French doctors in a stir over alcoholism 'cure'
A cardiologist’s claim that baclofen helped him get rid of his craving to drink has been criticised by other doctors.
26 November 2008
PARIS – France's medical community is embroiled in a fierce debate over a headline-making book that says a drug used to treat spasticity can also cure alcoholism.
In a book entitled Le Dernier Verre (The Last Glass), cardiologist Olivier Ameisen says he rid himself of the craving to drink by self-dosing with baclofen.
The drug has been around for nearly 70 years and is mainly used to treat painful, uncontrolled jerkiness in multiple sclerosis and other neurological disease.
Opinion within the medical fraternity is divided over Ameisen's book.
There are those who accuse Ameisen of irresponsibly encouraging a powerful drug and those who praise him for lifting a taboo surrounding mounting interest in baclofen - and the discreet use of it.
"One can criticise the pharmaceutical industry for being disinterested in investing in research for alcoholism, but let's stop this promotion of a 'miracle cure'," said Philippe Batel, a specialist at the Beaujon Hospital in the Paris suburbs.
"To make people think that there's a miracle treatment is to misunderstand the complexity of the disease of alcoholism," said Michel Reyaud of the Paul Brousse Hospital, also in the Paris region.
In Switzerland, Pascal Gache, in charge of the alcoholism unit at the Geneva University Hospital, said he had already treated around 30 patients with the drug, some of whom tolerated high doses but others less so.
He said he was finalising plans for a clinical trial among 200 patients, which were awaiting approval by an ethics board.
"We have to end the doubt as quickly as possible," Gache said.
The French health safety watchdog, Afssaps, said that doctors who prescribed baclofen for alcoholism "do so entirely under their own responsibility".
"It's not a run-of-the-mill drug, especially at high doses," Afssaps' deputy director, Fabienne Bartoli, said. "There is a risk of respiratory failure."
The agency said it was reflecting on "what can be done to encourage" clinical tests "enabling a scientifically established assessment" of the risks and benefits of baclofen as an anti-alcoholism treatment.
"We need to conduct proper studies on the workings of this product to determine if it's effective and, if so, at what dose, and whether this dosage is sufficiently harmless over the long term," said Alain Rigaud, president of France's National Association for Alcoholism and Addiction Prevention.
"But no-one should think that a drug that works will be itself be a cure-all for alcoholism," he said, stressing the need for social and psychological support to enable people to wean themselves from drink.
[AFP / Expatica]