The End of My Addiction

own exercise routine between binges.
    “I don’t know. If he is doing okay, maybe don’t change it. But I have never seen something like that.”
    It was far from the all-clear that I had hoped to hear. And the neurologist hadn’t given me a safety margin for increasing my dose above 180 milligrams a day. But at least he had no danger sign to warn me to watch for in my imaginary patient from America. For the present, I decided to keep my dose at 180 milligrams a day because of the clear health benefit it was giving me, and between binges to continue searching online for information about baclofen and its use in addiction research.
    For safety’s sake, I wrote in red on the back of my French national identity card that I was taking 180 milligrams of baclofen a day for muscular dystonia and the dose should not be cut off abruptly to prevent a risk of withdrawal. If I fell again during a binge and became unconscious or unable to communicate for a time, or if I had any other medical emergency that left me unable to communicate, medical personnel would at least know to keep giving me baclofen or taper me off it gradually.
    For the same reason, it was also important that my doctors know that I was taking baclofen. I spoke to my alcohol specialist and CBT therapist, and told them truthfully, if incompletely, that my neurologist in New York had recommended baclofen for the fasciculations in my calf muscles. They saw from the Physicians’ Desk Reference that resolving muscular tension was baclofen’s standard use, and were happy to prescribe it on that basis. Although baclofen was relatively inexpensive, this meant that I could be reimbursed for its cost rather than paying for it out of pocket. But the main benefit was that if I wound up in the ER, I could show a doctor’s prescription for it.
     
    My online searches for information on baclofen soon widened to include addiction research in general. Fabienne, Jean-Claude’s wife, gave me an important tip. In addition to her own work as a Chinese teacher, Fabienne helped Jean-Claude prepare his scientific papers on immunology. She told me that Google was a great general-purpose search engine, but that for medical papers I should try PubMed, a website at the National Institutes of Health in the United States. “With PubMed,” Fabienne said, “you can search and read abstracts from every medical journal in the world for free.”
    As I looked at an abstract, I often wished that I could read the full article, but online subscriptions to medical journals were and are prohibitively expensive. At $30 or more apiece, so were individual articles. Finally, even large medical libraries do not have all the specialized journals, and running from library to library every time I saw an interesting abstract online was not practical. The truth is, I was still a clinical associate professor of medicine at Cornell University’s Weill Medical College, and as such, I could have been accessing full articles online through the university’s library system, no matter where (or how) in the world I was. But that didn’t occur to me during my illness, and if it had, I would not have dared to phone Cornell for guidance lest the person at the other end of the line realize I was an alcoholic. In hindsight, it wasn’t bad being restricted to reading abstracts. The gist of every article was there, which meant I could read a dozen or more abstracts in less time than it took to read a single scholarly paper in its entirety. I could also more easily see the forest from the trees and retain the most important points, rather than find myself lost in the details.
    In the midst of a binge, I could barely focus on the computer screen, much less comprehend an abstract of a scientific paper. I also tried to stay away from the computer when I was drinking, lest I spill liquor into it, and immediately following a binge I needed a few days to recover some clarity of mind. But then I could search online with Google and PubMed for information on baclofen and addiction for several days or more, at least in the morning. In the afternoon, even between binges and with the moderating effect of baclofen, craving proved too distracting for me to concentrate on my search through dozens, hundreds, and ultimately tens of thousands of abstracts.
    It was like becoming a student all over again, and took me into fields I had not touched since medical school or my internships, especially chemistry, neurology, and