The End of My Addiction

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Overview

"After years of battling uncontrollable addiction, I have achieved the supposedly impossible: complete freedom from craving."

Dr. Olivier Ameisen was a brilliant cardiologist on the staff at one of America’s top teaching hospitals and running his own successful practice when he developed a profound addiction to alcohol. He broke bones with no memory of falling; he nearly lost his kidneys; he almost died from massive seizures during acute withdrawal. He gave up his flourishing practice and, fearing for his life, ...

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The End of My Addiction

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Overview

"After years of battling uncontrollable addiction, I have achieved the supposedly impossible: complete freedom from craving."

Dr. Olivier Ameisen was a brilliant cardiologist on the staff at one of America’s top teaching hospitals and running his own successful practice when he developed a profound addiction to alcohol. He broke bones with no memory of falling; he nearly lost his kidneys; he almost died from massive seizures during acute withdrawal. He gave up his flourishing practice and, fearing for his life, immersed himself in Alcoholics Anonymous, rehab, therapy, and a variety of medications. Nothing worked.

So he did the only thing he could: he took his treatment into his own hands. Searching for a cure for his deadly disease, he happened upon baclofen, a muscle relaxant that had been used safely for years as a treatment for various types of muscle spasticity, but had more recently shown promising results in studies with laboratory animals addicted to a wide variety of substances. Dr. Ameisen prescribed himself the drug and experimented with increasingly higher dosages until he finally reached a level high enough to leave him free of any craving for alcohol. That was more than five years ago.

Alcoholism claims three hundred lives per day in the United States alone; one in four U.S. deaths is attributable to alcohol, tobacco, or illegal drugs. Baclofen, as prescribed under a doctor’s care, could possibly free many addicts from tragic and debilitating illness. But as long as the medical and research establishments continue to ignore a cure for one of the most deadly diseases in the world, we won’t be able to understand baclofen’s full addiction-treatment potential.

The End of My Addiction is both a memoir of Dr. Ameisen’s own struggle and a groundbreaking call to action—an urgent plea for research that can rescue millions from the scourge of addiction and spare their loved ones the collateral damage of the disease.

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Editorial Reviews

Publishers Weekly

A French-American cardiologist then affiliated with New York Hospital-Cornell University Medical College descended into years of hellish alcohol addiction that essentially ended his medical practice in 1997. His move back to Paris and self-treatment with the unproven drug baclofen is the subject of this clinical, thoroughgoing memoir. Early on, Ameisen, the child of Holocaust survivors and an accomplished pianist, recognized that deep-seated anxiety was driving him to drink, yet doctors treated the drinking rather than the anxiety. He tried years of AA, rehab and medication, but in time he was binging again-blacking out and ending up in psych wards or the emergency room with broken bones. When he read about the muscle relaxant baclofen in a New York Times article, suggesting that it could repress the craving in addicts as well as control muscular spasm, he seized on the drug as his life line. He researched baclofen, prescribed it to himself (thanks to France's medical identity cards) and essentially used himself as a study over several months, increasing the dosage as necessary. The results were remarkable, and his dogged self-case study published by the journal Alcohol and Alcoholism in 2005 gathered slow but intensive interest. As a trained physician who is evidently well connected, Ameisen is not a typical patient, yet his work is brave, insightful and sure to be significant. (Jan.)

Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.
The Barnes & Noble Review
In recent decades, genetic research has supplied ample evidence to support the notion that alcoholism is not a moral failing but a disease of the brain -- a point of view that has had champions since at least the 18th century. But the general public -- and, surprisingly, many doctors -- largely persist in seeing addiction as a fundamental failure of willpower. As the French cardiologist Olivier Ameisen details in The End of My Addiction, moral judgments often interfere with doctors' ability to effectively treat addiction. "Treat" is the operative word, as conventional therapies offer support for the daily struggle to maintain abstinence rather than provide a cure. A habitué of AA meetings and rehab facilities, Ameisen often complained to his physicians that if they could treat his chronic anxiety disorder, his alcoholism would be cured. After years of frustration with conventional treatment, Ameisen began experimenting on himself with the muscle relaxant baclofen, which has successfully suppressed addiction to alcoholism, cocaine, and nicotine in laboratory rats. Ameisen was able to successfully treat his alcoholism -- as well as the underlying anxiety that led to his addiction -- and published a case study in a prominent medical journal. He was largely met with resistance from the entrenched medical community (though his work was later supported by the findings of other researchers), and in response he wrote this hybrid of a book. The result is part memoir, part critique of the medical establishment and drug industry. Most important, it's an argument for wider use of baclofen, made straight to the potential patient. This book will of course interest those who have suffered from addiction -- but it will also appeal to anyone curious about the science behind addiction's life-destroying power. --Jennifer Curry
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Product Details

  • ISBN-13: 9780374140977
  • Publisher: Farrar, Straus and Giroux
  • Publication date: 12/23/2008
  • Pages: 352
  • Product dimensions: 5.90 (w) x 8.40 (h) x 1.20 (d)

Meet the Author

Olivier Ameisen, MD, inaugurated the position of official physician to the prime minister of France. He came to the United States in 1983 to join the prestigious cardiology team at New York Hospital and Cornell University Medical Center, where he became an associate professor of clinical medicine and an associate attending physician. He is currently Visiting Professor of Medicine at the State University of New York Downstate Medical Center.

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Table of Contents

Foreword Jeffrey S. Borer Borer, Jeffrey S.

1 Moment of Truth 3

2 A Remedy Gone Wrong 18

3 Under Treatment and "In Recovery" 41

4 Doing Great and Feeling Awful 71

5 Falling Down 109

6 Against Medical Advice, or, The Life of Afterward 133

7 Cutting Through Craving 162

8 The End of Addiction? 181

9 How Baclofen Works: What We Know, and Need to Know 207

Appendix 233

Notes 315

Acknowledgments 321

Index 325

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Reading Group Guide

Questions for Discussion
1. The book's narrative weaves together a personal and a scientific story. Did you find the combination of these elements effective and compelling? What was the most powerful personal moment in the book for you? What part of the science of addiction most intrigued you?

2. The book reports that 1 in 4 U.S. deaths is caused by alcohol, tobacco, or illegal drugs, and observes that addiction to nicotine is the single biggest cause of cancer. Were you aware that addiction is such a huge public health problem? Would you support changing public health priorities to provide more funding for addiction research and treatment?

3. The rates of alcoholism and illegal substance dependence among physicians equal those in the general population. Based on what you've read in the book, do you think medical and governmental authorities are taking the right measures to identify and treat physicians with substance-dependence problems, in order to help them and safeguard the public?

4. Dr. Ameisen describes how the moral stigma of addiction pervades our society, despite overwhelming evidence that addiction is a biological disease that manifests itself in imbalanced neurotransmission in the brain. Studies cited in the book also show that the likeliest explanation for vulnerability to addiction is a preexisting imbalance in neurotransmission associated with chronic anxiety and depression, post-traumatic stress disorder, or related problems. Before reading the book, were you inclined to see addiction as a failure of moral character or self-control? Has reading it changed your view of addiction and those who suffer from it?

5. Dr. Ameisen explores the possibility that his mother's traumatic experiences as a Holocaust survivor may have predisposed him to chronic anxiety and thus made him vulnerable to addiction. Have you observed similar patterns in your own family or in friends' families?

6. Addiction has both direct and indirect victims -- not only alcoholics and other addicts, but also their families, loved ones, and friends. Has the book deepened your understanding of how the disease drives a wedge between the people who suffer from it and those around them? After reading it, do you feel any better equipped to reach out to a friend, relative, or coworker who is struggling with substance dependence?

7. As the book explains, studies show that people with anxiety, depression, and post-traumatic stress disorder or with so-called nondrug addictions -- gambling addiction, binge eating, sex addiction, and compulsive shopping, among others -- have the same imbalanced neurotransmission as people with drug addictions. Given this shared pattern, does it seem reasonable that a single medication might be effective against all these problems?

8. The history of medicine reveals that whenever medicine has lacked an effective treatment for an illness, it has blamed the patient for supposed immorality or a lack of positive attitude and willpower. Were you surprised to read in the book that victims of tuberculosis and cancer were once seen in this way? What can each of us do to change the way addiction is viewed by society?

9. The book reports studies documenting that doctors most often miss the signs of addiction in their patients, and even change the subject when patients bring it up. What should be done to encourage honest discussion between doctors and patients about addiction?

10. Serendipity -- a lucky break -- made Dr. Ameisen aware of baclofen, and many other important medical and scientific breakthroughs have depended on chance. Has luck ever played such a dramatic role in your own life? Do you think medical and scientific authorities are as open to serendipity as they should be?

11. When Dr. Ameisen first heard about baclofen and began self-experimenting with it, he did not know how safe it was. What do you think of his decision, as a patient and a physician, to prescribe himself baclofen?

12. After baclofen ended Dr. Ameisen's craving for alcohol and completely freed him from addiction, he was astonished to learn that neurologists have safely used high doses of baclofen for comfort care of patients with muscular spasms and similar problems since the 1960s, but that largely because of the specialization of modern medicine, addiction researchers and caregivers did not know anything about this. What should medical authorities and organizations do to encourage doctors in different fields to learn from one another?

13. Baclofen has been documented to be non-euphoric and nonaddictive. Do you agree with Dr. Ameisen that taking baclofen for addiction should be seen in the same way as taking a medication for any chronic condition, such as a beta-blocker for high blood pressure?

14. Before he found baclofen, Dr. Ameisen tried every available form of treatment for alcoholism. But as the book discusses, the existing treatments are not enough on their own to help the vast majority of alcoholics and other addicts to quit. Given the extremely high failure rate of existing treatments, and in light of baclofen's excellent safety record and documented effectiveness in both animals and humans, do you think addiction specialists' resistance to prescribing baclofen is reasonable?

15. Following Dr. Ameisen's example and treatment protocol, some other physicians are already prescribing baclofen to alcoholics and other addicts. Is this a good thing, or should more studies be done first?

16. The usual medications for addiction -- disulfiram, naltrexone, acamprosate, topiramate, and varenicline -- have shown only limited benefit in repeated trials, and all except acamprosate can have serious side effects. What do you think of pharmaceutical companies that continue to push these medications, and of doctors who continue to prescribe them? What is your reaction to seeing advertisements for these medications?

17. Prescribing baclofen for addiction is an "off-label" use. Before reading the book, did you know that more than 23 percent of all prescriptions are off-label? Has a physician ever advised you that he or she is prescribing something to you or a family member off-label?

18. A randomized clinical trial of baclofen for addiction would cost about $500,000. Because baclofen is out of patent and has been available as a generic prescription medication since the 1980s, no pharmaceutical company has a financial incentive to fund such a trial. Given the enormous cost to society of treating substance abuse-alcohol abuse-related costs have been estimated at $200 billion a year in the U.S. alone -- should government step in to fund randomized clinical trials of baclofen?

19. Dr. Ameisen observes that AIDS activists had a decisive influence on changing AIDS treatment to incorporate lifesaving medications, and he calls on patients, their families, and concerned physicians to lobby for clinical trials of baclofen for addiction. How much influence do you feel patients with addiction and their advocates should have on the direction of medical research and treatment?

20. A bill is pending in Congress to change the name of the National Institute on Drug Abuse to the National Institute on Diseases of Addiction and the name of the National Institute on Alcohol Abuse and Alcoholism to the National Institute on Alcohol Disorders and Health. As the book discusses, many scientists and physicians support this as part of the new understanding of addiction as a biological disease, but others criticize it as diminishing the importance of personal responsibility in recovery from addiction. Before reading the book, would you have supported the name changes? Has reading the book changed your opinion?
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  • Posted May 12, 2009

    Possibly the most important book written about addiction of our time. Through excruiating trial and error, Dr. Ameisen found a solution to his addiction to alcohol. This should be a must-read for all med students. God bless this man.

    Dr. Ameisen has given me hope that I, too, can end my alcohol addiction.
    It took tremendous courage for Dr. Ameisen to share his heartbreaking
    story of alcoholism and his desperate search for help. I firmly believe
    his story will save and change the lives of countless people who suffer
    from all types of addiction.

    4 out of 4 people found this review helpful.

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