Addiction is a disease where the symptom is the disease.  By suppressing the symptom, the disease no longer has any manifestation.  

Olivier Amiesen, MD, in his book, “The End of My Addiction“ documents his personal struggle with alcoholism.  He struggled against alcoholism using the conventional alcoholic treatment approaches for many years, but repeatedly relapsed back into alcoholism despite his firm commitment to stop drinking.  A friend of Dr. Amiesen sent him an article about a drug (Baclofen) that had been successful for treating alcoholism in animals.  He did considerable research on this drug and eventually concluded that it was safe and began self-treatment.  He raised the dose slowly and found that at a very high dose it completely removed his craving for alcohol.

The drug is inexpensive, generic, and used for treating muscle spasms.  Dr. Amiesen has been free of the craving for alcohol since 2004.  His craving led to binges, blackouts, and injuries.  He now no longer craves alcohol, can be around others who drink and can have an occasional social drink without escalating into a binge.  But, he must continue to take the drug to control his cravings, but as long as he maintains his dosing, the alcohol craving does not surface and he is able to live like a civilian.

Dr. Amiesen went through rehab multiple times, attended AA meetings 2x/day for 7 years, participated in CBT (Cognitive Behavioral Therapy) and positive self-talk therapy.  All these interventions were helpful in character development, but were not effective in helping him to stop binge drinking.  Dr. Amiesen believes that addiction is not a moral failure, but a disorder of desire.  He believes that if the craving is stopped, then the binge drinking can stop.

In his book, Dr. Amiesen reported on the use of this drug in 8 people.  The dose needed to produce suppression of craving varied over a very wide range (over 300%).  The drug treatment protocol is started at a low dose (5mg 3x/day), and gradually raised (15mg increments every 3-4 days), up to a maximum of 300mg/d.  The normal maximum dose of this drug for muscle spasms is 80mg/d.  The drug cannot be stopped suddenly as it will precipitate severe withdrawal symptoms.  It must be tapered down at the same rate it is tapered up.

The primary side effect of the drug is sleepiness each time the dose is raised, but this effect usually disappears after a few days.  After accommodating to a constant dosing rate, the mind is clear, and the emotions are calm.  Dr. Amiesen found it it may be an effective treatment for anxiety and depression.  The most serious side effect of the drug is respiratory suppression, which could happen in the case of an accidental or intentional overdose.  The highest overdose recorded was 2000mg, and the patient recovered completely with supportive treatment.  The drug does not produce addiction or dependency, but it must be tapered up and down.

The drug acts as a GABA agonist, which means that it acts like GABA, which is a calming neurotransmitter.  The method by which this drugs acts is unknown, but it probably calms down an emotional center that causes excessive desire.  It also appears to be helpful with depression and anxiety.

The drug may be effective in suppressing the craving for many of addictive substances including nicotine, heroin, cocaine, and methamphetamines.  There have been no double blind placebo controlled trials of this drug to prove its efficacy in suppressing alcohol, and other drug craving.  Thus, its use is off label, but off label use of a drug is legal if medical judgment justifies it.

Dr. Amiesen also had a severe anxiety disorder, and this drug also relieved him of that constant discomfort.  His anxiety disorder seemed to be intimately connected with triggering the use of alcohol.  

The drug that suppressed Dr. Amiesen’s alcohol craving will probably not be effective for every alcoholic, but in the small sample size of patients he reported, only one patient was unsuccessful, and that due to excessive sleepiness.