The French government’s Marketing Authority is now mentioned on Wikipedia’s Alcoholism page.
Which is good thing because when you google anything the Wiki entry always seems to come up first.
By way of background, the French national drugs agency, the ANSM, decided in 2017 to limit baclofen use to 80 mg per day after a report came out that baclofen was associated with more deaths and hospitalisations than other drugs for alcoholism. There was a huge outcry among baclofen users about this and a legal challenge was launched to try to overturn the decision, which challenge failed. However, at the same time, the government clarified the position and issued a statement that people could continue to use high doses of baclofen and that there would be futher investigation into the use of baclofen at high doses, so it’s not over yet.
The real issue, at the moment, is that only doses up to 80 mg per day are paid for by state medical insurance, so anything above that has to be paid for by the patient. I don’t think this is a huge problem since baclofen is initially started while still drinking and my experience is that a heavy-drinking alcoholic starting on baclofen treatment is going to do two things; 1. miss a lot of doses and accumulate a lot of baclofen and 2. lie about it. The result is that the doctor continues to prescribe and increase the dose while the alcoholic patient accumulates a basketful of baclofen.
The problem with the situation in France is that the ANSM reacted to a report which found that there were more deaths and hospital admissions “associated” with baclofen use than associated with Naltrexone, Nalmafene or Campral. It didn’t find that baclofen actually caused a single death or hosptial admission.
What I find incredible is that it still hasn’t got through to researchers or almost anyone that the fact that baclofen works at all suggests that it is working on a part of the brain which these other drugs don’t work on. And, they are used by a different cohort of patients. Campral is only supposed to be used for abstinence, in patients who are not drinking at all. So why would there be any reason to compare the two drugs? Both Nal drugs work as antagonists, not agonists, and on a different set of neuro receptors and are supposed to be taken before drinking. For those who take baclofen, all other treatments are supposed to have failed, and many baclofen users are taking 1 to 2 litres of hard spirits a day, which means they are always intoxicated and many start drinking the moment they wake up in the morning.
The study should have compared “like” drugs and the like drug for baclofen is alcohol itself. What percentage of people drinking a litre or more of spirits a day die or are hospitalised over a period of a year? That’s what should have been compared to problems with baclofen users.
Anyway, it’s still early days in all of this but at least there is movement. A few years ago I tried to amend the alcoholism page of Wiki and met huge resistance and there is, or will be, this year at least one country, France, where baclofen will be advertised and marketed as a cure/treatment for alcoholism and that can only go one way, forward.
It’s just sad it’s taken so long and there’s been such fierce and unreasoned objection to some people with a such a serious and life-threatening illness, being able to take the medication of their choice.