The End of My Addiction

most substance use disorders and independent mood and anxiety disorders were overwhelmingly positive and significant.” 3
    How I wished this article had been published years earlier! Nevertheless, I was grateful to have it now, and to be able to quote from it in the case report.
     
    I e-mailed the draft to Boris Pasche, who gave it to the deputy editor of JAMA , Dr. Richard Glass, a psychiatrist and an expert in addiction medicine. Dr. Glass quickly e-mailed me to say that while he thought the paper was fascinating, JAMA never published case reports. He recommended that I send it to the journal Alcohol and Alcoholism , which is published by Oxford University Press for the British Medical Council on Alcohol.
    Looking up the journal online, I saw that there were two coeditors-in-chief, one based in Edinburgh and the other in Belgium. The British Isles have a tradition of welcoming original ideas and being more open to innovation than is sometimes true on the European continent, and I hoped my paper would appeal to the Scottish editor, Dr. Jonathan Chick.
    Jonathan Chick later told me that he had been so moved by reading my self-case report that he wondered if his emotional reaction might be biasing his editorial judgment. Following the normal editorial procedures, he sent the paper to two leading addiction researchers to review and comment on it, and their anonymous comments were passed along to me in due course. Both reviewers enthusiastically recommended publication, and one said the paper was “a precious cameo that deserves to be disseminated in the scientific community.” The reviewers both said the paper would be more effective if it were shorter, and they offered a number of smaller suggestions for improving it.
    After I completed revisions and resubmitted the article, Jonathan Chick very appropriately asked for one more thing: corroboration by one of my physicians. I phoned Jean-Paul Descombey, who gave me an appointment the next day, and who then wrote Chick:
    I, the undersigned, Doctor Jean-Paul Descombey, former chief of psychiatry at Hôpital Ste.-Anne and member of the administrative council of the French Society of Alcohology, am in a position to offer the following testimony on Doctor Olivier Ameisen.
    1. Doctor Ameisen has been my patient since shortly after his return to France from the USA…He was suffering from alcohol addiction along with a strong neurotic component with symptoms of anxiety that were visible when not drowned by massive ingestion of alcohol (whisky).
    Despite many hospitalizations in various specialized settings, assiduous attendance at Alcoholics Anonymous meetings, and a positive relationship with me during sessions that were weekly as often as his state permitted it, Mr. Ameisen was never able to achieve sobriety for more than a few days during the years 2000–2002.
    The course of his disease was marked by numerous accidents, namely physical traumas related to his massive alcoholization. His somatic state deteriorated, worsened by the negligence of both his body and his living quarters. Apart from a few colleagues and friends, people close to him backed away, with the notable exception of a few AA friends, often themselves overwhelmed by the state and the behavior of Mr. Ameisen. Nevertheless, his biological parameters remained normal except for the [liver enzymes] GGTP [gamma-glutamyl transpeptidase] and the transaminases.
    His state had reached the point that even a continuous psychiatric professional relationship became impossible or would risk turning into a simulated form of therapy devoid of honesty.
    I did not see Mr. Ameisen again for over one year, although he occasionally phoned me to give his news.
    2. Mr. Ameisen contacted me recently by telephone, giving me his (good) news in a clear and self-assured voice, very different from the voice I had experienced in all previous phone conversations.
    He explained to me that he was self-treating himself with baclofen and writing a paper about this experience for publication in a specialized journal.
    We decided to meet on 3 November 2004.
    Mr. Ameisen’s appearance and behavior at this meeting were spectacularly changed on every level: self-assured body language reflecting a sense of ease within himself, open face, clear skin, with no signs of chronic alcohol use, easy contact, neither self-conscious nor obsequious, clear speaking, sober, impeccable articulation, suitably attired without being overdressed.
    In short,