Polypharmacy - Chasing the Baclofen Dragon - Baclofen, Curing our Alcoholism

The following definition is taken from Wikipedia

“The term polypharmacy generally refers to the use of multiple medications by a patient. The term is used when too many forms of medication are used by a patient, when more drugs are prescribed than is clinically warranted, or even when all prescribed medications are clinically indicated but there are too many pills to take (pill burden). Furthermore, a portion of the treatments may not be evidence-based. The most common results of polypharmacy are increased adverse drug reactions, drug-drug interactions and higher costs. Polypharmacy is most common in the elderly but is also widespread in the general population.”

On the B 4 a web site, there is a new section called All About Baclofen, in which all the previous discussions about various aspects of Baclofen are brought together. To them, I am adding a section on polypharmacy. It is an issue dear to my heart for two very distinct reasons.

The first one is that I am currently suffering the consequences of it; what with all the vomiting, itching, sweating et al, and now the “ELP” (see the Baclofen Diaries). “Can’t you take something for the vomiting?” I have been asked often. Well, I could, but that might make something else worse. Or something new develop.

Secondly, and much more apposite, in a previous life, polypharmacy was one of my hobby-horses. Most surgeons find that the average age of their patients is getting higher and higher. One of my colleagues jokes that he is now a “Geriatric Surgeon”, rather than a General Surgeon. Many of these patients come into hospital with almost suitcases of medications that they are taking at home. When questioned properly about their symptoms and medications (which I always did, but which few others seem to), the following pattern was oft repeated –

“When I was at the hospital, Dr Clever (my consultant) gave me drug A. Then I got symptom Z. I went to my GP, Dr Smith, who gave me drug B. That gave me symptom Y. So, I went back to the surgery, and saw a different GP, Dr Jones. He prescribed drug C. But that only gave me symptom X. When I went back to the hospital, I saw a junior doctor, can’t remember his name, nice man though, who ordered some X-Rays. They were normal, so he gave me drug D. That made me develop Horrid Syndrome, which apparently occurs if you take drug D with drug B. When I finally saw Dr Clever again, he stopped drugs B, C and D, and just reduced the dose of drug A, and apologised to me for the unnecessary X-Rays. I’m fine now.”

I think that that messy paragraph describes the point perfectly. But what is the real point here? Why am I bringing it up now?

The vitally important point is that with high dose (often very high dose) Baclofen being taken by such large numbers of us, we are in somewhat uncharted territory. Further, many of us also:

• Are self diagnosing, self-prescribing, self-dispensing, self-monitoring
• Are taking other anti-alcoholism medications alongside Baclofen
• Have other psychological, if not psychiatric, problems for which we may be prescribed powerful “brain chemistry altering” medications
• Are on other medications for other unrelated medical conditions
• Are not eating properly
• Are not sleeping properly
• Are, perhaps most importantly, still drinking
• And keeping the fact that we are taking high dose Baclofen secret from our doctors looking after all the other stuff

Consequently, we are each of us potentially concocting our own version of Baclofenestrone Soup, each with its own distinct recipe and unique effects. A recipe previously unknown within the annals of medical / pharmaceutical cookery. So individual to you that you may be first to add it to the books. God help you.

I’m not scare-mongering; I am merely highlighting an important issue, and asking you all to be very careful.

I hope that made sense.

Take care of yourselves.

Pip xx