The simple answer is, no it doesn’t fix all addictions.
Here’s an outline of the information out there on other drugs of addiction and baclofen.
Cocaine, amphetamine, methamphetamine, otherwise known as Ice or Crystal Meth.
There is evidence in rats and humans that baclofen can reduce cravings for these stimulant drugs. It’s quite unexpected that one medication can reduce cravings in both alcohol and stimulant addiction because they are very different types of drugs both chemically and in the desired effect- simplistically the stimulants are “uppers” and alcohol is a “downer”.
What they have in common is that both types of drug stimulate the release of dopamine, the “pleasure” hormone of the brain. Repeated use of alcohol or stimulants leads to the formation of an addiction pathway in two area of the brain – the limbic system, which links the memory of pleasure with the motivation to seek it again, and the dorsal striatum which establishes and reinforces compulsive behaviours like addiction.
The rat studies show unambiguous results – in strains of rats which are prone to becoming addicted, baclofen “normalises” their behaviour: they no longer seek the stimulant drug. The data from human studies and reports have been less consistent. Baclofen appears to have dramatic effects on stimulant craving in some individuals (link) and there are promising studies (link) with baclofen at fixed dose 60mg/day.
One reason for this difference between animal and human studies is that we can’t control the environment for humans – their relationships with others, where they live, what they do in life. But we can do this for laboratory animals.
The human studies on stimulant addiction have generally been done in outpatient clinics treating people addicted to crack cocaine. They often live in terrible social circumstances and this itself drives drug use. In these circumstances, stopping the drug doesn’t change much about the social situation in which chronic crack cocaine addicts are in, so there is little to be gained from sobriety.
An example comes from Vietnam war veterans. Around 20% of them used addictive drugs such as heroin during their time in service in Vietnam. At the time there was a major concern that large numbers of drug addicted servicemen would return to the US and overwhelm addiction services by their requests for treatment. In fact 95% of the drug using soldiers stopped using addictive drugs without help once they left the stressful environment of combat. If the army had tried to treat these soldiers’ addictions in the combat zone, it is highly unlikely that anywhere close to 95% would stop because they were using the drugs to cope with the horrors of war. It’s no surprise that many area of high drug use are ghettos of poverty and crime, often described as “war zones”.
Nevertheless, baclofen has potential in the treatment of stimulant addiction especially given that there aren’t any other anti-craving medications available and the recognised treatment, cognitive behavioural therapy, CBT, has a low success rate.
Baclofen may well have a place in treating stimulant addiction when “the party is over”.
In the early phase of addiction, the effects of stimulants such as meth are very pleasurable and there are no thoughts of stopping the drug. It is only when the ugly side of addiction appears and the person really wants to stop that baclofen can help by reducing cravings and anxiety. Baclofen should work really well combined with the standard CBT treatment for stimulant addiction.
There’s no information about what baclofen doses are needed and whether they are different from those needed for alcohol addiction. The simplest approach is to titrate the baclofen dose to effect in each patient, as for alcohol.
Overall there appears to be no consistent effect of baclofen on tobacco smoking but nevertheless, some patients do find that they smoke a lot less or cease cigarettes altogether when on baclofen treatment.
However there is already a range of treatments to help with tobacco addiction including substitution therapy with nicotine chewing gum and inhalers. There are two anti-craving medications, Bupropion (Zyban) and Varenicline (Champix) which appear to be effective, albeit at the cost of side effects in many.
There doesn’t appear to be any useful effect of baclofen on cannabis addiction. However because baclofen helps anxiety, this may allow patients who use cannabis for this purpose to reduce their dose or stop. Baclofen doesn’t appear to assist with withdrawal symptoms from cannabis.
There is no information about baclofen’s effect on “synthetic cannabis” addiction.
This is an interesting one. There are theoretical reasons why it might be helpful because opiates since both alcohol and opiate addiction work through the brain’s mesolimbic dopaminergic pathways which are calmed by GABA attaching to the GABA B receptors found in this area. There is some work in animal studies and one in humans from 2003 (link). The clinical trial in human opiate addicted patients in Iran showed improvement in their use of opiates on baclofen vs placebo but it was not a dramatic effect.
But again, there are already treatments available for opiate addiction, substitution therapies of methadone and buprenorphine (Subutex and Suboxone) as well as opiate blocking therapy with naltrexone to block opiate effect.
Baclofen has been found to be useful for this on anecdotal evidence from individual patients and in rat studies where it suppressed binge eating of pure fat but not mixed fat:sugar and not sugar alone. There is some evidence of an effect of baclofen on binge eating in a randomised control trial (link).
The effect on baclofen is likely to be confined to compulsive eaters who have the classic brain changes of addiction. It doesn’t help people who just eat too much of foods they like such as chocolate. There was controversy in France about ideas being spread in the popular press that baclofen might be a general remedy for obesity but this is far from true.