Does naltrexone work?

Thanks for advice everybody. I'll persist then.

Sporadic heavy drinker and I usually know when I'll binge. (A drink or two 4 times a week. A bottle and a half of wine once a week. Blackout stage 5/6 times a year. )

Have taken pill as instructed but not teally noticed much difference. Will try mindful drinking. Problem is a lot of work socialising in fancy restaurants.

Thanks again!

Yes please!

Done!

You will still feel the effects of alcohol on your GABA and Glutamate receptors (i.e., relaxed, "warm and fuzzy" feeling), but NB, part of the work that Naltrexone does happens in a part of the brain that has no "feelings" at all. 

Benzodiazepines generally thwart TSM, but I haven't seen anything that tells me if that's a concern for someone who takes them on occasion at bedtime. Of course, you would want to let your doctor know before changing the dose of any medication that has been prescribed. None of us here, save Paul Turner, are medical professionals, please keep that in mind.

Not everybody has the same rate of improvement with Naltrexone/Nalmefene. Some notice a big difference right away, but may see their drinking levels climb back up in a couple of weeks or so (the "Honeymoon Period"), then slowly drop from there. In general, it will take at least 3-4 months for pharmacological extinction of your cravings to occur, with many taking longer than that. 

Review Joanna's suggestions on mindful drinking, as it's never too early to get your conscious mind involved in the process. You won't get any particular results on any particular schedule, but getting into the practice of being mindful about drinking will help you get faster results. That's basically what's going to be happening anyway, the "automatic" part of your brain that wants to just chug the stuff down will get quieter and quieter and the conscious part of your brain will have more and more of a vote in the matter. 

https://patient.info/forums/discuss/naltrexone-nalmefene-selincro-the-sinclair-method-hints-and-tips-505275

This method works 'behind the scenes' in the brain. 

Once the tablet is taken, the blockage of the endorphins is happening regardless of how much someone believes in the method or not.  That cannot be changed. The only belief that is needed is the understanding that this method has been clinically proven to work for almost 80% of those doing it, and so taking the tablet and waiting the required time before the first drink is worth it.  The rest is time and patience.

The idea that we speak about with regards to mindfully drinking just makes the method as smooth as possible. 

Even if someone drinks more than they expected on the medication every time, it will still work EVENTUALLY.  Sooner or later (whether it's the 100th or the 1,000th drinking session) the brain will suddenly decide what is the point and the drinking will start to lessen.  For example, you can keep trying to drink a very hot coffee a 1,000 times and burn your tongue.  Eventually your brain will tell you that it just isn't worth trying.  It's just obviously much easier to get that message after the 100th time rather than the 1,000th!

The only issue with regards to the method is that someone must be 100% compliant, 100% of the time.  Starting and then stopping the medication, and then starting and stopping again and again etc, will not work.

So, yes, I certainly agree with you that someone needs to be absolutely ready to take some positive action to help their drinking, otherwise the compliance just will not happen contunually. But once that tablet is taken and has been absorbed into the body, there is no need to be concerned about whether it will work or not.  In fact, from a purely medical standpoint, there is only about 8-10% of the people that this does not work for.

I would agree that you can override any medication that you want to.

You have to have the right frame of mind and work with it. As we say, there is no magic pill.

Paper, you are most welcome and thank you for the kind thoughts! I'm so glad you're continuing to see benefits from TSM. Thank you too, for sharing your story with us. Seeing the stories of others that started from with similar circumstances, reading of their struggles and victories, that's what gives people the courage to say "Yes, I can do this too!".