Tuesday, October 4, 2011

A Pill to Stop Alcohol Cravings

If only the cravings for alcohol would go away, people trying to overcome the grip of alcoholism would stand a much better chance of fighting off the disease. Anybody who has had alcohol cravings knows what this is all about. It's one thing to experience a little temptation, but it's another to have an overwhelming, persistent urge and need for alcohol. There's always a problem. First we want to take the edge off the troubles of the day, so we have a drink. Then we want to take the edge off the craving for alcohol.

Those who have participated in 12-Step recovery turn to their "higher power" for strength and support, trusting that the "higher power" will restore them to sanity. They decide turn their will and their lives over to the care of God, as they understand Him, to be a guiding light and source of comfort. This is accomplished through an ever-deepening, personal relationship. But this is America and we want relief NOW. There might be a pharmacological intervention.

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The drug baclofen is a muscle relaxant, used to treat muscle symptoms caused by multiple sclerosis. The symptoms include spasms, stiffness and pain. Some of the side effects include impairment of thinking or reactions, so patients who need to be awake and alert need to be careful when using this drug. Patients who have used baclofen for a long time may experience serious withdrawal symptoms, such as seizures or hallucinations. The use of baclofen to help alcoholics with their cravings is relatively new, so there isn't an abundance of clinical testing

I read an article on medscape.com, which discussed results of clinical testing for patients with advanced liver disease. The 2007 study cast baclofen in a favorable light for a medical intervention.

"In conclusion, our results suggest that baclofen, because of its anti-craving action and safety, could have an important role for treatment of alcohol-dependent patients with advanced liver disease," the researchers, with first author Giovanni Addolorato, MD, from the Institute of Internal Medicine, Catholic University of Rome, in Italy, write. "We have shown that a pharmacological agent can promote alcohol abstinence and prevent alcohol relapse in individuals with alcoholic liver disease."

Patients with acidosis, who cannot stop drinking and are faced with death if they fail to stop doing so, and any treatment can't move forward as long as they are drinking. But this is a severe case. What about other patients with alcoholism, who are not in the latter stages of liver disease, or who are in one of the earlier stages of alcoholism?

Assuming that baclofen is safe and appropriate for treatment of alcohol cravings does it represent a one-stop cure for alcoholism? This introduces an interesting topic for discussion. Aside from physical dependence or alcohol cravings, what about other factors that contribute to one becoming an alcoholic, such as psychological makeup, environment or genetics? If I drink, for example, to numb the pain in my life, will taking away alcohol cravings help that pain to subside?

I can see baclofen as a piece of the solution puzzle, in limited cases. But I can't help but get back to 12 Step, because it is incorporated into an interdisciplinary program, meaning that physical, emotional and spiritual issues are addressed. Pharmacological interventions do not sooth the human spirit, nor with baclofen heal broken relationships. I can see, however, how this drug intervention, in theory, can save the lives of patients in the cases discussed in the study. I would caution against looking to a pill as a "cure."

The anti-12 Step crowd will herald any drug intervention as being a positive alternative to 12 Step, mainly because 12 Step takes time and is far more difficult than taking a pill. Baclofen does not require honesty, openness and willingness, nor does it necessitate self-examination. Perhaps baclofen can stop the alcohol cravings, or be used as a tool to help a person regain control of his/her life, and help bring about a return to health. I have no issue with this. But if the whole person is not treated, then the hole in the spirit that is filled with alcohol, or some other destructive force, is still there.

A Pill to Stop Alcohol Cravings

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