My Bac journey

[zampa75]

My Bac journey

Thanks guys : )
I find your feedback extremely helpful, and hope-feeding.

Yet another question: I've been reading a lot again today, here, especially about titrating up and side effects. I had decided to go up 10 mg every four days, but after reading some - more - nightmare stories about going up too fast too quick, I've decided that maybe I'll do that every 8 days, like some people here do...Thoughts?

Will see my doc again tomorrow. I will tell him about what I've been reading here, that it is apparent you need to go up slow and steady in order to hit the switch. As I mentioned before, he prescribed a bottle with 90 pills of 10 mg each, which would suggest he wanted me to stay at 30/day for a month. He did say "we'll see how it goes" but he never mentioned going up, however slowly...I am afraid he'll get pissed, but I must ask him. I know it is a marathon and not a race, but I do not want it to take three times the time required - so impatient as I am already!

If he does not agree about going up, I'll buy my extra bac online - and I've been reading you have to carefully, gradually go from one brand to the other to minimize SE's, which in itself makes it even more complicated and quite scary...Or doesn't it? Am I just being a chicken and making everything look worse than it is??

By the way: I know exactly now what you guys meant about experiencing very vivid dreams...Gosh it's like there is a director and a script behind them! Unbelievable...

I am also experiencing sleepiness in the afternoon - but nothing like on Topamax, so far - dry mouth and nausea, the latter however much milder today than a couple of days ago.
Currently at 40 mg/day - taken every four hours. I will make an effort to spread it out more, like every 6 hours...It will help when I start working again and will have to get up early.

Also, I've read very contradicting things about the link between weight and dosage...

[zampa75]

My Bac journey

Hmmm... Just checked the recommended dosage on the River pharmacy website: they say 15 mg a day for the first few days then 30mg/ day divided in 3 10 mg doses. Nothing else- no higher dosage. Which seems to be exactly what doc prescribed for me...

However, none of you guys has managed to switch on such a low dosage.

I keep thinking the doc might get pissed off at my sudden medical expertise... Can't afford to lose the guy...

On a side note: very very drowsy right now. If I were at work I'd need a gallon of coffee. Still not as heavy as on Topa, but heavier than any other day on Bac so far. I know it's very normal.

[zampa75]

My Bac journey

Just got back from doc's office. Good news is that he is willing to go up in dosage, not as slowly as I thought he would. Relief. I am always afraid to offend him and instead it turns out I anticipate his very moves.

Bad news is that his therapist hammered AA on me as not an option, meaning she said it is the only real way out and the only one that works. Crucial. Mandatory. If I don't do it it means I do not wan to get better. She was quite cut and dry in this respect. If I don't AA, there is no hope for me.
And when I said that I might get obsessed with staying sober every minute, terror of slipping gripping me all the time- that's for sure - she even said it would be a good obsession... To me, it looks like a miserable life in fear. She said I look miserable now - which I am, at the bottom of the pit, contemplating whether to start digging - but the alternative she offers does not manage to look un-miserable to me. At all. But there is no control or indifference possibility, she said. Just giving it up radically by using AA - or lose everything b/c of it.

Doc talks about AA too, but in a much more relaxed way. He says it helps a great deal, but he does not say I am doomed if I do not commit to that. Which she did. Doomed.

Incredibly depressed right now. I mean, I might as well start digging already.
I so hoped to get out of there feeling hopeful - it is so important to believe. I feel more hopeless now than when I went to bed last night, instead.

[Cassander]

My Bac journey

zampa75;1538529 wrote: Just got back from doc's office. Good news is that he is willing to go up in dosage, not as slowly as I thought he would. Relief. I am always afraid to offend him and instead it turns out I anticipate his very moves.

Bad news is that his therapist hammered AA on me as not an option, meaning she said it is the only real way out and the only one that works. Crucial. Mandatory. If I don't do it it means I do not wan to get better. She was quite cut and dry in this respect. If I don't AA, there is no hope for me.
And when I said that I might get obsessed with staying sober every minute, terror of slipping gripping me all the time- that's for sure - she even said it would be a good obsession... To me, it looks like a miserable life in fear. She said I look miserable now - which I am, at the bottom of the pit, contemplating whether to start digging - but the alternative she offers does not manage to look un-miserable to me. At all. But there is no control or indifference possibility, she said. Just giving it up radically by using AA - or lose everything b/c of it.

Doc talks about AA too, but in a much more relaxed way. He says it helps a great deal, but he does not say I am doomed if I do not commit to that. Which she did. Doomed.

Incredibly depressed right now. I mean, I might as well start digging already.
I so hoped to get out of there feeling hopeful - it is so important to believe. I feel more hopeless now than when I went to bed last night, instead.

Zamp...What are your therapist's qualifications? Age, education, certifications, experience? Just curious... Cassander

[Medicated&Motivated]

My Bac journey

Zampa,

Thank you for posting your progress with Baclofen. I'm currently doing Naltrexone/TSM but may also add the Baclofen at some point, especially since I'm in my fourth week on Nal and the drop in drinking isn't nearly where I'd like it to be. But enough about me.

It's exactly that kind of approach that drove me away from AA. AA is a prescription for relapse if you don't embrace the program 100% and completely swallow the koolaid. Which is going to be impossible if you're still drinking while doing your Baclafen therapy. Later, If you have a desire to stop drinking completely, then you might find AA to be beneficial, in conjunction with your Bac treatment. It depends what your overall goal is, too, to reduce your drinking to safe, healthy levels, or to be completely AF.

I'll say this, AA was helpful the first time I went cold-turkey AF many years ago, but I could never buy into all of its precepts, which of course meant I was DOOMED. "Rarely have we seen a person fail who has not thoroughly followed our path." I'm paraphrasing (or perhaps remembering pretty closely.) There was tremendous emphasis on the 'thoroughly' part. Didn't call your sponsor every day? Didn't work the steps? Didn't go to meetings as often as you 'should'? Didn't read the Big Book every night? Well, no wonder you slipped; you just weren't being thorough enough. In other words, let's blame the alcoholic and make them feel guilty and inferior that they couldn't follow such a "simple program of recovery." Never mind that Bill W. continued to suffer from debilitating depression and was begging for alcohol on his deathbed (so I've read somewhere). Never mind that these scientifically-backed programs for Nal and Baclofen have come along long after AA was founded.

For all those who transfer their addictions to AA and/or find relief and ongoing recovery in it, I support and respect their choice, and in fact still have good friends in AA. But it should be just that, a choice. It's reprehensible that your Dr.'s therapist is so unenlightened and inflexible to insist it's the only way. Ignore her, or go to AA if you have to to stay in your Dr.'s. good graces, and take what you want from it, but leave the rest. I would go myself it it weren't so "all or nothing" in its approach.

Once again I'm reminded how lucky I am to be seeing a physician who does support being in therapy, but does not require AA. And the counselor on staff is himself in AA, but is able to offer other cognitive behavioral approaches, rather than reproaches for not going the AA route.

Sorry for the rant. Touched a nerve.

Good luck with Baclofen and I'll look forward to reading about your journey.

[zampa75]

My Bac journey

Cassander, I think she is a psychologist specialized in addiction. I think she is in her mid-sixties and probably has been dealing with addicts most of her career. She did not say but that was my take, given her resolute, no-alternative-possible-ever tone.

I think, however, that years in the field may not mean you understand it all necessarily. My first specialist in addiction -yeah right- here in the US did more harm than good to me...

But if you let your skepticism only slightly appear, they tend to treat you exactly like this: if you do not want to do what I say, it means you don't want to get sober. Which therefore means there is no hope for you.

So damn low right now. I can't really wrap my head around this AA thing...

[zampa75]

My Bac journey

M&M, thanks so much for your input.

The blame game and the guilt are exactly what I dread the most 'cos I know they're there.
This insisting on all or nothing, and if you don't manage it's your fault. Period. Simple as that.

And the other point you make too: I'm not looking to be AF, not forever that's for sure. It's a recipe for guaranteed relapse for me- and consequential devastation b/c it would be the hundredth, worst failure of them all. I want to be indifferent to alcohol, just what Bac promises to do. But she wouldn't even listen to the option though she supported doc's prescription-????.
To her, it's total abstinence or, in fact, doom. And yes it is a shame they may be so narrow-minded when so much has been discovered and done in a hundred years after AA came around! I so agree with you!!

Doc stressed on the fact that you may go to AA while you're still drinking, which she did not at all. He said you have to have the intention to get sober, not necessarily be already sober... A thing that makes me agree with you n another point: I might go to meetings just to see, and to keep seeing the doc. Not certainly every day, not even close. You are lucky to have the staff you've found. But I consider myself lucky too having found him. Her? Not quite sure...nope.

Also I don't mean for anybody to hold my hand, but her attitude was already so hard: shame on you if you don't do it like this. You're condemning yourself. No alternative.

Funny that she did mention Nal: does it make any sense to take it if you're a 100 percent abstinent?? Don't think so. Been there more than once.

[skullbabyland]

My Bac journey

zampa75;1538227 wrote: Thanks guys : )
I find your feedback extremely helpful, and hope-feeding.

Yet another question: I've been reading a lot again today, here, especially about titrating up and side effects. I had decided to go up 10 mg every four days, but after reading some - more - nightmare stories about going up too fast too quick, I've decided that maybe I'll do that every 8 days, like some people here do...Thoughts?

Will see my doc again tomorrow. I will tell him about what I've been reading here, that it is apparent you need to go up slow and steady in order to hit the switch. As I mentioned before, he prescribed a bottle with 90 pills of 10 mg each, which would suggest he wanted me to stay at 30/day for a month. He did say "we'll see how it goes" but he never mentioned going up, however slowly...I am afraid he'll get pissed, but I must ask him. I know it is a marathon and not a race, but I do not want it to take three times the time required - so impatient as I am already!

If he does not agree about going up, I'll buy my extra bac online - and I've been reading you have to carefully, gradually go from one brand to the other to minimize SE's, which in itself makes it even more complicated and quite scary...Or doesn't it? Am I just being a chicken and making everything look worse than it is??

By the way: I know exactly now what you guys meant about experiencing very vivid dreams...Gosh it's like there is a director and a script behind them! Unbelievable...

I am also experiencing sleepiness in the afternoon - but nothing like on Topamax, so far - dry mouth and nausea, the latter however much milder today than a couple of days ago.
Currently at 40 mg/day - taken every four hours. I will make an effort to spread it out more, like every 6 hours...It will help when I start working again and will have to get up early.

Also, I've read very contradicting things about the link between weight and dosage...

Hey Z-- Just a couple thoughts. Keep in mind that these comments are just my perspective based on what I've read- if I'm incorrect about any of these things, I'll count on someone who's more knowledgeable to jump in and post corrections.

1. Regarding titrating up slowly, for instance 10mg every 8 days- I believe I'm the only one I've heard of who does that so slowly, and I've decided to do so because of the stories others have posted about difficult SE's. It feels right for me-- if that also feels right for you, go for it. I believe most people go up faster, like 10mg every 4 days, but most experience more intense SE's.

Among other things, I've read that for some people, going up or down too fast can intensify depression and anxiety. It sounds like from your writings that you're dealing with a fair amount of both already- you mention issues of insecurity, self-loathing, stuff like that. (No judgement, by the way-- I deal with those issues myself). My advice would be to maximize anything that can help those issues, and be careful with anything that might negatively intensify them. Do whatever you can to increase relaxation and self-acceptance, and try as much as possible to keep a positive mindset.

2. You say "about what I've been reading here, that it is apparent you need to go up slow and steady in order to hit the switch." Just to clarify, I don't think that's the case- you can also hit the switch if you go up fast-- but it's likely that the SE's will be significantly more intense. Again, that's why I've chosen to go up so slowly.

3. You write "and I've been reading you have to carefully, gradually go from one brand to the other to minimize SE's, which in itself makes it even more complicated and quite scary...Or doesn't it? Am I just being a chicken and making everything look worse than it is??" I don't believe you have to go from one brand to another to minimize SE's. If you have a brand that works well, stick with it. If you have a brand that does give you crappy SE's that don't diminish over time, then consider switching. But you won't know either way for a little while.

Out of curiosity, what brand do you take? My bottles say "Mfg: Ivax Pharmacy" which I've been told is the same as Teva, which is where a lot of pharmacies get their bac. I've also been told that Liofen and Lioresol are both good.

I'd encourage you to try to settle your mind about these issues and try to "relax into the treatment" for a while, and don't stress the minutia. Just get accustomed to life on bac, see how you do, and adjust later as you need to.

4. Regarding your doc and therapist- First off, sounds like you've got an open-minded doc! Congrats on that, you're lucky as they can be hard to find! It sounds like he's open to discussing how you feel about your own treatment... continue to talk with him openly as you feel comfortable with, and think of the treatment as a partnership.

Sounds like the therapist is much more challenging. Remember that it's ultimately up to YOU what you want to do. Nobody's word is law. Nobody lives in your body and your mind except you. Definitely take what they say under advisement, but ultimately you have to make your own call about what you feel is right for you. You're already doing that by starting bac treatment, so keep it up! And don't let anyone pressure you into something that you really feel is not right for your own treatment.

Lastly, I'll just say that with issues of self-confidence/loathing, it's important to remind yourself of the truth- that you're a good and worthy person, and just as deserving of love and acceptance as the rest of us! And that starts with loving yourself.

Hope that all didn't sound too sappy/cliche, but it's what I believe!

[skullbabyland]

My Bac journey

zampa75;1538550 wrote: M&M, thanks so much for your input.

The blame game and the guilt are exactly what I dread the most 'cos I know they're there.
This insisting on all or nothing, and if you don't manage it's your fault. Period. Simple as that.

And the other point you make too: I'm not looking to be AF, not forever that's for sure. It's a recipe for guaranteed relapse for me- and consequential devastation b/c it would be the hundredth, worst failure of them all. I want to be indifferent to alcohol, just what Bac promises to do. But she wouldn't even listen to the option though she supported doc's prescription-????.
To her, it's total abstinence or, in fact, doom. And yes it is a shame they may be so narrow-minded when so much has been discovered and done in a hundred years after AA came around! I so agree with you!!

Doc stressed on the fact that you may go to AA while you're still drinking, which she did not at all. He said you have to have the intention to get sober, not necessarily be already sober... A thing that makes me agree with you n another point: I might go to meetings just to see, and to keep seeing the doc. Not certainly every day, not even close. You are lucky to have the staff you've found. But I consider myself lucky too having found him. Her? Not quite sure...nope.

Also I don't mean for anybody to hold my hand, but her attitude was already so hard: shame on you if you don't do it like this. You're condemning yourself. No alternative.

Funny that she did mention Nal: does it make any sense to take it if you're a 100 percent abstinent?? Don't think so. Been there more than once.

Yup, it sounds to me like the doc will be helpful to work with, but the therapist not so much. If it was me in your shoes, I don't think I'd work well with someone who's so black and white cut and dry, and unwilling to listen to my thoughts about treatment, and might look for another therapist.

Ultimately it's up to you, good luck with everything. You're well on your way!

[zampa75]

My Bac journey

Thanks so much Skull.

I have read all you've said very carefully, only in this moment, this very moment, I am having a real hard time with the self-loathing issue you mention and you give me advice about. Can't be positive right now. It's just a very low moment - I can't see any light at the end of the tunnel. And I have so much to do I really could not afford to feel like that ( I just want to be swallowed by the couch for the next ten years). Bac's drowsiness - real strong today - does not help with that. When I function a bit better -may be in an hour, or ten - I will reply to you. But I do appreciate your attention to all those details I have talked about :thanks:

I don't know if it's the pills, but the positive attitude of two days ago has been totally replaced by sheer hopelessness. In a black hole this very moment.

[zampa75]

My Bac journey

Some time later...

Just talked on the phone to the AA contact suggested by therapist.
He assures me I will get better...
I'm supposed to go to a meeting Fri morning - we'll see if I have the guts to go.

More importantly: this last dose of Bac I've taken - not even the last of the day- totally knocked me out. I feel like I have a fever. Totally drowsy too and unable to focus, if not obsessively on my misery. Itchy eyes and foggy vision.The unnerving thing is that the last two days I was almost totally fine on the same dosage.
It's scary cos I have just started to go up. Barely started.
If it got worse than this, no way I could keep it up while working as a tutor in college while taking grad classes too -and commuting there. No way. So depressing. Buried in my hole right now.

Sorry for my death-like attitude right now, but I just can't help it...

[Xadrian]

My Bac journey

Are you spreading your doses as equally divided over the 24 hours as possible?

Like every 8 hours (for example 7AM-3PM-11PM), or if you need more sleep, every 7 hours (for example 8AM-3PM-10PM)?

I think last time you mentioned, you took 3 doses only 4 hours apart during the daytime. Looks too close together to me and could quite possibly be the reason for tyhe described SE's.
Since the half life value of baclofen in the blood (this is responsible for a lot of SE's) is 4 hours, this means that if you take 20 mgs every 4 hours, the first dose of the day would equal 21 mgs or so (including the remainder of the previous day) the second dose would equal 30 mgs and the third dose would equal 35 mgs of baclofen, because there's still half of the previous dose in your blood.

In comparistion, if taken 8 hours apart, that same 20 mg doses would equal 26 mgs including the remainders of the previous doses.

Taken 3 times every 4 hours would increase the peak level of the 2nd dose by 15% (30 mgs) and the 3rd dose by even 35% (35 mgs) compared to taken 3 times every 8 hours (26 mgs). It also fluctuates more.

Sorry to bother you with the figures, but in my opinion, you would do better to divide it better over 24 hours.

May I ask what made you decide to take the doses 4 hours apart anyway?

For the rest, I had my good and bad days going up. Some day you can feel terrible and the other you can feel fine. In my case it helped to go to bed on time. If I felt tired earlier than before baclofen, I just went to bed. Most of the time, the next day I would feel better than if I had stayed awake longer the evening before.

[bleep]

My Bac journey

Prove her wrong.

[Xadrian]

My Bac journey

bleep;1538688 wrote: Prove her wrong.

There's already proof that something is wrong. She posted it. Did you read it? Edit: wrong assumption of mine thinking you were replying me. Sorry. I already couldn't imagine it. Perhaps you could have included a quote.
I also calculated examples of the peak levels, based on a 4 hour half-life blood level, that show differences of 35% in the peak levels.

So, if she wants to find out if she can do something about the SE's, she can try to spread the doses more evenly and see how that goes.
It's only an advice. If it doesn't help, no harm done.

[Cassander]

My Bac journey

Hi Zamp, Xadrian and bleep

Seems to me what the bleepman is saying in his inimitably efficient way is that Zamp should simply prove the therapist wrong...I don't think he is criticising you, X.

Zamp --

You are doing everything right. You are second guessing yourself only because...that is what we do.

Your baclofen journey will take some time and, as others have said, there will be good and bad days on the way up. But it is worth it. The SEs are temporary and will subside and nothing you will experience is as bad as continuing alcoholism. Keep that in mind. Its all worth it.

I honestly don't think you should continue with this therapist. She is simply wrong. She may think she is right because for a long time (most of her career) AA was the only tool available.

I would look for a therapist who can help you deal with mood, anxiety and depression rather than an old school AAer. There are plenty of them around.

AA works for some who are able to quit, more or less cold turkey, or when they hit "rock bottom", and buy the whole program (abstention, higher power, character defects, daily obsession with not drinking, etc.). But it doesn't work for many, probably most. The success rate for AA is hard to determine but estimates range from a low of 5% to a high of 30%. You are certainly not doomed if it doesn't work for you. At least that's my opinion.

Once addicted to alcohol, you (any one) have a disease of the brain. Plain and simple. Back in the day, when we didn't know any better, AA (basically mutual support) developed as the only way to wean the brain back into chemical balance. It works through abstention, healing over the long term, and the psychological therapy of mutual support (kind of like what you get here).

Now we know better. We know alcoholism is a reversible disease. There are several medications which have been discovered, developed and tested which show efficacy in reversing the brain chemistry of addiction. One, as you know, is baclofen.

While there is still plenty more to learn, and there are several studies under way here in the US and in Europe, it is pretty clear that baclofen works. If not for all, for a very large number. Way more than AA.

And, the beauty of baclofen is the distinction between "abstention" and "indifference". In AA you learn how to abstain on a daily basis. But alcohol -- in the guise of NOT drinking -- remains a daily concern. The promise of baclofen is that you can become indifferent to alcohol. Meaning you can take it or leave it. The craving is cured.

One of the stories I remember from the early days of baclofen on mwo is the story of one member who succeeded with baclofen who had always, every day, stopped at the convenience store on the way home for a couple of six packs. A year or so later he and his wife were out driving and they decided they needed to purchase some small item. The guy said, no problem, we can just pick it up at the convenience store. His wife said, dear, they tore down that convenience store last year. He hadn't even noticed. The habit was broken and the obsessive compulsion was gone.

Stick with it Zamp and you'll be fine.

Cassander

PS Of course I am not a doctor and the foregoing is simply the product of my observations and reading. But I think I'm right ...