First naltrexone

Hi Kelly,

A few things for you to consider, because I am not too sure from your post if you actually understand how and why this medication and the Sinclair Method works so well.  Have you watched the documentary One Little Pill or read the book about this method called The Cure For Alcoholim?  These are really vital because once you understand how this medication works, you can then start to see where you are heading.

So....

1.  It isn't a magic pill.  It's not going to put you off alcohol, it's not designed to do that.  What it will do is stop that chemical cascade in your brain that has learned to associate alcohol equals reward.  It basically short circuits that reward mechanism in your brain so that when you drink, your brain doesn't receive a chemical reward for it.  If you think about it, diet pills don't work long term - to lose weight and keep it off it takes a change of lifestyle at the same time as using the benefits the tablets give.  People often have to start again and learn HOW to cook healthy.  The same is true with this and you need to begin to learn new ways to drink whilst taking advantage of the benefits that the naltrexone gives you to enable you to do this.

2.  The pathways in your brain that associate that alcohol equals reward have strengthened every time you have drank in the past.  They are now like motorways, and have been transmitting huge amounts of chemical responses relating to this.  The pathways have become strong and solid, and these pathways have become strong enough to overrule the smaller pathways in your brain which are the ones telling you that drinking isn't the best idea.  Because they are so strong, the natrexone can take some months to begin to weaken them and eventually break them altogether.   This is a medical treatment, and you need to be patient enough to understand that it will take a while for your brain to begin to understand that alcohol no longer equals reward.

3.  This is a partnership between the medication AND you.  Over the coming weeks and months, you need to do your part to help the treatment go smoothly.  This means learning to recognise that alcohol isn't giving you the reward (or high) that it used to, and start to learn to distance yourself from habitual drinking.  Again, this isn't achieved overnight and takes some practise.  I mean, we've never had control over our drinking before, so it's all new to us.  This involves things like logging down how much you are drinking, and learning to stop drinking on autopilot and start to bring your conscious deciion into it - are you satisfied?  Do you really need the next drink, or is it that you are drinking out of habit?  Try putting the drink into another room so that you can't just absent-mindedly pour and drink another (one of ADEfree's favourites and it works really well!) and have to actually make a decision about whether you want another or not - this is called being mindful and aware of how the drinking process is.

4.  There are a number of clinics offering this treatment now... and one of things they ALL insist on is that no spirits/liqour is drunk - at least in the beginning few months.  The reason is because the alcohol saturates the pre-frontal part of your brain, and this is the decision making part of your brain.  Once that is saturated you are basically getting under the influence, and rendering yourself unable to care about making decisions or not, so it makes the process of working with the medication a much more difficult thing to learn.  Experience is showing us that those who stay off the spirits at first, and drink longer drinks such as beer for example, are having a much easier time getting the hang of working with the medication and hearing/acting on the signs from the brain that it has had enough.  3-4 beers is massively different to 3-4 vodka drinks that are usually at last double pub measures (at least!).

I hope this helps.  This method works so, so well, but it's important to be sure that you get started from a good, solid foundation of understanding and you will make things far less stressful for yourself in the long run.

Hello Kelly. Joanne did a very detailed and thoughtful reply which is brilliant. Best of luck. Robin

Congrats on getting started with TSM, Kelly! 

Joanna has some sage words for you there. Even if you notice an initial drop in drinking, TSM is very up and down so it's good to understand that after a new low in your drinking numbers, your brain will fight back and reach out harder for it's "favorite toy". You'll likely see your consumption rise as a result. Totally normal. As long as you stay compliant with the dosing, the addicted part of your brain will continue to forget that alcohol brings pleasure. You may feel pleasure when you drink, but the addicted part of your brain won't remember that. This up and down continues throughout TSM (along a downward trendline), so lean against the upticks with mindful/conscious drinking techniques to counter this. One way you might do that is to use the vodka in a mixed drink to keep it from slamming into your system quite so hard, or switch to a different type of alcohol, keeping your drink beyond arm's length while you keep a NA drink close by, moving the alcoholic drink further and further away, bit by bit to avoid automatic/habitual drinking. It really is a partnership as Joanna says.