Excerpt: ‘The End of My Addiction’
French Doctor Writes About How He Believes a Muscle Relaxant Could Cure Alcoholism
Jan. 14, 2009
Dr. Olivier Ameisen, a French cardiologist, made international headlines with his claim that a muscle relaxant cured his alcoholism. In his new memoir, “The End of My Addiction,” Ameisen offers insight into his personal story and puts out a call to action to research the drug he believes ended his alcohol dependency.
Cardiologist says he overcame his addiction with the help of a muscle relaxant: BACLOFEN
Read an excerpt of his book below.
Note To The Reader
In the depths of a desperate struggle with alcoholism, I found a medicine, baclofen, that both freed me of all craving for alcohol and resolved the underlying disorder, overwhelming anxiety, that made me vulnerable to addiction.
By completely suppressing my addiction, baclofen saved my life. I believe it can save and improve the lives of many others by completely suppressing their addictions, and I have written this book to that end. It is in effect an extended self-case report on the etiology and course of my illness, including the severe anxiety that troubled me from early childhood, my descent into alcoholism in New York City and Paris, the fortunate circumstances that made me aware of baclofen before alcoholism irreversibly damaged my health or killed me, my decision to test baclofen on myself and then to break my anonymity as a physician with addiction and publish the results, and my efforts, in both concert and conflict with some of the world’s leading addiction researchers, to further understanding of this valuable medicine and make it available to others.
In what follows I draw on my personal experiences with the aim of illuminating common themes in both the experience and treatment of addiction. For reasons of privacy I have changed some names and identifying details.
This book is not a self-help manual, and it is in no way meant to be a guide to self-treatment. Addiction is a serious illness, and anyone suffering from it should seek qualified medical advice and care. Likewise, baclofen, a prescription drug, should be taken only as prescribed and closely supervised by a licensed physician.
I CAME TO MY SENSES and took stock of where I was: in a cab, with blood streaming down my face and spattering my trench coat. I looked out the window and in the glow of the streetlights saw the cab was on
My apartment was not too far away, on
As the cab pulled up in front of the hospital emergency room entrance, a memory of the evening began to come together. Around 8:30 p.m. I had visited my friend Jeff Steiner, the CEO of Fairchild Corporation, to ask his advice on running my cardiology practice, which I’d started two and a half years before. I’d been introduced to Jeff in the late 1980s by a mutual friend, another physician.
Although I’d intended not to drink that evening, I felt insulted when Jeff ‘s butler offered me a choice of teas. “Why doesn’t he offer me an alcoholic drink as well at this hour?” I thought. “Is this a judgmental message?”
I asked for and drank a glass of Scotch, then made a show of declining a refill. Much later I learned that Jeff was not aware that I had been drinking heavily. He’d known me only to have a few drinks at large parties, here and there, over the years. But my mounting concerns about my practice finances had changed that.
The standard expectation is that it will take a new medical practice two years to break even. Mine broke even in four months. And almost three years later, in March 1997, there it remained”” hovering a little over the break-even point.
Staggering into the emergency room, I thought, “They will see I’m drunk. That’s not so good. But at least I know the place is well run and will fix me up right.” I had been associated with
Inside the emergency room, I passed out again. When I came to, one of my ex-students, Matt, now a resident, was standing over me preparing to stitch the wound in my forehead. So as not to be left with a scar, I asked him to use Steri-Strips instead. He did and then left me to lie quietly for a few hours so I could sober up enough to walk home safely. He was plainly even more embarrassed to treat me in my drunken state than I was to need treatment. I cringed at the thought of my appearance in the ER being discussed around the hospital, then pushed the thought out of my mind. Matt was not the kind of person to talk about it; that was some comfort.
Lying there, I ran the video of the evening in my mind. “Run the video of what happens when you drink” was something I’d been hearing in Alcoholics Anonymous, where I was still very much a newcomer.
My conversation with Jeff Steiner had been frustrating for us both. Although he was eager to help, there was a mismatch between his expertise and my problems. What I really needed was a small business adviser, not a big corporate dealmaker.
As I left Jeff ‘s apartment, my mind whirled with conflicting thoughts. My cost-blind practice style might function better in
But my practice could not continue indefinitely at this rate, and the constant anxiety created by financial worries was growing into a source of full-blown panic. I struggled with a deep sense of failure, and I lived in fear that the world would see that my accomplishments were nothing but a sham, a house of cards that could collapse at any second.
This was not a new feeling to me. Throughout my life I had been plagued by anxious feelings of inadequacy, of being an impostor on the brink of being unmasked. I had been seeing therapists for a long time before I started drinking. To be honest, they never were much help with my anxiety. Nor was the Xanax they prescribed me.
The one Scotch at Jeff ‘s made me aware of how thirsty I was. I went to a Chinese restaurant, intending to have a meal as well, but wound up eating nothing and drinking one double vodka after another. And then … I found myself bleeding in the taxicab.
It wasn’t my first blackout drinking. But the blackouts were getting more common, whole stretches of evenings expunged from my memory. And this was the first time I’d come out of a blackout with a physical injury. Until then blackouts had only been sources of intense mortification as I wondered what embarrassing things I might have said or done.
The next morning I thought briefly about amusing tales I could concoct to explain the bandages on my forehead. Deciding that I was too hungover to go to work, I had my office assistant reschedule the day’s patients. As my drinking had increased, I had scrupulously honored my first duty as a doctor””to do no harm. I stopped driving. And I never set foot in my office or the hospital when I was not completely sober.
Still, I resisted seeing myself as a problem drinker. All I really needed, I thought, was to learn to drink better. This delusion was encouraged by a well-meaning friend and an equally well-meaning but I think even more misguided therapist, both of whom undertook to show me how to be a moderate wine drinker rather than a binger on Scotch or vodka. I even began AA with the thought that it might give me tips on managing my drinking better rather than stopping completely.
Not everyone thought I was a candidate for moderation. The two friends who escorted me to my first meeting didn’t think so. One was a longtime AA member, a poet and a writer and a very beautiful woman who looked a bit like Katharine Hepburn. She used to say, “I want you to see me before I lose my looks.” She still has those looks today. When we met, she had been sober for many years, yet she told me, “I am an alcoholic.” That struck me as very strange, and I was embarrassed to hear her say it. People with diabetes or hypertension didn’t identify themselves by their illnesses. Why should people with alcoholism?
Of course, I thought that because I did not want to admit”” to myself or anyone else””that I might be alcohol-dependent. And so I was terrified to go to a meeting. But my friends each took me by an arm, and escorted me from my apartment on East 63rd Street to the major AA meeting place in the neighborhood”” the 79th Street Workshop, in the basement of St. Monica’s Catholic Church, on 79th Street between York and First Avenues. It was my first step, taken reluctantly, toward facing my illness. But it was a vital one.
It is hard for everyone who attends AA to get past the potential embarrassment of being seen as an alcoholic. Shortly before I went to AA for the first time, my shrink began encouraging me to go. I said, “What about anonymity? My office and my apartment are right in the same neighborhood. What if a patient or somebody else I know sees me?”
He said, “Don’t worry. Anyone inside will be an alcoholic and won’t say anything.”
“But what if a colleague sees me entering or leaving the place?”
“It won’t happen.”
It did happen. But after I started going to AA, I told him, “AA is a great place. Have you been to a meeting?”
“You refer people. Maybe you should know what it’s like. Will you come with me to an open meeting?”
“Because somebody might see me.”
There is a moral stigma to addiction, and it is prospective shame that drives people to resist admitting they have a problem. It leads physicians to miss or delay a diagnosis of addiction, too. Only a couple of months earlier, I had brought up AA in a session with my shrink. “Oh, you’re not an alcoholic,” he said dismissively, “but you could become one.” Then he changed the subject away from alcohol and drinking.
Later on in my alcoholism, when I knew more about the course of the illness, I wondered how he could have missed the signs of its onset in me, and could even have turned a deaf ear to my first outright call for help. The responses of my physician colleagues at New York Hospital-Cornell puzzled me, too. When I would discreetly ask around about how to help “someone” with a drinking problem, they’d ask, “Is the person close to you?”
With great effort, I ended the binge and managed to dry out in time for my flight home to
My failure to stay sober on vacation frightened me. I called my office assistant, Erdie, and told her to cancel all appointments.
“For how long?” Erdie asked.
“Until the end of the summer,” I said.
“But why, Doctor Ameisen?”
I hesitated a moment, and then said, “Because I’m an alcoholic, Erdie.”
She laughed and said, “But seriously, Doc, why?”
“I am serious, Erdie.”
Over the next several weeks, I decided, I would either manage to arrest my downward slide or ease myself out of my practice until I regained control.
Almost immediately, I began drinking heavily every evening. Finally, I managed to wrench myself out of the abyss and stop. I grew ill, vomiting and aching all over, but as usual staved off acute withdrawal with B vitamins, gallons of fluids for hydration, and Valium. I was usually well supplied with Valium, which my physician prescribed for my anxiety, and since I had started bingeing, I had always made sure to have some on hand so that I could detox myself.
Detoxing from alcohol takes around five days. A day into this regimen, I called my girlfriend, Joan, who proved immensely empathetic and encouraging, even though we were having a rocky time over my inability to make a long-term commitment.
The next morning, August 19, 1997, I realized I had run out of Valium and could not remember when I had taken the last pill. With Joan’s help, I searched the apartment repeatedly, desperate to find at least a couple of pills, but there were none in the bathroom medicine cabinet, on the nightstand by my bed, in the kitchen drawer, or anywhere else. The doctors I knew and trusted were away, and I could not imagine explaining to another doctor why I needed a prescription on an emergency basis.
Joan did not understand my concern. “Why do you need Valium so badly?” she asked.
I explained that withdrawal from alcohol can easily become a medical emergency with delirium tremens (the DTs), seizures, loss of consciousness, hallucinations, major spikes in blood pressure, and even death. The risk of serious, and potentially lethal, medical consequences is much higher in acute withdrawal from alcohol than in withdrawal from any other drug of abuse.
I also explained that in the days before Valium and similar drugs existed, people were detoxed using diminishing doses of alcohol. If I could get out to a liquor store, I could halt the progression of my symptoms. But my arms and legs felt like they were made of rubber; I was so exhausted that I could not even stand. Terrified of what might happen, I begged Joan, “Please, buy a bottle of vodka and bring it to me.”
She refused. Looking back, I suppose I could have written Joan a prescription for Valium that she could then give to me. But I was horrified by the thought of doing something that would compromise my ethics.
I said, “I’m having a medical crisis. Either I drink or risk a negative neurological event, like a seizure.”
Joan knew that I was a good doctor, but she also knew the depth of my dependence on alcohol. A tall business executive, Joan looked me in the eye and said, “I’m sorry, Olivier, but I can’t bring you liquor.”
I gave up the fight. “Something is going to happen to me,” I said. “When it does, you must call EMS and have them take me to
“Isn’t there anything else we can do?”
“You can bring me liquor, or we can wait for the bad things to happen.”
Half an hour later, I felt a strange sense of agitation mixed with relief. I wondered if this was the “aura” that precedes a seizure. And then I lost consciousness except for a vague impression of medical personnel milling in the lobby of my building or on the street, and a bit later someone pulling a privacy curtain around me in the hospital and whispering, “He’s an attending,” shorthand for attending physician. Then I lost consciousness again.
When I awoke, I was attached to several IV tubes and a urinary catheter. A young medical student, a bit pompous but sweet, appeared and questioned me about my “malady.” I liked his choice of words so much that instead of asking for an experienced nurse or an intern, I let him draw arterial blood gases. This was a long, very painful process, because I was his first live patient.
My next visitor was Professor John Schaefer, an outstanding neurologist originally from
The seizures were so violent that they produced rhabdomyolysis, a breakdown in muscle tissue that is toxic to the kidneys and is measured by the level of CPKs””creatine phosphokinase isoenzymes””in the blood. The same thing can happen to people who suffer what is known as crush syndrome, from traumatic injuries in a car accident or being trapped in the rubble of an earthquake. Only recently, a colleague told me that on seeing my chart in the intensive care unit, he assumed I must have been in a massive car crash, because my CPKs were extraordinarily high. Rhabdomyolysis explained the urinary catheter and another of the IVs; they were to make sure I was getting enough fresh fluids to prevent renal failure.
“You almost lost your kidneys, my boy,” John said. His characteristic jovial “my boy” cheered me up and made me feel I could talk to him about the real problem, that I had subjected my body to this trauma by excessive drinking. (Perhaps fortunately for my state of mind at the time, he only told me much later that I was admitted to the hospital in “status epilepticus,” an ongoing seizure state that put me “near death.”)
“You are going to have to report me””” I began.
“On the contrary,” John said. “I’d like to commend you. I know you haven’t seen patients all summer. Too many doctors continue to practice for years when they are””and know they are”” alcohol-dependent.”
“I am going to resign as associate professor and associate attending physician here.”
John shook his head. “Are you crazy? You don’t resign because you have an illness.”
“I know alcoholism is a disease. But in my case, that’s not what it is. I know I should be able to control my drinking, but I have not succeeded so far. I guess it’s a weakness on my part. Do you understand?”
“No,” John said. “It is an illness. One you will have to recover from and then you will come back and work normally. To help that along, you should begin seeing an expert in these matters. With your permission I would like to call in a friend of mine, Professor Elizabeth Khuri, as a consultant. She is right next door to the hospital at
“Can I tell her …?”
“You can tell her anything and it will not filter to anyone here at the hospital, including me.”
“Okay, then, I will be glad to see her. Thank you. Thank you for everything.”
“Glad to be of service, my boy. I will check in on you in the morning. For now, just get some rest.”
“John, given the risk of infection, don’t you think this urinary catheter could be removed now?”
John laughed. “You must be feeling better if you’ve got the energy to resent that imposition, and you are right about the infection risk,” he said. “I’ll tell the head nurse about the catheter. Now get some rest, and you’ll be back to normal in no time.”
I wondered if things would ever be normal again for me. One fact was clear and could no longer be denied: I had become an alcoholic.
DR WEEKS’ COMMENT:
This is an effective option and it works in the same way that Xyrem does: via the GABA receptors. No-toxic and effective. Good science and great courage to share on this French cardiologists’s part. If you are suffering with alcoholism and want to get sober, ask your doctor to prescribe this safe and effective agent (as part of a complete corrective medical protocol utilizing amino acids, vitamins, minerals, diet considerations and CorrThot) , and when he or she says “No” (because it is not the standard of care and not FDA approved) forgive him or her, and move on. Your health is your responsibility.