Baclofen and Its Role in Overcoming Substance Use Disorder
Known under the brand names Kemstro and Lioresal, pharmaceutical manufacturers originally conceived baclofen to treat epilepsy. After synthesizing the drug in 1962, however, clinicians discovered that baclofen displayed minimal benefits in controlling seizures. Medical care providers have subsequently used the drug as a muscle relaxant to alleviate spasticity caused by a variety of diseases.
In 2009, Olivier Ameisen, a well-known French cardiologist, who also practiced at New York’s Weill-Cornell Medical Center, wrote a book detailing his own struggles with overcoming alcohol use disorder (AUD). In the text, he explained how he used baclofen to treat his addiction.
While inquiries into baclofen as a treatment for AUD already existed, new interest in the efficacy of the drug ensued as researchers continued exploring the medication as an option for treating chemical dependency with a keen emphasis on AUD. In the sections below, we’ll explore the benefits of baclofen as an addiction treatment, along with several other key considerations in prescribing the drug to individuals struggling with various forms of substance use disorder.
The Research About Baclofen for Alcohol Use Disorder (AUD)
Doctors have been prescribing baclofen in increasing numbers over the past decade to treat drug and alcohol addiction. In this capacity, the medication has been shown to render positive outcomes in lessening chemical withdrawal symptoms. While baclofen is considered an off-label medication and not approved for this specific use by the FDA, the clinical trials conducted over the past several years have revealed that the antispastic drug can be effective in reducing symptoms of alcohol withdrawal.
A significant body of preclinical evidence revealed that baclofen can be especially useful in treating AUD as early as the 1970s. Not all of these studies were conclusive, however, as some yielded conflicting results. Nonetheless, given the prevalence of alcohol use disorder, any safe treatment that can potentially reduce cravings and help those struggling with AUD overcome the disease was welcomed by the medical research community in these early phases.
According to the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), AUD comes in two distinct forms: alcohol abuse and alcohol dependence. To be diagnosed with this disorder, a person must meet two or more criteria out of 11 as outlined in DSM-5. Examples of these criteria include cravings, uncontrollable urges to consume alcohol, and adaptive problems, such as legal or job performance issues, associated with excessive alcohol use.
Early Preclinical Trials on Baclofen and AUD
AUD is characterized by periods of heavy drinking and chronic relapsing after remitting alcohol usage for an extended time. The primary objective of any medical treatment program for AUD is to help problematic drinkers achieve and sustain ongoing abstinence from the drug.
Depending on the severity of the disease, some clients may be able to reduce their consumption to what’s considered a low-risk, socially acceptable level of drinking. However, this may not be a safe option for the countless people battling an acute case of AUD. For these individuals, the preferred goal of any treatment for alcohol addiction is maintaining complete, life-long abstinence from the drug.
The latest research into baclofen, which is a gamma-aminobutyric acid-B (GABA-B) receptor agonist, as a treatment option for AUD and other substance use disorders has been promising. Drug makers first started marketing baclofen in the 1970s as a mycrorelaxant to help relieve secondary symptoms of neurological conditions like multiple sclerosis.
Some of the initial research from the 1970s dealing with animal addiction models indicated that baclofen could also be effective in treating AUD. These preclinical animal trials revealed a correlation between dosages of the drug and a reduction of the negative behavioral effects caused by alcohol. The studies focused on both binge drinking and drinking after a relapse event, along with the severity of withdrawal symptoms.
Clinical Trials on Baclofen for Addiction
Italian medical researcher and AUD treatment specialist Giovanni Addolorato and his colleagues were the first to conduct human clinical trials that explored baclofen as an effective treatment option for alcohol use disorder. Addolorato’s initial study included 10 male clients battling some form of AUD.
The clients in the study received 30 mg of baclofen to treat their alcohol withdrawal symptoms. They started with 5 mg of baclofen three times daily before upping the dosage to 10 mg in the same increments over four consecutive weeks.
The subjects all reported lowering their alcohol intake within the preceding 24 hours, and some clients in the controlled study were able to achieve and maintain complete abstinence from alcohol. These research findings were later replicated by Barbara A Flannery and her associates in a study published in 2002.
This group of researchers also found that prescribing baclofen for addiction offers an effective means of reducing alcohol consumption in some AUD clients. The 12-week clinical trial included nine men and three women who, after completing a comprehensive physical and psychiatric screening, were administered the same 10 mg of baclofen three times a day. These clients also received four sessions of motivational enhancement therapy during the clinical trial.
The results of both Addolorato and Flannery’s studies revealed that baclofen was reasonably effective for treating AUD in the alcohol-dependent population. At the time in the early 2000s, however, clinicians wanted to explore larger-scaled placebo-controlled studies that corroborated the positive outcomes they observed during the course of their research.
The most recent clinical trials lasting four weeks have demonstrated that baclofen is superior to placebo and that a GABA-B receptor agonist is likely a reliable pharmacotherapy for AUD. While baclofen has yet to be an FDA-approved medication for treating AUD, the existing randomized, controlled trials indicate that it can help safely reduce drinking in clients struggling with a chemical dependency, especially alcohol.
Benefits of Baclofen in Addiction Treatment
While addiction specialists still consider baclofen a relatively new option for treating substance use disorders, the outlook on the drug, as mentioned, is promising. Researchers believe that baclofen is beneficial for reducing the symptoms of withdrawal, particularly in AUD clients, but it isn’t entirely without side effects.
Nevertheless, clinical trials dating back to the early 2000s indicate that the benefits of baclofen in addiction treatment plans are numerous. Foremost, the medication has been demonstrated as efficacious in reducing alcohol cravings. Other studies show that baclofen is potentially useful in detox management and maintenance treatment for opioid-addicted clients. These individuals were less likely to relapse after following the recommended dosage of baclofen.
Baclofen helps reduce cravings among those struggling with a dependency on cocaine as well. In general, medical researchers have observed that self-administration across multiple addicted populations decreased notably after prescribing baclofen, regardless of the problematic substance.
While successful drug and alcohol recovery depends on multiple factors, baclofen can be used as an integrated treatment for addiction under the appropriate medical supervision. Foremost, the medication helps people struggling with substance use disorder manage the emotional triggers and cravings that lead to relapse.
Coupled with the appropriate therapies, baclofen has been sufficiently identified as a dependable resource for enabling long-term abstinence from alcohol and other drugs. For those battling a substance use disorder, partnering with a certified addiction treatment facility like Granite Recovery Centers is one of the most practical approaches to getting the most out of a baclofen-based treatment plan and achieving a lasting recovery.
Baclofen Dosage and Considerations During Treatment
Baclofen was initially developed as a muscle relaxant to treat specific types of spasticity associated with diseases like multiple sclerosis, and it isn’t entirely without negative side effects. The drug’s intended use was to act on the spinal cord nerves to decrease the severity of muscle spasms while relieving pain and improving muscle motion.
Doctors prescribe baclofen in either tablet or solution form to be ingested orally. As in the original clinical trials, the drug should be taken three times daily in evenly spaced intervals throughout the waking hours.
For liquid doses, to determine the appropriate dosage, clients use an oral syringe as a measuring device. Liquid syringes are typically included with the medication. If a syringe isn’t present, the client should request one.
Some may be allergic to baclofen without realizing it. If an individual is allergic to other medications, one way to determine a baclofen allergy is by reviewing the ingredients listed on the tablets or oral solution. If the ingredients are not visible on the packaging, a pharmacist should be able to provide them.
Anyone starting a baclofen treatment for AUD or a different substance use disorder should disclose all other prescription or non-prescription medications they’re taking or planning to take. These details could impact the medication dosage because doctors must monitor clients for the potential side effects of mixing multiple drugs.
Abruptly stopping the use of baclofen, especially after taking large doses, can result in several ill side effects, including:
- Confusion
- Drowsiness
- Upset stomach
- Muscle stiffness
- Difficulty breathing
- Seizures
- Hallucinations
Some of the above side effects may be present during treatment. Seizures, hallucinations, and trouble breathing are, of course, serious health symptoms that require urgent medical attention. In general, however, these ill-health effects don’t present in most clients who start baclofen as a treatment for AUD and other substance use disorders.
Populations particularly susceptible to baclofen’s side effects include elderly clients and anyone struggling with impaired renal function. Likewise, those battling a major psychiatric disorder, sphincter hypertonia, or liver disease should inform their doctor before starting any treatment for substance use disorder that includes baclofen.
Recommended dosages for baclofen vary from client to client and gradually increase over time. When someone is ready to come off the medication, doctors will taper the drug to prevent the potentially severe side effects listed above.
With some medically supervised exceptions, the maximum recommended dosage for baclofen is 100 mg. It may take several days before the client notices the positive effects of the medication.
Some studies indicate that baclofen is potentially addictive. The documented sudden withdrawal symptoms from the medication are:
- Anxiety
- Psychosis
- Convulsions
- Tachycardia
Clinicians prevent these symptoms by gradually decreasing the dosages over one to two weeks.
How Does Baclofen Compare With Traditional Treatments?
Historically, doctors have used benzodiazepines as the preferred medication for treating alcohol use disorder. Methadone, buprenorphine, and naltrexone are considered the conventional options for treating opioid addiction, while some clinicians use anti-convulsives like vigabatrin to treat cocaine dependence. Various inquiries into baclofen and the drug’s efficacy for treating substance use disorder between 2001 and 2004 indicated that the medication may be as effective as benzodiazepines. Both prescriptions help manage AUD withdrawal symptoms, and each has its own set of unique side effects.
Methadone and benzodiazepines and known to have addictive properties, and baclofen is also suspected to display at least some potential for addiction. Clinicians consider naltrexone to be well-tolerated for treating opioid addiction, but high doses come with a potential risk of hepatotoxicity in clients with liver disease.
One of the benefits of baclofen over other medications is that it’s primarily eliminated in the kidneys. As such, the treatment can be used in clients who might be struggling with the more minor forms of liver impairment.
Unlike other conventional treatments, baclofen shouldn’t be prescribed during pregnancy. A negative pregnancy test should be obtained for women of childbearing age before prescribing the drug.
Compared to other similar medications, the side effect profile of baclofen is relatively mild. The main symptoms people experience during treatment are nausea, fatigue, and, occasionally, vertigo. While the medication has a few potential downsides, the drug is, overall, considered to be safe by doctors and addiction treatment professionals.
Finding a Qualified Addiction Recovery Specialist
Seeking the right professional guidance before starting any baclofen treatment schedule for substance use disorder is crucial. The Granite Recovery Centers offer expert addiction recovery services. Our evidence-based treatment programs take a holistic approach to modifying addictive behaviors that won’t rely exclusively on treating a substance use disorder with more drugs.
Our best-in-class treatment facilities help clients find a genuinely lasting recovery after understanding the true origins of their disease. Learn more about how the Granite Recovery Centers can provide a compassionate, individualized path to rehabilitation for you or your loved one. Call 855-712-7784 to connect with a certified addiction recovery specialist today!
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