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**bleep** · March 7, 2011, 11:42 AM

link to the French forum Alcool et baclofène

Thanks a lot Florie - I think the chaps over on your forum will get sick of us quite quickly, but until then, this is fantastic!

**tiptronic_ct** · March 7, 2011, 11:43 AM

link to the French forum Alcool et baclofène

Thanks Florie :l

**Florieanne** · March 7, 2011, 11:48 AM

link to the French forum Alcool et baclofène

Hello Bleep & Tiptronic,

Bleep, they are as eager as you are here to exchange information..:earth::waving:

**bleep** · March 7, 2011, 01:25 PM

link to the French forum Alcool et baclofène

Then let's get to it! I have registered there...

**Florieanne** · March 7, 2011, 01:28 PM

link to the French forum Alcool et baclofène

To Murphyx
2) In the UK doctors appear to be constrained by the authorities to prevent them from prescribing medicines 'off-label' i.e. for the doses and uses other than those which they have been authorised. Is that also the case in France or do French doctors have a greater flexibility with their prescriptions?

It's a little different in France. From what I know the risk of an "off-label" ("hors AMM") prescription is that of being banned from the French Medical Associtation, or rather the fear of it.
Dr De Beaurepaire never fails to recall that prescribing AD to an alcohoolic is "off-label" and many prescriptions are...doctors just don't know it...
The problem with the Bac seems to be that it is an almost shocking piece of news, that it was discovered by an alcohoolic and that many addiction therapists seem to be afraid...of..losing jobs? changing? trying?
Dr De Beaurepaire ( first prescriber in France) has asked the Medical Associtation about the risks and the answer was that he could prescribe baclofen as a "compassionate prescription", that he should write some sort of "contract" between doctor and patient, to be read and signed by the patient, a contract containing the SE, the fact that it was prescribed because the patient had asked for it and and not the other way round ( so as to take the responsibility off the shoulders of the prescriber) and the mention that the patient was not allowed to drive during the first weeks of treatment.

What we usually do and advise is to go to your GP with research & magazine articles and the contract and try to win him or her to your cause. We have a special thread on the forum on "how to convince your GP"...

hope that answered your question. I'll try to get a hand on that contract and translate it if you're interested.
That's all for today

))

**tiptronic_ct** · March 7, 2011, 01:31 PM

link to the French forum Alcool et baclofène

Hey - they have a Tigger shaking his head as an emoticon for "No" - cool

**tiptronic_ct** · March 7, 2011, 01:34 PM

link to the French forum Alcool et baclofène

Florieanne;1071887 wrote: To Murphyx
2) In the UK doctors appear to be constrained by the authorities to prevent them from prescribing medicines 'off-label' i.e. for the doses and uses other than those which they have been authorised. Is that also the case in France or do French doctors have a greater flexibility with their prescriptions?

It's a little different in France. From what I know the risk of an "off-label" ("hors AMM") prescription is that of being banned from the French Medical Associtation, or rather the fear of it.
Dr De Beaurepaire never fails to recall that prescribing AD to an alcohoolic is "off-label" and many prescriptions are...doctors just don't know it...
The problem with the Bac seems to be that it is an almost shocking piece of news, that it was discovered by an alcohoolic and that many addiction therapists seem to be afraid...of..losing jobs? changing? trying?
Dr De Beaurepaire ( first prescriber in France) has asked the Medical Associtation about the risks and the answer was that he could prescribe baclofen as a "compassionate prescription", that he should write some sort of "contract" between doctor and patient, to be read and signed by the patient, a contract containing the SE, the fact that it was prescribed because the patient had asked for it and and not the other way round ( so as to take the responsibility off the shoulders of the prescriber) and the mention that the patient was not allowed to drive during the first weeks of treatment.

What we usually do and advise is to go to your GP with research & magazine articles and the contract and try to win him or her to your cause. We have a special thread on the forum on "how to convince your GP"...

hope that answered your question. I'll try to get a hand on that contract and translate it if you're interested.
That's all for today

))

That is quite diappointing. I think many of us were under the impression that prescribing baclofen for alcoholism was already fairly commonplace in France.

**Florieanne** · March 7, 2011, 02:01 PM

link to the French forum Alcool et baclofène

Hi Tip

Don't get a wrong impression...there are more and more GPs and addiction therapists who prescribe bac...but we do work on it..make lists of the doctors already won to the cause so as to be able to give adresses to new members of the forum...
But there is a lack of prescribers so far, and it's always better to work that issue with your GP for obvious reasons ( knowledge of the patient medical history, trust, etc...)

Florie

**bleep** · March 7, 2011, 02:24 PM

link to the French forum Alcool et baclofène

I think a lot of the posters here actually hide it from their GP's. A few have been laughed out the office. Very few have been fortunate enough to get a doctor who will prescribe.

**redhead77** · March 7, 2011, 03:18 PM

link to the French forum Alcool et baclofène

Florie,

I am so glad you're here. I tried to go on the French forum to research a couple of months ago and I couldn't get the translator thing to work. I'm sure it's just my computer illiteracy that is the problem.

It is very admirable you are trying to translate for us and bridging the gap. I am very excited about all of this. Thanks for taking the time with work and your own battle with SE's.

You rock girl!

P.S. I want some of that French coffee!

**Otter** · March 7, 2011, 04:17 PM

link to the French forum Alcool et baclofène

tiptronic_ct;1071894 wrote: That is quite diappointing. I think many of us were under the impression that prescribing baclofen for alcoholism was already fairly commonplace in France.

The contract is very important. In the UK, and probably the US, and elsewhere, doctors won't go over the guidelines because they fear negligence actions. Patients are supposed to know the risks of procedures and medicines before taking them and if they do not have that information, any consent they give to a procedure or medicine is said to have been obtained without informed consent, making it even easier to sue. It is not a question of the government or regulators saying that Baclofen is not safe over those levels. The medicines reguatory authorities allow prescription off-licence over that amount but doctors just don't have information about the side effects or on dosage so they stay away out of ignorance and fear. That is why a doctor needs to be provided with the information and a disclaimer so the doctor knows how to prescribe, knows the side effects and is legally protected.

Such is the litigation mind set of doctors these days. That is why I put some legal information on my site, because, ultimately, it is going to become negligent NOT to prescribe Baclofen so it is very important to provide doctors with as much information about Baclofen treatment as possible. Hopefully they will then spread the information among their colleagues.
:goodjob:

**Otter** · March 7, 2011, 04:29 PM

link to the French forum Alcool et baclofène

Florieanne;1071887 wrote: To Murphyx
2) In the UK doctors appear to be constrained by the authorities to prevent them from prescribing medicines 'off-label' i.e. for the doses and uses other than those which they have been authorised. Is that also the case in France or do French doctors have a greater flexibility with their prescriptions?

It's a little different in France. From what I know the risk of an "off-label" ("hors AMM") prescription is that of being banned from the French Medical Associtation, or rather the fear of it.
Dr De Beaurepaire never fails to recall that prescribing AD to an alcohoolic is "off-label" and many prescriptions are...doctors just don't know it...
The problem with the Bac seems to be that it is an almost shocking piece of news, that it was discovered by an alcohoolic and that many addiction therapists seem to be afraid...of..losing jobs? changing? trying?
Dr De Beaurepaire ( first prescriber in France) has asked the Medical Associtation about the risks and the answer was that he could prescribe baclofen as a "compassionate prescription", that he should write some sort of "contract" between doctor and patient, to be read and signed by the patient, a contract containing the SE, the fact that it was prescribed because the patient had asked for it and and not the other way round ( so as to take the responsibility off the shoulders of the prescriber) and the mention that the patient was not allowed to drive during the first weeks of treatment.

What we usually do and advise is to go to your GP with research & magazine articles and the contract and try to win him or her to your cause. We have a special thread on the forum on "how to convince your GP"...

hope that answered your question. I'll try to get a hand on that contract and translate it if you're interested.
That's all for today

))

The reason for problems in the UK and US is not that a doctor would lose his job, but might be sued, which might in turn lose him his job.

The contract is very important, as is the information. Doctors can be sued very easily if they fail to give information about side effects. Failing to give information means that the patient has not given "informed consent" to a procedure and the doctor is almost automatically liable for any injury, read side effect, which results. The patient does not have to prove that the doctor fell below an acceptable standard and that the treatment, ie., Baclofen is wrong or incorrect. He only has to show he did not know about the side effects and the doctor has to pay up.

The problem is that doctors don't know how to treat with Baclofen and don't know what the side effects are so they are not prescribing out of ignorance and fear.

It is therefore essential to get as much information to the doctor as possible and the contract which protects him from law suits. Ultimately, if enough doctors get information about Baclofen then they may be negligent in NOT prescribing it.

Maybe we should start a new thread, like on the French site, with advice on how to approach doctors. Once we have the contract we can put all the information on a thread for anyone who wants to go to their doctor. Maybe we can start a movement towards getting doctors prescribing. If they have the information and a contract and still refuse, then it should be possible to sue them for NOT prescribing and allowing patients to remain ill with alcoholism. And, just one instance of a doctor refusing to prescribe and getting a threat of legal action could send a ripple through the medical insurance industry. Hmmm.....
:goodjob:

**TracyA** · March 7, 2011, 04:57 PM

link to the French forum Alcool et baclofène

Otter;1071989 wrote: Maybe we should start a new thread, like on the French site, with advice on how to approach doctors. Once we have the contract we can put all the information on a thread for anyone who wants to go to their doctor.

I don't haven't had much time to read or post today, but saw the above quote.

If it's still possible to get a "sticky" on this site, that would be the one! I'll check into it. And if when people present the rest of the info and also present that contract to a reluctant GP, I bet it would be enough to turn a "no" into a "yes" for a lot of people.

It still wouldn't solve the other "insurance mafia" problems we face in the US, but I'm guessing that it would help a lot of folks.

Florie, thanks again.

**Florieanne** · March 7, 2011, 05:24 PM

link to the French forum Alcool et baclofène

Hi Otter,

Maybe we should start a new thread, like on the French site, with advice on how to approach doctors. Once we have the contract we can put all the information on a thread for anyone who wants to go to their doctor. Maybe we can start a movement towards getting doctors prescribing. If they have the information and a contract and still refuse, then it should be possible to sue them for NOT prescribing and allowing patients to remain ill with alcoholism. And, just one instance of a doctor refusing to prescribe and getting a threat of legal action could send a ripple through the medical insurance industry. Hmmm.....

Well I'm not sure about sueing for not prescribing...though Dr De Beaurepaire has mentionned the fact that it could very well happen in the future in a "letter" published in a specialized medical review Sept. 2010.

Trust between patient and doctor seems essential to me.
I've given a copy of the first French clinical study on bac carried out by Drs O. Ameisen & De Beaurepaire to my GP. He has found the idea & principles very clever, logical.
So may-be by handing that sort of document, written in their own language, and giving them some time to reflect upon it , GPs would less feel like some sort of drug dealers you go hurriedly to to get a drug they've never heard of.

True that our forum is very well-organized as far as threads are concerned.
We have a thread for countries & regions so that people from the same place can get in touch ( exchanges on GPs ' addresses are made through PM)
Another thread on SE, one on the neccesity of psychological work, one on how to reconstruct yourself ( health, food..), another where you can find everything that has been officially published...

Just reflecting that it might be a good idea to translate each of our threads so as to make it easier for you to find you way on our forum.
Florie

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