Naltrexone question - General Discussions - The End of my Addiction
Naltrexone question
the sinclair method naltrexone
I'm still an active dependent drinker and very unhappy to be so. Naltrexone is a route I have not yet tried (tried baclofen but the SEs were too much for me).
I've been reading quite a lot about Naltrexone and I am thinking about trying the Sinclair method. I've read a bit about the science/chemistry behind it but I am left with a question in my mind.
I read that Naltrexone inhibits the euphoric effect of drinking and that the reinforcement of the habit is short circuited as a result, with a resulting reduction in the desire to drink.
I do however find myself wondering if the same result might be achieved simply by diluting one's drinks by a couple of percent every night over a few months.
Apologies if I have missed something basic in the reasoning behind the Sinclair method - and hoping very much that I have!
Mentium 11 posts
joesixpack 16 posts
I'm still an active dependent drinker and very unhappy to be so. Naltrexone is a route I have not yet tried (tried baclofen but the SEs were too much for me). I've been reading quite a lot about
Hopefully there will be more yet, @Baclofenman. More, easier, cheaper, faster. There must be other out of patent drugs out there that could help, sounds like a good way to put people to work, l
Thanks @joesixpack. TSM is one thing I haven't tried. I'm getting near the end of my rope, so maybe that's something I'll consider. In better news, I'm doing an OK job of trying to get off this bend
Hi @Mentium! I have no experience with Naltrexone, but @phoenix is a font of information on the Sinclair Method. I would think that by diluting your drinks you'd still get the euphoria, and possibly just drink an extra drink in order to get the high after you'd had a couple. But again, I'm no expert. Hopefully she'll see this and weigh in. Best of luck to you.
Hi Mentium! I am new to Naltrexone but I have been reading a lot about it. I am in week 4 of my personal journey with Nal. In my humble opinion, I don't think you would get the same result from diluting your drink every night. I think that would be a different approach than taking Nal. According to TSM, the Nal works by blocking the endorphins in the brain. So, basically, over a period of many months, you are extinguishing the "high" you get from drinking. I guess you can do that from diluting drinks but that would be tapering, not blocking endorphins, so would be a different process.
I hope that helps! Again, I am a newbie to this process so would welcome other thoughts and perspectives on your question. Take care - AG
Hi Menty! Sorry for the circumstances, but glad to hear from you.
Naltrexone is an opioid antagonist. That means they bind to the receptors where endorphins (feel good chemicals) would normally attach, without creating a feel good reaction. In other words, they block the receptors that make you feel good from drinking. And other things, too! Endorphins are released when you have sex, when you exercise, and lots of other times, too. It's important to tell a doctor that you're taking Nal if you are taking Nal and you need pain relief or anesthesia. Those chemicals react with the same receptors and you'll need more of the pain med/anesthesia or different ones that block pain in other ways.
It has been proven, repeatedly, that Nal is gene-dependent. So for people with the right genes, it works really well. Less so for others. You won't know until you try. There aren't tests yet, for specific gene markers like that.
The good news is that it's approved for use, and you should be able to get it from a doctor after jumping through all the regular hoops, that is. (So frustrating, I know.)
By diluting your drinks, you're just...diluting your drinks. You will likely drink more to make up for it. Right? I know I would. I can never fake myself out of anything, especially getting drunk.
Mentium, I would hope you can get it from a doc in the UK, but I wouldn't hold my breath. UK so-called addiction specialists seem to know f*ck all about useful meds & how to use them. The Sinclair method, which research says works best, seems to be virtually unknown in the UK.
Sorry, don't let me put you off trying to get a referral to a psychiatrist, which is what you will need to get started.
On 22/06/2016 at 10:08 PM, Mentium said:
I think you are talking about titrating off alcohol, which is a method many, many alcoholics try (I have) and most fail. The reason they fail is that they haven't broken the addiction, the addiction mehcanism hasn't been quashed and there they are desperately trying to drink controlled or lowered amounts. A very, very difficult task.
Alcohol is still alcohol, it still has the same effect end of story. What TSM does is block the endorphins released by any amount of alcohol - it doesn't actually block the alcohol itself, so you still get the effect of alcohol, if the drink is weaker you get drunk slower presuming you drink at the same speed. Often alcoholics drinking lower proof drinks, simply end up trying to drink more of the fluid = same intake, or at least chasing same. TSM can sometimes work better if the person switches from high strength to lower weadrinks, which I think is because it means you can retain greater awareness about the point at which you actually don't wish to drink any more in that session - whereas stronger drinks whizz you right into oblivion.
What TSM does is take away the desire, so that you naturally want to drink less, and with this in your awareness you choose to drink less. The basic craving, the burning desire is quashed.
I seem to remember that you've been thinking about TSM for some time now, and I think someone here told you to get on with it. That would be my advice right now. Overthinking can be another form of avoidance, which when someone is addicted to something is something they will do in spades. Also in my experience of people using TSM over thinking gets in the way. The beauty of the method is you take 1 pill, 1 hour before, then drink as you feel. That is it. It's not complicated and if you are drinking anyway I don't see why it's not worth doing. What's the worst that can happen?You carry on as you are, which you'll probably do anyway.
Mentium, given what Phoenix says above, TSM sounds ideal for you - I seem to recall you only drink in the evenings, which makes the idea of a pill an hour before drinking very convenient. If you are a creature of habit, then this sort of regime is so easy to follow.
My only reservation would be that Naltrexone has no anti-anxiety or mood altering properties. So you end up AF - but in the same state of mind as you were before when you weren't drinking. Personally, I don't think I would like that. I need the change of brain chemistry that bac provides!
I disagree I'm definitely not the same person I was before, or during my drinking. I found the lowering in alcohol intake allowed me to start to make changes to myself mentally and psychologically. I was able to learn how to deal with life, emotions and learn about me and how I work as a person. Whilst I did use a counsellor to help this process, I also experienced a lot of growth during periods when I wasn't using counselling. I am definitely not the same person mentally, emotionally, in my relationships as I was before or during my drinking. There's been huge change and no reason why that cannot happen for anyone else if they want it.
Thank you all for your responses. My original question was really around the difference between 'titrating down' and the impact of naltrexone. I think that has been answered.
I have little faith in my local GP system to help me with my addiction. Won't go into details but the only time I have sought help from that source ended up with being referred to a very unhelpful 'drug advisory' team.
So I am going to order some Nal on-line - without a prescription. I have used InHouse before and while they are reliable their payment system is really complicated and I'm amazed I haven't messed it up (when I was ordering baclofen last year). I will use them again if I have to but if anyone can recommend someone else that they have found easy to interact with I would be grateful.
Apparently, according to a post I recently read on mwo they now take cards
I have always had good results from
Thanks BM. Placing my order.
Follow up question if I may. I have read about Nalmefene both here and elsewhere. A trial concerning it is widely reported as not hugely successful (I have read also that the trial was a poor one).
Anyway my question is whether or not there is any meaningful difference between naltrexone and Nalmefene. Anyone know?
Apparently there have been no trials comparing naltrexone to nalmefene. I suspect naltrexone is the stonger/better of the two, as there are plenty of good trials showing that it works for alcoholism. Naltrexone is off patent, so they had to come up with a "new" drug to patent it & make a profit. The fact that it's aimed at GPs suggests that it is marketed as a "safer" alternative to naltrexone, ie less effective.
But that's just my suspicious mind when it comes to drug marketing.
Thanks again. I have another question if people will be patient with me!
I have my Nal order in place now - so just waiting but I have been reading about the Sinclair method and stuff around it.
I am probably being dim here, but I still don't understand if the 'buzz' of alcohol is reduced and that this is what reduces the desire to drink, or if it is in some other way related to the opioid receptors - a sort of secondary effect. I am left thinking as per the OP that if the buzz is reduced then surely all one (as an 'addict') would do is stop taking the pills - or increase the amount one drinks.
If anyone knows of an active Sinclair method forum (I have found a couple which seem pretty quiet) then I will stop asking silly questions here and ask them there instead. : )
As I understand it, the process is one of extinction. You don't get the buzz from AL, you keep drinking (of course you do, you're an alcoholic!) & gradually this activity comes to seem meaningless.
I believe it can take a long time - especially if your drinking habit is well established.
I'm not an expert, but I did read up on it when I was looking at treatments.
Someone like Phoenix will be along in a minute with more info I'm sure.
Well I must be missing something then - and it takes me back to my original point. If all Naltrexone does is reduce the effect of alcohol on those bits of the brain chemistry that produce the euphoria then why, I wonder, would an addict bother? As I said in the OP, why not just dilute your drinks very gradually? Same end result surely?
Again - apologies if I am missing something basic in all this.
..nor am I looking for a way out. Will go with it when the Nal arrives!
No, not same result! You will go on drinking more to get the same effect you had previously - unless you have super strong willpower, in which case you wouldn't need any drug. With Nal you can never get that same effect no matter how much you drink, so eventually your brain says "What's the point?".
Unless it says 'stop taking the pills'? That's not the plan however!
Posting as an afterthought here by the way. I ordered the Naltrexone from Inhouse in the end. I discovered I have an account with Orbit remit - the money order system they use, which makes it easier. That was after trying to phone River and getting no reply. And the point of this is that Inhouse now accept credit cards - if you have American Express.
That's true. You have to commit to taking the pills an hour before you drink, each and every time you drink. If you don't do that, then the 'reward' from drinking is reinforced. It is counter-productive! I think the difference between tapering down and 'extinction' is that tapering down still leaves you wanting more. Extinction changes your brain chemistry, over time, so that you stop needing to, and then wanting to, drink. They're actually two very different things. But you have to have the discipline to take the pill the way it is prescribed. Have you read the book? I think that would help clarify things a great deal.
There's another thing to consider, too. In most of the research naltrexone was being studied as a once-a-day pill for people trying to abstain. And it worked. Not great, but it worked. And as I mentioned before, it's probably got a lot to do with your personal genome. So you won't know until you try!
I don't know of any active TSM or nal forums. I think if you posted on the TSM forum, someone would answer you. It's probably a lot like MWO, in that there are people who check in on it to make sure that no one is left dangling in the wind without answers or support. I don't know that for sure, though.
I'm actually really thankful that you're posting here. I promise you that I'll try my best to answer your questions! I'm even going to read the book, and look back over the research, this week. This forum is supposed to be for ALL medications. Not just baclofen. And I think it's vitally important that people share about naltrexone/nalmefene here because there aren't any active forums that cover the information. So ask away! Others will join in, eventually. And in the meantime, at least you know us! Also, I know that there is another member, in addition to @phoenix, who can and will answer questions about nal and TSM. I can't remember her name on this forum, but will figure it out and reach out to her.
Thanks Ne. Yes, I have the book. I've cherry picked the bits that are specific to the Sinclair 'system' and now I've gone back to read it from start to finish - I'm about 1/4 the way through.
I'm hopeful because I meet quite a few of the criteria for people who do well on it. In addition my drinking follows a very regular patters. I open a bottle of wine around 8.30 to 8.45 every evening. So timing the pills will be easy.
Once the pills arrive I'll do the check in thing here and report my progress - and drinking log too (one of the recommendations).
Fingers crossed - I am heartily fed up with this ball and chain around my neck.
That's encouraging, Menty! Glad to hear it.
I've started an excel document to keep track of my progress related to a bunch of things, not just the booze (but that, too) and I think it's a really valuable tool.
I love my old notebooks from when I titrated up on baclofen the first time. I was usually pretty drunk when I wrote in them, because I wrote at the end of the day how much baclofen I took and the side effects, and how much I drank. Some of it's quite funny, (and sad, too). There are pages that are pretty illegible.
I showed them to Ed once, a long time ago, and he was impressed with my attempted diligence, but said it broke his heart, too. (He was not at all supportive of my taking baclofen OR my decision to quit drinking for good and all. Plus it was sad to read [or try to read] some of the entries.)
What were we talking about, again? Sheesh. I've totally lost my train of thought.
OH! Yes. I remember. It was the ball and chain comment. I'm not totally alcohol free yet, but I'm damn close. It is such an enormous relief to not have it be a driving force in my life on a daily basis. I hope the same is true for you, and soon.
Tracking is definitely a very important tool with TSM, many get months down the line and feel they are still stuck drinking. Then they look at their units and they are down to 50% of pre-TSM levels.
That realisation really puts it into perspective. For most problem drinkers halving their intake sounds impossible.
I'm coming up to 3 years AF - which is a result of TSM, it got me to a place where I was no longer interested in alcohol. Because I no longer drink, I no longer take the medication. Very freeing!
That is very encouraging! My daily ration of booze has hardly changed in years. The only way I have managed to stop alcohol taking over completely is to follow a few rules of my own. I never drink in the day, drink red wine of the same strength every day and somehow know when I have had 'enough'. I think that is relatively unusual for alcohol addicts. That is at about 1.5 bottles usually, though on social and other occasions it will be more in all likelihood.
Anyway I am very conscious of how much I consume. Even so, I have already set up a spreadsheet!
I'm surprised there isn't an app for this! Much easier to track with a device that's normally with you, rather than jumping on to a spreadsheet at the end of the night. I'd never be able to get it right, good for you for being able to.
I suppose you could just replace the ones that track coffee intake with booze if so inclined.
Well there are! On the Apple App Store there are several, having looked after your post. On ipad here so can't post a link but type 'alcohol tracker' and you'll get there. I assume there are other non Apple ones too.
Just browsing the internet and looking for more Naltrexone links when I stumbled on a thread in SoberRecovery (one of the biggest and busiest alcohol addiction support forums out there).
Now I'm not in a position to bang the drum about the Sinclair method as I haven't even started on the stuff yet, but when I went to the forum I saw that all the posts were about taking Nal after stopping drinking, supposedly to reduce cravings.
I have used SoberRecovery in the past when trying to abstain and it helped - it is great in its own way, but having almost been banned for daring to start a thread about baclofen I think I'll avoid the same mistake again. I can only imagine the reaction to a post about a treatment that actually requires you to drink as you take the pills!
What I learned is it's best to just get on with your 'method', saves a lot of headspace. If people want to notice that you are doing well, looking well, sounding well, well that's brilliant. Only a couple of people really close to me knew, a few outside that circle did but it didn't register with them properly. They'd ask me how long I'd been sober, meaning AF, that's the different TSM made. I then had to explain that I wasn't AF, I was TSMing which meant I drank but my units were hugely down. Sorta went over most heads, but all they cared about was that I was much, much 'better'. Later a few did pick up on the method and recommended it to others, one person actually did it themselves (I hadn't a clue that person had a drink problem), most were successful although it took varying lengths of time.
The one thing in common the successes seem to have is that they kept on, and they also really wanted it.
Been on TSM quite a few times. First time circa 2012 I did really well for around 6 months and for one reason or another stopped. The thing with TSM for me anyway is that I don't get a buzz from the booze. I can barely get et past 6 beer and in the end I was like fuck this if I'm gonna drink I might as well enjoy it.
Everyone's different though and looking back I had a decent few months on it that first time. Forgot to say it did nothing for my cravings even after 6 months I think that's partly why I stopped. I was also drinking more regularly to try and speed things up which is a bad idea . I actually have some still knocking around along with every other anti craving med?
Forgot to say it did nothing for my cravings even after 6 months I think that's partly why I stopped.
Welcome Tm1210.
I think that's what would put me off TSM. Though others seem to find their cravings disappear I think?