Dosage and Frequency - Take 2 - Binge Drinking

[RedThread12]

Dosage and Frequency - Take 2 - Binge Drinking

Thanks, all, for my laugh-out-loud moment of the day (well, there was one other one, but it had nothing at all to do with geography and/or alcoholism).

I just want to say thanks to Otter for re-mentioning a life saved by a VERY unorthodox use of baclofen. I, too, was in close touch with Suzanne during PaulSlice's extremely intense emergence from a binge. No hospital on the planet would have considered the treatment he chose, with the full aid and assistance of his family. I responded to the situation because Suzanne's posts demonstrated her intelligence and commitment and ability to assess what was needed from moment to moment. And without the information she received from board members who kept helping instead of freaking out, I doubt she would have had the fortitude to see him through to his current happy state of indifference.

I haven't looked at your site for some time, Otter, but will do so tut suit. I'm just grateful the info is somewhere. I just find it so intriguing when the envelop-pushers think someone has pushed the envelop beyond the bounds of the Atlantic Archipelago , or wherever . . . .

[SlipperyPete]

Dosage and Frequency - Take 2 - Binge Drinking

GingerDust;1192058 wrote:
If I tell people on the other side that I?m from Washington, they immediately think D.C. Does ANYONE actually live in D.C.? If so, I feel sorry for them. But other-side-of-the-ponders don?t think Seattle? when you say ?Washington?

Don't worry, Ginger, I'm slowly getting the word out that Washington means the state, and not the district. When I say I'm from Washington, and they go "D.C.?" I launch into a 20 minute profanity laced tirade about how if I meant D.C. I would've said D.C., and George Washington was left handed so he would've preferred his name to be associated with the West Coast and and Amurrrica wouldn't be shit if it weren't for the REAL WA and WHY ARE YOU LOOKING AT ME LIKE THAT!?!?!

[GingerDust]

Dosage and Frequency - Take 2 - Binge Drinking

lease:

Lo0p;1192066 wrote: I'd rather they conjure up that mental picture rather than one of whatever kind of an idiot would've voted for someone who coined the term "Amurrica."

OK. But I think you might have just dissed the entire state of Texas, the only state larger than California. Except for Alaska, of course, and we all know what Wasilla begot! YIIIIIIKES!

No wonder the world makes fun of us. :upset:

[GingerDust]

Dosage and Frequency - Take 2 - Binge Drinking

SlipperyPete;1192070 wrote: Don't worry, Ginger, I'm slowly getting the word out that Washington means the state, and not the district.
You would think that they might notice the size difference. The VERY big Washington state compared to the miniscule D.C. The very gorgeous Washington state compared to the irreparably ugly D.C.

When I say I'm from Washington, and they go "D.C.?" I launch into a 20 minute profanity laced tirade about how if I meant D.C. I would've said D.C., and George Washington was left handed so he would've preferred his name to be associated with the West Coast and and Amurrrica wouldn't be shit if it weren't for the REAL WA and WHY ARE YOU LOOKING AT ME LIKE THAT!?!?

I know! You gather the most drop-dead, gorgeous greenery, combined with most pristine beaches, along with soaring mountains and, and, AND . . . they somehow confuse that with D.C.? And we're ignorant????

Someone would have to give me a VERY good reason to go east of Kansas! Or west of the west coast. That's all have to say about that.

[Greg]

Dosage and Frequency - Take 2 - Binge Drinking

Sorry to butt in, but I just want to say that my experience of alcoholism and hospitalisation here in Australia is that they will admit you in most cases for detox unless absolutely full and unable to take any more patients. Diazepam (Valium) is the usual drug used for detox, or sometimes lorazepam (Ativan).

Drinkers who show up in emergency wards on Friday and Saturday nights from parties, pubs, and clubs are a different story, as they are usually assumed to be loud yobbos who are not physically dependent on alcohol.

[Otter]

Dosage and Frequency - Take 2 - Binge Drinking

I just moved this from Lo0ps thread about Dr. Levin.

Bill P

I absolutely 100% agree with you. I have been going on about this for over a year now. If there is a treatment which can stop someone from dying, killing themselves or someone else, losing their job , family, AND a doctor, as a professional, agrees to treat someone with it then he has a duty of care to that person and is negligent if he does not dispense the treatment properly. If it is safe to start at a high dose and that would avoid one of these consequences then a doctor should be held to account in negligence because he ought to do the medical research necessary to allow him to make the right decision for the patient. The whole point of Baclofen treatment is that it is for people who are not able to make the decision to stop because they are physically addicted so their ability to rationally decide not to drink is impaired by a brain disorder.

There are a few issues arising out of this :

1. Did the doctor take a proper history of the patient to determine how serious his drinking was? Did he then consider the risk to the patient of starting at a higher dose in relation to the potential health risks of continuing to drink while gradually increasing dose both in terms of the patient's health and other factors such as dui, effect on family, career?

2. If he did not take such a history then on the face of it he may have fallen below the standard of care of a reasonable doctor as well as breached his code of professional conduct. If he did not do the research, same result. There are plenty of studies now showing that Baclofen is effective in detox and there are doctors involved with Baclofen who are familiar with the use of Baclofen for detox and they use it starting at a high dose because they weigh the benefits of stopping drinking against the risks of Baclofen side effects.

3. Many changes in the way doctors practice are brought about by mistakes. The insurers then pick up on it as do professional bodies; directives and advisory bulletins are issued, etc.

4. The study in Glasgow points out that doses need to be tailored and those doctors are aware of the use of Baclofen in detox and that it can be started at higher doses rather than be titrated up slowly.

5. I recall reading somewhere that the effects of alcohol are accentuated if one is on Baclofen. It seems to me that if a doctor prescribes Baclofen at a dose which does not suppress alcoholic carving then he has to consider, not only the side effects of Baclofen, but the interaction with and combined effects of Baclofen with alcohol which, of course, is continuing to be consumed during this treatment.

6. High dose Baclofen which is being taken without prescription may be reaching a level in the population that doctors should be advising patients about it even though they are not in treatment supervised by the doctor. There are two aspects to this. One is that if a doctor has a number of patients on his books who are alcoholics (I would guess that all do) then he should be writing to them advising that there is a new treatment which could be life saving. Not to do so could be looked at in a few years as negligent. The limitation period in the US is still 6 years so the issues which could be raised by a patient who develops cirrhosis in the next six years will be, when did his doctor know about Baclofen, what efforts did he make to tell the patient, and, if he did not know about it, why did he not know about it. The second issue is that there are risks associated with taking Baclofen without medical supervision. This is more of a public health issue. People are taking massive amounts of this medication and exposing themselves to risks of Baclofen at high dose, withdrawal and the combination of Baclofen with alcohol. It is obvious from one report on this forum what can go wrong in a hospital emergency room. Why did those ER doctors not know about Baclofen and how to treat withdrawal from it?

This is very much along the lines of what I was saying in the Dosage and Frequency take 2 thread that doctors MUST start looking at the risks and benefits of Baclofen versus leaving someone in an acute alcoholic state. Diazapam is NOT used concurrently with alcohol consumption and not until alcohol is clear from the system. Baclofen IS used while a patient is still inebriated and it has the effect of slowing consumption of alcohol and stopping it if used from the start at a proper level which stops craving. This is, IMHO, a huge issue in public medicine because people are not being treated properly by doctors and hospitals who are not using Baclofen in this way and they are subjecting patients to the risk of withdrawal from alcohol, which Baclofen reduces, simply to give them another medication, Librium, which is addictive and should only be used for short periods in detox and DOES NOT reduce cravings, putting the patient at risk of cross addiction and morbidity.

Well done Bill!

PS. There are also Jersey, Guernsey, Aldernay, Sark, and the Isle of Man which have the same Queen, separate governments, the same UK passport and services such as defence (while remaining Tax havens), rights of residence as though they are part of the UK but are not part of the UK or Great Britain nor are they independent countries nor do they vote for members of the UK parliament. Figure that one out. I live here and I don't get it. I also don't know what their hospital admissions policies are.

[Ne/Neva Eva]

Dosage and Frequency - Take 2 - Binge Drinking

I don't have time to give this the full attention it needs, but I take issue with much of what you've written in your last two posts.

Particularly, Otter, at your insistence that this is a litigious issue and we should be forcing physicians to do it as YOU see it. Enough. That is not only not conducive to encouraging doctors to treat addiction with baclofen it is absolutely counter-productive.

Dr. Levin has helped more of us, in a way that puts him at risk, and with very little in exchange except our gratitude. To include him in your tirade is irresponsible and frankly, outrageous.

In addition, many of your points are erroneous if not outright falsehoods. I would suggest that you start by looking at the number of people who have achieved success using the methods (unsubstantiated and uncorroborated by anyone) that you insist work. Paul had an extreme amount of support from knowledgeable family members that were able to acquire what was needed to help him. Bluto has not posted in quite a while. I seriously worry for his health and well being. There are many, many, many examples of people who titrate extremely quickly that quit taking baclofen or worse. One of them, Gearhead, gave up and was dead within a couple of months. If you are going to continue to propose this as a viable alternative a few legitimate examples would be of great benefit. If the only example you have is Paul, then I suggest you point out, as Redthread did, that he had an inordinate amount of care 24 hours a day, for several days.

Also, which doctor said that the thread you started should be closed and why did you (we) take his word for it when you feel this is so important?

[Ne/Neva Eva]

Dosage and Frequency - Take 2 - Binge Drinking

Otter;1191820 wrote:
1 if you present yourself to a hospital in a life threatening condition due to alcoholism you are turned away.

2 I don't like posting about these things here because I post some legal point and get someone coming back saying I am wrong and they are a medical negligence lawyer, then a few months later it becomes obvious that they are wrong.
...
3 This is a support forum and I don't find it that useful for what I am trying to do.
...
4 If one goes on this forum and encourages people do do something like I did or Bluto did with liquid Baclofen you can get yourself banned or the thread cancelled when in fact it is a major public health issue.

1. Where? We've established that in the UK, Australia and the US you can and will be admitted.
2. It is not obvious that the medical negligence lawyer was wrong. In fact, just the opposite.
3. What are you trying to do exactly?
4. You are not banned. Bluto was not banned. The threads were not cancelled. The threads that you have instigated were closed NOT because of what you were proposing about baclofen but because they are the single most contentious and flagrantly abusive threads I've read on this forum. I would like you to ask yourself whether or not it's the issues you raise, or the near-fanatic approach you take to baclofen and the resulting abuse that is heaped on all other methods of finding a way out. In addition, your supportive evidence in each of these cases was wrong.

I repeat, what is it exactly that you wish to accomplish?

[GingerDust]

Dosage and Frequency - Take 2 - Binge Drinking

Zenstyle;1192113 wrote:
Anyway, where was I? Oh yeah... no we don't lump yer into categories like that!

Sorry. I got very plastered very fast yesterday. I didn't have enough beer to explain it so it was a combo effect, I'm afraid.

I would love to visit Sea Ranch and Scotland too.

I suspect that we have a lot of detoxing going on in jails in the US since detox centers are closing due to funding cuts. On the other hand, I can't imagine that someone showing up in ER with vitals pointing to an imminent seizure would be refused service.

[Otter]

Dosage and Frequency - Take 2 - Binge Drinking

GingerDust;1192421 wrote: Sorry. I got very plastered very fast yesterday. I didn't have enough beer to explain it so it was a combo effect, I'm afraid.

I would love to visit Sea Ranch and Scotland too.

I suspect that we have a lot of detoxing going on in jails in the US since detox centers are closing due to funding cuts. On the other hand, I can't imagine that someone showing up in ER with vitals pointing to an imminent seizure would be refused service.

Well, start imagining. That is just what happens here. No one in that state would be accepted into a hospital here. No one would take them to a hospital in the first place. They would just be left where they are in their bed or, if they were found in the street they would be arrested. For some its such a cruel, cruel world and there's no way out

[Otter]

Dosage and Frequency - Take 2 - Binge Drinking

What, St. Kilda?

[Otter]

Dosage and Frequency - Take 2 - Binge Drinking

Yes, but if someone was in that state due to some illness not connected to alcoholism and was left in the same way there would be an uproar about it. With alcoholism it would go unnoticed.

Aha, my mother in law is from Barra.

[terryk]

Dosage and Frequency - Take 2 - Binge Drinking

Zenstyle;1192675 wrote: Isle of Lewis...

Isle of Lucy?

David St. Hubbins: Jazz blues festival. Where was that?
Nigel Tufnel: Blues jazz, really.
Derek Smalls: Blues jazz festival. Misnamed.
Nigel Tufnel: It was in the Isle of, uh...
David St. Hubbins: Isle of Lucy. The Isle of Lucy jazz and blues festival.

Probably works better in the film then on teh internets.....

[GingerDust]

Dosage and Frequency - Take 2 - Binge Drinking

I thought of beautiful and very expensive chess sets when I saw "Isle of Lewis."

[terryk]

Dosage and Frequency - Take 2 - Binge Drinking

Zenstyle;1192761 wrote: Yay!!! Yes, you got it Ginger! The chess sets! :l

I'm glad someone knows what I'm about... )

Terry, I didn't see that one... I'll look on youtube...

Check out "This is Spinal Tap"