Clinical use of dihydrocodeine for severe alcohol dependence

[Greg]

Please note : This is not a 'cure' for addiction, it is at best a harm reduction method, and I'm not suggesting that anyone here actually try this. It would truly be a last ditch method, as you would be dependent on a large daily dose of opiates. I only posted it here due to my general interest in various ways of stopping drinking:

The following medical article from Europe includes a very well written critique of conventional/standard therapies for severe alcohol dependent patients who have detoxified and relapsed multiple times. It is worth reading just for that part alone.

It mentions baclofen, but the main form of treatment these doctors gave, starting in 1997, was the opiate dihydrocodeine (DHC). Not that any of us here are likely to get a chance at trying such a treatment, and most of us probably don't need it either, but I wanted to add the link in case anyone was interested in reading it:

Dihydrocodeine/Agonists for Alcohol Dependents

To summarize, it is a very long term and high dose treatment. Starting dose was 120 mg per day (divided into 4 doses), dose was raised to an average of 336 mg after 4 years and 9 months, and then reduced slowly to an average of 137 mg after 8 years and 4 months. EDIT : The sedative clomethiazole was also given for a while at the start, longer than a normal detox period by the sound of it, but was discontinued in most patients a while

Such a treatment regimen would have once sounded ridiculously controversial, but given the very high doses of baclofen needed for most people to reach their "switch", and the likely long-term nature of baclofen treatment, this DHC therapy now sounds (to me) a little less over-the-top than it once would have.

By the way, my continuing apologies for not yet knowing the details of the new Australian hospital-run treatment. I should have kept quiet until I knew the exact details, but I had no idea it would take my own addiction specialist so long to find out about it.

[YouKayBee]

Clinical use of dihydrocodeine for severe alcohol dependence

Greg;1334315 wrote: The following medical article from Europe includes a very well written critique of conventional/standard therapies for severe alcohol dependent patients who have detoxified and relapsed multiple times. It is worth reading just for that part alone.

It mentions baclofen, but the main form of treatment these doctors gave, starting in 1997, was the opiate dihydrocodeine (DHC). Not that any of us here are likely to get a chance at trying such a treatment, and most of us probably don't need it either, but I wanted to add the link in case anyone was interested in reading it:

Dihydrocodeine/Agonists for Alcohol Dependents

To summarize, it is a very long term and high dose treatment. Starting dose was 120 mg per day (divided into 4 doses), dose was raised to an average of 336 mg after 4 years and 9 months, and then reduced slowly to an average of 137 mg after 8 years and 4 months. EDIT : The sedative clomethiazole was also given for a while at the start, longer than a normal detox period by the sound of it, but was discontinued in most patients a while

Such a treatment regimen would have once sounded ridiculously controversial, but given the very high doses of baclofen needed for most people to reach their "switch", and the likely long-term nature of baclofen treatment, this DHC therapy now sounds (to me) a little less over-the-top than it once would have.

By the way, my continuing apologies for not yet knowing the details of the new Australian hospital-run treatment. I should have kept quiet until I knew the exact details, but I had no idea it would take my own addiction specialist so long to find out about it.

Hmm, I'll take a look at this later. Only thing I have to say is that I was once in a treatment centre with someone who had codeine addiction, it does happen - so would be very wary of using it for this reason.

[Greg]

Clinical use of dihydrocodeine for severe alcohol dependence

Ukblonde;1334423 wrote: Hmm, I'll take a look at this later. Only thing I have to say is that I was once in a treatment centre with someone who had codeine addiction, it does happen - so would be very wary of using it for this reason.

Hi Uk, I hope you are doing well.

Yes codeine addiction does happen, and the authors openly acknowledge that they are using a potentially addictive substance to treat alcoholism. That is why they only talk about the most severe, constantly-relapsing alcoholics, the ones who have detoxed over and over again but who just cannot stay off booze by any normal methods. They see this method as the lesser of two evils, with the other one being almost certain death from alcoholism.

I see it as being analogous to the use of methadone for heroin addiction, or (as a milder form) nicotine replacement therapy for smoking. There are still critics of methadone treatment, since it is obviously an addictive substance.

Personally, I think almost any treatment attempt is preferable to death from alcoholism, which is what unfortunately happens to most alcoholics once they have become chronically-relapsing, 15-20-25 standard drink per day drunks. Of course, the safest treatment methods should all be tried before anything like dihydrocodeine, however.

[Greg]

Clinical use of dihydrocodeine for severe alcohol dependence

...I also want to say that I realize the treatment isn't an escape from addiction, it's a harm reduction method at most by the look of it. Sorry if I have sounded like I was presenting it as a way of becoming free of all addictive substances. It was for information purposes only also, not for anyone here to go out and try...I am not trying it myself.