The End of My Addiction

60 milligrams of baclofen a day to calm the muscular spasms associated with his paraplegia, Edward Coleman found it wasn’t enough and tried 80 milligrams. That quieted the spasms, but also had two side effects, one negative and one positive, at least from his perspective. The negative side effect was that “it would block his high if he took the baclofen too close to the time he took cocaine.” The positive side effect was that “the medication could reduce his craving when cocaine was unavailable.” Professor Childress, who had conducted an earlier, pilot study of the effect of baclofen on cravings and planned a longer study, generously acknowledged Edward Coleman’s insights, saying, “In a way, he’s done my experiment for me.” 1
     
    Over the next few days, my mind buzzed with excitement about baclofen—and with dread. What if this was just another dead end in my quest for a cure? Two questions haunted me: Was baclofen available in France, and was it safe? I wanted to call Childress and ask her, but feared I wouldn’t be taken seriously if I called on my own behalf.
    Emotional agitation from all these questions and worries spilled over into anxiety, and one evening I drank fairly heavily. The next day I gathered my courage, and allowing for the time difference between Paris and Philadelphia, called Childress hungover. I identified myself as a cardiologist with an alcoholic patient, said I had come across the year-old New York Times article, and asked, “Does it make sense to use baclofen for alcoholism?”
    Childress said, “I believe there is a fellow in Rome, Dolo-something, I am not sure of the name, who is looking at baclofen for alcoholism.”
    I asked about the dose of baclofen her study used: Had she considered trying a higher dose to see if it had a greater effect on addictive craving? She said that this was certainly a subject for further investigation, but that she did not know enough about baclofen at that point to speculate on the likely effect of a higher dose. All she could tell me was that Edward Coleman reported no unpleasant side effects from taking 60 to 80 milligrams of baclofen a day for his muscle spasms.
    It was a very encouraging conversation, and Professor Childress kindly invited me to keep in touch. But my two burning questions remained unanswered: Was baclofen available in France, and was it safe?
    I asked my alcohol treatment specialist and the psychiatrist I was seeing for cognitive behavioral therapy about baclofen. They knew nothing about it and were not interested in discussing an unproven medication.
    I was clearly alone with the problem of how to learn more about the drug. As an associate professor at Cornell University Medical College and an associate attending physician at New York Hospital, I had been part of a research team and a community of physician-scientists, but I was living thousands of miles away and had no contact with the institutions or my colleagues there.
    Addiction isolates everyone who suffers from it, and I felt very much alone in the world in general. I had come to rely on seeing Jean-Claude and Eva every Sunday at lunch with our mother, and we got along so well on these occasions that I thought the rift between us was healed. Yet after our mother died, I showed up at the Chinese restaurant on Sunday as usual for several weeks, and I was shocked and hurt that they never came. It felt impossible to call them. I thought they had had enough of me, and was simultaneously convinced that they were right to feel that way—and that it was unjust of them to abandon me. For their part, as I only learned after I became well, they were frustrated and baffled at how to help me, especially when doctors told them, “Leave Olivier alone and let him hit bottom. He hasn’t lost enough to stop drinking yet.”
    People in AA often told me the same thing. Yet how much more was there to lose? If only quitting drinking were possible on the basis of willpower, twelve-step support, rehab, cognitive behavioral therapy, and the usual medications. For me, as for most alcoholics, it was not, and the idea that I needed to lose more before I could face up to reality and pull myself together was a cruel joke.
     
    I thought about talking to Philippe Coumel about baclofen. Philippe was a great friend to me during this period, often inviting me to lunch, engaging in long, thoughtful conversations about a range of topics, including my illness. But I had too often excitedly