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Tuesday, December 9, 2008

Doctor Claims Cure for Alcoholism in a Pill

French Doctor Says He Cured Himself of Addiction by Taking a Muscle Relaxer

By RUSSELL GOLDMAN

Dec. 9, 2008—

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A French cardiologist says he has discovered a cure for alcoholism and ended his own decades-long addiction to alcohol by dosing himself with a drug usually used for treating muscle spasms.

Dr. Olivier Ameisen, 55, a French physician who practiced for a time at New York's Weill-Cornell Medical Center claims in his new book "Le Dernier Verre" ("The Last Glass") that since he started taking the drug baclofen, he has lost his desire to consume alcohol.

The book, a best-seller in France slated for release in the United States next year under the title "The End of My Addiction," has caused a stir on both sides of the Atlantic, with some doctors cautiously optimistic about the drug's results in lab tests and others warning that no single drug can cure alcoholism's many root causes.

Despite a lucrative cardiology practice he began in 1994, Amesein writes that he felt like "an impostor waiting to be unmasked." The doctor writes that he drank large quantities of whiskey and gin, though he hated the taste of alcohol.

"I detested the taste of alcohol, but I needed its effects to exist in society," he writes in the book.

Ameisen writes that he began using baclofen, a muscle relaxant typically used to treat muscle spasms in people with multiple sclerosis, after reading a 2000 New York Times article about how the drug cured a cocaine addict of his addiction after he was prescribed the drug for a muscle problem.

"We've been interested in baclofen to treat alcoholism for years and continue to study its effects," said Dr. James Garbutt, a researcher at the Bowles Center for Alcohol Studies at the University of North Carolina at Chapel Hill School of Medicine.

Garbutt said two different clinical tests of the drug to treat alcohol addiction in humans yielded different, inconclusive results, but that the drug was "not just snake oil.

"There is a fair amount of evidence that the drug does something. The basic science is sound, and it's been shown to work in animals," Garbutt said. "There is a good amount of good science that has shown good results, but there are still many, many questions. How effective is it really? What's the right dose? How safe is it? Will it work for everyone?"

Drug Suppressing Alcohol Addiction

In one of the human trials, the drug was shown to be no more effective than a placebo. Another double-blind study, conducted last year by scientists at the Institute of Internal Medicine in Rome, found 70 percent of alcohol-dependent patients who were treated with baclofen achieved sobriety, compared with 30 percent of those on a placebo.

Once off the drug, however, patients remained sober for just two months on average.

According to published reports about the book's contents, Ameisen spent nine months trying to shake his addiction, including entering a clinic and undergoing hypnosis and acupuncture.

In March 2002, he began taking 5 milligrams of baclofen.

"The first effects were a magical muscular relaxation and babylike sleep," he wrote, according to the British newspaper The Independent.

After increasing his daily dose to 270 milligrams, Ameisen declared himself "cured." He continues to take 50 milligrams a day.

"Mine is the first case in which a course of medicine has completely suppressed alcohol addiction," Ameisen said, according to The Independent. "Now I can have a glass, and it has no effect. Above all, I no longer have that irrepressible need to drink."

Ameisen's claim that he can continue to drink socially, flies in the face of what scientists know about treating alcoholism, said Dr. Nicholas Pace, an addiction expert and a clinical professor of medicine at New York University.

"I have studied alcoholism for the past 40 years, and there is no single magic bullet. This is a complex disease, and you can't just flip one switch," Pace said.

"The idea that an alcoholic can drink socially is simply a lot of bull," he said.

Pace said beyond just physical and psychological cravings, the very way an alcoholic's body, particularly his liver, responds is different from that of nonalcoholics. Furthermore, he said, the causes for the disease are complicated, and any effective treatment has to address them all.

"There are all kinds of factors that contribute to the disease of alcoholism. There is genetic predisposition, biology and social triggers," he said. "A pill can't change someone's genetics, his liver or the social settings [in which] he finds himself."

Alcoholic's Miracle Cure?

European researchers are also skeptical that baclofen is a miracle cure.

"To let people think that there is a miracle molecule is to misjudge the complexity of alcoholism, and this is irresponsible," Michel Reynaud, a researcher at Paris' Hopital Paul-Brousse, who has applied for a grant to study baclofen's efficacy, told Agence France Presse.

Since the release of "Le Derner Verre," French doctors have reported an increase in patients seeking the drug as treatment for their addiction.

Fabienne Bartoli, deputy director of the AFSSAPS, the French equivalent of the Food and Drug Administration, which tests and certifies drugs as safe, said doctors prescribing the drug in an off-label way do so at their own risk.

In high doses, she said, the drug can be dangerous and cause respiratory failure.

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