Let's Shout it from the Rooftops

[Cassander]

I was surprised to see this old thread at the top of the queue this morning when I chanced to visit mwo. I must admit that my first thought was that some mischief maker had found it and was probably twisting it around for god knows what purpose. I was relieved to see that it was merely a 'bump' from my friend, tk, who I know has our best interests at heart.

I re-read my initial post and the reactions -- all wonderful, reminding me of a time when it was possible to be positive and idealistic on this forum. It also reminds me that nearly 5 years have passed since these posts were written and despite all the shouting on mwo -- for better or worse -- baclofen treatment for alcoholism is still little known in most places around the world, controversial to some, and not a generally accepted medical treatment. And this notwithstanding the completion of more and more positive studies and the experience, in particular, in France, where baclofen treatment is now a recognized medical therapy for alcoholism, with, so far as I know, tens of thousands of successful outcomes.

We are certainly a strange animal -- human beings -- who are able to do such harm to ourselves, often in the face of rational alternatives. Despite all of the angry words and drama which has unfolded on this board since 2011, I remain convinced: baclofen works.

There is no denying the medication comes with side effects, mostly bearable, many of which disappear over time, and that for some smaller number, indifference is elusive. It is probably also true that indifference is not a cure for being human: even if indifferent to alcohol, we will still be who we are -- anxious, happy, depressed, elated, scared, confident. In some cases, we are still still indisputably suffering and mentally ill. It is also likely true that better chemical agents can and will be found to reduce the side effects and improve results. Its just damn frustrating that it is taking so long and in the meantime lives are still being wrecked and lost.

So, in the meantime, I guess I would still say:

Let's shout it from the rooftops!

[freeihope]

Hi Cass and thank you for your post(s) as always. You are a true statesman.

Regarding Baclofen, it just does not appear to work for the majority in ending their AUD (alcoholism). I do believe that it can help, but when all is said and done, it quite simply id not the "magic pill" all was hoping for. What Baclofen has done for the world of addiction is to to wake people up to other real possibilities in resolving addiction, and this, in and of itself, makes Baclofen a hero.

[terryk]

Hi Cass and thank you for your post(s) as always. You are a true statesman.

Regarding Baclofen, it just does not appear to work for the majority in ending their AUD (alcoholism). I do believe that it can help, but when all is said and done, it quite simply id not the "magic pill" all was hoping for. What Baclofen has done for the world of addiction is to to wake people up to other real possibilities in resolving addiction, and this, in and of itself, makes Baclofen a hero.

freeihope is banned member spiritwolf333/spiritfree/befreenow/Alfree. Apparently, he just got banned again as I was reading this.

The truth is that Baclofen has been proven effacious in several studies including a double-blind random controlled trial:

High-dose baclofen for the treatment of alcohol dependence (BACLAD study): a randomized, placebo-controlled trial.
M?_ller CA1, Geisel O2, Pelz P2, Higl V2, Kr?_ger J2, Stickel A2, Beck A2, Wernecke KD3, Hellweg R2, Heinz A2.

Abstract

Previous randomized, placebo-controlled trials (RCTs) assessing the efficacy of the selective γ-aminobutyric acid (GABA)-B receptor agonist baclofen in the treatment of alcohol dependence have reported divergent results, possibly related to the low to medium dosages of baclofen used in these studies (30-80mg/d). Based on preclinical observations of a dose-dependent effect and positive case reports in alcohol-dependent patients, the present RCT aimed to assess the efficacy and safety of individually titrated high-dose baclofen for the treatment of alcohol dependence. Out of 93 alcohol-dependent patients initially screened, 56 were randomly assigned to a double-blind treatment with individually titrated baclofen or placebo using dosages of 30-270mg/d. The multiple primary outcome measures were (1) total abstinence and (2) cumulative abstinence duration during a 12-week high-dose phase. More patients of the baclofen group maintained total abstinence during the high-dose phase than those receiving placebo (15/22, 68.2% vs. 5/21, 23.8%, p=0.014). Cumulative abstinence duration was significantly higher in patients given baclofen compared to patients of the placebo group (mean 67.8 (SD 30) vs. 51.8 (SD 29.6) days, p=0.047). No drug-related serious adverse events were observed during the trial. Individually titrated high-dose baclofen effectively supported alcohol-dependent patients in maintaining alcohol abstinence and showed a high tolerability, even in the event of relapse. These results provide further evidence for the potential of baclofen, thereby possibly extending the current pharmacological treatment options in alcohol dependence.


Suppression of alcohol dependence using baclofen: a 2-year observational study of 100 patients.
de Beaurepaire R1.

Abstract
AIMS:

The purpose of this study was to examine the long-term effects of baclofen in a large cohort of alcohol-dependent patients compliant to baclofen treatment.
METHODS:

A hundred patients with alcohol dependence, resistant to usual treatments, were treated with escalating doses of baclofen (no superior limit). Alcohol consumption (in grams) and craving for alcohol were assessed before treatment and at 3, 6, 12, and 24 months. Assessments were simply based on patients' statements. The outcome measure was the consumption of alcohol, rated according to the World Health Organization criteria for risk of chronic harm.

RESULTS:

While all patients were rated "at high risk" at baseline, approximately half of them were rated "at low risk" at 3, 6, 12, and 24 months. The sum of patients who were at "low risk" and at "moderate risk" (improved patients) was 84% at 3 months, 70% at 6 months, 63% at 1 year, and 62% at 2 years. The constancy of improvement over the 2-years was remarkable. The average maximal dose of baclofen taken was 147 mg/day. Ninety-two percentage of patients reported that they experienced the craving-suppressing effect of baclofen. Significant relationships were found between the amount in grams of alcohol taken before treatment and the maximal dose of baclofen required, and between the existence of a mental disorder and a lesser effect of baclofen.

CONCLUSION:

Baclofen produces an effortless decrease or suppression of alcohol craving when it is prescribed with no superior limit of dose. Potential limitations in the effectiveness of baclofen include the coexistence of a mental disorder, the concomitant use of other psychotropic drugs, a lack of real motivation in patients to stop drinking, and the impossibility to reach the optimal dose of baclofen because of unbearable side-effects (sometimes possibly related to too sharp a protocol of dose escalation).


Abstinence and 'low-risk' consumption 1 year after the initiation of high-dose baclofen: a retrospective study among 'high-risk' drinkers.
Rigal L1, Alexandre-Dubroeucq C, de Beaurepaire R, Le Jeunne C, Jaury P.

Abstract
AIMS:

The aim of the study was to assess the proportions of 'high-risk' drinkers' abstinent or with 'low-risk' consumption levels 1 year after the initiation of high-dose baclofen.

METHODS:

This is a retrospective 'open' study; the outcome of this study was to assess the level of alcohol consumption in the 12th month of treatment.
RESULTS:

Of the 181 patients included, a follow-up evaluation was possible in 132 patients. The initial alcohol consumption of the 132 patients analysed averaged 182 ?? 92 g/day. After 1 year, 80% of the 132 (i.e. 58% of 181) were either abstinent (n = 78) or drinking at low-risk levels (n = 28) in their 12th month of treatment. The mean baclofen dose at 1 year was 129 ?? 71 mg/day.
CONCLUSION:

High-dose baclofen should be tested in randomized placebo-controlled trials among high-risk drinkers.

-tk

[Otter]

freeihope is banned member spiritwolf333/spiritfree/befreenow/Alfree. Apparently, he just got banned again as I was reading this.


lol

[carlmartin1000]

Hi Cass and thank you for your post(s) as always. You are a true statesman.

Regarding Baclofen, it just does not appear to work for the majority in ending their AUD (alcoholism). I do believe that it can help, but when all is said and done, it quite simply id not the "magic pill" all was hoping for. What Baclofen has done for the world of addiction is to to wake people up to other real possibilities in resolving addiction, and this, in and of itself, makes Baclofen a hero.

Let's talk about asbestos!

[Leafy]

Lol

just a thought....

Sheesh, really amazed he keeps trying. I am still trying to figure out if this is a safe place because of whatever Free-Ass Whoever posting.

[_serenity_]

Leafy - sending you a PM

[Otter]

I just received an email from Spiritwolf/free to my personal email account, which he persuaded me to disclose to him. As a caution to users of this forum about people wanting to be your friend, because they, so THEY say, think you are wonderful and want to be your "friend", here is what SF has sent me:

"David, I do feel very, very sorry and sad for you.

You turned out to be everything all had warned me that your were.
Good luck with your treatment counseling and promotion.

I wish you well as you continue to struggle through this life."


Hmmm.... what an odd man.

[Otter]

Attachment 2590



Life is great. We could not have done this without baclofen. I am at sailing classes having a Coke on Fathers day.

[Ne/Neva Eva]

...Baclofen has been proven effacious in several studies including a double-blind random controlled trial:



High-dose baclofen for the treatment of alcohol dependence (BACLAD study): a randomized, placebo-controlled trial.

M?_ller CA1, Geisel O2, Pelz P2, Higl V2, Kr?_ger J2, Stickel A2, Beck A2, Wernecke KD3, Hellweg R2, Heinz A2.



Abstract



Previous randomized, placebo-controlled trials (RCTs) assessing the efficacy of the selective γ-aminobutyric acid (GABA)-B receptor agonist baclofen in the treatment of alcohol dependence have reported divergent results, possibly related to the low to medium dosages of baclofen used in these studies (30-80mg/d). Based on preclinical observations of a dose-dependent effect and positive case reports in alcohol-dependent patients, the present RCT aimed to assess the efficacy and safety of individually titrated high-dose baclofen for the treatment of alcohol dependence. Out of 93 alcohol-dependent patients initially screened, 56 were randomly assigned to a double-blind treatment with individually titrated baclofen or placebo using dosages of 30-270mg/d. The multiple primary outcome measures were (1) total abstinence and (2) cumulative abstinence duration during a 12-week high-dose phase. More patients of the baclofen group maintained total abstinence during the high-dose phase than those receiving placebo (15/22, 68.2% vs. 5/21, 23.8%, p=0.014). Cumulative abstinence duration was significantly higher in patients given baclofen compared to patients of the placebo group (mean 67.8 (SD 30) vs. 51.8 (SD 29.6) days, p=0.047). No drug-related serious adverse events were observed during the trial. Individually titrated high-dose baclofen effectively supported alcohol-dependent patients in maintaining alcohol abstinence and showed a high tolerability, even in the event of relapse. These results provide further evidence for the potential of baclofen, thereby possibly extending the current pharmacological treatment options in alcohol dependence.





Suppression of alcohol dependence using baclofen: a 2-year observational study of 100 patients.

de Beaurepaire R1.



Abstract

AIMS:



The purpose of this study was to examine the long-term effects of baclofen in a large cohort of alcohol-dependent patients compliant to baclofen treatment.

METHODS:



A hundred patients with alcohol dependence, resistant to usual treatments, were treated with escalating doses of baclofen (no superior limit). Alcohol consumption (in grams) and craving for alcohol were assessed before treatment and at 3, 6, 12, and 24 months. Assessments were simply based on patients' statements. The outcome measure was the consumption of alcohol, rated according to the World Health Organization criteria for risk of chronic harm.



RESULTS:



While all patients were rated "at high risk" at baseline, approximately half of them were rated "at low risk" at 3, 6, 12, and 24 months. The sum of patients who were at "low risk" and at "moderate risk" (improved patients) was 84% at 3 months, 70% at 6 months, 63% at 1 year, and 62% at 2 years. The constancy of improvement over the 2-years was remarkable. The average maximal dose of baclofen taken was 147 mg/day. Ninety-two percentage of patients reported that they experienced the craving-suppressing effect of baclofen. Significant relationships were found between the amount in grams of alcohol taken before treatment and the maximal dose of baclofen required, and between the existence of a mental disorder and a lesser effect of baclofen.



CONCLUSION:



Baclofen produces an effortless decrease or suppression of alcohol craving when it is prescribed with no superior limit of dose. Potential limitations in the effectiveness of baclofen include the coexistence of a mental disorder, the concomitant use of other psychotropic drugs, a lack of real motivation in patients to stop drinking, and the impossibility to reach the optimal dose of baclofen because of unbearable side-effects (sometimes possibly related to too sharp a protocol of dose escalation).





Abstinence and 'low-risk' consumption 1 year after the initiation of high-dose baclofen: a retrospective study among 'high-risk' drinkers.

Rigal L1, Alexandre-Dubroeucq C, de Beaurepaire R, Le Jeunne C, Jaury P.



Abstract

AIMS:



The aim of the study was to assess the proportions of 'high-risk' drinkers' abstinent or with 'low-risk' consumption levels 1 year after the initiation of high-dose baclofen.



METHODS:



This is a retrospective 'open' study; the outcome of this study was to assess the level of alcohol consumption in the 12th month of treatment.

RESULTS:



Of the 181 patients included, a follow-up evaluation was possible in 132 patients. The initial alcohol consumption of the 132 patients analysed averaged 182 ?? 92 g/day. After 1 year, 80% of the 132 (i.e. 58% of 181) were either abstinent (n = 78) or drinking at low-risk levels (n = 28) in their 12th month of treatment. The mean baclofen dose at 1 year was 129 ?? 71 mg/day.

CONCLUSION:



High-dose baclofen should be tested in randomized placebo-controlled trials among high-risk drinkers.



-tk

Thanks, Tk.