Baclofen Works - New study results!!!!!!

[Otter]

Baclofen Works - New study results!!!!!!

Cass,

I don't know what the figures mean. I sent the results to the UK Department of Health and got an answer which was typically political. Yes they know about Baclofen and doctors should also find out about it through self study. The growth of Baclofen as a treatment would appear to be in the lap of the Gods. At least here is some sort of government acknowledgement of the treatment which one could take to a doctor, together with the study results to show that it is right for a doctor to prescribe.

Here is the response:


Thank you for your recent email to the Home Office about the use of Baclofen in treating alcohol dependence. As this is a health-related matter, your email has been transferred to the Department of Health for reply.

Thank you for providing the summary of the results of the recent Greater Glasgow and Clyde NHS research study, whose authors do report positive and very interesting results, and recommend further study using a prospective design.

The Department is aware of the developing evidence on Baclofen. This emerging evidence is discussed in the guideline published by the National Institute for Health and Clinical Excellence, 'Alcohol use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence'. The guideline is available to NHS organisations and clinicians.

It is certainly true that the developing evidence on Baclofen has not lead to its use in routine clinical practice to date. It is important that any potentially valuable new treatments are always carefully considered. It may be helpful to confirm that clinical decisions on the most appropriate treatment for an individual lie with the treating clinician in discussion with their patient. Clinicians are able to prescribe Baclofen if they consider the evidence justifies this.

NHS organisations have systems of clinical governance aimed at supporting clinicians to deliver good clinical practice that is appropriately responsive to the changing evidence base. Doctors are required by the General Medical Council to engage in continuing professional development, which includes keeping up-to-date with the evidence in relation to their own practice.

I can assure you that the Department supports the prevention of alcohol dependence and recognises the important need to continue to improve treatment for alcohol dependence throughout England .

Yours sincerely,

Edward Corbett
Customer Service Centre
Department of Health


It is increasingly difficult for any medical professional to ignore this given the status of the people involved in the study.

[Cassander]

Baclofen Works - New study results!!!!!!

Hi Otter

Wow, there is a lot of bureaucratic double-speak there. I thought only Americans could torture the mother tongue beyond comprehension. But I think the bottom line is that he is saying that

1 There is good evidence that baclofen works.
2 Doctors are required by the rules of good clinical practice to consider new evidence of better treatments.
3 So long as the treatment is carefully considered by the clinician and discussed with the patient,
4 The clinician may prescribe Baclofen.

I agree with you that a doctor who is approached by a patient with this conclusion in hand asking to be treated with baclofen would have a hard time turning the patient down.


Just for the fun of it, I have re-written his letter in "plain English" to say clearly what I think he tried to say:

Thank you for your recent email, which has been transferred to the Department of Health for reply. We understand that the recent Greater Glasgow and Clyde NHS research study reports positive and very interesting results for the treatment of alcoholism with the drug baclofen.

We are aware of the developing evidence on Baclofen. This evidence is discussed in the guideline 'Alcohol use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence', published by the National Institute for Health and Clinical Excellence and available to all NHS organisations and clinicians.

We acknowledge that the developing evidence on Baclofen has not lead to its use in routine clinical practice to date. We note that any new treatment, no matter how potentially valuable, must be carefully considered before being broadly adopted. Also, we note that all decisions on appropriate treatment for an individual lie with the treating clinician in discussion with his or her patient.

Nevertheless, our clinical governance systems require the delivery of good clinical practice appropriately responsive to changing evidence. Doctors are required by the General Medical Council to engage in continuing professional development, which includes keeping up-to-date with the relevant evidence. Clinicians are able to prescribe Baclofen if they consider the evidence justifies this.

I can assure you that the Department supports the prevention of alcohol dependence and recognises the important need to continue to improve treatment for alcohol dependence throughout England.


What do you think?

Cass

[Cassander]

Baclofen Works - New study results!!!!!!

Otter:

I went and looked at the guideline for 'Alcohol use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence', published by the National Institute for Health and Clinical Excellence. Here's a link:

http://www.nice.org.uk/nicemedia/liv...3190/53190.pdf

It is true that baclofen is discussed, but the Greater Glasgow and Clyde NHS research study is not mentioned (yet). The guidelines suggest that there is limited and inconclusive evidence of the efficacy for baclofen (see p. 423). So I am not sure that Corbett's response is all that helpful in persuading a clinician to prescribe baclofen. A clinician still has to do a bunch of work on his own to get there.

Cass

[Otter]

Baclofen Works - New study results!!!!!!

Cassander;1203482 wrote: Otter:

So I am not sure that Corbett's response is all that helpful in persuading a clinician to prescribe baclofen. A clinician still has to do a bunch of work on his own to get there.

Cass

No, it is just a nonsense response. It suggests a laissez faire attitude towards a major health issue. Since there are no clinicians as such who deal with alcoholism there are none who are going to look at that paragraph about Baclofen and act on it. The Glasgow study won't be cirulated by anyone. GP's don't deal in alcoholism. The addictions teams deal with opiate addiction, not alcoholism. So, it sounds like a nice response. They have what is called "polite society" here. People are judged by how polite they are, not whether they are interested in their fellow man. The policy to deal with alcohol is to raise the price of it, criminalize alcoholics and provide no treatment for them because they just don't merit it because they are inflicting the problem on themselves.
The net will eventually draw in on these people but not for a while. All you can do is keep making them feel uncomfortable.

I wish I had some help in this but I am on my own and even here I get abuse if I rub one of the senior members the wrong way because I don't adequately reference a comment or I express a view they don't like. Then they attack all guns blazing as though they own the forum and no one is entitled to a view. So what hope is there for a public movement to sort this out. If everyone sent an email to someone of consequence instead of spending just half an hour a week here, you might get some more movement, or maybe you wouldn't. Who knows.

I get some pretty nasty things said about me. I am not a drinker. How cheeky of me to come here and talk. Most people write alcoholics off as alkies and would be out with friends having a life and a drink on a Friday night. So why am I here? I, for some reason, have always had friends who have been notorious drinkers. Except that they were exceptionally bright, insightful and funny people. I never saw them as alcoholics. I was ribbed at work when my friend was seen limping across the street and he must have been drunk. I pointed out that he did not walk that way because he had been drinking and but because he had polio. People are sh.ts some times particularly when it comes to abusing the less well off than themselves and yet they go out and get plastered themselves. Hypocrisy and indifference to others thrives, sadly.

Look Cass, we are the only non alcoholics here. Crazy.

[Greg]

Baclofen Works - New study results!!!!!!

Hey Otter, I think you do great work in trying to promote treatment for alcoholism, and being here on this forum. I'm partly here due to two of my friends who have severe alcohol problems, although I'm also an alcoholic myself. As for doctors, they sound even worse there than here. I complain about our doctors but at least they make some effort to help alcoholics, although high-dose baclofen is definitely not widely used here yet either. Hopefully this will change over the next few years, and people won't have to order online and be their own doctor.

[Otter]

Baclofen Works - New study results!!!!!!

Cassander;1203455 wrote: Hi Otter

Wow, there is a lot of bureaucratic double-speak there. I thought only Americans could torture the mother tongue beyond comprehension. But I think the bottom line is that he is saying that

1 There is good evidence that baclofen works.
2 Doctors are required by the rules of good clinical practice to consider new evidence of better treatments.
3 So long as the treatment is carefully considered by the clinician and discussed with the patient,
4 The clinician may prescribe Baclofen.

I agree with you that a doctor who is approached by a patient with this conclusion in hand asking to be treated with baclofen would have a hard time turning the patient down.


Just for the fun of it, I have re-written his letter in "plain English" to say clearly what I think he tried to say:

Thank you for your recent email, which has been transferred to the Department of Health for reply. We understand that the recent Greater Glasgow and Clyde NHS research study reports positive and very interesting results for the treatment of alcoholism with the drug baclofen.

We are aware of the developing evidence on Baclofen. This evidence is discussed in the guideline 'Alcohol use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence', published by the National Institute for Health and Clinical Excellence and available to all NHS organisations and clinicians.

We acknowledge that the developing evidence on Baclofen has not lead to its use in routine clinical practice to date. We note that any new treatment, no matter how potentially valuable, must be carefully considered before being broadly adopted. Also, we note that all decisions on appropriate treatment for an individual lie with the treating clinician in discussion with his or her patient.

Nevertheless, our clinical governance systems require the delivery of good clinical practice appropriately responsive to changing evidence. Doctors are required by the General Medical Council to engage in continuing professional development, which includes keeping up-to-date with the relevant evidence. Clinicians are able to prescribe Baclofen if they consider the evidence justifies this.

I can assure you that the Department supports the prevention of alcohol dependence and recognises the important need to continue to improve treatment for alcohol dependence throughout England.


What do you think?

Cass

It still sounds very political. I initially wrote to the Home Office because they are responsible for policy on the use of medicines in relation to crime. They oversee the prescription of subutex for opiate addiction. So, why not Baclofen for alcoholism? I just think you have to put people in a position where they fear being asked the question, "when did you know about this and what did you do?" I suppose the next line of questioning is to Mr. Corbett along the lines of asking what does his department intend to do about this given that Baclofen is the first medicine to be considered as a functional cure of alcoholism and given the seriousness of the drink problem. Just keep pinning them down and write to politicians as well.

The UK is a strange place. It was one of the last places to legislate for seat belts in cars. Before that I knew Brits who would argue that seat belts were a bad thing because, for instance, you needed to be able to slide under the steering wheel if you had a head on collision. When it became law, everyone jumped on board and now it is extensively policed.

Because the prejudice against alcoholics isn't even seen as prejudice. It is so sad, twisted and ugly I can't bear to think about it.

I had a client years ago who was a parliamentary candidate. He used to come into my office regularly and chat and we became quite good friends. He became very frightened all of a sudden and started asking if he could work with me. Then he hit the front pages when his body was found in his apartment. I went to the police station and tried to assist as it all seemed suspicious and I knew who he had been with when he died. I was met with smiles from the police. I realized much later that he was just thought of as another alcoholic and he had drunk himself to death. Nothing suspicious at all about the trail of blood he left down the stairs of his apartment block. I never figured out what happened to him.

[Otter]

Baclofen Works - New study results!!!!!!

The whole point of opening the Baclofen UK site was to collect and make available this sort of information so it could be used to get prescriptions. I have had no offer of help from anyone here and the other day someone decided to sabotage my forum by posting Louis Vuiton adds on every thread. I closed the forum down because no one much used it anyway but the overriding impression I had is that it was someone from this forum doing that.

[Cassander]

Baclofen Works - New study results!!!!!!

Otter;1203551 wrote: I closed the forum down because no one much used it anyway but the overriding impression I had is that it was someone from this forum doing that.

Otter, Otter, Otter

You can be your own worst enemy. Pls don't be a victim. Its possible someone here has it out for you and has the time and knowledge to mess with your forum...but not likely...but even if so, so what?

As you often remind me, let's keep the bigger goal clearly in sight and keep going for it.

The petty fights that break out here on this site are regrettable, especially in light of everyone's real purpose in coming here, but I think we just have to look past them.

Because

Baclofen works.

Cass

[Otter]

Baclofen Works - New study results!!!!!!

I try not to be a victim and then I come across as aggressive. I just desperately wanted us to have a chance for this treatment to work but people just won't listen and I have to go through a process of educating them when I am no scientist myself. If you are not a medic, forget it. Some just follow what a bit of paper says if it has an official stamp of approval. That is why the study is important. One despairs this is sill not in the public domain to any great extent. I am sure it will be soon but it is taking such a long time here. Maybe I underestimate the actual knowledge of it out there. I keep going back to TV programs, guilty pleasures like Sex and the City which started off as a bit amateurish on Home Box Office. Everyone watched it but no one wanted to admit it at first. Who knows. I don't want to come across this way and I hate the fights and I really do not mean to hurt anyone's feelings. It is just me acting out my frustrations because things have not gone well despite Baclofen working. It is so easy for it to stop working if circumstances conspire against one.