Feel like I'm relapsing on Naltrexone

Since for most folks with the problem of AUD the desire for a super buzz, and if Naltrexone kills that buzz on the first drink, isn't it likely that one will continue to get the buzz or is the hope that Naltrexone will create in one a satisfaction from the one drink enough to not desire to continue?

Yes, the naltrexone will (over time) reduce the desire for alcohol and people will find that after one or two drinks they are satisfied.

You know that feeling you get when you are gasping and would kill for a fizzy drink like a coke?  Usually one glass of coke is enough to quell that thirst and desire.  You don't tend to find yourself guzzling beyond the point when your urge for the first drink is satisfied.

Well, part of the reason that someone keeps drinking alcohol way beyond what they should is part chemical endorphin driven and part habit or learned behaviour.

The naltrexone stops that chemical part, and so one someone has learned to no longer keep throwing it down out of habit, they will find that the combination of the two means that they are totally satisfied with one or two alcoholic drinks then they are done.  And as an added plus, at times they will think do I want a drink really?  And they will actually say no, they don't want a drink at all and have a cup of tea!

Oh and once the naltrexone has been taken and an hour has passed, no matter how much someone drinks they just will not get a buzz from it, period.  In order to overide the naltrexone blockage, you would have to drink so much alcohol that you would be dead from alcohol posioning long before the blockage was overridden!

So, you know you cannot get the buzz and will eventually stop trying to get it.  There is just no point in doing so.

And that can take several months of correct usage to not get the buzz, stands to reason that mindfulness is most important up to that point.

Absolutely!

It is worth saying that this method is working scientifically in someone's brain, behind the scenes.  This means that it will work with or without mindfulness.

However, mindfulness makes the process smoother for the person.

If someone is constantly getting drunk and suffering, then the perception can become that they are not moving forwards because you can't actually see what it is doing in your brain and their drinking seems to be remaining the same in the short term.

This makes non-compliance WAY more likely before the required months have passed.

Non-compliance = no success.

And so that is why we talk of mindfulness with such importance.  Not having any mindfulness when drinking can IN-DIRECTLY affect the process of TSM is someone stops taking the tablets.  Whereas having mindfulness when drinking means that someone can 'see' some progress in their thoughts and behaviour, and in their ability to control when and how much they drink.  When they experience this success, they are far, far more likely to last out however many months the method may take to work for them without a risk of non-compliance :-)

I'm not 100% sure of the question you're asking. I'm going to hazard a guess. Any medication for the treatment of AUD (I used a different one to naltrexone) works (along with mindfulness) by de-establishing the link of reward with alcohol. We then become somewhat immune to it and feel no need to chase the buzz, we can take it or leave it.

The problem with someone who has got the 'taste' of alcohol, is that they just can't let go and it is very difficult for them to imagine a time when they might be ambivalent to it. Wine often appeals to people then, because they can actually enjoy the taste of it even though they aren't getting the buzz, and because of no buzz, there is no compulsion to keep going.

I think it may be discouraging that although you may say you are being mindful in the beginning there may be several times you go over the desired limit. In those times is is it important to understand that just thinking about mindfulness and taking the pill correctly may not give the desired benefit YET but it is working in the background?

Yes thank you

Hey  friend,

Have you ever considered having a 'so called ' ... 'luxury' vacation package aka TSM that might be something very important... just a thought. I'd sign up for sure!

 

Could certainly use the vacation, ha ha

Been on it a month, yes you can get drunk.

Hi, thanks!

I don't get the buzz from vodka or any alcohol anymore but I can still drink a lot of vodka compared to wine say. 

I wish I could change how I'm viewing this and instead of switching to spirits to go back to wine  

I'm actively avoiding wine so I can still get drunk even though I don't get a buzz from it, which seems ridculous. I'm getting nothing from it at all now apart from ill. 

The brand of Nal might be different as it comes in a different box everytime as they always have to order it in specially. But I am sticking to at least an hour before every drink to take it and more time if I can as that seems to help also. 

I think I will go back to wine! and avoid spirits now if i can. I can't see any other way around it! 

I wish i could motivate myself back into some kind of routine because i feel like that would help, but life has been up in the air the last few years lol. 

'I'm actively avoiding wine so I can still get drunk'

The problem is, if naltrexone works for spirits, will you move onto something else?

'The brand of Nal might be different as it comes in a different box everytime'

I think what Joanna is worried about, is have you switched (been switched) from Naltima to Nodict. What is your current brand?

What you are saying here confirms that it absolutely isn't anything to do with the dosage - which, incidently, it rarely is.  Though there will always be the exception to the rule when it comes to maybe needing a little more naltrexone, it usually has more to do with action than dosage.   And the fact that you are not getting the buzz means that the brand of naltrexone is fine too.

Here is the thing with these (any) medications.  They do not stop you if you are insisted on pouring the drink down your neck.  With naltrexone, all it does it block the endorphin rush that means you are compulsively being driven to continue drinking.

With that blockage in place, there becomes the question of putting some action in to learn NEW habits in place of the old drinking habits.  This takes time and patience, because most all of us have ever really known is drinking.

Here is a good question for you:  why do you feel the need to get drunk?  Is it a way that you cope with stresses of daily life?  Are you looking to escape something?

The answer to this, whatever it is, will tell you that in place of alcohol you need to be looking to change your lifestyle in other ways.  For example, if it is a coping technique, then you will need to learn new and more healthy/appropriate ways of coping.

If you do nothing but remain compliant, then the good news is that eventually your brain will realise that getting drunk without the buzz is a pointless thing to do, but how long would that be?  The longer it goes on, the more likely you are to eventually convince yourself to not take the tablet and you will be back to where you started pre-naltrexone.  This treatment is a marathon, not a sprint.  It took me 8 months to complete become indifferent to alcohol.

And when it does happen, you will still be left with having to find something to fill the void.  For nearly all of us, alcohol has filled some kind of void - whether that was pain or boredom.  Take the alcohol away, and there is a huge big void that you can fill with lots and lots of GOOD things.

Take this as an opportunity which is both exciting and exiting in equal measure.  It's like an etch-a-sketch?  (Remember that, ha ha!).  You have the opportunity to shake away the old remnants of something you were happy with - drinking - and redraw a new future for yourself that is far, far, far more rewarding that your old one!

Sorry, I meant 'exciting and enthralling in equal measure'.

Wish we could edit posts!

And of course 'something you were UNhappy with'.

Gosh, can you tell I haven't had a coffee yet this morning???  I am going to get one right now!!!!

Hi Joanna,

Do you really think it's true that if you remain compliant eventually your brain will adjust and you will just give up trying to drink? That's what I've been advised and told that regardless of mindful drinking or not that eventually it will work.

Do you think that's true (trying to remain hopeful)

Thanks

You have hit the nail on the head. 

If i had to question why i drink...in the past it was because i was unhappy with my relationship and life and bored. I have changed the relationship and my life somewhat....

But i still feel kind of empty? I keep trying to find hobbies or make friends or take up something to fill my time and I have not succeeded yet. I only work part time and almost desperately want to up[ my hours to try and stop the week day drinking, but I'm in a job I don't particulary love so not sure it would help. 

I do suffer with depression but i always assumed that was the drinking too. 

I feel like i might need more help, but i tried councelling more than once, and have been to the ARC clinics etc. 

Now looking into hypnosis maybe? I dunno....I know i have mental issues as well as drinking ones, which lead to which i dont know anymore? 

Sometimes i feel without drinking there would be no excitement in my life, not that i find drinking exciting anymore? It's odd and hard to explain. 

But your right the drinking is not my only issue, it's maybe a mainifestation or underlaying things. Councelling is meant to drag this stuff out but it never really did to be honest. 

I think that sometimes i think that life is pointless, stuck in this stupid rut of having to work until you die with limited freedom. Sometimes all i wanna do is pack a bag and fly off somewhere but responsibilies tie you down. 

 

The science has shown that it is true, and that is also confirmed by my own experience of counselling people on this method.

The issue is that the longer someone perceives an issue with TSM working, the more chance there is that they will get impatient or dissillusioned and start not waiting the hour, or skipping/stopping the tablets altogether.

From my experience, it is certainly a smoother process if someone works with the tablets to start learning new habits etc - simply because they start to see results and they don't fall into that high-risk area of non-compliance.

The stats show this method is effective for around 78% of those who remain compliant.  Interestingly enough, it worked for 100% of the rats prior to human clinical testing.

Of the remaining 22% of humans, around half of those cause themselves not to be in the success group because they stop taking the tablets for whatever reason.  It is thought that this method is not clinically effective for 10% or less of humans.

When I counsel people through this, I focus a lot of this element of mindfulness when drinking and habit-changing.  Just because it seems to give people a noticable change and that change, no matter how small in the first few months, helps spur them forwards. 

The more you write here, Natalie, the more I hope you can begin to see that these things take time and will not be eradicated in just a few short months.  I know, for me, the patience aspect of this treatment was one of the difficult things to get used to, but it's worth it.

All I can urge you to do is stop the vodka and start to visualise where you want to be at in the future.  If you can see it, then you can start to realise that you are not stuck and are, in fact, moving towards that future.

If you do feel that the depression is an issue, then please see a doctor to see if you are depressed as opposed to just feeling down.  Depression is a chemical imbalance in the brain that, if you suffer from it, will not go away on its own.  I am not saying about immediately asking for anti-depressents, but rather just talk to someone qualified in treating those with depression to see if you are, indeed, a sufferer.

You had a great 5 months, and now the reality of not being able to rely on drinking any longer is kicking in.  This is not unique to TSM and you will find that any type of treatment involves some sort of lifestyle change in order to live comfortably without relying on alcohol.  I can't remember if you have ever attended AA, but one thing that they advocate (and I agree with) is that just removing the alcohol makes someone what they call a 'dry drunk'.  This means that they are no longer drinking, but everything about their mindset has not moved forward and they exhibit all the traits of a problem drinker, but just without the alcohol.  That's not a nice way to live, and once you find them, you will see that things are so much better without the reliance on alcohol.

Thanks Joanna that's really helpful. You are right it's hard to believe it will work so I can see why you would want to help people have quicker success. I am being compliant but not mindful. And am hoping it will still work as you say.

I can still drink 2 bottles of wine - but usually it's less and it used to be often 4- so I know it is a reduction over all. But it's hard to keep faith- and i was beginning to worry that actually you have to do the mindful drinking to make it work- and that then felt hard and was making me despondent. But I'm glad you're also say you think eventually it will work even without.

Oh my those words could've come out of my mouth! I feel exactly the same way. I have been a binge drinker my whole adult life, worsening as the years went on. I have anxiety and depression. I drink to excess almost every time I drink, having black outs many times; forgetting what I said or antics I did. Thank God nothing major, never drive drinking or hurt myself. My hangover lasts 4 days of depression then a cloud lifts. I need off this roller coaster. This happens about 1-2 times a month. I exercise every day. I have almost quit smoking for over a year; meaning I smoke when I drink.

I am praying mightily that Naltexone works for me. I just started following this group today… I just began counseling also for my unhappy private life as well as the drinking. I am going to switch back to drinking wine… I had actually stopped drinking wine because it makes me feel so terrible the next day… Have been drinking spirits. But based on these threads I think I will switch back to wine and be more mindful of it and the use of naltrexone.

I am 57 and feel like I've wasted a lot of my life with this binge drinking… My tendency to beat myself up and blame myself and the drinking for everything that is happened to me in my life and I've had plenty of negative things happen. I am single I don't have a boyfriend though… no children. I drink to forget my unhappiness my unsettledness my feeling that I always belong somewhere other than where I am…I have one brother both of my parents are gone. I have a few good friends. But I feel very alone and I know that is part of the reason it's not much of the reason that I'm a binge drinker.

This is my first post. I am grateful that I have found you all and send a prayer up for myself and everyone in here for supporting each other. I will be here for the long run it will post my progress with Naltexone, and in general.

I meant I do have a BF....phone can't hear lol

Please do let us know how you're doing, Dee! 

HI there. you seem to be in a spiral going down and few friends a family to help you. Perhaps you have hit rock bottom like I did and thought enough is enough...time for a change!! Try it.....think of how much better you will feel then next day and also how much less guilty....Robin

As I mentioned secondslong, not being mindful only increases the chance that sooner or later (before the treatment has achieved it's goal) you will give in to that 'hard to keep the faith' bit and stop the treatment.

It's a risk you need to weigh up, because it is a very, very real risk of non-compliance. 

I admit that I can never understand why people don't try to help make things a smoother process by being more aware and mindful when they are drinking.

I think because it takes a little more magic out of the bullet. I agree that mindfulness is very important.....it's like instead of taking the medicine with a full glass of water or food, you're taking it with mindfulness.

It wasn't something I was told about as necessary when starting the treatment so I suppose it wasn't on my radar as being necessary. So I suppose that makes a significant difference. Plus all kinds of other very longstanding psychological reasons which I won't go into here. For me the deprivation effect of giving up is absolutely huge which was one of the reasons tsm was suggested and I imagine why mindful drinking wasn't sold as part of it. But I can understand you not understanding. And maybe if I'd been working with you it may have been different. Maybe it still will be. The panic of not doing it right- another failure and self blame has been taken away (if it's true- well it hasn't but I like it as an idea) with the idea that this is a medical problem with a medical solution and that with compliance it will work even if it takes time - is what I have been told and then reading here about mindfulness worried me because it made me doubt that.

I know that for others I don't believe in blame and judgement whatever the cause of difficulty (not just with addiction ) be it medical or mental health wise- I'm absolutely passionate about and committed to that in my working life. I believe that also about people who cause harm to others - not just themselves. I don't expect others to agree- but this (nothing to do with tsm and my own alcohol) is a long term way of understanding others for me. And not something I can really go into online. But I don't expect others to agree. I understand you have been helping many people and giving people hope. I've heard about the amazing support you have offered. I think if I had understood this was needed for this approach it may have been different but it wasn't. Im really not knocking the support I have had from the person who has helped me - prescribed me this. It's been amazing. Just a different message from here.

Leaving aside the drug treatment comments to those who understand them, I was impressed by your self awareness and I think you are actually answering your own question at the start as to why the Nal doesn't seem to be working as well as before.

Clearly you are looking for an escape and I have done the same via the bottle. Why? Because (in the short term) it works! You really can drown your sorrows. Personally I think understanding the psychology of drinking is more important or, at least just as important, as understanding the chemistry of the brain and how this can be manipulated by drugs. I would even go so far as to say that the drugs may give a temporary respite by controlling the booze but they will fade in the long term if you don't get to the bottom of why you drink too much in the first place. Whilst some of us may be more prone to alcohol dependency for all sorts of reasons, there is usually something driving the desire to let the booze take over for a while.

I'm glad im not alone in feeling this way. Things started going wrong for me when i went from being a child to a very confused teenager.

Alcohol has always been an escape from age 16, however i only drank socially and at weekends. I went 4 years sober before and soon after habing my daughter then i was under massive pressure as she was ill fpr a long time resulting in me having no life or freedom for ages.

Suddenly when things started to get easier boom i started drinking, just pne bottle of wine a week. No big deal.

Over the last 10 years that had obviously escated out of control.

I have had lots of councelling and spoken about it all but it hasnt helped lol.

Now im heading fast towards 40 and wondering wtf happened and where my life went!

I am going back to wine and will try to be more mindful and get out of this rut

Fourth day tryinh Naltrexone. Started having a little wine with friends around 2 PM had a few glasses share the bottle with one other person… Went to dinner had two more glasses with dinner… Returned home and drank an entire bottle by midnight.Was trying to be mindful but just threw caution out the window… Feeling awful today had to take a Xanax for anxiety didn't sleep well. Discouraged.

I'm not clear how the Naltrexone by itself will cut down your drinking. Sharing a bottle with one other person would give you 4-5 units and at that point, if I don't stop, I could be going - well, anything from a binge (8 units) upwards. Probably upwards. Were the first glasses on an empty stomach?

I would find that dinner might stop me, but I have done what happened to you and opened another bottle. (Michael Caine controls his drinking by having wine removed from the table when the food is finished). It's asking a lot of yourself to exercise any self-control when you are bingeing. As for the sleep, well there are chemical reasons to do with how the liver processes alcohol which explain why it either disrupts sleep or stops us going to sleep altogether. I would wonder if this level of drinking isn't a cause for anxiety and depression on top of everything else. So cutting down alcohol may also cut down some of the anxiety and depression too. And give you a better night's sleep (also helpful to cope with anxiety etc.).

Yes on all points. Once I start I can't seem to stop and I Know what will happen but I just ignore it. I feel like I need to go to AA I'm in trouble on this roller coaster. And to top it off smoking on top of it which I never do unless drinking. So sad about this situation I feel like I wasted my life away drinking . Thank you for listening. I'm going to my second visit with counselor next week and an AA meeting possibly. Next weekend I'm having a girls weekend and I would like to challenge myself not to drink at all but it may be the hardest thing I've ever done.

I would imagine the hangover and lack of sleep isn't making you feel too good. I've had deep moments of regret too (usually the day after, like you) and it may be that a reality check is one step on the road to making stuff a bit better. But I appreciate it probably feels quite the opposite right now. I don't think I'd challenge myself too much as that may just be setting yourself up for failure. I don't know how you find the counselling but I would try and develop a strategy involving support from others to see if you can get things where you want them to be. I don't know much about AA firsthand; but I would just try and start with one thing - like a plan with your counsellor - and then work at that. Hope you get a better night's sleep tonight .

Dee,

If you took the first drink at 2pm then presumably you took the tablet at 1pm, yes?

You tell me you started with mindfullness and then as time wore on it went by the wayside and threw caution to the wine.  The prefrontal part of your brain got flooded with alcohol and you basically got under the influence.  At this point, it becomes almost impossible to make a good decision.

From what you say:

A few small glasses

Went to dinner and had 2 more

Came home continued, finishing the bottle with someone.

This is the part at which you need to work WITH the naltrexone.  The naltrexone will stop the chemical reaction in your brain that has previously made you compulsively driven to continue drinking.  Now, it is time for you to act on that ability and start to focus on whether your continued drinking is habit or not.  This is something new for you to learn, but you have to start somewhere..... You are not going to change things in 4 attempts!  The naltrexone will not stop you lifting the glass to your mouth if you just continue to do so.

So, what you should consider is think back over yesterday and work out at what point you could've thrown a spanner in the works and interrupted the habitual side of your drinking.  Then you start to implement that next time.  The goal is to allow the naltrexone to break the chemical compulsion, and then learn to bring your conscious decision making process into it BEFORE you drink enough to get under the influence.

Some examples of where you can start to do this:

Where you actually craving a couple of glasses of wine before you went to dinner?  If so, fine, take the tablet at the first sign of the craving and then have a glass of wine.  At that point, recognise that the usual buzz isn't in your brain and instead of pouring another, have a soft drink.  If you weren't craving, then do not take the naltrexone until one hour prior to the first glass at dinner.

Next, start to begin to recognise that the first glass at dinner isn't giving you a buzz.  Same situation as above, alternate with a soft drink.

Once dinner was over, remembering that you weren't being compulsively driven to continue drinking at home, you have to begin to start learning to decide to stop drinking for a while.  If you crave a wine again later on, maybe in the evening, then treat it as two separate sessions - take a second tablet to ensure that the protection from the chemical buzz is still going to be fully active in your brain and repeat the process as above.

To begin with, between each drink you need to be learning to try and throw that spanner into things and learn to stay really, really asking yourself if this is you being driven to drink..... or is it just habit?  When the answer is habit, then you need to actually put some effort in to replace the next drink with a soft drink.  Then ask yourself again, do you really NEED another wine after the soft drink.

It is this 'asking' yourself each time that allows you to start learning new ways of doing things.  Each time you do this, your brain is learning that alcohol isn't giving you the chemical buzz anymore and over the weeks and months ahead, your urges to drink will lessen.  BUT, whilst that is going on in the background, you should be focusing on learning to make a conscious decision about whether the next drink you pick up is alcoholic or non-alcoholic.

You have established your current way of drinking over many years, and this is a strongly driven habit.  It stands to reason that it might take weeks or months, more likely, to completely reverse this habit.  But it will happen in time, and you can make your current situation more manageable by working with the naltrexone.  That is what we mean when we say 'mindful' drinking.

In addition, are you aware that the tablet will provide you with around 9 or 10 hours of 100% protection from the chemical rush?  Then it starts to wear down and some of the buzz may get through.  To prevent this, this is why I talk about treating it as two sessions if you need to for the time being.  One session at lunch if drink is going to be available, during which you drink mindfully and then learn to stop.  And then a second session for the evening if there will be drink available - waiting the full hour each time, of course.  However, the ultimate goal is to take the tablet when you experience a craving or urge to drink, wait the hour and then drink mindfully.  Just because you do need to drink alcohol to make this method work for you, that is a requirement of one drink.  Don't fall into the mindset that just because you have to have a drink, that means you can continue all day and all night.

If you didn't stop drinking until around midnight last night, then the chances are high that the tablet you took was no longer providing you the cover you need later on.

And very lastly, if you have the urge to drink DO NOT try deprive yourself.  All this is doing is allowing the cravings and urges to drink to build, and build.  And whenever you do finally cave in to them, you will feel what is called the Alcohol Deprivation Effect (ADE) and the rush of relief in your brain will be so high and so amazing that you are extremely unlikely to be able to control your drinking at all - leading to another massive binge.

Instead, start to learn to work with the naltrexone as I write above in order to begin to learn how to control your drinking.  It's isn't a magic pill - it takes input and work from you too.

Are you saying that the pill if taken an hour before the first glass of wine, will inhibit getting a buzz from it? I do think I got a buzz from the first glass, albeit maybe a bit less than usual. Also, it may be psychosomatic, but I feel the pill gives me a few heart palpitations during the hour after I take it and before the buzz. This continued until the first drink is down, squelching the palps.

The Sinclair Method IS to take the pill at the first sign of a craving or urge to drink, then wait one hour before taking that first drink.

Can you confirm have you been waiting the full hour prior to the first drink?  If not, how long have you been waiting between taking the pill and drinking?

Waiting the hour will block the chemical reward aspect of the drink (that is the chemical reaction or buzz that compels you to keep drinking) but will not affect the other relaxation and intoxicating effects of the alochol.

I'm having a hard time with the difference between the chemical reaction/buzz vs relaxation/intoxification.

Forget that for a moment.

What I really need to know is that on the past 4 times you have taken naltrexone, how long passed between the tablet and drinking on each occasion?

I want to help you of course, but the advise and help I can give you will differ depending on how long you waited.

 

First 3 times one hour almost exactly but I drank spirits. I am off spirits now. Last night 35-45 mins and then had red wine.

Okay, thank you, Dee.

I am not going to tell you off or anything!  What I say below is only out of concern for ensuring that you get well again.  This is YOUR recovery and whether it is going to work is up to you.  We can help and suggest and advise and encourage, but the ultimate decision to put that into action is down to you.  Waiting the hour 'almost exactly' means what?  I would expect you mean that it was maybe 50 or 55 minutes, if not less.  I have taken enough people successfully through this now that I can tell when something isn't quite running according to plan.  As I say, I am not getting angry at you, but I am trying to get across to you that you are on a medical treatment and it simply will not work if you chose to not follow the most basic instruction, which is compliance.  Put simply, I WANT you to recover (I really do!) and this method is clinically proven to be able to help you achieve that.  But whether you do comply with the 'golden rule' and recover is your decision. It's isn't a magic pill that is going to turn your life around unless you meet ALL of the intergral parts of the treatment.  Put it this way, if your doctor was treating you for cancer and told you to wait one hour after taking a pill to eat or drink, would you recognise how important that was?  This is the same.  Alcohol misuse is a chronic condition that can kill.

The fundemental - and vital - ingredient as to whether The Sinclair Method works for you will be compliance.  It is simply NOT negotiable.  I can't stress that enough.  Over 20 years of research went into this, and one hour was found to be the length of time that was needed.  Some people even wait 75 minutes to be absolutely sure because they do not want to run the risk of this not working for them, but one hour should be fine.

The reason you are likely struggling between what is chemical buzz and what is relaxtion is not just because this is new to you, and so this takes a little self-examination to figure out which is which, but because I don't feel that you have previously 100% blocked the endorphin buzz since you didn't want the hour.  This means that some of the chemical buzz is leaking through to your opioid receptors so you are likely getting a mixture of both.

So, time to be make the decision.  If you want to continue on TSM, then you MUST, MUST, MUST commit to doing it as it should be done.  50 or 55 minutes is dodgy and you run the risk of the tablet not being fully in effect. 35-45 minutes is absolutely NOT going to give you full protection from the chemical buzz.

I would suggest that you set an alarm at the same time you take the tablet, for 60 minutes.  This will then mean nothing is left to chance.  Until that alarm goes off 60 minutes later, you simply CANNOT drink, no matter what the circumstances.  It's not too late to change things, but you must do so immediately.

Do this, and I feel you will very quickly begin to recognise that he buzz is stopped.

I don't like being harsh with anyone, but I do so because I know that this treatment works when the instructions are followed.

Understood and I thank you for your candid comments and the help.

I started w vodka then went to wine because it's said not to work well with spirits. I won't go back to spirits and it's the buzz and getting drunk that I wish to rid myself of.

Hi

Just wanted to pop you a message as it sounds like I have exactly the same drinking pattern as you - and its rare that I find someone whose drinking issue is like mine! I binge a few times a month - but usually to black out. I dont struggle with sobriety between the binges. I am wondering, how is your experience of naltrexone going? Has it helped you? I have just started doing the sinclair method (ie just taking half a pill before I drink) - but last night i did this and still managed to have a big old binge. I am hoping that over time if i continue with the naltrexone, this will change...

Hope you are doing well!

Liz 

Hi deebe how r u? Going OK?

Liz, if you are free from the initial few days of side effects, then move up to the full tablet from now on.  Half a tablet will not be 100% blocking the endorphins (you are not fully protected with half a pill) and so that will have gone some way to explain why you drank more than you intended.

hi all!  i'm brand new to the sinclair method.  i started a few days ago and today is my second day to take the pill.  what i'm wondering is, what if i wait 2 hours to drink after taking naltrexone.  is that too long?

Hello skeye,

The hour wait is because this is the time that it takes the tablet to be metabolised and fully blocking your opioid receptors in your brain.  Some people do report that waiting 90 minutes or 2 hours is better for them in terms of results, so that is fine.  Everyone is a little different, and as long as you don't drink before the 60 minutes has gone, then you can test out if that makes a difference to you too. 

The above is for naltrexone.  If you happen to be taking nalmefene (Selincro) then 90 minutes to 2 hours is definitely recommended anyway.

The main thing is that you want the maximum impact of the tablets to be in blocking the endorphins that are released when you drink.  This is what tells your brain that drinking is no longer reinforcing the reward circuitry in your brain.  So, no matter how long you wait, try not to do any other activities that release endorphins during the wait - such as exercise, or sex, or a eating a spicy meal.

It IS good to do these things BEFORE taking the pill.  This gives the double effect of you getting a good reinforcing reward from normal activities, and then your brain really gets the contrast that when you drink, the reward is not there.  If you imagine something like a pendulum in your brain, it will start to swing away from what doesn't give it a reward (alcohol) to wanting to do those other activities because they do feel good.

Just know I have the EXACT same situation as you do!

Also, for me, Naltrexone has made me feel 'depressed' in a way that it has 'stolen' from me my urges to do the things I love to do. I feel BLAH but I know it's the Nal...the good part: it has taken away my appetite which is making others think I'm sick but I do eat and take plenty of vitamins and supplements.