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What to do if you are running low on (or out of) Baclofen - updated 2016

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    What to do if you are running low on (or out of) Baclofen - updated 2016

    Disclaimer: I am not a doctor or medical professional.

    Here's some general information on what to do if you are running low on baclofen, if you can no longer obtain baclofen from your regular supplier, or if you run out.

    Why this is important:

    While Baclofen is not addictive in the conventional medical use of the word (tolerance, dose escalation, and drug cravings do not occur amongst recipients) - physical dependence is a feature of medium to long term use in all users. If that scares you, it shouldn't - for some clarification see: Why Distinguishing between Drug Dependence and Drug Addiction is Important
    Abruptly stopping baclofen, or stopping too rapidly, can cause withdrawal symptoms in any person that has been taking baclofen at any dose level for any length of time.

    Severe withdrawal symptoms usually occur more frequently in people who have been taking higher doses for longer periods of time, but everyone's individual body chemistry is different and your experience may vary.

    Titrating Down Safely (and comfortably):

    It's been widely recommended that anyone who wants (or needs) to taper down or off baclofen do so by decreasing no more than 10mg/d per week. That means if you are taking 200mg/day, it's week one at 200mg, week two at 190mg, etc.

    There are reports of people on MWO who have been able to taper down faster than that with little or no trouble. Once again everyone's individual experience will be different and it's better to err on the safe side and have enough spare medication to go at the pace your body needs to go.

    It's my firm recommendation that *everyone* that makes the decision to use Baclofen, whether it be by self-medicating with pills/liquid purchased online, or through a bona-fide physician, take whatever steps necessary to secure enough baclofen to always have on hand to titrate down safely and comfortably in the event of an emergency.

    How much baclofen to always have at hand to taper down at 10mg/d per week:

    Code:
    					
    daily dose in mg        total mg needed    # of 10mg pills
    10		        70                7
    20			210              21
    30			420              42
    40			700              70
    50			1050            105
    60			1470            147
    70			1960            196
    80			2520            252
    90			3150            315
    100			3850            385
    110			4620            462
    120			5460            546
    130			6370            637
    140			7350            735
    150			8400            840
    160			9520            952
    170		        10710          1071
    180			11970          1197
    190			13300          1130
    200		        14700          1470
    210			16170          1617
    220			17710          1771 
    230			19320          1932
    240		        21000          2100
    250			22750          2275
    260			24570          2457
    270			26460          2646
    280			28420          2842
    290			30450          3045
    To figure out how many pills you need, divide the total number of mg needed by the size in milligrams of the pills you have (10, 20, 25). If you have multiple pill sizes, just add all of the different amounts up to see if they equal the minimum mg to titrate down safely from a dosage. With liquid baclofen, total mg per bottle is mg per ml X # of ml in the bottle.

    Total amounts for daily doses greater than 290mg/day can be calculated as follows:

    For 400mg/day: (400X7) + (390X7) + (380X7) + etc all the way down to + (10X7)= a whole lotta milligrams and pills


    Online Pharmacies:

    Goldpharma
    River Pharmacy
    Inhouse Pharmacy

    Note: some online pharmacies have blocked access from specific countries in the past for legal reasons. Using a proxy or VPN is (has been) a way around this barrier.

    Asking for help on a baclofen forum:

    You can ask online if anyone has some spare baclofen to borrow until you can stock up from another supplier:

    CIDRAM (German)
    Forum de discussions baclofene, alcoolisme et autres addictions (French)


    Doctors that prescribe baclofen:

    Your regular physician / Hospital Emergency Department
    You may be able explain your situation (or at least "a" situation) to you regular doctor or a doctor in the ER/ED/A&E and have them give you a few days/week/month script of baclofen at 80mg/day (the "recommended maximum") to give you some time to find another source - a week at 80/d will give someone at 200/d another 2 1/2 days. Baclofen is *not* a controlled substance, and it's not associated with drug-seeking behavior. That said, you probably won't find too many sympathetic physicians out there and might earn yourself an earful of scolding.

    Switching brands:

    To minimize side-effects when switching brands always taper in the new baclofen whilst simultaneously tapering out the old, like this: Week 1: 100% Brand A, Week 2: 75% Brand A + 25% Brand B, Week 3: 50% Brand A + 50% Brand B, Week 4: 5% Brand A + 75% Brand B, Week 5: 100% Brand B

    It's been reported that switching between liquid and solid baclofen can cause marked side-effects, so be extra careful when tapering the pills.

    Running Out of Baclofen:

    It's been reported in medical literature that people taking baclofen become susceptible to withdrawal symptoms upon abrupt cessation (or too rapid downward titration) after about 1-2 months at a dosage level. That said, each individual's body chemistry will affect that person's experience, but it's safe to say the the majority of people who stop baclofen abruptly after taking any dose for more than a month or two will experience withdrawal symptoms.

    As compared to alcohol or benzodiazepine withdrawal which can set in within 12-24 hours of cessation, onset of baclofen withdrawal can take from 1-4 days after the last dose. And unlike alcohol or benzo withdrawal which can be remedied quickly with a few doses of equivalent medication, resolution of baclofen withdrawal requires reinstitution of baclofen (with possibly additional medications) and may take 48 to 72 hours. [/b]

    Acute baclofen withdrawal, especially from high dose, is a medical emergency. If you are experiencing it go immediately to your nearest ER, ED, A&E, and enlist the care of medical professionals.

    It would not hurt to print out this journal article to have with you to give to your doctor: Delirium Associated With Baclofen Withdrawal: A Review of Common Presentations and Management Strategies


    Delirium Associated With Baclofen Withdrawal: A Review of Common Presentations and Management Strategies (ABSTRACT) (FULL TEXT)
    TerryK celebrates 6 years of sobriety and indifference to alcohol thanks to baclofen
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