I am Dr Ameisen,
Greetings.
I wish to congratulate you on a very good forum.
I have adopted a policy to not intervene in forums because these are yours and should remain so. But I thought it might be help stimulate the debate.
You should in no way worry about the future of baclofen for alcoholism. Its present is already quite extraordinary. Progress has been spectacular and hundreds of patients have already gotten ?disease-free? (I am quoting the figures of academic physicians) and the number of saved patients is growing exponentially. The treatment I discovered ? high-dose baclofen ? has already received wide recognition both in the US and internationally.
In a 2005 paper in JAMA: Naltrexone treatment for alcohol dependency. [JAMA. 2005] - PubMed result
I explain that injectable naltrexone achieves in fact nothing new as compared to old treatments (oral naltrexone (Revia), acamprosate (Campral), low-dose baclofen (30-60mg/day), topiramate (Topamax) etc. These medications, at best, slightly reduce craving whereas baclofen ? at high-dose ? is the sole medication shown to completely suppress the urge to drink alcohol in animals. In this paper, as in all my seven sole-authored papers in peer-reviewed medical journals, including my latest in Lancet in 2009, I have called for randomized trials of high-dose baclofen to test elimination of craving and its consequences. And in five years, addiction experts have been unwilling to conduct any such trial, despite the fact that alcohol kills nearly 300 patients per day (more than any cancer!) in the US alone. For the past twenty years, all above named patented medications have been tested in randomized trials over and over again? to over and over again show that they all are inefficient at suppressing craving/dependence. Despite very wide use, none of these medications, naltrexone, acamprosate, baclofen at the low-dose it has been used for 17 years (30 mg/day) topiramate etc... have helped reduce mortality of alcoholism. In Medicine, efficacy of medications is judged by their ability to reduce mortality/morbidity. Reducing blood pressure in hypertension, reducing the viral charge in HIV/AIDS has crushed the mortality/morbidity of these diseases. Reducing craving in alcoholism has left the disease unchanged.
In France, the most respected newspaper, ?Le Monde? and the ones with the widest circulation, ?Metro?, ?20 minutes? to name only a few recently have recently devoted there front page to openly accuse alcohol and addiction experts of unscientific and unethical behavior for having refused for five straight years to perform their duty, that is to conduct randomized trials of high-dose baclofen. These are the gold standards of evidence-based medicine. The media has even accused these French addiction experts to refuse to conduct trials and to refuse prescribing baclofen out of fear of losing their patients. In France, alcohol and addiction specialists are the only physicians to refuse to prescribe baclofen. In Germany, a few days ago, the most respected daily, ?Die Welt? devoted the entirety of its ?Wissenchaft? (Science) section to my treatment and claims that refusal of addiction experts to conduct randomized is simply leading general practitioners to compassionately prescribing baclofen to save lives and alleviate the sufferring of victims of alcohol dependence. Many physicians now say that randomized trials will come in due time only to confirm what everyone already knows: that baclofen simply renders alcoholics ?disease-free?, and in a matter of only days or sometimes weeks.
On March 1, the evening Irish daily ?Herald.ie? wrote a story:
?Has this man really cured addiction??
You will find all the URL links to all articles in the ?Press? section of my website, as well as comments by world experts including Nobel prize in Medicine Jean Dausset on:
Olivier Ameisen, MD
In France, as internet forums report:
Baclofene
currently, 9 out of 10 general practitioners, at the request of alcoholic patients, prescribe baclofen off-label at high-dose. So do psychiatrists (except for those who are alcohol and/or addiction specialists). These forums in Europe are becoming very structured, combative and organized. They recommend to their readers to simply visit their general practitioners to try to convince them to prescribe them high-dose baclofen, and to simply avoid consulting alcohol or addiction specialists who are the only ones to refuse to prescribe baclofen. General practitioners lend a genuine and empathic ear to all their sufferring patients, and this of course includes alcoholics. They realize they have nothing to lose in compassionately prescribing oral baclofen, a medication that has been safely prescribed for nearly fifty years by neurologists at high-dose (300 mg in adults, 180 mg in children), simply for comfort care for benign conditions such as muscular spasms. No dangerous or irreversible side effect have been reported. Not one single case of baclofen dependence/addiction has ever been reported. To doctors who have experience with baclofen, it is much safer a drug than aspirin (that can lead to strokes or death through cerebral bleeding or gastro-intestinal bleeding, even at regular dose), or paracetamol that can lead to severe liver complications, also at therapeutic dose.
To give you a few examples of the degree of the degree of acceptance of my work in academia :
1) In recognition of my discovery of both, the first treatment ever described in the medical literature that completely suppresses the disease of alcoholism, and of the probable mechanism underlying addiction - a biological deficiency in GHB - I have, in 2008, been appointed visiting professor of medicine at State University of New York Downstate Medical Center, my current title.
2) On March 9, 2009, a review of my book ?Heal Thyself?/?The end of my addiction? has been published by one of the leading medical journal in the field of alcoholism, ?Alcohol and Alcoholism? link: The End of My Addiction. How One Man Cured Himself of Alcoholism. By Dr Olivier Ameisen -- Mcintosh 44 (3): 337 -- Alcohol and Alcoholism . The title of the review is ?The end of my addiction: how a man cured himself of alcoholism. By Dr Olivier Ameisen?. The initial paragraph states: ?Dr Olivier Ameisen is a remarkable medical researcher who shares his journey from profound alcohol addiction to sobriety in this fascinating book.? The last paragraph concludes: ?This book is to be recommended. It provides ample literature to strongly consider baclofen for patients who fail to respond to treatments in our conventional current repertoire. It is also a useful educational resource for those who work in the addiction field and for people who seek to gain a greater understanding of alcohol dependence.?
3) In an unusual step for a chief-editor of a medical journal, the editor-in-chief of this journal, Dr Jonathan Chick has supported the use of baclofen in the public media. In a recent declaration in the media: ?Ameisen has done extraordinary things. The results were very striking? ? patients who have been prescribed it who have benefited a great deal? ? it can correct the addictive process in the cells. It seems there are no dangerous side-effects, only a slight discomfort for some people who don?t tolerate the medicine.? In January 2010, a new statement by Dr Chick: ?I state that Dr Olivier Ameisen?s letters and papers in scientific journals, and his book, have made a very significant contribution to understanding and treating alcohol dependence. His contributions to the public media, radio, TV and newspapers, have given many sufferers and their families renewed hope for a condition which is demoralizing and sometimes fatal."
4) In September/October 2009 I delivered my lecture titled ?Addiction: a cure at last? as part of ?inaugural grand rounds in psychiatry, in addiction medicine and as medical grand rounds in medicine in various prestigious institutions in the US and in Europe. Only in New York, at the personal invitations of Dr Petros Levounis, MD, MA, director of The Addiction Institute of New York and Chief of Addiction Psychiatry at St. Luke?s and Roosevelt Hospitals, of Dr Stephen Ross, M.D., professor of psychiatry at New York University and director of Bellevue Hospital's rehabilitation program, of Dr Jeffrey S. Borer, M.D., professor and chairman of the department of medicine at State University of New York Downstate Medical Center. As a consequence, Dr Ross, a few psychiatrists at St-Lukes Roosevelt have told me they have started prescribing high-dose baclofen and Dr Ross has asked me to help designing a protocol for a randomized trial of high-dose baclofen for alcoholism. I have been invited by the Program Director at McLean Hospital Division of Alcohol and Drug Abuse of Harvard University to deliver my lecture in a couple of weeks at McLean. I have an open invitation from Professor Anna Rose Childress, Ph. D to deliver ?Addiction: a cure at last? in psychiatry/addiction at University of Pennsylvania as well as by Dr Virgilio Arenas, head of addiction medicine at Feinberg School of Medicine, in Chicago. I have delivered my lecture at the invitation of Dr Andreas Heinz, professor and chief of psychiatry and of addiction medicine in the presence of doctors, patients and journalists at the prestigious ?Charit?? hospital, Humboldt University in Berlin. Dr Heinz and his team now actively prescribe high-dose baclofen with suppression of alcoholism as a consequence and are in the process of mounting a randomized trial.
5) In 2009, Jerome Posner, M.D., Evelyn Frew American Cancer Society Clinical Research Professor; George C. Cotzias Chair of Neuro-oncology, Memorial Sloan-Kettering Cancer Center. Weill Medical College of Cornell University wrote: ?One wonders if high-dose baclofen will apparently become the treatment of choice without ever undergoing a controlled trial, simply because more and more alcoholics will be treated and the effectiveness will spread by word of mouth. If it works as well as you indicate that it does, it shouldn't need controlled trials. Even if a controlled trial were to show no overall benefit, it is clear that at least some (maybe all?) patient's do respond.? In 2005, Dr Posner had already written about my discovery: ?Your treatment is reminiscent of the way in which George Cotzias was able to prove that L-dopa could successfully treat parkinsonism. Others had tried the drug with little success because they were unwilling to push the dose to full tolerance.? Later, Dr Posner had followed his statement by: ?It is possible that an appropriate a randomized-controlled study will never be mounted for some of the reasons that you have indicated in the book. I recognize that such studies represent the "gold standard" for proving an idea. However, there are other standards, as for example your own very carefully studied case. If a few physicians who treat many patients for alcoholism were to adopt baclofen in appropriate doses as treatment of their patients, they may rapidly accumulate sufficient patients to compare the effect (that is the percentage of patients who succeed and no longer crave the drug ) of baclofen with the known effects (the percentage of patients who fail or still crave) of the many other treatments that have been reported. If, for example, a few series with a significant number patients were to report a 60 or 70% success rate with little or no craving, comparing that with a high failure rate of "historical controls" would be compelling evidence for the usefulness of the drug. I congratulate you. You may be responsible for making a signal discovery, much like, but better than that of George Cotzias, in that so many more patients may be involved.?
These are all good news!
Greetings.
I wish to congratulate you on a very good forum.
I have adopted a policy to not intervene in forums because these are yours and should remain so. But I thought it might be help stimulate the debate.
You should in no way worry about the future of baclofen for alcoholism. Its present is already quite extraordinary. Progress has been spectacular and hundreds of patients have already gotten ?disease-free? (I am quoting the figures of academic physicians) and the number of saved patients is growing exponentially. The treatment I discovered ? high-dose baclofen ? has already received wide recognition both in the US and internationally.
In a 2005 paper in JAMA: Naltrexone treatment for alcohol dependency. [JAMA. 2005] - PubMed result
I explain that injectable naltrexone achieves in fact nothing new as compared to old treatments (oral naltrexone (Revia), acamprosate (Campral), low-dose baclofen (30-60mg/day), topiramate (Topamax) etc. These medications, at best, slightly reduce craving whereas baclofen ? at high-dose ? is the sole medication shown to completely suppress the urge to drink alcohol in animals. In this paper, as in all my seven sole-authored papers in peer-reviewed medical journals, including my latest in Lancet in 2009, I have called for randomized trials of high-dose baclofen to test elimination of craving and its consequences. And in five years, addiction experts have been unwilling to conduct any such trial, despite the fact that alcohol kills nearly 300 patients per day (more than any cancer!) in the US alone. For the past twenty years, all above named patented medications have been tested in randomized trials over and over again? to over and over again show that they all are inefficient at suppressing craving/dependence. Despite very wide use, none of these medications, naltrexone, acamprosate, baclofen at the low-dose it has been used for 17 years (30 mg/day) topiramate etc... have helped reduce mortality of alcoholism. In Medicine, efficacy of medications is judged by their ability to reduce mortality/morbidity. Reducing blood pressure in hypertension, reducing the viral charge in HIV/AIDS has crushed the mortality/morbidity of these diseases. Reducing craving in alcoholism has left the disease unchanged.
In France, the most respected newspaper, ?Le Monde? and the ones with the widest circulation, ?Metro?, ?20 minutes? to name only a few recently have recently devoted there front page to openly accuse alcohol and addiction experts of unscientific and unethical behavior for having refused for five straight years to perform their duty, that is to conduct randomized trials of high-dose baclofen. These are the gold standards of evidence-based medicine. The media has even accused these French addiction experts to refuse to conduct trials and to refuse prescribing baclofen out of fear of losing their patients. In France, alcohol and addiction specialists are the only physicians to refuse to prescribe baclofen. In Germany, a few days ago, the most respected daily, ?Die Welt? devoted the entirety of its ?Wissenchaft? (Science) section to my treatment and claims that refusal of addiction experts to conduct randomized is simply leading general practitioners to compassionately prescribing baclofen to save lives and alleviate the sufferring of victims of alcohol dependence. Many physicians now say that randomized trials will come in due time only to confirm what everyone already knows: that baclofen simply renders alcoholics ?disease-free?, and in a matter of only days or sometimes weeks.
On March 1, the evening Irish daily ?Herald.ie? wrote a story:
?Has this man really cured addiction??
You will find all the URL links to all articles in the ?Press? section of my website, as well as comments by world experts including Nobel prize in Medicine Jean Dausset on:
Olivier Ameisen, MD
In France, as internet forums report:
Baclofene
currently, 9 out of 10 general practitioners, at the request of alcoholic patients, prescribe baclofen off-label at high-dose. So do psychiatrists (except for those who are alcohol and/or addiction specialists). These forums in Europe are becoming very structured, combative and organized. They recommend to their readers to simply visit their general practitioners to try to convince them to prescribe them high-dose baclofen, and to simply avoid consulting alcohol or addiction specialists who are the only ones to refuse to prescribe baclofen. General practitioners lend a genuine and empathic ear to all their sufferring patients, and this of course includes alcoholics. They realize they have nothing to lose in compassionately prescribing oral baclofen, a medication that has been safely prescribed for nearly fifty years by neurologists at high-dose (300 mg in adults, 180 mg in children), simply for comfort care for benign conditions such as muscular spasms. No dangerous or irreversible side effect have been reported. Not one single case of baclofen dependence/addiction has ever been reported. To doctors who have experience with baclofen, it is much safer a drug than aspirin (that can lead to strokes or death through cerebral bleeding or gastro-intestinal bleeding, even at regular dose), or paracetamol that can lead to severe liver complications, also at therapeutic dose.
To give you a few examples of the degree of the degree of acceptance of my work in academia :
1) In recognition of my discovery of both, the first treatment ever described in the medical literature that completely suppresses the disease of alcoholism, and of the probable mechanism underlying addiction - a biological deficiency in GHB - I have, in 2008, been appointed visiting professor of medicine at State University of New York Downstate Medical Center, my current title.
2) On March 9, 2009, a review of my book ?Heal Thyself?/?The end of my addiction? has been published by one of the leading medical journal in the field of alcoholism, ?Alcohol and Alcoholism? link: The End of My Addiction. How One Man Cured Himself of Alcoholism. By Dr Olivier Ameisen -- Mcintosh 44 (3): 337 -- Alcohol and Alcoholism . The title of the review is ?The end of my addiction: how a man cured himself of alcoholism. By Dr Olivier Ameisen?. The initial paragraph states: ?Dr Olivier Ameisen is a remarkable medical researcher who shares his journey from profound alcohol addiction to sobriety in this fascinating book.? The last paragraph concludes: ?This book is to be recommended. It provides ample literature to strongly consider baclofen for patients who fail to respond to treatments in our conventional current repertoire. It is also a useful educational resource for those who work in the addiction field and for people who seek to gain a greater understanding of alcohol dependence.?
3) In an unusual step for a chief-editor of a medical journal, the editor-in-chief of this journal, Dr Jonathan Chick has supported the use of baclofen in the public media. In a recent declaration in the media: ?Ameisen has done extraordinary things. The results were very striking? ? patients who have been prescribed it who have benefited a great deal? ? it can correct the addictive process in the cells. It seems there are no dangerous side-effects, only a slight discomfort for some people who don?t tolerate the medicine.? In January 2010, a new statement by Dr Chick: ?I state that Dr Olivier Ameisen?s letters and papers in scientific journals, and his book, have made a very significant contribution to understanding and treating alcohol dependence. His contributions to the public media, radio, TV and newspapers, have given many sufferers and their families renewed hope for a condition which is demoralizing and sometimes fatal."
4) In September/October 2009 I delivered my lecture titled ?Addiction: a cure at last? as part of ?inaugural grand rounds in psychiatry, in addiction medicine and as medical grand rounds in medicine in various prestigious institutions in the US and in Europe. Only in New York, at the personal invitations of Dr Petros Levounis, MD, MA, director of The Addiction Institute of New York and Chief of Addiction Psychiatry at St. Luke?s and Roosevelt Hospitals, of Dr Stephen Ross, M.D., professor of psychiatry at New York University and director of Bellevue Hospital's rehabilitation program, of Dr Jeffrey S. Borer, M.D., professor and chairman of the department of medicine at State University of New York Downstate Medical Center. As a consequence, Dr Ross, a few psychiatrists at St-Lukes Roosevelt have told me they have started prescribing high-dose baclofen and Dr Ross has asked me to help designing a protocol for a randomized trial of high-dose baclofen for alcoholism. I have been invited by the Program Director at McLean Hospital Division of Alcohol and Drug Abuse of Harvard University to deliver my lecture in a couple of weeks at McLean. I have an open invitation from Professor Anna Rose Childress, Ph. D to deliver ?Addiction: a cure at last? in psychiatry/addiction at University of Pennsylvania as well as by Dr Virgilio Arenas, head of addiction medicine at Feinberg School of Medicine, in Chicago. I have delivered my lecture at the invitation of Dr Andreas Heinz, professor and chief of psychiatry and of addiction medicine in the presence of doctors, patients and journalists at the prestigious ?Charit?? hospital, Humboldt University in Berlin. Dr Heinz and his team now actively prescribe high-dose baclofen with suppression of alcoholism as a consequence and are in the process of mounting a randomized trial.
5) In 2009, Jerome Posner, M.D., Evelyn Frew American Cancer Society Clinical Research Professor; George C. Cotzias Chair of Neuro-oncology, Memorial Sloan-Kettering Cancer Center. Weill Medical College of Cornell University wrote: ?One wonders if high-dose baclofen will apparently become the treatment of choice without ever undergoing a controlled trial, simply because more and more alcoholics will be treated and the effectiveness will spread by word of mouth. If it works as well as you indicate that it does, it shouldn't need controlled trials. Even if a controlled trial were to show no overall benefit, it is clear that at least some (maybe all?) patient's do respond.? In 2005, Dr Posner had already written about my discovery: ?Your treatment is reminiscent of the way in which George Cotzias was able to prove that L-dopa could successfully treat parkinsonism. Others had tried the drug with little success because they were unwilling to push the dose to full tolerance.? Later, Dr Posner had followed his statement by: ?It is possible that an appropriate a randomized-controlled study will never be mounted for some of the reasons that you have indicated in the book. I recognize that such studies represent the "gold standard" for proving an idea. However, there are other standards, as for example your own very carefully studied case. If a few physicians who treat many patients for alcoholism were to adopt baclofen in appropriate doses as treatment of their patients, they may rapidly accumulate sufficient patients to compare the effect (that is the percentage of patients who succeed and no longer crave the drug ) of baclofen with the known effects (the percentage of patients who fail or still crave) of the many other treatments that have been reported. If, for example, a few series with a significant number patients were to report a 60 or 70% success rate with little or no craving, comparing that with a high failure rate of "historical controls" would be compelling evidence for the usefulness of the drug. I congratulate you. You may be responsible for making a signal discovery, much like, but better than that of George Cotzias, in that so many more patients may be involved.?
These are all good news!
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