Baclofen advice required

[Ne/Neva Eva]

God, that was a great post Knobert.

Colin is in Holland, I think. Doctors there have been prescribing HDB for quite some time. Lowcountryman was the first Dutch guy I met here and he was prescribed HDB by his doc back when I was titrating up, 5 years ago. (He's also the one who came up with "Just keep taking the damn pills." His advice to me on one of the many occasions when I was ready to throw in the towel. We've shortened that to JKTTDP over the years, and I've stopped using it since it sounds too trite. But I still love it and him. Anyway, what were we talking about? )

[Ne/Neva Eva]

For the record, I wouldn't post my doctor's name here without her permission, and I'm fairly certain she would be uncomfortable with her name being associated on the interwebs with taking a drug off label for alkies like us. Especially since she knows that it may take more than what she is comfortable prescribing. That said, if anyone here is in need of a doctor in eastern Virginia, PM me and I'll hook you up with her name and number in a heartbeat.

[knobert]

Hey Ne

I certainly would not post their names on the forum, but there must be some kind of mechanism we could come up with to share info. I know that if I could give my Dr. names, she would take it on her own to verify with that Dr. or Dr.s , without it being public, so to speak.
Sadly, except in countries where it is allowed, I haven't heard anyone say that their Dr. is prescribing off label.

Knobert

[Ne/Neva Eva]

Knob, what kind of doctor are you seeing? A general practitioner or a psychiatrist? Addiction specialist?

[knobert]

Ne

She's my gp. Her specialty is internal medicine

[Mentium]

My prescription was for 84x3 lots of 10mg. No time limit or expectation that I am aware of. That woukd suggest that my doctor is pushing the boune is a bit.

[Stevo]

My doctor prescribes off label for me but he only goes to 100mg and then leaves the rest up to me(I have discretion),meaning he knows I take more but he doesn't mind as long as I am being responsible.He just writes the scripts and leaves it in my hands.
I am lucky that my switch was hit at a relatively low dose(142.5mg)so I have never needed to look for other ways of accessing bac.
He is quietly impressed with the outcomes that he has seen and asked me to provide him with evidence and documentation about bac and AUD which I got from here.
The next time I saw him I asked him what he thought of the documents I provided and he said that he had found it very interesting and he thought that it could work for others.
Sadly though I am in Australia and I don't think that this can help any of the guys on here.

[Ne/Neva Eva]

Knobert, that makes a big difference. Mine is a psychiatrist and much more willing to push the bounds.

Mentium, I'm a little confused. I think you're the one that got a script from Dr. Chick for more than what he said was what he was willing to prescribe, right? If I'm wrong, just ignore me.

It sounded to me like he was playing both sides of the issue. In other words, he prescribed for a short amount of time, knowing that you were already taking that much baclofen. And then you would renew that rx for another short period of time...At least that was my take on it. I could be way off base. Hell, it might not even be you! I'm not willing to read back to find out, because I've got to run.

Anyway, I used to be angry with Chick (even though I'm in the U.S. and have never met the man and never will). But now that I've spent the last couple of years studying medicine, I'm really clear about how hard it is for physicians to walk the line between protecting themselves, (and their patients!) and thinking outside the box. At the very least, the man is promoting baclofen.

On the other hand, he participated in a research paper, or an article or something, a couple of years ago, that made me think he still didn't really understand baclofen treatment. I couldn't tell you where it is, though it was posted here. Maybe Tk can jump in? Or you could google.

Anyway, enough from me today. Hope you guys can just keep the focus!
Cheers, mates. (That's what you brits say, right? )

[knobert]

[SIZE=2]Hey Stevo

You say he prescribes off label but only goes to 100mgs. What is the max that Dr.s are allowed to prescribe in Australia?

Also, how did you get to 142.5 only being prescribed 100 mgs?

Thanks
Knobert

[Mentium]

You are right to be confused. I am a bit too. There are mixed messages here. Dr. Chick apparently has a limit he works to but he prescribed approx 300 10 mg pills for me. We had an agreement that at 3 months we would try to get my GP to take over and if he refused he would carry on. I was new to all this and didn't realise some of the issues, not least the potential risk to medics prescribing off label. Will keep the forum informed!

[Stevo]

Knobert,
His hands are tied and 100 is the most he can do but he knows I take more and allows me to do so.It is off label because bac is still not recognised as a treatment for AUD here in Australia.He just writes a new script whenever I need one,no questions asked.

At first he was dubious because I was having it prescribed by another doctor and I was already over 100mg,he reluctantly agreed to prescribe it for me and stated that he would like for me to be on a lower dose but over time(about a year now)he has changed his stance as he sees it as a positive thing.
He was a methadone prescribing doctor for many years and has a soft spot for addictions,I think that he enjoys seeing someone having success over their addiction which doesn't happen very often.

[knobert]

Hi Ment

You said Dr. Chick prescribed 300 10mg pills.
The prescriptions I get in the U.S. are for 1 month

300 pills at 10mgs = 3000mgs = 100mg/day for 1 month

Would that be right?

Knob :thumbsup:

[knobert]

Hey Stevo

Thanks for the reply

I guess I may be using the wrong term. My Dr. prescribes my 80 mgs with no questions asked because it doesn't exceed the FDA's guidelines. She is not telling anyone it is for alcohol dependence. She doesn't have to. For billing reasons it can be coded as anything, for example muscular dystonia, to get my insurance to cover it.

They have to go off label only if they want to prescribe more than the FDA approves. I guess what I'm saying here is that, in my opinion, it is not necessary to be off label unless it exceeds the FDA guideline.

So, I guess what I'm saying is your Dr. is not exceeding regulatory guidelines. Is that correct?

Thanks
Knob :thumbsup:

[knobert]

Stevo

It sounds like your Dr. is a pretty good guy. It sounds like he understands. If he or any Dr. wanted to, they could prescribe over 100mgs, but they would have to prescribe it off label because it exceeds the guidelines.

Does that make sense?

Knob

[Stevo]

Knobert,

Yeah it makes sense but my understanding of off label was prescribing a drug that was used for something other than what it is normally used for.I may have been mistaken either way it is not an issue.

What does occur is on my prescriptions it says "if the bearer needs to refill the prescription by a certain date the pharmacist needs to be notified."

These dates don't cause me any worry as I always run out on the day or the day after.I am actually stock piling 10mg tablets as I always need the 25mg ones quicker due to using more of them.So when I need to get more 25mg tablets I always have heaps of 10mg ones left but I always get both filled.