On the other hand, lawsuits of this type are legitimate because they push policy and practice where other branches of government fear to tread.

Finally, it's doubtful an attorney would take my case on speculation. My gf Heather would probably pursue the case if I was dead-set on it, but I'd most certainly be counter-sued and be at risk of having to pay the doctor's attorney fees if I did not prevail. My income is in the same ballpark of the average doctor in private practice, so I don't come to the fight with nothing to lose.

I want to fight the good fight and make a difference. We alcoholics are treated like SHIT everywhere we turn. My doctor refused to continue treatment 100% because of truthful information I volunteered... NOT because of any aberrant behavior. I was abstinent when I began with this doc and I KNEW the risk I was taking in volunteering the truth about my lapse... and my fears were completely born out.

Color me the alcoholic that can't seem to find rock-bottom motivation, and I defiantly resist the status-quo assumption that I need to run over someone while driving or lose my career in order to appreciate the gravity of my condition. I'm a serious alcoholic, and my health is at real risk, even if my behavior is benign.

I can only hope this discussion leads me to pursue some end that is productive for me and all of us who fight addiction. FWIW I've had three coffee mugs full of vodka over ice just over the course of writing this post...

With much affection all around,

M

[Ne/Neva Eva]

Baclofen doc in Austin, TX?

Coverto/M,
OUCH! to the vodka. I'm sorry, friend. I've definitely been there.

Yes to almost everything you've written. It's time for each of us to find an advocate. And the going is WAY too hard given the state of addiction treatment.

That said, I think you said your shrink fired you because you were unwilling to go to detox and he probably has sound medical reasoning for that. Unrelated to your pursuit of baclofen. The threat of legal repercussions is moot simply because s/he can say that she couldn't treat you when you were at grave risk for severe/life threatening withdrawal symptoms.

There are doctors all over the place that are using this. They understandably can't/won't come forward publicly. Imagine how overwhelmed they would be! Still it sucks. It's reprehensible that it is STILL SO DAMN HARD to find someone to treat with high-dose-bac. But the research isn't there and the evidence can be dismissed as anecdotal, for the most part. We know it works, though. Period. It works. No doc needed. (preferred of course, but not needed!)
Keep up the fight! But with eyes on the goal. It's going to be a lot easier for me to find a doc now (after slogging through months of pain!) Maybe with your gfs help you can just start calling doctors until you find one that has actually HEARD of baclofen. bleep did something similar. In the meantime, Dr. L will prescribe while you're getting your wits together to help us ALL bring the message to others who are suffering.
We will change treatment protocol for this disease, one small-town-doc at a time, if needs be.
Hang in there. The view from the other side is pretty spectacular!
xo
K/Ne

[coverto]

Baclofen doc in Austin, TX?

Golden, Neva... and I know you took time to respond and reply to Heather previously. You're certainly right - and not wanting to single out this doc is one of my conflicting motivations.

This forum is the awesome!
:thanks:
:goodjob:

I'm titrating up on Baclofen according to protocol. Just a wee 25 mg/day so far, so my journey has just begun. I KNOW full-well that this community places itself at risk when it advocates self-medication, and I am NOT advocating it, though I'm pleased to find a community advocating a RESPONSIBLE path amidst genuine adversity.

Speaking ONLY for myself, I'm guilty of the arrogance that self-treatment is my best bet. I had a doc give me Topamax a few years ago. 100 mg. pills. Intolerable starting dose for me. I couldn't work - aphasia is a bitch when you're trying to make a living. 30 seconds of Googling will reveal that is 4x the accepted starting dose. I like and respect that doc for doing SOMETHING for me, but I don't think I'm out-of-bounds in thinking MY research and knowledge (read - in no small part what I've learned from you good folks) trumps what is - at best - a crap shoot in finding a sympathetic physician. Hell, we've all presumably read what Ameisen himself went through as a genuine peer in the medical community (!!!).

Cash is not the primary issue for me, but my time and effort is - it is hard to rationalize paying $$$ to interview docs to see if they might even be vaguely open to a treatment protocol I can (RISKILY!) pursue on my own.

For the sake of this community I want to be clear that grey-market self treatment is not a thing to publicly advocate.

At 25 mg. a day (t.i.d. dosing) Baclofen is taking a wonderful edge off my anxiety, but not yet curbing my liter-plus daily consumption of vodka and other drink. It took me many, many years to reach this level of alcoholism (with some solid stretches of abstinence), and Heather and I are committed to many months to a slow and responsible titration of baclofen.

This alcoholism and Baclofen story shouldn't be construed as advice to others. It has only just begun, after all!

M

[Otter]

Baclofen doc in Austin, TX?

Hi all,

I would like to clarify a couple of points.

First, I also agree that self prescribing is not good. All controlled drugs should be taken under the supervision of a doctor. However, there aren't any!!

Secondly, I would not recommend taking anyone to court lightly. You won't get costs awarded against you for making a claim against their insurance policy. You have six years to issue a claim against a professional in most jurisdictions. You would first start with a letter which would be passed on to the doctor's insurer, as he is obliged to do. That alone would trigger an investigation by the insurers into Baclofen treatment for you and for others. Until you actually started court proceedings you would not expose yourself to litigation costs, nor would you ever be countersued as the doctor would have no claim against you.

A doctor who has refused to supervise your medication, knowing that you are self prescribing and could suffer personal injury as a result, is exposing you to risk and is acting negligently.

Most claims under insurance policies settle without court proceedings starting. The cost to the insurer makes it important that they settle claims before they get to court.

What you need is a personal injury lawyer and most of them are contingency lawyers. I don't think any of them would charge you nor would you have any real personal exposure.


I worked in insurance and the way it works is this: They would get a letter making a claim. They make an investigation and then they are bound by law to set what is called a "reserve". That means they set up in their accounts a notional fund to settle your claim should you decide to sue their insured doctor. More or less automatically, as soon as you make a claim there is a pot of money sitting waiting for you to collect it. It also sets in motion directives to other doctors in relation to prescribing. In this case, I would expect that there would be some concern that doctors are using "dirty" drugs, ie., drugs that are actually ineffective against alcoholism, or dangerous, in relation to Baclofen. Antabuse springs to mind. Putting a claim in against a doctor is the most effective way of changing medical practice. Insurance companies are not in the business of taking a "stand" against a new treatment. They just look at the infomation and assess the risk.

Reporting the matter to a public medical examiner is just going to get a typical response that Baclofen has not been double blind trialed, yada, yada, yada.

You might get the same answer from an insurance company but it would just be bluster to divert your attention from the plain fact that they have put money aside to pay you if you should pursue your claim.

That is what is so great about personal injury litigation.

There was some guy who was paid money by an insurance company because he drove his Winnibago off the road. He thought, because it had cruise control and a kitchen that he could get up and make a cup of coffee while driving down the road at 60 mph. He succeeded because he had not been warned not to leave the driver's seat.

So, why is suing a doctor for refusing treatment when you could die as a result something you would not consider worth at least writing a letter about? You have already suffered injury to your body by way of stress and drinking when you could be reducing your consumption with correct medication...and there is plenty of advice on this site alone and information, including from doctors, about correct prescription. You can get a medico-legal report to support your claim from experienced doctors who treat with Baclofen.

Doctors have a duty to treat so I cannot see how it would result in them not treating. The opposite is more likely.

[Otter]

Baclofen doc in Austin, TX?

neva eva;1062664 wrote: Coverto/M,
OUCH! to the vodka. I'm sorry, friend. I've definitely been there.

Yes to almost everything you've written. It's time for each of us to find an advocate. And the going is WAY too hard given the state of addiction treatment.

That said, I think you said your shrink fired you because you were unwilling to go to detox and he probably has sound medical reasoning for that. Unrelated to your pursuit of baclofen. The threat of legal repercussions is moot simply because s/he can say that she couldn't treat you when you were at grave risk for severe/life threatening withdrawal symptoms.

There are doctors all over the place that are using this. They understandably can't/won't come forward publicly. Imagine how overwhelmed they would be! Still it sucks. It's reprehensible that it is STILL SO DAMN HARD to find someone to treat with high-dose-bac. But the research isn't there and the evidence can be dismissed as anecdotal, for the most part. We know it works, though. Period. It works. No doc needed. (preferred of course, but not needed!)
Keep up the fight! But with eyes on the goal. It's going to be a lot easier for me to find a doc now (after slogging through months of pain!) Maybe with your gfs help you can just start calling doctors until you find one that has actually HEARD of baclofen. bleep did something similar. In the meantime, Dr. L will prescribe while you're getting your wits together to help us ALL bring the message to others who are suffering.
We will change treatment protocol for this disease, one small-town-doc at a time, if needs be.
Hang in there. The view from the other side is pretty spectacular!
xo
K/Ne

Yes, except that there are now two studies which show that Baclofen can be used to avoid these withdrawal sypmtoms. The Italian and recent Minnesota studies. And, I hasten to remind everyone, Paul's story on the Dosage and Frequency thread.

So why should someone submit to an outdated and useless "detox" which rarely works, involves outdated, obsolete, dangerous and useless drugs and a lot of ineffective talk therapy at great cost and potential loss of employment etc.

This goes beyond negligence. By putting a person in the position that they are refused treatment unless they undergo some expensive and useless procedure rather than having a medication which is used by Harvard University's Addictions Hospital and has been shown to work in real life, and is something the patient is insisting on, doctors are engaging in degrading treatment which is prohibited under the UN Convention on Human Rights.

It is that bad.

[coverto]

Baclofen doc in Austin, TX?

Hey Otter,

Thanks for weighing in. I discussed this briefly with Heather and she doesn't think the case would have enough merit to make anyone flinch. I'm no expert in law or insurance, but I'll take it on faith you are both correct and the devil lies somewhere in the details.

I'm not the least surprised the doc refused to prescribe baclofen. I think if anything he's more negligent for presiding over my unsupervised discontinuation of Pristiq (desvenlafaxine), given to me at a dose 2x of that recommended in the PI sheet... =/

Desvenlafaxine has a suspicious number of anecdotal reports for actually POTENTIATING alcohol abuse, incidentally. Double =/

Not to knock off-label dosage or application (under which doctors may prescribe us baclofen) but dismissing a patient on a high dosage of a drug with withdrawal issues? Triple =/

Oy.

[Otter]

Baclofen doc in Austin, TX?

Hi

I am not saying you are going to get a huge amount of money or that you should do it for money.

I am a lawyer and began my career in professional negligence work, including claims against doctors. It is not about making anyone flinch. Insurance companies operate by raising premiums based upon the risk they face. If they fail to assess their risks, they themselves risk a shortfall. It is a clinical business of assessing risk based on the information they have.

Of course, you would need to find a doctor to prescribe Baclofen and get well so it is not a matter of rifling off a letter tomorrow but once all that is in the works you may look back and feel that it is something worth doing for the sake of changing how doctors prescribe.

Unfortunately, I am now in the position of having to get medico-legal reports on Baclofen and am putting various people on notice of potential claims against them over the treatment of my wife. It is not a pleasant thing but I absolutely will not live the rest of my life or let my family live under the stigma this illness brings when there is now a very effective cure.

Why should doctors be allowed to get away with this? Medical treatment is a basic human right and they hold a monopoly on prescription. What right do any of them have to refuse you a treatment which is working for other people because they refuse to educate themselves or "believe" that people are getting well. There are very prominent doctors all over the world now engaging in this therapy.

[Ne/Neva Eva]

Baclofen doc in Austin, TX?

I have spent a considerable amount of time wondering what it is that you do for a living, Otter. Really. Should've just asked you! :H
I'm about to hijack. Sorry.
[Otter, the following is an intellectual (or what passes for it in my mind) argument. That said, I am not insensitive to your frustration or the horrors that your wife has been through. (It is beyond imagination and endurance, and I know you know that you both are in my thoughts.)]

I am very intrigued by what you've written here, Otter.
There has to be something about 'standard operating procedure' in the law that protects doctors, and patients, too. That would mean that if someone is in danger of severe withdrawal symptoms they need to be medically supervised, for instance.
And though we consider other things obsolete in the treatment of alcoholism, and could make a good argument for that, they are still the standard for care.
A lot like court-ordered AA treatment for a drunk driving offense. Even the die-hard AAers know that the chances for recovery aren't very good!

Even now alcoholism is considered incurable and untreatable. Again, for good reason. In order to change that, well, wow! Wasn't homosexuality listed in the DSM until relatively recently? If I remember correctly it was a psychiatrist on the board (or something) that came out of the closet. It's a great story.
But to the point: Alcoholism is (EDIT: considered) a mental illness. Not a disease. (which we know it is) That transition may take generations, but hopefully there will be a lot of ALkies treated with high-dose-bac in the intervening years.

I wonder, though, if you're not on to something about the insurance companies. For instance, mine doesn't cover the cost of high dose bac, or treatment with it, at all for this purpose. I am loathe to tell them why I need it, but could they deny it? Alcoholism is all over MY permanent records so I'm not particularly concerned about keeping anything off of the radar.
Is that one way to approach getting some sort of recognition for bac treatment? Or something similar without the necessity of being turned down for bac treatment in a dire emergency, similar to what c0ffee went through?
I think you started a thread that was hijacked some months back, maybe we can revive that and take this off of poor coverto's thread.
He just started bac and is going to need the space!
:H

:goodjob: coverto. Keep it coming! yippppeeeee!
I logged on this evening specifically to revive an old thread on titration, specifically for you. In my experience going too slow, especially at low doses, was really detrimental.
Can't wait to hear more about your ride!
K/Ne
Also wanted to say that I promised Heather bac in the beginning of this thread that I would put some links up. I then realized that it would just compound the frustration because they were about shitty-doctor experiences. Including one asshole who went through treatment for drug/AL after it was discovered that he was stealing drugs from the people he was treating in a public meth clinic where he was the director. Whose shrink said he was a megalomaniacal nut-case in the hearing where he DID NOT lose his license to practice. A man I had an appt. with the week I uncovered that stuff. I LOVE the internet. In a moment of clarity, I figured you two didn't need more angst. It still makes me angry enough to do ... well, something awful.
:l

[bleep]

Baclofen doc in Austin, TX?

Coverto, when I suggested this, it wasn't actually to take it to court, it was just to give that asshole of a doctor something to ruin his wa with. Let him have a sleepless night for a change, maybe it will drive him to drink!

On those grounds, I'd still do it. Or the alternative - get well pissed and write a loony, nut-case type letter vaguely but not directly threatening. Include his car registration number, try come across as a deranged psychopath. Just something to make him look over his shoulder!

No follow through on either of them, just a bit of good ol' fashioned psychological warfare...

"Everyday your daughter goes to piano recital at half past three..."

Might be fun.