Sober Now

Herein are some ideas that helped me stop abusing alcohol.

Tuesday, September 27, 2016

Olivier Ameisen wrote "The End of My Addiction"

Good descriptions of anxiety and alcohol cravings ....

I read his book years ago.  It was about a drug MS,ers take to prevent muscle cramps that he used to end his alcohol addiction.  He took huge doses of the drug, Baclofen to halt his cravings for alcohol...

“One of the first duties of the physician is to educate the masses not to take medicine.” Sir William Osler, physician

The End of Alcoholism? Part 1

© Katarzyna Białasiewicz |
© Katarzyna Białasiewicz |

There is an existing generic medication called baclofen, a muscle relaxant, which has been primarily used to treat spasticity and multiple sclerosis.
Now it is in the early research stages as a treatment for alcoholism. Olivier Ameisen, a French-American cardiologist used himself as guinea pig in testing baclofen to treat his own alcoholism.

He said that baclofen saved his life by freeing him of all cravings for alcohol and suppressing his addiction. He’s written several journal articles and a book, The End of My Addiction, describing his active drinking and how baclofen helped him stop. Ameisen died of a heart attack on July 18, 2013, but his “discovery” lives on. Let’s see if it is a miracle treatment; or not.

First we will summarize his experiences by looking at The End of My Addiction and an article he wrote for the journal, Alcohol and Alcoholism about nine months after his “complete liberation from symptoms of alcohol dependence.” Afterwards, we will look at some of what the research literature has to say about baclofen.

Ameisen said he began to struggle with symptoms of alcohol dependence in the 1990s. In his struggles to stop drinking, he had numerous emergency hospitalizations, emergency room visits, detoxifications, and years of both inpatient and outpatient rehabilitation services. Because of his persistent and strong cravings for alcohol he tried disulfiram (Antabuse), but drank on it. He tried Naltrexone and acamprosate, which didn’t stop his cravings or his relapses. He achieved periods of prolonged abstinence, but always struggled with cravings and a preoccupation with alcohol.

He attended Alcoholics Anonymous—sometimes as often as two, three or four meetings a day. He had a sponsor and a home group. Twice he did a “90 in 90,” attending ninety meetings in ninety days. He achieved prolonged periods of abstinence, but continued to relapse. By his estimate, he attended roughly 700 meetings a year, over a period of 7 years between 1997 and 2004. But until he began using baclofen to treat himself, he was unable to maintain abstinence.

Ameisen noted that physicians are notoriously bad patients “who often inhibit their recovery by trying to run their own cases.” And he seems to have been one of the worst. Long before he experimented with baclofen, he preferred to administer his own detox at home after his binges. He objected to CPH (the Committee for Physician Health of the New York Medical Society) refusal for him to continue using benzodiazepines for his anxiety. “Being denied a standard medication for severe anxiety, the condition that triggered and fueled my craving for alcohol, was at best counterproductive and at worst callous and cruel.”

He moved back to France in 1999, where he continued to drink off and on; and continued to seek help to stop his drinking. His binge cycles became shorter and shorter. A treating psychiatrist told him he was afraid he would not live much longer. In the midst of a binge, a friend from New York sent him an article on baclofen treatment for cocaine craving she saw in the New York Times. He was in the midst of a binge and misplaced it. A year later in November 2001 he remembered the article and had the friend track it down and send him another copy. Thus began his investigation and growing belief that baclofen could be a treatment for his alcoholism.

He contacted the doctor mentioned in the New York Times article. In February of 2002 he bought a PC and began to search the internet for information on “baclofen and panic.” He added “baclofen anxiety;” and finally baclofen alcohol.” This led him to a 2000 research article written by an Italian researcher, Giovanni Addolorato on the ability of baclofen to reduce alcohol craving and intake.

Ameisen checked with a neurologist friend who told him it was a safe drug; not addictive (Baclofen is not a controlled substance, but can impair thinking or reactions. Withdrawal can result in seizures and hallucinations in some long term users). He decided to order some baclofen and try it on himself. In The End of My Addiction, Ameisen wrote:
Until this point, I had steadfastly tried to be a good patient and had avoided benig my own physician, but it seemed to me that in order to save my life from alcoholism, I had no choice but to risk walking out onto a tightrope without the normal safety net of another physician’s supervision.
This seems to be an inconsistent memory by Ameisen. He had been acting as his own doctor from the time of preferring his own detox at home. Nevertheless, he started using baclofen on March 22, 2002 and gradually increased his dose to 180 mg daily. He found some immediate relief of his muscular tension. He slept better and felt calmer. But he continued to binge drink and he continued to do research into baclofen. Eventually he saw an animal study that suggested even higher doses of baclofen could suppress cocaine intake in rats addicted to cocaine. “The more I learned, the more I came to believe that at a high enough dose of baclofen, I too could reach a point where I would lose the motivation to consume alcohol.”

Then on January 8, 2004, he decided it was now or never. “If I continued to follow my doctor’s advice and the conventional treatments for alcoholism, I was going to keep lapsing into binges and eventually die from drinking. I had to take my treatment into my own hands.”
From the first day, he reported his anxiety was substantially reduced and his sleep became restful. By the 37th day on 270 mg of baclofen, “I experienced no craving or desire for alcohol for the first time in my alcoholic life.” He reported that even in a restaurant with friends, he was indifferent to people drinking. Drowsiness became an inconvenient side effect, so he tapered his dose down to 120 mg per day from days 49-63 of his abstinence from alcohol. He stabilized at that dose, with occasional additions of 40 mg as needed in stressful situations.

At first he avoided situations and places where alcohol was present. But then believed he did not have to be concerned about this. Even when socializing with friends who were drinking, he had no cravings for alcohol. He realized he was “completely and effortlessly indifferent” to alcohol. He was encouraged by a friend and physician to write a paper of his self experiment, which was eventually published in the journal Alcohol and Alcoholism. In the article he said:
At the end of my ninth month of complete liberation from symptoms of alcohol dependence, I remain indifferent to alcohol. Abstinence has become natural to me. I no longer plan my life around alcohol. Alcohol thoughts no longer occur. . . . I no longer suffer anticipatory anxiety of relapse, of embarrassing or dangerous alcohol-related situations. I am no longer depressed about having an incurable stigmatizing disease.
Eventually he wondered if he was vulnerable to relapse. “Would one drink plunge me back into the hell of alcoholism?” So in May of 2005, sixteen months after his abstinence with baclofen, he decided to put his recovery to the test with three successive challenges.

First, while continuing his maintenance dose of 120 mg of baclofen, he had three standard drinks over a few hours at a social gathering. He didn’t guzzle his first drink. He also didn’t finish his third drink. The second test was increasing his alcohol intake to five standard drinks over a six-hour span.

Again, he had no urge to drink rapidly and experienced only a mild euphoria. But the following afternoon, he had a serious craving that he said an additional dose of 40 mg of baclofen suppressed within an hour.

His final test was to consume a massive amount of alcohol; similar to that he ingested during active relapse. Over an evening, he drank about 600 milliliters of Scotch. The next day he had a mild hangover, but no cravings. “It was good to discover that with baclofen I could drink in a nondependent way.” On occasions he said he would have a glass or two of champagne or a mixed drink. But he preferred to not drink. In a 2010 article for The Guardian, James Medd, reported

Ameisen can now even drink socially. “I became disease free-free,” he said.
After his “self-case report” was published in Alcohol and Alcoholism, it didn’t cause much professional excitement. “But he found that potential patients were much more interested.” After two unsuccessful years of trying to work up interest within the medical system, Ameisen decided to write The End of My Addiction, published in France as Le Dernier Verre (The Last Glass). Small groups using high-dose baclofen sprung up around doctors who adopted Ameisen’s ideas and who were willing to prescribe baclofen off-label. Interest in researching the potential treatment benefits of baclofen also began to occur.

Ameisen did begin to gather some research and media interest in his treatment method with baclofen. Here is a 2009 video of Diane Sawyer interviewing him after the publication of his book.  Ameisen began to correspond with George Koob in 2005, who would become the Director of the NIAAA, the National Institute on Alcohol and Alcoholism in January of 2014. He reported agreeing to act as a consultant to a prospective study Koob planned to do on baclofen. There was a mention in a report by the Committee on the Neurobiology of Addictive Disorders (where Koob was the Committee Chair before moving to the NIAAA) that baclofen could block alcohol self-administration in rats. Here is a link to Koob’s 2007 published study.

Ameisen was not the first person to theorize baclofen could be useful in the treatment of alcoholism. But his self-experimentation and the publication of his results spurred an interest in baclofen. His theories may or may not be ultimately demonstrated as valid. But what is clear is that while he claimed baclofen ended his cravings for and addiction to alcohol, it didn’t end his drinking. Ameisen believes that “In addiction the symptoms ARE the disease.” So he sees suppressing his symptoms as “curing” his alcoholism. Since he doesn’t have cravings and doesn’t obsess over alcohol and drinking, he’s “cured.”

But what are the long-term consequences of high-dose baclofen treatment for alcoholism? It isn’t listed as a controlled substance, but there is a baclofen withdrawal syndrome and high dose users are discouraged from rapid tapering or withdrawal. So is there a slow developing physical dependency or dysregulation of the GABA system in the brain from long term use of baclofen? Is taking a dose of a drug daily to not drink alcohol really a cure for alcoholism? Ameisen asserted that he has yet to find a patient where it hasn’t been a success. But is that the whole story? Ameisen’s death came before there was an answer to these questions.

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The End of Alcoholism? Part 2

Within an introductory “Note to the Reader,” to his book, The End of My Addiction, Olivier Ameisen said: “By completely suppressing my addiction, baclofen saved my life. I believe it can save and improve the lives of many others by completely suppressing their addictions, and I have written this book to that end.” He ended his note with a caution that his book was not a self-help manual or a guide to self-treatment. Baclofen, a prescription drug, “should be taken only as prescribed … and closely monitored by a licensed physician.” Yet his book is a detailed discussion of how he did exactly the opposite of everything he had just cautioned others not to do.

There had been some ongoing research into the potential of baclofen as a treatment for alcohol use disorders (see the References for Ameisen’s Alcohol and Alcoholism article) before Ameisen wrote his book. But Ameisen’s personal experimentation and its description in his book brought it to the attention of the public and sparked further interest in researching the potential of baclofen to treat addiction. “The End of Alcoholism? Part 1” looks in more detail at that story. Here I want to explore some of the research supportive of using baclofen in treating alcohol use disorders.

Giovanni Addolorato of the Catholic University of Rome was one of the initial baclofen researchers Ameisen read. Eventually they began to correspond and shared their interest its potential to treat alcoholism. A sampling of Addolorato’s published research studies looks at the ability of baclofen to reduce cravings and alcohol intake (2000); the suppression of alcohol withdrawal syndrome with baclofen (2002); a comparison of baclofen to diazepam in treating alcohol withdrawal (2006); the effectiveness of baclofen in maintaining abstinence with patients with cirrhosis of the liver (2007). Addolorato found baclofen to be effective in reducing craving and alcohol intake; it was comparable to diazepam in treating withdrawal; and it promoted abstinence—even in alcohol-dependent patients with cirrhosis of the liver.

Colombo et al. (2002) found that baclofen inhibited the drinking behavior of selectively bred alcohol-preferring rats. Baclofen is a known GABA(B) receptor and the results suggested that the GABA(B) receptor was involved in the disclosure and experience of the psychopharmacological effects of alcohol.

William Bucknam published a case study in 2007 to investigate whether baclofen-induced suppression to consume alcohol in animals could be transposed to humans. The patient, Mr. A., wanted to be able to control his drinking not establish and maintain abstinence. He “experienced a satisfactory response to high-dose baclofen that [was] sustained over ten months without significant side-effect.”

Lorenzo Leggio (2009) suggested that baclofen “represents a promising medication in the treatment of alcohol-dependent subjects.” It demonstrated an ability to reduce alcohol craving and intake. So it could be useful for promoting abstinence “as well as relieving alcohol withdrawal syndromes.”

In 2012 Renaud de Beaurepaire published a 2-year observational study of 100 individuals using baclofen. Initially 132 individuals were included in the study, but 32 were excluded for various reasons. These reasons included: not providing feedback after their first visit, stopping their use of baclofen because of adverse drug effects, and not being motivated to stop drinking. The effects of baclofen in the first three months were not included in the study, “because the effect of the treatment during this period does not represent the full potential of the drug.” (So what was going on in the initial three months that might give an unfavorable view of baclofen, I wonder?) The participants were evaluated before treatment with baclofen and then at 3, 6, 12 and 24 months to fit into three categories: low risk, medium risk and high risk.
In the “at low risk” category, patients experienced a suppression of craving, and their complete control over drinking was effortless. In the “at medium risk” category, patients experienced a clear decrease in craving but, for various reasons (in general, too strong an attachment to their drinking habits associated with an incomplete motivation to cease drinking), they were not able to control completely their drinking compulsions. In the “at high risk” category, patients either experienced an insufficient reduction of craving, or, although they experienced a significant decrease in craving, after a period of decrease in drinking, relapsed in their addiction. The risk category was defined according to the control over drinking during the last 4 weeks [before the evaluation].
Fifty-nine percent of the participants had one or more concomitant psychiatric disorders, including: 53% with anxiety disorder, 34% with depression, 18% with bipolar disorder, 42% with a sleep disorder, 11% with another addiction (mostly cannabis), 8% with psychosis, and 5% with an eating disorder.

At the end of the first visit, participants were told they could drink as usual. Using baclofen was expected to suppress the motivation to drink. No additional therapeutic intervention other than baclofen was given or suggested.

The doses ranged from 20 mg to 330 mg, with an average dose of 147 mg. Eighty-eight percent of the participants reported at least one undesirable side effect. The five most frequently reported were: fatigue or sleepiness (64%); insomnia (31%); dizziness (21%); tingling or abnormal sensations (18%); nausea or vomiting (17%).  There were several others, including: weight loss, memory loss, mental confusion, hypomania, dysphoria (a state of profound unease or dissatisfaction). De Beaurepaire assessed these side effects as “always benign.” However, eleven individuals discontinued treatment because they could not tolerate the side effects. And 20 participants did not reach an optimum dose because of the worsening of side effects.

The study reported that 92% reported a decrease in their motivation to drink at one time or another during the follow up time period. About half reported that at sufficient doses of baclofen, they had “a complete and effortless control” of alcohol craving. All participants were rated “at high risk” initially, but about half were rated “at low risk” at 3, 6, 12, and 24 months of follow up.

De Beaurepaire concluded that baclofen was very effective in treating alcohol dependence, particularly in reducing the motivation to drink. High doses were often necessary to obtain an optimum effect. The principle limitations seemed to be the side effects, the absence of a strong willingness in some to stop drinking, and co-occurring psychiatric illness—with the possibility that the concomitant use of psychotropic medications was a factor. “Baclofen should be considered a major help for drinking cessation, but other factors (psychological and environmental) are likely to play an important role with many patients.”

Ameisen sees baclofen as essentially a miracle cure for alcoholism. “So far it seems to work in all types except for one … and that’s people who turn up once and don’t come again.” He admits that no medication works effectively for everyone, and that includes baclofen. It’s not one size fits all; “you have to refine it.” There is a parallel here to methadone maintenance for opioid addiction. Ameisen’s “threshold dose,” refining the dosage until it’s high enough to eliminate cravings, sounds like raising a person’s methadone dose until they don’t want to get high anymore.

But the miracle cure claims of his treatment have provoked skepticism. Dr. Nicholas Pace, a clinical professor of medicine at New York University said: “I have studied alcoholism for the past 40 years, and there is no single magic bullet. This is a complex disease, and you can’t just flip one switch. The idea that an alcoholic can drink socially is simply a lot of bull.”

Ameisen said this kind of reaction from addiction professionals is because they feel threatened. “If baclofen works, then their specialism is going to fall apart.” But James Medd, writing for The Guardian suggested there could be another reason. This isn’t the first time someone claimed they found a cure for alcoholism. Barbiturates, benzodiazepines like Valium and antidepressants such as Prozac were hyped at one time as an end to addiction. Naltrexone has also been proposed as a “cure” for alcoholism in the Sinclair Method (See A “Cure” for Alcoholism).

At least for Ameisen, baclofen seems to have turned his life around. He reportedly had over nine years without drinking compulsively. There are several studies being done to investigate the treatment potential of baclofen. Here is sample a of some of those listed on Assistance Publique – Hôpitaux de Paris (study 8) is completing a study to show the effectiveness of a year of baclofen treatment to that of a placebo. It was planned to increase the dose to a maximum of 300mg daily. In case of intolerance, the dosage would be decreased.  Essentia Health (study 9) is investingating the use of baclofen to prevent the symptoms of Alcohol Withdrawal Syndrome. The University of North Carolina at Chapel Hill (study 14) is investigating whether a 90mg dose of baclofen is effective and safe with individuals with alcohol dependence.

While there are some potential benefits with baclofen in treating alcohol use disorders, there are some clear adverse effects as well. We will look closer at those side effects in Part 3. Amiesen did not describe or dwell on the adverse effects with baclofen. Perhaps this was because he came to it when his own fight against alcoholism was at the point that he thought he was going to die from it. He had a blind spot to its negative effects because baclofen became the miracle drug that saved his life. As a physician writing a book on baclofen he cautioned his readers to not self-treat with baclofen. As an active binge drinker he was desperate to find something—anything—that would put an end to his addiction and did it anyway.


Tag Archives: Olivier Ameisen


The End of Alcoholism? Part 3

© f8grapher |

“One of the first duties of the physician is to educate the masses not to take medicine.” Sir William Osler, physician

Olivier Ameisen wrote in The End of My Addiction that thoughts about an addictive substance could insinuate themselves into an addict’s consciousness and quickly preoccupy the whole mind with anxiety about how to get it. “This is a harrowing experience mentally and emotionally as well as physically, because it is charges with shame and self-loathing for even experiencing the craving.” Cravings could propel him into a trance-like state. He would set out to buy liquor, feeling as if someone else was controlling his body. “When craving defeated me, I could only hope, pray, and strive to do a better job of resisting it the next day.”

Ameisen was “a French-American male physician with alcohol dependence and comorbid pre-existing anxiety disorder.”  He said he had been plagued by anxious feelings of inadequacy throughout his life. He’d been seeing therapists for a long time before he started drinking. They were never much help with his anxiety. “Nor was the Xanax they prescribed me.” So he turned to alcohol.
I was terrified of living without alcohol. Without it, I would be an anxious wreck. Admitting my problem drinking to most of my friends and my colleagues terrified me too. I feared being ostracized, and since I felt that drinking should be under my control I felt ostracism would be justified.
He told every physician and therapist he saw that his fundamental problem was anxiety, “which expressed itself in chronic muscle tension, and which intensifying to a panic state, triggered the overwhelming need to drink for relief.” None of the addiction professionals took him seriously. So he looked around to prescribe his own treatment. He thus disregarded another observation of the Canadian physician, William Osler: “A physician who treats himself has a fool for a patient.”

An old girlfriend sent him a copy of a New York Times article that discussed baclofen reduced craving with cocaine, but he was in the midst of a binge and misplaced the copy. He eventually contacted the doctor mentioned in the article and asked her about baclofen. Although he was encouraged by the conversation, his alcohol treatment specialist and psychiatrist weren’t interested in discussing an unproven medication. In early February of 2002 he began doing an internet research into baclofen. Panic was his most crippling symptom, so he searched first under “baclofen panic.” He found several reported studies, including the 2000 study by Addolorato, “Ability of baclofen in reducing alcohol craving and intake.”

Ameisen developed a theory that there is a “threshold dose” of baclofen needed to break the cycle of craving, preoccupation and obsessive thoughts with alcoholism. And he decided to try out the theory on himself. He began his self-medicated treatment with baclofen on January 9, 2004. See “The End of Alcoholism? Part 1” for a fuller description of this process. Ameisen did attempt social, controlled drinking, about fifteen months after establishing alcohol abstinence by taking baclofen. But he said he preferred not drinking. James Medd in The Guardian suggested that “He can now drink socially—an idea entirely counter to the teachings of AA and most other therapies.”

Ameisen saw anxiety as his primary disorder, with his drinking as a way to self-medicate his anxiety. Additionally, he held on to a belief that he should be able to control his drinking: “I should be able to control my urge to drink. . . . Since I felt that drinking should be under my control, I felt ostracism would be justified.” Even though he reportedly went to hundreds of Alcoholics Anonymous (A.A.) meetings, if he held onto a belief that he should be able to control his drinking, he would not be able to effectively use A.A. to remain abstinent, because he didn’t entirely accept their first Step: “We admitted that we were powerless over alcohol, and that out lives had become unmanageable.”

Other medical professionals were concerned with his use of high dose baclofen. Jonathan Crick, the psychiatrist who is the editor-in-chief of Alcohol and Alcoholism, said he’s been encouraged with his own treatment of 50 patients with baclofen, but won’t use the high doses of Ameisen’s method. He stays under 100 mg a day. “I do actually have some concerns about unwanted effects in large doses. . . . This is a drug which is active in the brain, and there are some concerns about some unwanted effects of higher doses.”

I also wonder if he turned a blind eye to some of the concerns raised about baclofen in the literature. He saw it as essential to his own ability to manage anxiety, cravings, and to refrain from compulsive, out of control drinking.

There have been a series of studies reporting what has been called a “baclofen withdrawal syndrome.” A 1981 article, Complication of Baclofen Withdrawal, reported that three patients taking baclofen on a long-term basis experienced hallucinogens and/or seizures with abrupt reduction of their dose or discontinuation of baclofen therapy. A 1998 article, “Prolonged Severe Withdrawal Symptoms,” reported that an abrupt decrease or too rapid taper off baclofen could result in a withdrawal syndrome manifesting hallucinations, delirium, seizures and high fever.

A 2005 study, “Delirium Associated with Baclofen Withdrawal,” reviewed 23 published cases of psychiatric symptoms with baclofen withdrawal. Delirium, but not other symptoms was found to arise from abrupt baclofen withdrawal. The delirium appeared to be greater in individuals who received chronic baclofen therapy. A 2001 case study reported on the case of a man with neuroleptic malignant-like syndrome, with disorientation, signs of autonomic dysfunction and rigidity from abruptly stopping his long-term baclofen treatment. “He improved markedly after the reintroduction of baclofen.”

In contrast to published studies saying that baclofen helped with alcohol withdrawal, a Cochrane review published in May of 2015, “Baclofen for alcohol withdrawal syndrome,” concluded that the evidence for recommending baclofen for alcohol withdrawal syndrome was insufficient. “We therefore need more well-designed RCTs to prove its efficacy and safety.”

A 2013 article assessed the potential to confuse baclofen withdrawal for alcohol withdrawal. The authors said the clinical and psychopharmacological overlap between acute intoxication and the withdrawal symptoms of baclofen, alcohol and benzodiazepines could lead to diagnostic uncertainty.

“In every case of unexplained confusion, agitation, hallucinations, seizures, and psychosis occurring in patients with current drinking, both AWS and BWS should be systematically considered.”

A small study by Franchitto et al. in 2013 did a retrospective study of the medical records for 12 individuals diagnosed with alcohol dependence who had overdosed on baclofen. The median dose of ingested baclofen was estimated at 340 mg. Ten had a previous suicide attempt. Three had co-ingested benzodiazepines. The “classic” effects of baclofen overdose associated with neurotransmitter inhibitory effects were evident:
Impaired consciousness or coma, generalized muscular hypotonia with absent limb reflexes, respiratory depression, seizures, hemodynamic changes and cardiac abnormalities such as supraventricular tachycardias, premature atrial contractions and first-degree heart block.
Four patients were in coma before admission, and required intubation and respiratory support. Coma after a baclofen overdose may persist for several days because of the drugs’ depression of neuronal activity in the central nervous system. Nevertheless, the authors concluded that consistent with other reports, “most patients with baclofen overdose had a good outcome with adequate supportive care.”

There have been reports of heart problems and even mania. A 2014 case report concluded that cardiac arrest occurred with baclofen withdrawal syndrome. A 2014 article concluded that baclofen-induced manic symptoms could appear in individuals regardless of a history of bipolar or mood disorders. The question to be raised about the use of baclofen for alcohol use disorders is what effects does it have on the brain? To the extent that these effects correspond to the effects of alcohol, or any other potentially “addictive” substance, its use in substance misuse treatment is a double-edged sword.

A 2015 study by Rigal et al. reviewed the records of 146 patients who used baclofen to treat their alcohol use disorder. Ninety (78%) reported at least one adverse effect. The most frequently reported adverse effect was a disruption of the wake-sleep cycle in 73 patients (63%). “Persistent adverse effects occurred in 62 patients (53%).” There were 8 patients who had adverse effects that led them to stop taking baclofen. Women reported more adverse events than men. “High-dose baclofen exposes patients with alcohol disorders to many adverse effects. Generally persistent, some adverse effects appear at low doses and may be dangerous.”

The evidence seems clear for a baclofen withdrawal syndrome. There is a state of tolerance or dependence that develops with long term, high dose use. Are patients given baclofen informed of the potential for them to develop a dependency upon this medication? My concern is this dependency is a “sleeper” symptom that initially goes largely unnoticed as with medications used to “treat” opioid use disorders—buprenorphine, and methadone. This same problem with dependency also exists with benzodiazepines prescribed for anxiety or sleep disturbance. They initially work so effectively that the dependency, if it’s noticed at all, is minimized. Only after it becomes seriously entrenched physically and psychologically do people realize what has happened.

So where might all of this lead? Baclofen is a generic drug with no potential for a pharmaceutical company to patent, and thus become a highly profitable product for them. So pharmaceutical companies are largely not interested in developing baclofen as a treatment for addictions. However, there is a prodrug version of baclofen called arbaclofen palcarbil that was initially in development by XenoPort as a treatment for GERD and spasticity due to multiple sclerosis. In May of 2013, XenoPort announced that Phase 3 clinical trials for arbaclofen palcarbil were unsuccessful and they decided to terminate further investment in the program.

In May of 2014, Reckitt Benckiser Pharmaceuticals and XenoPort announced they had entered into a joint license agreement, where Reckitt Benckiser will have the exclusive rights to develop and commercialize arbaclofen palcarbil as a treatment for alcohol use indicated that a Phase 2 study by Reckitt Benckiser was scheduled to begin in September of 2015 and should be completed by April of 2016. The purpose of this clinical trial is to determine the maximum tolerated dose of arbaclofen palcarbil in treating alcohol use disorder.

Reckitt Benckiser appears to be looking for a replacement blockbuster product since its opioid treatment drug, Suboxone, went generic. Before losing its patent rights, Suboxone had become a billion dollar drug for Reckitt Benckiser, rising to the 25th best selling drug of 2010, according to The existing research on baclofen gives us a pretty good idea on what the future holds for any arbaclofen palcarbil product. Also, the potential population for a maintenance drug for alcohol use disorder is significantly larger than there was for an opioid maintenance drug. If Reckitt Benckiser can successfully move arbaclofen palcarbil through the FDA approval gauntlet, we will see a patented knock off product of baclofen on the market to treat alcohol use disorder in a few years.
Suboxone made another top drug list in 2013. It was listed as the #2 most abused prescription drug of 2013 by Genetic Engineering & Biotechnology News. Hopefully, any arbaclofen palcarbil product will not repeat that ‘achievement’ for Reckitt Benckiser.




Wednesday, April 27, 2016

Mindful Awareness

UCLA Mindful Awareness Research Center

Mindfulness is making the news these days. It has been depicted in the media primarily as a tool to hone attention, to cultivate sensory awareness, and to keep us in the present moment.

Developing these tools takes effort and determination, but why is it we can sometimes be mindful without really even trying? Perhaps we were naturally mindful at points in life before we ever learned what mindfulness was. Maybe we feel naturally connected, present, and at ease in nature. Or we become mindful while talking authentically with a friend, or in the midst of music, art, or athletic activity.

Mindfulness is not only a meditation technique, but also a state of being. This state is available to anyone; it is a natural human capacity. Mindfulness practice, as a tool, is tremendously helpful to cultivate this awareness, and the state can arise at any moment. Mindfulness is also connected to a set of powerful outcomes: happiness, emotional regulation, compassion, altruism, and kindness.

We encourage you to attend an array of offerings to cultivate the moment-to-moment awareness, which is the foundation of our practice.


Mindfulness-based cognitive therapy can help prevent recurrence of depression.

Review finds mindfulness-based cognitive therapy can help prevent recurrence of depression.

Tuesday, April 19, 2016

Transcending addiction and redefining recovery: Jacki Hillios

are some able to transcend their addiction while others are not? What
do people really need to escape the shame of their addiction and achieve
sustained recovery? Jacki's talk focuses on answering these questions
and demonstrates how resilience of the human spirit intersects with
social contextual factors to set the stage for those struggling with
addiction to choose a pathway to health.

Sunday, November 22, 2015

Why binge drinking can lead to alcoholism

Enzyme malfunction may be why binge drinking can lead to alcoholism, Stanford study finds


Adapted media release

A malfunctioning enzyme may be a reason that binge drinking increases the odds of alcoholism, according to a study by scientists at the Stanford University School of Medicine.
The scientists identified a previously unsuspected job performed by the enzyme, ALDH1a1, in mice. The discovery could help guide the development of medications that extinguish the urge to consume alcohol, said Jun Ding, PhD, assistant professor of neurosurgery.
Ding is the senior author of the study, which will be published Oct. 2 in Science. The study's lead author is postdoctoral scholar Jae-Ick Kim, PhD.
Alcoholism is an immense national and international health problem. More than 200 million people globally, including 18 million Americans, suffer from it. Binge drinking substantially increases the likelihood of developing alcoholism. As many as one in four American adults report having engaged in binge drinking in the past month.
Existing medications for treating alcoholism have had mixed results. Disulfiram (Antabuse) and similar substances, for example, work by inducing unpleasant side effects -- including shortness of breath, nausea, vomiting and throbbing headaches -- if the person taking it consumes alcohol. "But these drugs don't reduce the craving -- you still feel a strong urge to drink," Ding said.
In the new study, Ding and his associates showed that blocking ALDH1a1 activity caused mice's consumption of and preference for alcohol to rise to levels equivalent to those observed in mice that had experienced several rounds of the equivalent of binge drinking. Restoring ALDH1a1 levels reversed this effect.
Previous studies have shown that mutations in the gene for ALDH1a1 are associated with alcoholism, but the reasons for this have been obscure. A key finding in the new study is that in certain nerve cells strongly implicated in addictive behaviors, ALDH1a1 is an essential piece of a previously unknown biochemical assembly line for the manufacture of an important neurotransmitter called GABA. Neurotransmitters are chemicals that bind to receptors on nerve cells, promoting or inhibiting signaling activity in those cells.
GABA is the brain's main inhibitory neurotransmitter. It was previously thought that GABA was made in mammalian brains only via a different biochemical assembly line that doesn't involve ALDH1a1.
An alternative assembly line
While GABA is produced widely throughout the brain, the novel GABA-production assembly line identified by Ding's group was observed only in a group of nerve cells known to play a powerful role in addiction. The new finding has potentially great clinical significance because a drug that could increase GABA synthesis through this alternative assembly line -- by boosting ALDH1a1 levels in the brain -- could potentially restore the balance in neural circuitry that's been thrown out of kilter by excessive alcohol consumption without dangerously elevating GABA levels elsewhere in the brain.
Another neurotransmitter substance, dopamine, is famous among neuroscientists for its involvement in modulating motion and motivation. Dopamine supercharges the machinery of the brain's so-called reward circuit, which is involved in all types of addictive behavior from cocaine, morphine and alcohol abuse to compulsive gambling.
The reward circuit is a network of nerve cells and connections found in the brains of living creatures from flies to humans and every animal in between. It guides individuals' behavior -- and ensures species' survival -- by offering pleasurable sensations as a reward for eating, sleeping, having sex and making friends. Key components of this circuit are fueled by dopamine.
Until recently, neuroscientists widely assumed that each type of nerve cell in the brain can release one and only one neurotransmitter. But in a study published in Nature in 2012, Ding, then a postdoctoral scholar at Harvard Medical School, and his colleagues demonstrated that dopamine-producing nerve cells can manufacture and release other types of neurotransmitters, too, including GABA. These cells not only produce both dopamine and GABA but release them simultaneously.
"We wondered what GABA is doing in there," Ding said. "Why does one nerve cell need two neurotransmitters?"
Ding also had another question. "All of us normally encounter countless reward-inducing situations without getting addicted," he said. "Every time I publish a paper, my dopamine-producing nerve cells go crazy, but I don't get addicted. Why not?"
GABA's role in countering addiction
To find out whether GABA in dopamine-producing cells might have something to do with addiction, Ding and his associates initially tried to examine GABA's effects by blocking its production through the conventional assembly line -- that is, the only one known at the time -- while stimulating only dopamine-producing cells in mice's brains. To their surprise, these tried-and-tested methods failed to reduce GABA levels in these cells or the neurotransmitter's effects on nearby downstream nerve cells. That was puzzling.

Curious, Ding began a literature search to see if there were any other ways that biological systems manufacture GABA. He learned that in plants, GABA can be produced via a biochemical assembly line quite separate from the common, previously known one our brains use. He found that one step in this alternative GABA-manufacturing pathway is performed by a family of enzymes, aldehyde dehydrogenases, that are better known for being involved in the breakdown of alcohol. Ding also found that aldehyde dehydrogenases are expressed not only in the liver, where most of the alcohol we drink gets metabolized, but in some parts of the brain that, to Ding -- whose professional career has focused on the brain's dopamine-producing nerve circuitry -- looked anatomically identical to the dopamine-producing nerve cells that feed the reward circuit. Ding's team verified that the specific family member at work in those dopamine-producing cells was ALDH1a1.

Using advanced laboratory methods to impair ALDH1a1 activity in mice, the scientists saw GABA levels in dopamine-producing nerve cells drop, just as they did when mice with normal ALDH1a1 activity underwent repeated bouts of high alcohol intake -- the equivalent of binge drinking. In behavioral tests, the ALDH1a1-deficient mice showed the same increased alcohol preference and intake as did otherwise normal "binge-drinker" mice. These effects were reversed by manipulations that raised ALDH1a1 levels in the mice.
Ding said he thinks that GABA's co-release with dopamine, and GABA's inhibitory character, may be what prevents everyday pleasurable sensations from causing most of us, most of the time, to become addicted to the behaviors that produce them. Mutations in ALDH1a1, he said, may predispose some people to alcoholism by disabling this brake on our reward machinery. His lab is now exploring whether the same molecular mechanisms may be at work in other forms of addiction.

Saturday, October 31, 2015

Lapse or relapse?

 Businessman falling

Lapse or relapse?

‘Often the fear of a relapse can be the trigger for us to slip and slide. Just as lapses must be recognized as an opportunity to work our program of recovery diligently, the relapse must also be seen as a GIFT: A Great Indicator For Throwing Stuff out. They are the emergency alarm bell telling us we are on fire, and need to stop and pause to put the fire out. Dreading the relapse will just put us onto the vicious cycle of addiction.’
—Eight Step Recovery: Using The Buddha’s Teachings to Overcome Addiction.
Relapse is part of the continuum for recovery. Few people manage to get total abstinence of their recovering journey from day one. And those who do, most probably were practising some form of harm reduction before they came out and publicly said: ‘No more. I’ve had enough. I’m not picking up ever again.’
Many of us do harm reduction, and/or relapse, under the scornful eyes that can judge us. Such overt or covert judgement can trigger nihilistic and facilitative thoughts inside of us like; ‘I’m a loser, I can never get clean, I may as well continue’, and we can begin to inhabit toxic feelings of shame. The scornful eyes, or the judging comments from others may never change but our relationship to relapse and our inner world of toxic stinking thinking can.
First we must begin to identify between a lapse and a relapse. For example, we have a row with someone, we feel nauseated, and we turn away from the overwhelming feeling without being aware of the thoughts in our head that we have identified with, like, ‘F***, I want a drink’. This identification is often unconscious and sometimes conscious, and the ending result of both is picking up our fix and using. This can be a lapse and turn into a relapse.
A lapse can end at that first sip, first puff, picking up the needle, turning on the computer. It could be by accident you pick up your stimulant of choice, unaware it had alcohol or sugar in it. Unaware that when you woke up your computer there were triggering images glaring back at you. Or it may be that you slip after a difficult situation, you pick up, become aware of what you have done, and you have a choice, do you put it down or do you continue? When you put it down it’s a lapse. When you continue it is a relapse.
Sometimes a lapse can be as long as a day, and then you get back on track and lapse again. However, if this pattern is occurring more than a week, then you really do have to admit you are in a relapse. A lapse is most definitely not an excuse to say well: ‘I can have one drink and call that a lapse’. The intention of having the drink, the motivation of having the drink would be acted out of a mind conning itself and would most probably end up in relapse.
Recognizing a genuine lapse is important. There is a gap after a lapse where thoughts and emotions emerge. In this gap we can make a new decision. We do this with the breath. When powerful thoughts like: ‘What the heck, I’m gonna use anyway’ arise, we must become absorbed in our breathing rather than absorbed in our thoughts. If we go for refuge to these thoughts — give them a prominent place in the heart and mind — we will inevitably spiral into relapse.
If we do lapse we have to be prepared that our thoughts can become overwhelming and we will lose sobriety of mind. This is where we have to work our recovery, because for the next few days our mind will be full of all sorts of thoughts of using, and we have to turn toward them kindly and know that all the mind is doing is producing thoughts we have no control over, and trust they will quieten down.
If we resist these thoughts the mind will go into mindless obsessing and before we know it we will be sliding helter-skelter into a relapse. And so recovering from a lapse is perhaps one of the most challenging things we have to do if we want to strengthen our abstinence and sobriety.
We have to stop listening to both the external and internal judgments made by others and ourselves. We have to choose our recovery over the relapse. This is even harder. Many of us relapse because in that moment of being triggered we want the our stimulant or distraction of choice, more than we want our recovery. A relapse can also be premeditated, planned and often triggered by a lapse.
Awareness of body, feelings and thought can help deter a relapse and lapse. When we can pause and connect to the body, feelings, and thoughts, everything slows down, and we can catch the catastrophic drama unravelling in the mind. We relapse because we disappear into the thoughts which are so overwhelming that the inevitability of falling of the wagon is lurking in the next moment. If we can learn to disappear into the breath, thoughts will become impermanent, and will not exist or grip us in the same way.
If we train the heart-mind to be more mindful we may begin to see that if we always do what we’ve always done, we will always get what we have always got. We will see the insanity of our relapses which are habitual behaviours that keep on producing the same results.

Please email us at for a free copy of the booklet on how to run meetings, and for the free collection of 21 meditations for recovery.

Lapse or relapse? | Wildmind Buddhist Meditation:


'via Blog this'

Apps That Aid Addiction Recovery

Apps That Aid Addiction Recovery

By Matt McMillen

Recovering from addiction or alcoholism is a difficult and lifelong commitment. Of course, the first step in recovery is getting help – whether with 12-step programs like Alcoholics Anonymous and Narcotics Anonymous or through a treatment center. Once you’ve made up your mind to quit and have sought treatment, you can also enlist your smart phone in your efforts to get and stay sober.

Here are a few of the apps designed to aid in addiction recovery:

Step Away (iOS). Produced with support from the NIH’s National Institute on Alcohol Abuse and Alcoholism, this free iPhone app has shown promise in a pilot study, helping users to cut in half the number of drinks they consumed each day. As far as we can tell, it’s one of the very few apps with some research to back its effectiveness (another, A-CHESS, shows great promise but is not widely available yet).

“Much like a personal coach or sponsor, the app helps [users] gain insight into their alcohol problem and teaches them skills they can use to manage problems, such as alcohol cravings, anxiety and moving away from a drinking lifestyle,” writes’s Steven Chan, MD, a resident physician in psychiatry & human behavior at the University of California, Davis School of Medicine.

When you get a craving, you can record it and review strategies to overcome it. Step Away also lets you designate high-risk locations, where you feel you might be tempted to drink. And the app can help you connect with people you have designated as supportive.

The 12 Steps AA Companion app ($ 1.99 for Android, $ 2.99 for iOS) is another excellent app option. It includes a sobriety counter to keep track of the number of days you’ve stayed sober. It also contains the Big Book, the basic AA text, and a meeting finder to help you connect with others when you feel the need, no matter where you are.

The MORE Field Guide to Life (Android and Apple – both $ 7.99) Based on the Hazelden Betty Ford Foundation’s My Ongoing Recovery Experience (MORE) addiction treatment program, the app offers daily guidance and weekly challenges to help keep you motivated, while its support network feature connects you with your sponsor at the push of a button. There’s also a version designed for young people ages 12 to 25, My Sober Life (Android and iOS).

The opinions expressed in WebMD Second Opinion are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of WebMD. Second Opinion are... Expand


Wednesday, September 30, 2015

Inspiring talk by Earl Nightingale

 This is a transcript...

The Strangest Secret

Transcribed from The Strangest Secret audio program by Earl Nightingale

Some years ago, the late Nobel prize-winning Dr. Albert Schweitzer was asked by a reporter, “Doctor, what’s wrong with men today?” The great doctor was silent a moment, and then he said, “Men simply don’t think!”

It’s about this that I want to talk with you. We live today in a golden age. This is an era that humanity has looked forward to, dreamed of, and worked toward for thousands of years. We live in the richest era that ever existed on the face of the earth … a land of abundant opportunity for everyone.

However, if you take 100 individuals who start even at the age of 25, do you have any idea what will happen to those men and women by the time they’re 65? These 100 people believe they’re going to be successful. They are eager toward life, there is a certain sparkle in their eye, an erectness to their carriage, and life seems like a pretty interesting adventure to them.

But by the time they’re 65, only one will be rich, four will be financially independent, five will still be working, and 54 will be broke and depending on others for life’s necessities.

Only five out of 100 make the grade! Why do so many fail? What has happened to the sparkle that was there when they were 25? What has become of the dreams, the hopes, the plans … and why is there such a large disparity between what these people intended to do and what they actually accomplished?


First, we have to define success and here is the best definition I’ve ever been able to find:

“Success is the progressive realization of a worthy ideal.”

A success is the school teacher who is teaching because that’s what he or she wants to do. A success is the entrepreneur who start his own company because that was his dream and that’s what he wanted to do. A success is the salesperson who wants to become the best salesperson in his or her company and sets forth on the pursuit of that goal.

A success is anyone who is realizing a worthy predetermined ideal, because that’s what he or she decided to do … deliberately. But only one out of 20 does that! The rest are “failures.”

Rollo May, the distinguished psychiatrist, wrote a wonderful book called Man’s Search for Himself, and in this book he says: “The opposite of courage in our society is not cowardice … it is conformity.” And there you have the reason for so many failures. Conformity and people acting like everyone else, without knowing why or where they are going.

We learn to read by the time we’re seven. We learn to make a living by the time we’re 30. Often by that time we’re not only making a living, we’re supporting a family. And yet by the time we’re 65, we haven’t learned how to become financially independent in the richest land that has ever been known. Why? We conform! Most of us are acting like the wrong percentage group and the 95 who don’t succeed.


Have you ever wondered why so many people work so hard and honestly without ever achieving anything in particular, and why others don’t seem to work hard, yet seem to get everything? They seem to have the “magic touch.” You’ve heard people say, “Everything he touches turns to gold.” Have you ever noticed that a person who becomes successful tends to continue to become more successful? And, on the other hand, have you noticed how someone who’s a failure tends to continue to fail?

The difference is goals. 

People with goals succeed because they know where they’re going. It’s that simple. 

Failures, on the other hand, believe that their lives are shaped by circumstances … by things that happen to them … by exterior forces.
Think of a ship with the complete voyage mapped out and planned. The captain and crew know exactly where the ship is going and how long it will take and it has a definite goal. And 9,999 times out of 10,000, it will get there.

Now let’s take another ship and just like the first and only let’s not put a crew on it, or a captain at the helm. Let’s give it no aiming point, no goal, and no destination. We just start the engines and let it go. I think you’ll agree that if it gets out of the harbor at all, it will either sink or wind up on some deserted beach and a derelict. It can’t go anyplace because it has no destination and no guidance.

It’s the same with a human being. However, the human race is fixed, not to prevent the strong from winning, but to prevent the weak from losing. Society today can be likened to a convoy in time of war. The entire society is slowed down to protect its weakest link, just as the naval convoy has to go at the speed that will permit its slowest vessel to remain in formation.

That’s why it’s so easy to make a living today. It takes no particular brains or talent to make a living and support a family today. We have a plateau of so-called “security.” So, to succeed, all we must do is decide how high above this plateau we want to aim.

Throughout history, the great wise men and teachers, philosophers, and prophets have disagreed with one another on many different things. It is only on this one point that they are in complete and unanimous agreement and the key to success and the key to failure is this:


This is The Strangest Secret! Now, why do I say it’s strange, and why do I call it a secret? Actually, it isn’t a secret at all. It was first promulgated by some of the earliest wise men, and it appears again and again throughout the Bible. But very few people have learned it or understand it. That’s why it’s strange, and why for some equally strange reason it virtually remains a secret.

Marcus Aurelius, the great Roman Emperor, said: “A man’s life is what his thoughts make of it.”

Disraeli said this: “Everything comes if a man will only wait … a human being with a settled purpose must accomplish it, and nothing can resist a will that will stake even existence for its fulfillment.”

William James said: “We need only in cold blood act as if the thing in question were real, and it will become infallibly real by growing into such a connection with our life that it will become real. It will become so knit with habit and emotion that our interests in it will be those which characterize belief.” 

He continues, ” … only you must, then, really wish these things, and wish them exclusively, and not wish at the same time a hundred other incompatible things just as strongly.”

My old friend Dr. Norman Vincent Peale put it this way: “If you think in negative terms, you will get negative results. If you think in positive terms, you will achieve positive results.” 

George Bernard Shaw said: “People are always blaming their circumstances for what they are. I don’t believe in circumstances. The people who get on in this world are the people who get up and look for the circumstances they want, and if they can’t find them, make them.”

Well, it’s pretty apparent, isn’t it?   We become what we think about. 

A person who is thinking about a concrete and worthwhile goal is going to reach it, because that’s what he’s thinking about. 

Conversely, the person who has no goal, who doesn’t know where he’s going, and whose thoughts must therefore be thoughts of confusion, anxiety, fear, and worry will thereby create a life of frustration, fear, anxiety and worry. And if he thinks about nothing … he becomes nothing.


The human mind is much like a farmer’s land. The land gives the farmer a choice. He may plant in that land whatever he chooses. The land doesn’t care what is planted. It’s up to the farmer to make the decision. 

The mind, like the land, will return what you plant, but it doesn’t care what you plant. If the farmer plants too seeds and one a seed of corn, the other nightshade, a deadly poison, waters and takes care of the land, what will happen?

Remember, the land doesn’t care. It will return poison in just as wonderful abundance as it will corn. So up come the two plants and one corn, one poison as it’s written in the Bible, “As ye sow, so shall ye reap.”

The human mind is far more fertile, far more incredible and mysterious than the land, but it works the same way. It doesn’t care what we plant … success … or failure. A concrete, worthwhile goal … or confusion, misunderstanding, fear, anxiety, and so on. But what we plant it must return to us.

The problem is that our mind comes as standard equipment at birth. It’s free. And things that are given to us for nothing, we place little value on. Things that we pay money for, we value.

The paradox is that exactly the reverse is true. 

Everything that’s really worthwhile in life came to us free and our minds, our souls, our bodies, our hopes, our dreams, our ambitions, our intelligence, our love of family and children and friends and country. All these priceless possessions are free.

But the things that cost us money are actually very cheap and can be replaced at any time. A good man can be completely wiped out and make another fortune. He can do that several times. Even if our home burns down, we can rebuild it. But the things we got for nothing, we can never replace.

Our mind can do any kind of job we assign to it, but generally speaking, we use it for little jobs instead of big ones. 

So decide now. What is it you want? Plant your goal in your mind. It’s the most important decision you’ll ever make in your entire life.

Do you want to excel at your particular job? Do you want to go places in your company … in your community? Do you want to get rich?

All you have got to do is plant that seed in your mind, care for it, work steadily toward your goal, and it will become a reality.

It not only will, there’s no way that it cannot. You see, that’s a law and like the laws of Sir Isaac Newton, the laws of gravity. If you get on top of a building and jump off, you’ll always go down and you’ll never go up.

And it’s the same with all the other laws of nature. They always work. They’re inflexible. 

Think about your goal in a relaxed, positive way. 

Picture yourself in your mind’s eye as having already achieved this goal. 

See yourself doing the things you will be doing when you have reached your goal.

Every one of us is the sum total of our own thoughts. 

We are where we are because that’s exactly where we really want or feel we deserve to be and whether we’ll admit that or not. 

Each of us must live off the fruit of our thoughts in the future, because what you think today and tomorrow and next month and next year and will mold your life and determine your future. You’re guided by your mind.

I remember one time I was driving through e a s t e r n Arizona and I saw one of those giant earth-moving machines roaring along the road with what looked like 30 tons of dirt in it and a tremendous, incredible machine and and there was a little man perched way up on top with the wheel in his hands, guiding it.

As I drove along I was struck by the similarity of that machine to the human mind. 

Just suppose you’re sitting at the controls of such a vast source of energy. 

Are you going to sit back and fold your arms and let it run itself into a ditch?

Or are you going to keep both hands firmly on the wheel and control and direct this power to a specific, worthwhile purpose? 

It’s up to you. You’re in the driver’s seat. 

You see, the very law that gives us success is a double-edged sword. 

We must control our thinking. 

The same rule that can lead people to lives of success, wealth, happiness, and all the things they ever dreamed of and that very same law can lead them into the gutter. 

It’s all in how they use it … for good or for bad. 

That is The Strangest Secret!

Do what the experts since the dawn of recorded history have told us to do:

pay the price, by becoming the person you want to become. 

It’s not nearly as difficult as living unsuccessfully.

The moment you decide on a goal to work toward, you’re immediately a successful person 
and you are then in that rare group of people who know where they’re going. 

Out of every hundred people, you belong to the top five. 

Don’t concern yourself too much with how you are going to achieve your goal.

 Leave that completely to a power greater than yourself. 

All you have to do is know where you’re going. The answers will come to you of their own accord, and at the right time.

Start today. You have nothing to lose and but you have your whole life to win.


For the next 30-days follow each of these steps every day until you have achieved your goal.

1. Write on a card what it is you want more that anything else
. It may be more money. Perhaps you’d like to double your income or make a specific amount of money. It may be a beautiful home. It may be success at your job. It may be a particular position in life. It could be a more harmonious family.

Write down on your card specifically what it is you want. Make sure it’s a single goal and clearly defined. 
You needn’t show it to anyone, but carry it with you so that you can look at it several times a day. 

Think about it in a cheerful, relaxed, positive way each morning when you get up, and immediately you have something to work for and something to get out of bed for, something to live for.

Look at it every chance you get during the day and just before going to bed at night. 

As you look at it, remember that you must become what you think about, and since you’re thinking about your goal, you realize that soon it will be yours. In fact, it’s really yours the moment you write it down and begin to think about it.

2. Stop thinking about what it is you fear. 

Each time a fearful or negative thought comes into your mind, replace it with a mental picture of your positive and worthwhile goal. 

And there will come a time when you’ll feel like giving up. It’s easier for a human being to think negatively than positively. That’s why only five percent are successful! You must begin now to place yourself in that group.

“Act as though it were impossible to fail,” as Dorothea Brande said. No matter what your goal, if you’ve kept your goal before you every day, you’ll wonder and marvel at this new life you’ve found.

3. Your success will always be measured by the quality and quantity of service you render. 

Most people will tell you that they want to make money, without understanding this law. The only people who make money work in a mint. The rest of us must earn money. This is what causes those who keep looking for something for nothing, or a free ride, to fail in life. 

Success is not the result of making money; earning money is the result of success and and success is in direct proportion to our service.

Most people have this law backwards. It’s like the man who stands in front of the stove and says to it: “Give me heat and then I’ll add the wood.” 

How many men and women do you know, or do you suppose there are today, who take the same attitude toward life? There are millions.

We’ve got to put the fuel in before we can expect heat. 

Likewise, we’ve got to be of service first before we can expect money

Don’t concern yourself with the money. Be of service … build … work … dream … create! Do this and you’ll find there is no limit to the prosperity and abundance that will come to you.

Don’t start your test until you’ve made up your mind to stick with it. If you should fail during your first 30 days and by that I mean suddenly find yourself overwhelmed by negative thoughts and simply start over again from that point and go 30 more days.

Gradually, your new habit will form, until you find yourself one of that wonderful minority to whom virtually nothing is impossible.

Above all … don’t worry! Worry brings fear, and fear is crippling. 

The only thing that can cause you to worry during your test is trying to do it all yourself

Know that all you have to do is hold your goal before you; everything else will take care of itself.

Take this 30-day test, then repeat it … then repeat it again. Each time it will become more a part of you until you’ll wonder how you could have ever have lived any other way.

Live this new way and the floodgates of abundance will open and pour over you more riches than you may have dreamed existed. Money? Yes, lots of it. 

But what’s more important, you’ll have peace … you’ll be in that wonderful minority who lead calm, cheerful, successful lives.

Learn more about Earl Nightingale and his many timeless books and audio programs.
The Strangest Secret
The Strangest Secret Article by: Earl Nightingale

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Learn more about Earl Nightingale and his many timeless books and audio programs.

The Strangest Secret - Advantedge Article By Earl Nightingale


The Strangest Secret Earl Nightingale Conant 1950's Origional FULL 31:35 Min.
31:35 - 4 years ago
Earl Nightingale Conant The Strangest Secret 1956 1950's