The End of My Addiction

told him about grand hopes for alcoholism treatment, only to lapse back into bingeing. It was too soon to mention baclofen; I needed to learn more about the drug first.
    Fortunately I had recently made a friend who indirectly put me on the path to some answers, an American expat named Alexander, a very Brando-in- Last-Tango-in-Paris -looking guy, an ex-journalist who taught English language classes. Alexander and I used to see each other for espressos every afternoon at the same bistro, when I was between binges, and we talked a lot about politics. Our views diverged widely, but we gave each other full credit for good arguments and developed a warm rapport. For a long time I avoided telling Alexander about my drinking, for fear he’d drop me as a friend. And like Brando’s character in Last Tango , Alexander never pried when I showed up after a binge. But eventually he pressed me to have dinner with him and his girlfriend, and I had to explain that I was too embarrassed about my alcoholism to meet new people and socialize with them. He understood: he had struggled with drug use himself. Still, I held back from meeting his girlfriend or seeing him anywhere except for coffee in the afternoons.
    In our conversations, Alexander often mentioned things connected with the Internet and e-mail, and it dawned on me that because of my drinking I had been missing out on the great technological and societal revolution of our time. Oh, I had used computers a bit in New York, but so much had changed since then. Search engines could now connect you to information anywhere in the world; Google was four years old. If I was going to learn about baclofen, it was by searching the Internet.
    In early February 2002, I bought a PC and printer, and while it took a bit to set up the computer and get connected (I am not technical-minded), I was soon able to join the rest of the world. Panic was my most crippling symptom, so I began by typing in the words “baclofen panic.”
    The first hit was a link to the abstract of a 1989 paper in The American Journal of Psychiatry by the University of Arizona researcher M. F. Breslow et al. The paper was titled “Role of gamma-aminobutyric acid in antipanic drug efficacy,” and the few lines describing it on Google’s webpage said that baclofen was “significantly more effective than placebo” in reducing panic attacks. That astonished and tantalized me.
    I clicked on the link and read the 103-word abstract:
    All effective pharmacologic agents used to treat panic disorder augment gamma-aminobutyric acid (GABA) transmission…To test the hypothesis that GABA activity is a component of antipanic drug efficacy, the authors treated nine medication-free panic disorder subjects with oral baclofen (30 mg/day for 4 weeks) in a double-blind, placebo-controlled crossover trial. Baclofen, a selective GABA agonist, was significantly more effective than placebo in reducing the number of panic attacks and scores on the Hamilton anxiety scale…
    Panic affects gamma-aminobutyric acid (GABA) transmission in the brain and baclofen is a GABA agonist …—I made a note of this for future investigation. For the moment, I was absorbed by the finding that it only took 30 milligrams of baclofen to measurably reduce the experience of anxiety and panic. That was half, or less than half, the amount that Edward Coleman, the patient in Professor Childress’s experiment, used on a daily basis for his muscle spasms.
    If baclofen was good for panic, I wondered why none of my physicians had ever prescribed it and whether it had a serious drawback. Of course, as a cardiologist I knew that physicians’ prescribing habits are formed not on the basis of all potentially applicable medications, but by their training and the marketing of pharmaceutical companies. I don’t say this to pass moral judgment. It is a fact of modern medical practice created by increasing specialization and by innovation in the pharmaceutical industry, both of which have been of great benefit to patients. No physician can keep up on developments throughout medicine’s many specialized fields or on all available medications.
    When I joined the cardiology division at New York Hospital–Cornell as a research fellow, I was surprised to find that American physicians did not commonly take advantage of a unique property of nadolol, a beta-blocker I had been trained to use in France. In 1984 Philippe Coumel et al. reported in American Heart Journal that nadolol