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    A recent conversation with my doctor....

    I received a blessing early in my bac journey. I found an extremely open minded addictionologist in a nearby city. He had actually been prescribing low dose bac to cocaine addicts for numerous years, so he was familiar with it.

    I took all my research material, including a copy of Dr. A’s book, and made my sales pitch. He agreed to allow me to be his first “high dose” patient, as long as I coupled the medication with some type of counseling or 12 step program. He was really intrigued by the possibilities of bac.

    Earlier this week I went in for my monthly consult. My doctor had done quite a bit of research on bac since my last visit. He had been in contact with the research institutions on both the west and east coasts who use or had studied bac. He had contacted many of his contemporaries, who are also board certified in addiction medicine.

    I wanted to share what he told me with ya’ll. Most of this has already been said throughout this forum. A little of it might be new. But I think it is important because it comes from an objective member of the medical profession. Here it is:

    1. In the fight against addiction, bac is one of the most “individualized” medications there is. Some people get its full benefit at low doses and others at much higher doses. There is no rhyme or reason as to why it works this way. I asked him if it depended on “genetics” and “chemistry”. He laughed and said when a doctor mentions “genetics” and “chemistry”, he is really saying, “I don’t know”.

    2. The fact that bac is so “individualized” is the reason a lot of the addiction medicine community shy away from it. Some docs are lazy and want to write easy, run-of-the-mill scripts. To prescribe bac the right way you have to be diligent and disciplined. You have to really take time with your patients, especially when you are titrating down and trying to determine the maintenance dose.

    3. He would never be comfortable with any of his patients going over 300 mgs a day.

    4. We should be able to come completely off bac after 24 months at the most. It is not a lifetime thing.

    5. To be completely effective, some type of counseling or therapy should be incorporated into the treatment. In and of itself, bac is not a cure.

    6. Bac works for most alcoholics and almost all stimulant addicts.

    I am not holding this out as the gospel truth, I am merely sharing with you what my doctor said. He came to these conclusions after doing his own research and consulting his colleagues. We already knew about #1. I found #2 interesting, and 3-5 are the subjects of great debate.
    Look at a stone cutter hammering away at his rock, perhaps a hundred times without as much as a crack showing in it. Yet at the hundred-and-first blow it will split in two, and I know it was not the last blow that did it, but all that had gone before.
    - Jacob August Riis

    #2
    A recent conversation with my doctor....

    Interesting stuff. How many patients is he treating with baclofen? It sounds like there is at least some consensus position among this group of doctors. Do they have any written guidlines they follow?

    I agree that Bac won't help in the absence of motivation but am not sure that extensive counselling is required. I believe that part is individualized as well. It could be self serving to say their patient must return regularly for follow up visits. Part of the problem is that this is so new and all. No one really knows with authority and each case is so different.

    I will keep my options open with respect how long to take it. I reserve the right to take it indefinitely at my maintenance dose or higher should the need arise. I have come too far to let someone yank that rug out from under me without solid research backing it up.
    Thanks for the information.
    S

    Comment


      #3
      A recent conversation with my doctor....

      Thanks for this Pbar, you are lucky to have found such a thinking doc.

      Did he give reasons why someone wouldn't want to remain on baclofen for more than 2 years? The "individualized" bit's I am in complete agreement with, just take a look at the various posters here! Nobody has had the same journey as anyone else.

      Also, did you ask him why he wouldn't go over 300mg's? It's just a number. What specifically was he afraid of?

      Comment


        #4
        A recent conversation with my doctor....

        Thanks for the info Pbare. You are lucky to have a thinking doctor!

        Sunny I agree with you about the counseling, but I wonder if that is his way of addressing the fact that people need to change their habits. For long term alkies such as myself, the habit can be so ingrained it is a challenge to replace the habit. So far I am having enough success dealing with the habit part but if that changes I wouldn't hesitate to seek counseling. Plus as somebody else recently pointed out if mental instability was what drove someone into alcoholism then imo counseling would still be needed to address those issues. And then there are the lucky ones who are so grateful not to be drunk anymore that the desire to never be there again is motivation enough.

        Pbare can you tell me where you are in this journey with bac? I'm also interested to hear your doctors thoughts along the way.

        Comment


          #5
          A recent conversation with my doctor....

          Pbar

          He is right about it being individualized. The reason for this is that everyone metabolizes medication at a different rate and eliminates it at a different rate. It is very tricky getting it right which is part of the reason why doctors don't want to prescribe it, apart from just not knowing about it.

          I have a funny feeling that OA is trying to find out whether he can come off it altogether which is possibly why he is down to 20 mg a day.

          I think this forum is a far superior form of "counselling". Far better than AA. I feel a thread coming on...
          BACLOFENISTA

          baclofenuk.com

          http://www.theendofmyaddiction.org





          Olivier Ameisen

          In addiction, suppression of symptoms should suppress the disease altogether since addiction is, as he observed, a "symptom-driven disease". Of all "anticraving medications used in animals, only one - baclofen - has the unique property of suppressing the motivation to consume cocaine, heroin, alcohol, nicotine and d-amphetamine"

          Comment


            #6
            A recent conversation with my doctor....

            I am not against counselling. Just saying it needs to be based on individual needs and goals rather than a blanket prescription for all. For me after years of counselling I continued to drink addictively. It was only the baclofen that allowed me to reach my goal of abstinence. Once there the counselling was unnecessary and superfluous.
            All the best
            Sunny

            Comment


              #7
              A recent conversation with my doctor....

              Just to reiterate, I was my doctor's first "high dose" patient. He knew very little about it. But he was diligent enough to get on the phone and consult with other experienced docs, so those six points are the consensus opinion of the docs he talked to.

              bleep, I don't know why the docs picked 300 as a ceiling. That number was mentioned in OA's book as well. If the docs had the opportunity to talk to someone like you, who has scaled the rugged heights of Mount Bacmore, they might change their mind. But I think they are loathe to take chances with the brain.

              As for coming off of bac after two years, I sent my doc an e-mail asking specifically why that is so. In my visit with him, he just told me by that time my brain would have "cooled off". I will post his answer when I get it.

              I think Chi is spot on about the reason they suggest counselling. At least for me, there were some underlying issues that drove me to abuse drugs, aside from the fact I liked getting high. Most alkies and addicts are that way. That is probably the reason for the blanket prescription, SV.

              In answer to you question Chi, I have been on bac for 100 days today. And I have been clean and sober the whole time.

              I started at 20 and went to 280 before coming back down. Initially, I used the thrice daily dosing method in OA's book. But I switched to the "bleep method" around 200, and continue to use that today. I am at 120 now, and will stay here for awhile. If the cravings return, I will go back up pronto. If they continue to stay gone, I might drop down a bit. I would really love to be at 80 mgs.
              Look at a stone cutter hammering away at his rock, perhaps a hundred times without as much as a crack showing in it. Yet at the hundred-and-first blow it will split in two, and I know it was not the last blow that did it, but all that had gone before.
              - Jacob August Riis

              Comment


                #8
                A recent conversation with my doctor....

                Otter;1093570 wrote:
                I think this forum is a far superior form of "counselling". Far better than AA. I feel a thread coming on...
                Sometimes it reminds of one!
                Look at a stone cutter hammering away at his rock, perhaps a hundred times without as much as a crack showing in it. Yet at the hundred-and-first blow it will split in two, and I know it was not the last blow that did it, but all that had gone before.
                - Jacob August Riis

                Comment


                  #9
                  A recent conversation with my doctor....

                  Thanks for getting back to us. I'd like to reiterate again what a good doctor you seem to have.

                  Personally, i think each person's limit should be where they find indifference, at least until they can point to a specific health risk from taking high doses. The brain "cooling down" theory after 2 years sounds good to me, if for no other reason than it would be nice to not have take medication for the rest of my life.

                  As to counseling, I think it's probably a good idea, and certainly can't hurt. I've started to give this area a lot of thought recently - why did I choose to get drunk so much in the beginning? Unfortunately, the best answer I have managed to come up with is simply that I really, really enjoyed it. It made me feel complete. I don't think those motivations would respond well to counseling!

                  Comment


                    #10
                    A recent conversation with my doctor....

                    I'm glad you have such a cool doc. It's thought, by a small sample size of course, that family members seem to hit the switch around the same dose. That's where the genetic thing comes from. Of course, most of us are the first people to try this in our family. As we know alcoholism is genetic, and as baclofen becomes more mainstream, it will be interesting to see if it's true.
                    This Princess Saved Herself

                    Comment


                      #11
                      A recent conversation with my doctor....

                      bleep;1093768 wrote: Thanks for getting back to us. I'd like to reiterate again what a good doctor you seem to have.

                      Personally, i think each person's limit should be where they find indifference, at least until they can point to a specific health risk from taking high doses. The brain "cooling down" theory after 2 years sounds good to me, if for no other reason than it would be nice to not have take medication for the rest of my life.

                      As to counseling, I think it's probably a good idea, and certainly can't hurt. I've started to give this area a lot of thought recently - why did I choose to get drunk so much in the beginning? Unfortunately, the best answer I have managed to come up with is simply that I really, really enjoyed it. It made me feel complete. I don't think those motivations would respond well to counseling!
                      bleep I hear you. I too thought drinking was really, really fun. I didn't have to be having a hard time to want to drink. The part I couldn't understand was why I couldn't stop. Drinking to the point of passing out wasn't "fun" but that became the goal, that's when I knew it was warped, knew I had a problem. I think that may be where genetics can come in and that whole alcoholic profile. To me that is what CRAVING is. To be shit faced drunk and still wanting another one.

                      Do this long enough and even if life didn't start out dysfunctional, it gets dysfunctional. We all know this.

                      That is why baclofen has worked for me. It affects an area of my brain that I think was problematic to begin with. If only baclofen would have been around as a treatment years ago when I knew I was drinking too much, but did it anyway....

                      Oh well, thanks to OA it is here now. That is the main thing.

                      Comment


                        #12
                        A recent conversation with my doctor....

                        Hi Pharb Lucky you to find such a supportive doctor. As for the therapy bit I wont go to AA for my own reasons but I have started going to SMART groups and find them really helpful and I also have started going to CBT therapy which my doctor referred me to and I get on the NHS here in the UK, and Im finding that to be ok, so far Im working on my anxiety and panic there and she just gives me advice, most of it I already know but going once every 2 weeks is helping keep me on track and also I go so as not to be seen refusing treatment off my doctor.

                        Comment

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