The End of My Addiction

life-threatening complications. Surely it was only a matter of time before I broke my back or my neck and wound up paraplegic or quadriplegic. Who would give me a drink to quiet my alcohol craving then, or help me pass out of this world and end my alcoholism that way?

    It wasn’t until November of that year that I dimly recalled the New York Times article Joan had sent me twelve months earlier. I called Joan and asked her to track it down and send it to me again, which she did.
    This time, I was not intoxicated when it arrived, and I read with fascination about how positron emission tomography (PET) scans conducted by the psychologist Dr. Anna Rose Childress, an addiction researcher at the University of Pennsylvania’s Treatment Research Center, showed a remarkable quieting of brain activity in a cocaine addict who was taking baclofen, a muscle relaxant, to control spasms. The addict said that this medication reduced his craving substantially. I did not want to get my hopes up too much, but I did have to wonder: Could baclofen help me stop drinking?

6. Against Medical Advice, or, The Life of Afterward
    READING—WITH A CLEAR HEAD, between binges—the New York Times article about baclofen’s effect on an addicted patient, I was encouraged by three things.
    First, baclofen reduced craving as experienced by the patient in the experiment—a cocaine addict and paraplegic—and did so not only for cocaine but also for alcohol and nicotine.
    Second, baclofen changed the patterns of neurotransmission in the patient’s brain visible on PET scans, quieting activity in the amygdala. Studies associate the amygdala with memories of pleasurable events, and with experiences of craving for, or anticipation of, a variety of addictive substances and compulsive behaviors.
    Third, baclofen resolved the patient’s muscular spasms, the purpose for which the medicine was originally prescribed.
    The reporter, Linda Carroll, vividly conveyed all this, dramatically and scientifically, in her article. For me, the idea that a drug could quiet both a patient’s muscular spasms and addictive cravings was tantalizing. Perhaps baclofen could relax my chronic muscular and nervous tension, keep it from intensifying into chronic anxiety and panic, and thereby short-circuit the craving for alcohol to resolve that extreme distress.
    Relaxation exercises feature prominently in many addiction treatment programs, on the principle that if the body relaxes, the mind will follow. That made sense to me both from my own experience and my observations of others. Although the phenomenon has not been written up in the medical literature, alcoholics and addicts seem to share a high degree of physical agitation. Attend an open AA or NA meeting, and you will see a good deal of leg pumping, toe tapping, fidgeting, and so forth. The question is: Does the agitation result from addictive behavior, precede it, or both? I constantly heard from others in AA that they never felt well, relaxed, easy in their own skins, until they started drinking. I felt the same way, and my suspicion is that chronic physical uneasiness triggers addictive behavior and then is exacerbated by this self-medication gone wrong.
    In rehab and outpatient programs, I did relaxation exercises faithfully. I took frequent yoga classes, and practiced self-hypnosis techniques, too, but I could never achieve full relaxation. In group exercises, other people sometimes became so relaxed that they actually fell asleep, and many people reported that they remained physically relaxed for up to a day or more after a set of relaxation exercises or a yoga class. For me, the muscular and nervous tension began to return after twenty to thirty minutes.
    Commonly prescribed anti-anxiety medications like Valium and other benzos belong to the larger category of so-called sedative-hypnotics, and as the label suggests, they do affect muscular and nervous tension. For example, Valium is often given to relieve severe back spasms. But benzos also induce dependency and have serious side effects, including impaired memory and cognitive function. I never liked the experience of taking these medications—they made me feel loopy or groggy. If baclofen lacked such drawbacks—and no unpleasant side effects were mentioned in the New York Times article—it might very well help me.
    It was interesting that the experiment on baclofen to reduce craving had its impetus partly in the patient’s self-observations. Prescribed