Breaking the Cycle: Treating Alcohol Dependency with Compound Baclofen
“Just one more drink,” was an all-too-common refrain for Sarah, a 38-year-old human resources assistant. Sarah consumed half a bottle of gin and an entire bottle of wine every single day and her health, work, and relationships suffered. Sarah tried psychotherapy, rehab, and more traditional medications to try to address her alcoholism. Nothing worked for long. Then she was prescribed a moderate dose of baclofen. Two and a half years after beginning baclofen treatments, she has been sober two years.1
Baclofen has shown an ability to reduce cravings for alcohol in heavy drinkers who have not responded to more traditional treatment methods, and with alcoholism affecting an estimated 16.6 million adults, the time to find more effective treatments for alcoholism is right now.2
What the Pharmacist Should Know About Treating Alcoholism with Baclofen
First synthesized by Swiss chemist Heinrich Kaberle as a medication for treating epilepsy, baclofen is a GABA receptor agonist most often used today to treat spasticity or muscle spasms. Not only has baclofen been shown to produce a state of indifference to alcohol, but it also has been shown in studies to reduce the symptoms of alcohol withdrawal syndrome consistent with the current leading medication diazepam.3
Treatment for alcoholism continues to progress from social, neurological, and behavioral to exploring more chemical and pharmacotherapy options. Focusing on the addiction at the base of alcoholism has resulted in some breakthroughs. Since the 1980s, more medications for alcoholism have been approved, but most are aversive agents or opiate antagonists that work on users’ reaction to the alcohol rather than the underlying addiction. GABA receptor agonists like baclofen have only just recently begun to be seriously examined for their effectiveness in treating alcoholism.
In the late 1990s, researchers tested the effects of baclofen on cocaine-addicted mice, which inspired French-American Dr. Olivier Ameisen to experiment with baclofen compounds for alcoholism treatment. After doses of baclofen, the mice no longer sought out cocaine hits in the lab. In some theories, baclofen acts on the same brain receptors as the addictive substance, whether cocaine or alcohol, specifically triggering a feeling of contentment and relaxation, which allows the user to feel that same feeling without needing the substance at all.4
By severing the connection between the alcohol and the pleasurable neuropathic reaction, the pharmacologic compound baclofen actually assists the user with rewiring the brain to no longer desire the alcohol. Naturally, this pays dividends because it reduces the likelihood of relapses and does not leave continued sobriety up to the individual’s will to conquer cravings. Lower doses of 30 mg/day significantly reduce desire for alcohol (and subsequently, actual levels of consumption), and higher doses of up to 300 mg daily can lead to complete abstinence.5 Baclofen is relatively easy to compound into medications and has minimal side effects at recommended doses and does not exhibit addictive qualities of its own.6
Current State of Research Into Compound Baclofen for Alcoholism Treatment
There have been several small-sample studies of the effects of compound baclofen on alcohol addiction. A 2002 study run by current National Institute on Alcohol Abuse and Alcoholism (NIAA) chief of psychoneuroendocrinology and neuropsychopharmacology Dr. Lorenzo Leggio and Italian researcher Dr. Giovanni Addolorato tested doses of baclofen and placebos on 39 patients and showed that the baclofen was more effective than the placebo at reducing craving and abstinence duration. A later 2008 NIAA-funded study on 80 patients by Dr. James C. Garbutt seemed to produce negligible differences between the baclofen and the placebo, though Dr. Garbutt later indicated that he did not believe the doses were high enough in his trial. Dr. Garbutt and Dr. Leggio continue to work together for future research, despite their conflicting results.7
One of the areas where more research is required is the exact dosage of baclofen necessary to produce results in alcoholic patients. Dr. Leggio was running trials in 2014 with doses between 30 and 90 mg daily. Pioneer of baclofen studies Dr. Ameisen recommended up to 300 mg daily in his trials. There is not enough evidence, however, to adjust the current recommendations of baclofen dosages, which in America is 80 mg daily and in Europe is 100 mg daily. Higher doses can result in some side effects like nausea that are not seen at lower doses.
Ultimately, compound baclofen is still in the early stages of being tested for alcohol treatment, but hopes are high. Online forums have sprung up with patients detailing their treatment successes thanks to baclofen doses and promoting physicians willing to work with them to try compound baclofen for their alcoholism. The National Institute on Alcohol Abuse and Alcoholism (NIAA) has emphasized the urgency to develop new medications for alcoholism, calling research into baclofen one of their top priorities.8
More studies will be forthcoming, but for people like Sarah who regained control of her life thanks to compound baclofen treatments for her destructive alcoholism, these treatments can be life-changing. Alcoholism can affect any person at any stage of their life, and has been shown to disproportionately affect some of the country’s more vulnerable populations, including racial minorities and veterans. As more researchers and physicians take up the work of continuing these studies and carefully prescribing baclofen to specific patients, more alcoholism sufferers move closer and closer to an effective treatment.
Pharmaceutica North America is a premier provider of top-quality pharmaceutical ingredients for compounding crucial medications for today’s world and tomorrow’s needs. Contact us to find out more about our Baclofen API and how it can be part of compound medication to treat alcoholism.
- “The use of very high-doses of baclofen for the treatment of alcohol-dependence: a case series,” Oct. 10, 2014, http://dx.doi.org/10.3389/fpsyt.2014.00143 ↩
- “Alcohol Facts and Statistics,” March 2015, http://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics ↩
- Novel Therapeutic Strategies for Alcohol and Drug Addiction: Focus on GABA, Ion Channels and Transcranial Magnetic Stimulation,” Oct. 26, 2011, http://www.nature.com/npp/journal/v37/n1/full/npp2011216a.html ↩
- “Baclomania,: The Cult of a Cure for Alcoholism,” March 24, 2015, https://www.thefix.com/content/baclomania-cult-cure-alcoholism ↩
- “Suppression of Alcohol Dependence Using Baclofen: A 2-Year Observational Study of 100 Patients,” Dec. 3, 2012, http://dx.doi.org/10.3389%2Ffpsyt.2012.00103 ↩
- Lowinson and Ruiz’s Substance Abuse: A Comprehensive Textbook, p. 155, 2011, https://goo.gl/4QjQ0L ↩
- “Baclofen: Hope for alcoholism treatment, but more trials needed,” April 7, 2014, https://www.med.unc.edu/psych/research/addiction/research-findings/baclofen-featured-in-alcohol-drug-abuse-weekly; Essential Evidence-Based Psychopharmacology, p. 226, July 5, 2012, https://goo.gl/wzCP9u ↩
- “Baclofen: Hope for alcoholism treatment, but more trials needed,” ibid. ↩