Campral with TSM

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If being compliant on Nal for TSM has become very difficult to do bc one cannot stop drinking Vodka in the evenings, often times straight, and drinks past the allotted time span for the pill what would you suggest? Could Campral be considered to help initially? Could one use Campral successfully for a given period of time then add alcohol such as wine or beer or cider  back in using Nal and TSM? Other suggestions on how would you handle the inability to give up Vodka and be compliant? Thanks 

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  • Posted

    Hi Popofcolo

    Are you saying that you are drinking vodka for over 12 hours a day?  And is that because if you don't drink vodka you will go into withdrawals?

    If that is the case, then you need to chat to a doctor about being detoxed off alcohol.

    Both naltrexone and campral are excellent treatments but they both need some help.  For naltrexone, as you know that is compliance.  For Campral, it will only work if you completely stop drinking and take it 3 times a day. 

    My question is that if you can't stop drinking vodka to take naltrexone compliantly, then how would you be able to stop drinking vodka to take campral compliantly?


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    • Posted

      It absolutely does not build up in your system, CM.  Sadly, the level of understanding from doctors about this medication is terribly low. frown

      The length of time that the blockage is 100% in force varies depending on metabolism, but as a general guide, most doctors who do understand about this treatment say around 8 to 10 hours from taking the tablet. 

      However, many people fall into a little 'trap' when they hear that.  This doesn't mean that someone can drink for that length of time because remember that the goal for this treatment is to release the endorphins from the first drink, and then work towards stopping as soon as possible after that first drink.  It is a limit, not a target!

      What it does mean is that if someone interrupts and stops their drinking, then great, but if the craving returns during that 8 to 10 hours, then they can have another drink safely, knowing they are still protected during that 8 to 10 hours.

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  • Posted

    Hi Popofcolor

    I was hoping Joanna would reply because you’ve got an excellent answer from an expert.

    My reply would have been the same, but I’ve no experience with TSM. Yes I understand how it works and being compliant.

    I have used campral very successfully. Both are excellent medications for AUD, but work in different.

    Campral is an anti craving drug. For it to work, as Joanna has said, you don’t drink alcohol and it must be taken 3 x daily.

    Campral takes a week to 10 days to kick in, so if you can’t stop drinking and would suffer withdrawals, then a detox from alcohol is what you probably need. Campral is successful when taken before detox finishes, or straight after.

    I would suggest seeing your gp and asking for a medical detox.

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    • Posted

      How did Campral feel taking it? How long did it take to feel it help? Glad to hear someone has experience with it.  I do believe it could be the extra help my spouse needs to get to a compliant TSM. 
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  • Posted

    Interested in responses.  I am thinking ab0ut starting TSM soon, and Im a vodka drinker.  Is there a rule that you can't drink hard vodka or booze in general?  I've heard someone say that but don't recall reading about it anywhere.  Also have a friend who I would like to look into TSM, but at the moment he would have a hard time waiting an hour for the pill.

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    • Posted

      It isn't that TSM doesn't work for someone drinking vodka (or other spirits) because the science behind it is sound and the endorphins we want to block are released by ethanol, no matter whether that ethanol is in spirit form or beer, the issue is more to do with the person and their perception of how things are going on TSM.  Let me try explain this way:

      Imagine TSM to be the equivalent of someone who has been to their doctor and has been prescribed a tablet to take an hour prior to eating.  These tablets exist and they work very well, actually.  However, losing weight is a long process and if that person continues to be stuffing McDonalds down them every day, then any progress they see with the tablets will be patchy at best, and non-existent at worse.  At this point, they can perceive that the tablets aren't working for them, feel a failure because they aren't losing weight, and simply stop taking them.  To get the smoothest results, those tablets need to be taken correctly, but also that person should be actively moving towards making better choices about their eating.... starting to eat less fat-laden products, and then taking steps towards learning to cook, perhaps.

      For TSM, the same is true in that it can take a number of months to extinguish the dependency to alcohol.  So, during that time, compliance is absolutely vital.  The science, as I say, is sound and it will do it, but not drinking hard spirits can make the entire process much smoother and eliminate the chances of someone not seeing much progress and stopping taking the tablet.  The number 1 reason that TSM doesn't work is non-compliance (ie. not taking the tablet, not waiting the time before drinking or simply stopping taking it altogether).

      To provide a smooth a recovery as possible, it is much, much, MUCH better to work with in partnership with the tablet.  Be that person who actively begins to work towards recovery rather than just leaving it to chance.  Instead of drinking vodka at such a rate as to allow the alcohol to affect the pre-frontal part of the brain to become saturated, try a drink that means you remain in control longer because you are not drinking as fast as to become intoxicated.  Should you have a loved one in your life, too, this is also something that can help them be at ease with the treating.  At the end of the day, they want you to stop drinking.  It's hard enough for them to accept TSM and accept that someone has to drink for this treatment to work.  The last thing they want to see is someone still drinking as they were prior to TSM, because then they will start to believe it isn't working too and can also pressure the drinker to find an alternative.... when all the drinker really needs is to make the process smoother for themselves and their loved one.

      I was, myself, a vodka drinker too but I switched to lager (Stella Artois) in the beginning of TSM.  I literally HAD to stop drinking and when I was told this from the person who took me through TSM, I decided that the most important thing for me was that it HAD to work and I didn't want to leave anything to chance.  Honestly, if that person had suggested to me that things would be better if I stood on my head for the hour wait, then I would've done it!!!

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  • Posted

    Hi everyone! This is my spouse actually.  To answer the questions...typically drinking is in the evening around 5pm.  The issue is that he drinks fast and hard to blackout sometimes, not always.  Then he will finally fall asleep.  When he wakes up, I am not sure what he does compliance wise.  But there are days usually on the weekend where he may drink this way much earlier like 10-11am.  Then he does same thing and then is up late at night watching TV.  I was under impression that every 6 hours he would need to retake Nal.  And he’s usually waiting 1.5-2 hours to drink. 

    The other thing he and I have talked about is that if he could get off the vodka and do sort of a reset on drink of choice via Campral then he could do the TSM much more efficiently.  I think he gave up on his first run with TSM bc of all the above.  He can go a week without drinking if needed. He has done so recently.  But that’s about as much as he’s ever done.  

    Hope that gives some info! 

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    • Posted

      I had no issues or side effects taking campral. After about a week of starting it, I suddenly realised I’d not thought about alcohol all morning. After ten days all cravings and thoughts about drinking disappeared. I took it for about ten months, roughly the maximum time. After that time, I don’t think there’s any benefit.

      Many years ago, I gave up alcohol completely for four years. However the craving was still there. My social life was nil, didn’t see the point as I couldn’t drink. I was envious of people being able to drink ‘normall’. Was much easier with campral.

      With regards campral and TSM together, I’ve no experience, so can’t really comment. To my mind, TSM  enables you to drink, whilst campral won’t work with alcohol, so basically they’re working against each other.

      There was a discussion on this forum a couple of years ago on campral and TSM together. Might be worth having a read. Just type acamposate (campral) and TSM in search and you should find it.

      I do drink socially now and have no problems with doing so. However, I don’t drink spirits, don’t drink alone and never secretively

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    • Posted

      To be blunt, it’s a waste of time him taking campral, it won’t work. The whole idea of campral is to reduce the craving for a drink. Ideally campral is best taken just before the end of an alcohol detox or immediately after.

      An alcohol detox with the right dose of medication, usually chlordiazepoxide   (Librium), or diazepam (Valium) should be relatively pain free. Once the alcohol is out of the system, then start campral.

      The detox is the ‘easy bit’. However with nothing in place straight after, apart from will power, many people relapse. Campral helps by taking the craving for alcohol away.

      Like any medication, it only works when taken properly. Two tablets 3 x daily and no alcohol. As I’ve said it takes about a week to start working, which is why it’s best taken during, or straight after a medical detox.

      I must stress, I’m no doctor so this is only my experience with campral, but I do know, you don’t drink alcohol with campral, it defeats the object.

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