In need of a little guidance about Baclofen

[kdogdogdogg]

Hi all, first post here, so here's a little background.

I was on Baclofen between about mid-July to September of this year. For the last couple years I've been struggling with crippling, non-functional alcoholism. I have not been able to keep a job, save any money, be responsible, etc. for a long time. I was getting desperate, as I found myself binging and vomiting at least every few weeks or so, and each time was traumatizing. So I started titrating up my dose very quickly. All the while I was taking Baclofen, I was drinking heavily.

Early September, I had a terrifying episode. I got blackout drunk, which happens occasionally, but I also started experiencing powerful delusions, which has never happened. I spent 3 days or so by myself trying to wean myself off the alcohol, but I was unsuccessful, and the delusions got extremely powerful. I woke up in the hospital after being in a coma for a few days. My memories of that time are nothing but nightmares and paranoid psychosis. It was awful.

I was up to about 160mg before this episode, and in my desperation, I had taken a few doses of 300mg. Upon entering the hospital, I had no access to my Baclofen, so I was on a cold turkey withdrawal from both alcohol and Baclofen. My severe symptoms lasted over a week, including hallucinations and insomnia. After that, I entered a 28-day rehab program, and now am in sober living, with over 80 days since my last drink.

Literally no one I have been in treatment with has ever heard of Baclofen, not even the counselors. I am being forced into 12-step programs right now as part of my sober living arrangement, but I can definitely tell that is just not for me. I am told on a daily basis how 12-step programs are really the "best" way to recovery right now, and if I'm not ready to do them, then I'm not really serious about quitting drinking.

I find myself very alone in seeking out Baclofen as a treatment option. It seems like no one else has ever heard of it, and the research behind it is pretty lacking. And since my last experience didn't work out well, it's making me feel like this whole thing is just a pipe dream. At least every day, the thought of getting drunk and jumping off a cliff passes through my mind, as if it was somehow my destiny to become a casualty of this disease.

What words do you guys have for this struggling alcoholic? Should I try Baclofen again? I can't take it while I'm in sober living as I can't risk it showing up on a UA, but maybe after I get out? How can I stay sober between the time I start the regimen and when I reach my switch dose?

Thanks guys, and sorry for the length.

[StuckInCA]

Hi there, and welcome. I'm so sorry you've had some struggles recently. That sucks a lot. A lot. I can't say much about delusions - I never had any on baclofen - but I can say that massive overdoses, which is basically what you did with the 300mg, can really mess with you. No judgement. I get the impulse to try to fix things. It's just that baclofen overdose, and withdrawal, can f**k you up in ways big and small. It's also pretty rough when drinking on top of it.

I can't (won't) give advice, but the chances that the drug tests you are taking will find baclofen are pretty small. A slow, steady titration up, while sober, could be really good for you. Or maybe not. Hopefully TerryK will stop by, or others, with their perspectives.

I will say this, though. I got drunk one night while also on 250mg or so, and had what I swear was a near-death experience. It wasn't, it was totally alcohol and drug induced, but it felt like the real f**king thing. So I'm not surprised to hear about your rough ride those couple of days. Hang in there, brother, best of luck to you.

[TooCurious]

Hi kdog,

Your story sounds somewhat similar to mine. I started my own thread and gave a brief history of my drinking, it's not too far down on the medication section. But yea, I've been to four 30-day inpatient rehabs, and spent six months in a sober living house, so I know exactly what you're talking about and how you're feeling. I'm also a binge drinker, except my binges never end until, like you, I end up in a hospital or in jail, and even then I start drinking again the minute I get out.

Regardless, congrats on 80 days sober!! That's huge! I've been on baclofen for about aboout a month and a half now, but haven't gone up to a high dose yet. I'm taking 90mg/day right now, coupled with 1,800 mg of gabapentin, another off-label anti-craving medication. It's been alright for me so far, but I'm still messing around trying to find what works. No one had ever heard of baclofen for alcoholism at the treatment centers I went to either, and it can be discouraging. But there actually are a lot of research studies on the topic, and it's worth informing people about.

Anyways, I would say try not to be too judgmental about the 12-step stuff. Sure a lot of it seems cult-ish and dogmatic, but it does provide a support network and something to hold on to. I decided to use what I learned in 12-step recovery, and not to make 12-step recovery my life as so many do. As far as getting drug tested goes, I'm pretty sure that baclofen doesn't show up on a drug test. It's worth looking into, but I got drug tested at my intensive outpatient group a few weeks ago and they didn't say anything...so I'm assuming it came back clean. Just stay strong, reach out for help and do NOT put yourself back in that hell-hole no matter what!! Trust me I have insane thoughts of returning to drinking too, but I ALWAYS end up either in jail, a hospital, or back in rehab.

Sorry for the long post. As far as resuming baclofen, I can't really advise you on that. Go to a psychiatrist, tell them about your cravings and see what they say. PM me if you need anything and good luck. Sorry for the long reply but I'm bored haha:happy2:

[kdogdogdogg]

Thanks guys for your responses. StuckInCA, thanks for the insight about the Baclofen overdose. I never really considered that overdose was a thing, so I was being pretty careless with it. I was just desperately trying to reach a switch dose because my job and life were on the line. I believe you that Baclofen won't show up on a drug screen, but I really can't afford to take that chance. I'm broke and homeless without this place, so I need to stay until I get a new job.

TooCurious, yeah I read your story just before posting mine Thanks for sharing! You seem to be on a pretty good path. I'm not being judgmental about the 12 steps, but now that I'm actually in the program, I'm just consistently turned off/disturbed by the dogmatism and other aspects. I'm happy if it works for other people, but I'm just going to go crazy trying to follow that program.

Anyway thanks for chipping in. I like that I can be fully honest here and people actually listen to and understand what I'm talking about. I can't get that at AA meetings.

[spiritwolf333]

Hi kDog -glad to see you on the forum and thanks for your post.

It sounds like you are doing really good now **80** days alcohol free. Congrats -huge. Did baclofen ever do anything for you before you ended up in the ER? Have you considered any other medications? And wow, it really does sound as if you are in a pickle. Broke and homeless -so you may not even have access to medications anyway?

Keep up the sober days kDog and I hope that you are somehow enjoying part of the freedom.

[Lostinspace]

Hi kdog :welcome: I’m sorry you’re in such a rough spot right now. That’s a really hard place to be. I would agree that the frightening incident in September was likely an overdose. 160 mg to 300 is a huge jump. I completely understand the impulse to rush the switch, but if you don’t give your body time to adjust to each dose change, it’ll likely end with problems.

I can assure you that bac doesn’t show up on a UA. I’ve had a few since I started bac, and have never had a problem. Chemically speaking, bac is too dissimilar to the drugs that they’re testing for, so it won’t cause false positives. And the chance that they’re testing for bac, specifically, is very small.

As far as starting on bac again, are you able to see another doctor at this point, or are you limited to a doctor that’s associated with the program you’re in? There’s plenty of good research on bac to show them that might make them more amenable to prescribing. Here's a link to some of those articles/resources: https://www.mywayout.org/community/sh...on-thread-2014

I would definitely recommend trying to go through a doctor first. They can help you come up with a titration plan that will prevent any major problems from happening in the future. But if that’s not possible, and you decide to go it alone again, make sure to go up slowly. The rate of titration makes a huge difference in how well you tolerate it. Keep us posted on how you’re doing.

[Ne/Neva Eva]

Hi Kdog and welcome to the forum! Love your username. It makes me smile.

Congratulations on the 80 days, on the sober living, and on continuing to look for long-lasting solutions. My husband did Oxford House for about a year! (We were even married at the time, and stayed married, living separately, throughout the ordeal. He just couldn't stay sober without it and he HAD to stay sober during that period of time.)

I have a couple of suggestions, which you might not like and should feel free to dismiss if you want. I won't take it personally, I promise. Which means you can still post here regardless and no one is going to think anything bad.

The first is that perhaps you can throw yourself into the 12-step thing. To be honest, I don't know if I could do it, because the reasons and the things the steps suggest are at the root of alcoholism are patently wrong. (We are NOT spiritually misaligned, morally inferior, particularly selfish, or, most importantly, powerless over alcohol. Just the opposite.) On the other hand, there are traditions from time out of mind that suggest we are powerless over everything, selfish and spiritually disconnected simply because we're human and morally squeamish simply because it's harder to put the greater good in front of our own desires and needs.

I guess I'm suggesting that if you can ignore everything that's said about alcohol in a 12-step program, and focus on the ideas based on being a more fulfilled and content person, there is real value in the steps. Hard to do, for sure. But it will likely help you get to where you want to go if you can just suck it up simply because they are going to continue to insist it is the "only way" to get sober. (Also bull, but whatever. You can wrestle with that stuff later.)

The biggest danger of a 12-step program, and one that kept me sick for a long time, is it's insistence that we are bad people. Please disregard that right now and forever more.

About taking baclofen: I can't say one way or another what you should do, but I can say what you could do. Depending on where you are in the country, it might be pretty easy to find a doctor to prescribe. If not, you can certainly order online. I overdosed the first time I took it, and while my experience wasn't as horrific as yours, it was awful. (I'm sorry you went through that. It's harrowing and frightening just to read, much less to live through. Glad you made it out okay.)

Baclofen is a relatively safe medication when taken reasonably. It is much easier to take if one is not drinking. It's certainly a viable option, and one that has many benefits over other medications that presumably work toward the same goal. It does not show up in a urinalysis, or in any tox screen, as it's not an addictive substance. Definitely not worth risking your home and life for, though.

Are you working? How long are you staying in sober living? Are you comfortable there? (Again, feel free to ignore my probing questions. I know it can be hard to post personal stuff here initially.)

Hang in there, Kdog. We're here if you want to share more.

EDIT: Just noticed your second post, which explained a bit more. I'll leave my post as it is, though.

[frogdog]

You need something for craving. Combatting craving will help you with not relapsing. This is research based info. Go on the HAMS Network. org site and pull up any research that they give that supports this ideology and present it to whomever is in control of your current situation. Also, if you cannot get baclofen (because it is a muscle relaxer, people in recovery may look at it suspect), ask for Gabapentin. Dosing should be 600 mg tid. This is supported in January 2014 edition of JAMA which published research studying 150 people and showed significant difference with Gabapentin and craving / withdrawal.

[Otter]

Our experience with Baclofen was along the same lines, that it is very tricky to get the dose right. You can get results at a low level and then think all is well but then relapse and it all seems like it was a big mistake. My wife was given very high doses for a while and that reduce her drinking but then that creates a situation where you are in withdrawal from alcohol which brings its own issues, such as delirium, and if your baclofen dose wears off, you get a double dose of witdrawal DTs. It's not so much baclofen side effects but the effects of reducing alcohol in a body which is used to living off it and changes in the brain, as well as constant ups and downs from irregular doses of baclofen, ie., it wears off overnight and you can wake up with cravings, huge anxiety and DTS.

Baclofen treatment, for those with severe alcohol disease, is a rough road...

But, it's a bit like fighting FARC in Columbia. It is better now than it was. You have to look at it as a battle for your health and that you have a secret weapon. The set backs are horrible and discouraging but, precisely because baclofen suppresses the desire to drink, you can get periods of sobriety which allow your brain to heal and over a long time, that is what cures you of alcoholism.

My concern about taking drugs which only reduce alcohol consumption in a minority of people on a trial is that you are just going to prolong the battle and if your condition is very serious, it may just mean you are in an alcoholic condition for much longer and you put yourself and those around you at risk from drinking. I'm not a doctor though and it is best you find someone who understands the pharmacology of all these drugs and how to use them alone or in conjunction with other medications, a mentioned in the Prescribing Guidelines for Baclofen which are on my websites (in my signature).

[Otter]

You need something for craving. Combatting craving will help you with not relapsing. This is research based info. Go on the HAMS Network. org site and pull up any research that they give that supports this ideology and present it to whomever is in control of your current situation. Also, if you cannot get baclofen (because it is a muscle relaxer, people in recovery may look at it suspect), ask for Gabapentin. Dosing should be 600 mg tid. This is supported in January 2014 edition of JAMA which published research studying 150 people and showed significant difference with Gabapentin and craving / withdrawal.

I believe this is the study you are referring to:

Results Gabapentin significantly improved the rates of abstinence and no heavy drinking. The abstinence rate was 4.1% (95% CI, 1.1%-13.7%) in the placebo group, 11.1% (95% CI, 5.2%-22.2%) in the 900-mg group, and 17.0% (95% CI, 8.9%-30.1%) in the 1800-mg group (P = .04 for linear dose effect; number needed to treat [NNT] = 8 for 1800 mg). The no heavy drinking rate was 22.5% (95% CI, 13.6%-37.2%) in the placebo group, 29.6% (95% CI, 19.1%-42.8%) in the 900-mg group, and 44.7% (95% CI, 31.4%-58.8%) in the 1800-mg group (P = .02 for linear dose effect; NNT = 5 for 1800 mg). Similar linear dose effects were obtained with measures of mood (F2 = 7.37; P = .001), sleep (F2 = 136; P < .001), and craving (F2 = 3.56; P = .03). There were no serious drug-related adverse events, and terminations owing to adverse events (9 of 150 participants), time in the study (mean [SD], 9.1 [3.8] weeks), and rate of study completion (85 of 150 participants) did not differ among groups.

Conclusions and Relevance Gabapentin (particularly the 1800-mg dosage) was effective in treating alcohol dependence and relapse-related symptoms of insomnia, dysphoria, and craving, with a favorable safety profile. Increased implementation of pharmacological treatment of alcohol dependence in primary care may be a major benefit of gabapentin as a treatment option for alcohol dependence.


This study shows limited success in helping maintain abstinence, up to 17% of partipants...not very impressive. And, of those in the majority who drank again, less than half of them had fewer heavy drinking days.

What surprises me is that this should be called "significant". I suppose that is using the word in it's technical sense, that a difference of a few percent shows that it is the drug which is causing this as opposed to some anomaly or problem with the trial or that it was just a statistically insignificant "blip".

The results for baclofen tests show suppression of consumption of alcohol in a majority of those in the trials, some showing over 80% success rates. It is being used by senior doctors treating alcohol disease in patients who are, sometimes, in or near a terminal condition.