I'm up to about 120mg baclofen. I've titrated up a bit too quickly and got some side effects from this, pretty woozy and a good bit of insomnia (which is a strange combination). Right now I've got a bit of a pins and needles sensation on my skin. Overall the side effects are plenty tolerable and it does have a subtle calming effect, and somehow, the urge to drink (like having a really bad case of cabin fever) just doesn't come up so much.

For instance: last night my girlfriend and I essentially consummated the breakup of our six year relationship... I considered drinking, but I didn't feel like it, and I didn't. There was no reason not to, really, I was home and I've got a nice collection of good beer, but I was busy building an amplifier, high voltages are involved and I'm not much good at it (yet), and I thought it would cause me to make mistakes. By the way I plugged the thing in this morning and it sounds fantastic.

What is most striking is how these new thinking patterns just emerge out of nowhere. Six months ago there were days when I would find myself walking into the bar at 4pm as a voice repeated in the back of my head "oh ****, you know this isn't going to end well, you idiot, stop, go do something else" but this voice was unable to control my feet... This bar is a downstairs place, and I'd descend the stairs, terrified of the embarrassment that I was going to feel when I found out that I'd been banned the last time I was in there. (In fact, this was mostly in my head, but that doesn't change anything.) To make matters worse, several times I walked through the door and the bartender announced "oh no, here we go again". She likes to take the piss, but I never really knew, because I didn't remember much. In my experience, not remembering is the worst... I find it impossible to come to terms with something I don't remember, and the consequent verbal self-abuse is vicious and unrelenting.

The drinking is holding steady at a rate that is more than the doctor-recommended 14/week (not that I place too much confidence in doctors when it comes to Alcohol), but the significant negative effects are gone, namely:

- blackouts
- getting too drunk and being an asshole
- three day hangovers
- violent attacks of shame and self-loathing on the hangover days
- being afraid to socialize because of items one and two

The difference is absolutely dramatic. My social life is improving, I'm taking up new interests, my self-esteem is turning around in a big way, I spend much less time cursing myself under (or over) my breath. If you had told me six weeks ago that I just had to take some pills to get this I would never have believed you. I have every reason to believe that things will continue to improve as extinction takes its course and I stabilize and reduce my baclofen intake. If it didn't, though, I would still be satisfied. I am indescribably glad that I googled
for "alternatives to AA" those weeks ago. I have told several friends about what I am doing

On the meds: I continue to believe it is good to supplement naltrexone with baclofen, as necessary to keep consumption to tolerable levels. Baclofen has the ability to dampen the extinction-burst effect, apparently without interfering with extinction itself (though to the best of my knowledge this has not been studied), I don't personally see a reason not to use it, especially if despair is setting in. I don't think I'm going to go much higher on the baclofen, I'm not so interested in hitting my "off switch", I'm going to continue drinking and allow pharmacological extinction to do its thing.

-Ned

This is very interesting, Ned. Thanks for posting. -wort