What are we missing?

It's odd that it took over a century between the first recognition of anorexia as a medical illness to the first specific use of food as therapy. I'm not talking the idea that people with eating disorders ultimately need to eat (though I'm sure this, too, was revolutionary at a point in time), but that food could be medicine.

For over 100 years, this idea was really overlooked. What else could we be missing?

Although I don't have an answer specific to the ED world, the field of addition and alcohol abuse might have some interesting new leads. A new book out by a recovering alcoholic and renowned cardiac surgeon speaks of his recovery thanks to a drug called baclofen. Baclofen isn't a new drug, nor was it developed for use in addictions. The drug is actually a muscle relaxant, and works on the brain's GABA receptors to increase levels of GABA in the brain. In this manner, it provides many of the similar anxiolytic properties of alcohol in much the same way.

Several years ago, a case series (a series of case studies of addicts who were treated with baclofen) appeared in the medical journals, with seemingly promising results. Later studies--both in humans and in mice--showed mixed results. But our alcoholic cardiologist either didn't know or didn't care. Down and out and headed even further down, he got a friend to prescribe him baclofen* and found that his cravings for alcohol had disappeared.

Olivier Ameisen, the cardiologist in question, wrote a book about his experiences called "The End of My Addiction," which was reviewed on the wonderful blog Neurotopia. While the review is interesting (and provided much of the background information here), it is the ending that really got me thinking about the parallels to the field of eating disorders

The book ends in bafflement that more studies are not taking advantage of what could be the cure addiction researchers have been looking for for years.

And I also wonder, why not? The book was published very recently, and I still haven't heard of a large scale clinical trial for baclofen (though I could have missed it, of course). The drug appears relatively safe in high doses (as is known through its use in treating muscle spasms), and appears to provide relief from both the craving and the anxiety that drug users experience. What is going wrong?

Ameisen proposes one theory. He believes that, since baclofen is an old drug and no longer under patent, drug companies will never fund a large scale clinical trial. There's no money in it. He may very well be right. But I've got another theory. Most researchers who work in addiction know that addiction is a disease. It's something that you simply cannot cure through an exercise of will. It's not a problem with will power or lack of faith. And though we all know this, I wonder how many addiction researchers really believe it. A lot of the resistance that Ameisen encountered was from people who could give no real reason as to why they weren't interested in a clinical trial. Could it have been the concept of a cure? The idea that you just take a pill and make it go away? It is possible that, even though we all know that alcoholism and other kinds of drug abuse are diseases that cost the public billions of dollars per year, that society has still made up believe in will power. That we think, at some level, that addicts should suffer for what they have done. Ameisen had no suffering. He just stopped. Is our society ready to accept that kind of a cure?

I don't think that most people in the field of EDs think that people need to "suffer" because of their illness. I have yet to meet a specialist who wasn't ultimately compassionate and didn't want people to get better. However, instead of feeling that people need to "suffer," the mentality is that people need to "figure it out" in order to get better.

It's true- some people do "figure it out" and get better and if you're an adult, that's the most researched option we've got. But are we so busy trying to figure out causes and effects that we could be missing a cure that's right underneath our noses?

*I don't know what potential for abuse this drug has, but if it's being used to treat addictions, I'll bet it's fairly low. But you never know.


mary said...

Interesting stuff Carrie. I'm going to research it a bit more though I recall doing so in the past. A quick withdrawal from baclofen can send someone on quite a "trip". I imagine that those who like to get high might be tempted to use it for such. If the temptation is truly lifted then maybe abusing it wouldn't be a problem. I'm not sure.
I'm curious about other ways this med may help. Depression? Anxiety? I mean when an alcoholic is withdrawing they normally go through a phase that tries to pull them back. Plus, cost and availability must be honest ...even though alcohol isn't cheap. I did find some forums where they are discussing baclofen so perhaps those who are using it can answer these questions best. Apparently it's powerful medicine. thanks for bringing this up.
Spring is coming/****

Anonymous said...

It's interesting that you posted about Baclofen, as my doctor prescribed this for me about 5 weeks ago. It made me crazy manic...but at the same time feeling 'drugged up', if that makes sense. It also made me very constipated and bloated, and didn't help with any of the ED issues, nor smoking. I stopped taking it for a few days, and my anxiety went sky-high and I was shaking uncontrollably. Apparently you DO NOT stop taking this med without tapering it off. I immediately started taking my full dose once I learned this. I am now working on tapering off. In my opinion...a med that can cause that much of withdrawal is VERY addictive. I hope to be able to completely get off of it and feeling back to normal. I'm glad it works for some, though. But it is NOT for me.

Anonymous said...

Also...what is the benefit of trading one addiction for another?

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About Me

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I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

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Have any questions or comments about this blog? Feel free to email me at carrie@edbites.com

nour·ish: (v); to sustain with food or nutriment; supply with what is necessary for life, health, and growth; to cherish, foster, keep alive; to strengthen, build up, or promote


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