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Death from alcohol overuse can be prevented with medications

JacksinPA

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Death from alcohol overuse can be prevented with medications | TheHill

Getting off alcohol is all about getting rid of the cravings for it


Forget your 12-step meetings. You're only trading one addiction for another.

The root of the problem of alcohol withdrawal is biological, not social. It's in your brain, not your friends at meetings.

Alcohol is the most common problem encountered by primary care providers, yet the one they are least able to manage. Often missing from treatment is discussion of medication as an option. It is still rare for a person struggling with alcohol to hear that medication therapy exists.

People in alcohol treatment, then, often have the most serious problems. Yet less than 10 percent of them are prescribed medications, which are very effective.

The FDA has approved 3 drugs for alcohol withdrawal symptoms: Naltrexone and acamprosate are the two drugs on the market for patients with alcohol cravings and they’re effective. Both are easily tolerated and produce few side effects. There’s ample evidence they work. But they don't really nullify the cravings. They just take some of the high out of being drunk. And naltrexone is an opioid. I'm not familiar with it or its side effects, such as constipation or failing a drug test for opioids.

The one that does work is not yet approved by the FDA but may be prescribed off-label by a doctor: baclofen. Originally developed as a muscle relaxant, it works on the same brain receptor as does alcohol: GABA-B. It has the same biological effect as a couple of stiff drinks without the resulting intoxication. It can be overused and does have side effects, especially if overused: loss of balance is one significant one. But it has the peculiar property of having an extended effect on the brain: weeks or months between taking a pill. And the craving for alcohol just vanishes. Amazing stuff.

A final word of caution: muscle relaxants like baclofen are often in the drugs of abuse category & can have there own withdrawal problems. Moderation in all things.

Moderation In All Things
moderation in all things proverbial saying, mid 19th century; a more recent formulation of the idea contained in there is measure in all things. The essential thought is found in the work of the Greek poet Hesiod (c.700 bc), ‘observe due measure; moderation is best in all things’, and of the Roman comic dramatist Plautus (c.250–184 bc), ‘moderation in all things is the best policy.’
 
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Death from alcohol overuse can be prevented with medications | TheHill

Getting off alcohol is all about getting rid of the cravings for it


Forget your 12-step meetings. You're only trading one addiction for another.

The root of the problem of alcohol withdrawal is biological, not social. It's in your brain, not your friends at meetings.

Alcohol is the most common problem encountered by primary care providers, yet the one they are least able to manage. Often missing from treatment is discussion of medication as an option. It is still rare for a person struggling with alcohol to hear that medication therapy exists.

People in alcohol treatment, then, often have the most serious problems. Yet less than 10 percent of them are prescribed medications, which are very effective.

The FDA has approved 3 drugs for alcohol withdrawal symptoms: Naltrexone and acamprosate are the two drugs on the market for patients with alcohol cravings and they’re effective. Both are easily tolerated and produce few side effects. There’s ample evidence they work. But they don't really nullify the cravings. They just take some of the high out of being drunk.

The one that does work is not yet approved by the FDA but may be prescribed off-label by a doctor: baclofen. Originally developed as a muscle relaxant, it works on the same brain receptor as does alcohol: GABA-B. It can be overused and does have side effects, especially if overused: loss of balance is one significant one. But it has the peculiar property of having an extended effect on the brain: weeks or months between taking a pill. And the craving for alcohol just vanishes. Amazing stuff.

Man, that's gotta be tough and hard thing to wrap my head around. I've dealt with addicts and drunks most of my professional life and have never once understand what it must be like to have unquenchable physical cravings for some sort of substance. I deal with it in other people, but just can't imagine a substance that I couldn't say 'no' to.
 
Man, that's gotta be tough and hard thing to wrap my head around. I've dealt with addicts and drunks most of my professional life and have never once understand what it must be like to have unquenchable physical cravings for some sort of substance. I deal with it in other people, but just can't imagine a substance that I couldn't say 'no' to.

They do exist: alcohol, heroin, cocaine. But the important thing is that there are seldom sought & therefore seldom used remedies for the cravings.

It is easy to give up these substances. But the really hard part is dealing with & succumbing to the cravings that inevitably follow, which are biological. My field is chemistry, BTW.

Most doctors have no clue about these treatments, which is a pity.
 
They do exist: alcohol, heroin, cocaine. But the important thing is that there are seldom sought & therefore seldom used remedies for the cravings.

It is easy to give up these substances. But the really hard part is dealing with & succumbing to the cravings that inevitably follow, which are biological. My field is chemistry, BTW.

Most doctors have no clue about these treatments, which is a pity.

Oh, I know they exist. I've dealt with them extensively.

The real problems, to my experience, are:

A. the remnants of our puritanical roots that demand PUNISHMENT.
B. from that the idea that addiction comes from moral failure and deserves denigration.
C. that denigration should come in the form of incarceration

I could go on, but you get the point.
 
Literature reference abstracts on the use of baclofen for cocaine, heroin, alcohol and nicotine addiction:

Drug Alcohol Depend. 2002 Feb 1;65(3):209-20.
GABA(B) receptor agonists for the treatment of drug addiction: a review of recent findings.
Cousins MS1, Roberts DC, de Wit H.
Author information
1
Department of Psychiatry, University of Chicago, 5841 South Maryland Avenue, Chicago, IL 60637, USA. hdew@midway.uchicago.edu
Abstract
A growing preclinical and clinical literature suggests that GABA(B) receptor agonists promote abstinence and reduce the use of cocaine, heroin, alcohol and nicotine. The purpose of this paper is to critically review these data. GABA(B) receptor agonists, such as baclofen, appear to reduce the reinforcing effects of abused drugs in animal models under multiple experimental procedures. This occurs at doses that have little effect on responding for other positive reinforcers such as food or water. We review evidence that these potential therapeutic effects may be mediated by modulation of mesolimbic dopamine neurons. This review also examines the preliminary clinical data from studies of the efficacy of baclofen for treatment of cocaine, alcohol, and nicotine dependence. We suggest that these preliminary data provide a rationale for conducting more systematic studies of the effects of GABA(B) receptor agonists as treatment for drug abuse. This line of research may also improve our understanding of the neurochemical mechanisms underlying the drug dependence process.
===============================================================
Curr Pharm Des. 2015;21(23):3367-72.
GABAB Agonists for the Treatment of Alcohol Use Disorder.
Mirijello A, Caputo F, Vassallo G, Rolland B, Tarli C, Gasbarrini A, Addolorato G1.
Author information
1
Department of Internal Medicine, Catholic University of Rome, Gemelli Hospital, Largo Gemelli 8, 00168 Rome, Italy. g.addolorato@rm.unicatt.it.
Abstract
Almost 10% of the world's population is affected by alcohol use disorder (AUD). The combination between psychosocial intervention and pharmacological treatment seems to be the most effective approach for patients affected by AUD. Among effective drugs useful in the treatment of AUD, GABAB-ergic medications have been tested with encouraging results (i.e. sodium oxybate, baclofen, gabapentin, pregabalin and tiagabine). The present review will summarize available data on these medications.
 
Man, that's gotta be tough and hard thing to wrap my head around. I've dealt with addicts and drunks most of my professional life and have never once understand what it must be like to have unquenchable physical cravings for some sort of substance. I deal with it in other people, but just can't imagine a substance that I couldn't say 'no' to.

Interesting.

I just compare it to what starvation must feel like. Knowing there is food, but not allowing oneself to eat it.

Terrifyingly difficult I imagine. Certainly hard as hell when I try.
 
Interesting.

I just compare it to what starvation must feel like. Knowing there is food, but not allowing oneself to eat it.

Terrifyingly difficult I imagine. Certainly hard as hell when I try.

Thanks, Lursa. It's something unfathomable to me.
 
Interesting.

I just compare it to what starvation must feel like. Knowing there is food, but not allowing oneself to eat it.

Terrifyingly difficult I imagine. Certainly hard as hell when I try.

Just find yourself a psych who specializes in addiction problems & ask for a prescription for a month's supply of baclofen. Generic & cheap.
 
Just find yourself a psych who specializes in addiction problems & ask for a prescription for a month's supply of baclofen. Generic & cheap.

By itself it wont cure anything in most people
 
Not in less you try it. How are you the expert?

How are you the expert?

Addictive personalities & characteristics of humans will always be a enigma.

Drinking, drugs, betting, hoarding, violence, lying, etc. ..........................just take a pill. Right?

Let's see how this all pans out. :lamo
 
30 years a a therapist....did drug treatment for about 6 years

It still does not hurt to try it. Granted, some people may react differently than others. Worth a try.
 
It still does not hurt to try it. Granted, some people may react differently than others. Worth a try.

Go for it. If you could cure alcoholism with a pill the drug companies would make billions and be pushing it every day
 
Just find yourself a psych who specializes in addiction problems & ask for a prescription for a month's supply of baclofen. Generic & cheap.

I have avoided addictions, thankfully.
 
How are you the expert?

Addictive personalities & characteristics of humans will always be a enigma.

Drinking, drugs, betting, hoarding, violence, lying, etc. ..........................just take a pill. Right?

Let's see how this all pans out. :lamo

I know people on baclofen who haven't had the need for a drink in over 6 months. I know of no one who has tried it & failed.
 
It still does not hurt to try.

I am the first to welcome more research into pharmacological interventions for addiction. It will likely be a part of the future.


I just dont think we are there yet and it can hurt if you do this and dont also use other inventions at the same time. It can be fatal
 
Man, that's gotta be tough and hard thing to wrap my head around. I've dealt with addicts and drunks most of my professional life and have never once understand what it must be like to have unquenchable physical cravings for some sort of substance. I deal with it in other people, but just can't imagine a substance that I couldn't say 'no' to.

Escaping reality is becoming an artform in this nation.

THe silent addition that is killing is FOOD. This country is eating itself to death along with drinking and drugs.
 
I know people on baclofen who haven't had the need for a drink in over 6 months. I know of no one who has tried it & failed.

And this is a good thing for sure!

But, it doesn't cure the addictive nature of the patient. What will happen when the addicted person decides to get off the baclofen do to the possible long term side effects?
 
Go for it. If you could cure alcoholism with a pill the drug companies would make billions and be pushing it every day

Baclofen was developed in the 60s so there is no current patent coverage & therefore no big $$$ to be made. You can see in the literature that they are working on other GABA-B agonists that might have advantages over baclofen & that they could make $$$ on.
 
Its interesting but I await the evidence

Here's some. I understand the NIH is studying baclofen to be added to the on-label drugs for treating alcohol withdrawal craving symptoms.

Baclofen - StatPearls - NCBI Bookshelf

Baclofen
Shirin Ghanavatian; Armen Derian.

Author Information
Last Update: October 1, 2019.

Go to:
Indications
Baclofen was originally designed in 1960 to treat epilepsy. However, the result was not satisfactory. Baclofen was then reintroduced in 1971 when it was found to treat muscle spasticity and has seen wide use since. Baclofen is FDA-approved for the management of reversible spasticity, particularly for the relief of flexor spasms, clonus, and concomitant pain, common sequelae of spinal cord lesions and multiple sclerosis. However, for patients who experience intolerable adverse effects or who fail to respond to oral therapy, intrathecal baclofen might be considered.[1] Intrathecal baclofen administration is FDA-approved for the management of spasticity of cerebral origins, such as traumatic brain injury or severe spasticity of spinal cord origin that is unresponsive to treatment with maximum doses of oral baclofen, tizanidine, and/or dantrolene.


One last note: 90+% of baclofen is excreted unchanged via the kidneys, so no liver interaction as with alcohol.

Baclofen is also used off-label for maintenance of alcohol abstinence by decreasing alcohol cravings,
 
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