How can I achieve abstinence?

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I'm on day 2 of naltrexone after over 10 years of alcohol dependence and abuse (so early days i know) and feel really positive....last night i only had/needed 3 pints instead of my usual 6 plus wine. i've agreed with the counsellor i'll use naltrexone to cut down and then start a detox when i finish my exams in a month's time, but i'm worried how i'll manage. if i still need a couple of pints when i'm on naltrexone, how will i ever manage to make the switch to abstinence? i'd really appreciate advice from someone who has done this....

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  • Posted

    Hi there,

    I haven't started the process yet but from what I've read if you stick to the rules naltrexone + drinking and never drink without it your desire will continuously decrease. If on the none drinking none naltrexone days you do more and more activities which release endorphins such as exercise, you'll eventually lose interest in using alcohol the way you have been.

    You're only on day 2 and you said you've been drinking heavily for 10 years so I'd give it time.

    Good luck with it.

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    • Posted

      hey, thanks so much for replying. that sounds like good advice about doing things that release endorphins - i had started to think about what hobbies i might like to do when i don't feel like i need to be in the pub every night but hadn't thought about the "feel-good" hormones aspect :-)

      you're quite right i'm only on day 2 but you know what it's like, you end up with a million questions swimming about in your head. i'm already thinking about next year rather than focussing on getting through tomorrow!

      good luck to you if/when you decide to embark on the process. on day 1 of naltrexone (yesterday) i realised how people without alcohol problems must feel. i had 3 pints and for once i didn't want any more, that little voice in my head was gone, i felt it trying to creep in a few times but naltrexone was like a club bouncer and wasn't letting it in!

      thanks again for your support :-)

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    • Posted

      Hey,

      No worries. I understand. We're all so used to trying and failing so many times to cut down or abstain it's hard not to let the mind doubt and fret.

      This approach makes so much sense to me, more than anything else. It will just take a while for it to be accepted.

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  • Posted

    I can't tell you my own experience as I am a practitioner, not a patient, Keith, but I'll respond anyway smile

    I am unsure about a couple of things. Firstly, why the concern about reaching abstinence? Is this something you have been told you must do? The purpose of this drug is to stop you getting the 'reward' you get from alcohol. By doing that, over a period of time, it makes you 'un-learn' your addiction. This way, as long as you always take a pill before drinking, you can return to controlled drinking. You may find that, without the added reward that people with this pre-disposition to alcohol addiction get, you will automatically stop drinking because it just doesn't interest you anymore but, if this is the case, it will happen naturally and you don't need to be worrying about it now.

    Secondly, if your alcohol level has reduced further, there is a very good chance that you won't need a detox because you will have detoxed yourself using reducing amounts of alcohol.

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    • Posted

      Hi Paul, thanks for taking time to share your advice, I appreciate it. I had an appointment at the clinic today and luckily saw your post in advance so was able to ask relevant questions.

      The counsellor said she recommended aiming for a period of abstinence of minimum 2-3 months but ideally a year before considering returning to controlled drinking. I'm still a bit confused as I raised your point of still having to take naltrexone then and she agreed I might have to, although she said that the brain can repair itself after a year and lose the addiction, but anyway that's a long way down the line so I guess I'll just have to wait and see....

      When I mentioned your point about detox, she agreed that I could see how I go with naltrexone over the next month and that if I had cut down significantly I may not need a detox and we can review it in a month to 6 weeks so that's good news. I guess she's just waiting to see how I get on with naltrexone and then going to review it then.

      Thanks again for your advice Paul, I really appreciate it :-) 

       

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    • Posted

      Yes, she hasn't got it at all. There is no need to have a period of abstinence. In fact the research that Sinclair did, found that Naltrexone was completely ineffective if taken without drinking, because that prevents the 'pharmacological extinction' (unlearning the addiction) occurring. If you are not going to have a drink within a couple of hours, you should not take either Naltrexone or Nalmefene.

      Why would a person get back to drinking a couple of pints a week and then need to abstain for two or three months? smile

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  • Posted

    Hi Keith, ...... Like you I have just atarted (6 days) after a long period of alcohol abuse.  Tried with Selincro back last October taking the pills and stopped drinking.  Thought I was clear stopped the pills ..... and you know what .... started to drink again, just as heavily.  I found this forum which explained/showed I had been doing it wrong.  Started last week back with Selincro for a couple of days did not drink as I felt absolutely crap, ...... have endured some of the well documented side effects but now after six days was able to walk to the pub last nigh have two pints an walk way (took the tablet 1/1.5 hours before) ....... no desire for any more alcohol ...... walked home feel great this morning !! ....... this is the start of a long process using Selincro to wean me off the addiction ...... my comment to you is listen and see the comment /advise on this site ...... Paul is great and will explain very clearly where the path lies and how to join it .... I just read his posts to others and this showed me where I was going wrong ....... stick with it .... this is my second attempt after I "crashed and burned" the first time due to being illiterate as to what I was trying to achieve !! ........ Good Luck !!
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    • Posted

      Hi anthony, thanks for the tips, you're right, I'll do as much reading on here as I can as it sounds like this is where you get the best practical advice.

      Like you, I'm loving how good it is to be able to have a few pints and then just leave it there and how good you feel in the morning...it's a revelation!

      Good luck with selincro...

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  • Posted

    Hi Keith,

    I have also just started taking selincro, my 4th tablet today. My aim is to return to 'normal' drinking habits. I am finding this forum a real source of support. Everyone in the disucssion is encoruaging and helpful. Paul offers expert advice. Stick with it and don't think too far ahead ( I know I tend to do that too). Good luck. smile

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    • Posted

      Hi Kathryn, thanks for your tips & support. you're right, i'm very happy I found this forum otherwise I'd feel like I was the only one in the world doing this. Since I finally admitted the extent of the problem to some friends and family, I've found they all want to help but also become self-appointed alcohol addiction advisors overnight, so it's good to chat to people who understand a bit more!!

      Good luck with the selincro :-)

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  • Posted

    I'm seeing my doctor on Wednesday. Can I just ask did you guys all have any issues getting Selincro subscribed? Was your doc aware of it?

    Thanks.

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    • Posted

      Hi odishon, I'm North of the border and the drug and alcohol service said they preferred naltrexone to selincro but that GPs would prescribe nalmafene too.

      Good luck on Wednesday :-)

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    • Posted

      In Scotland, in the first year after Nalmefene was approved for use with people with alcohol problems, it was prescribed for 53 patients!
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    • Posted

      hi paul, i got the impression they felt nalmefene was a big pharma cash cow...that's us Scots, we're "thrawn" as they say!
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    • Posted

      It's like all new drugs. There is a period when the company that develops it has to get its money back for all the research etc and, for a period of time, they have a patent and are the only company allowed to make it. Once the patent expires, other companies are free to manufacture it and the cost comes right down.
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    • Posted

      odishon, ...... I heard about Selincro from the news papers and an article on the Tv ....... did some research on the internet and printed all the documentation available.  I went to my GP, a lady and always very supportive of my situation and presented this information to her.  Although NICE approved the local PCT would not sanction GP's (an consequently her) to prescribe Selincro due to the "apparent" cost.  After considerable discussion and many apologies ...... she suggested that I approach the on-line pharmacy company ....... she completed an examnation in line with the information to ensure I was not doing something that would be detrimental to my health and that the parameters outlined in the Selincro documentation (and she obtained a far more medical evaluation of the drug) would not be harmful.  After the first failed attempt previously describe
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    • Posted

      sory this is a continuation ....... After a first failed attempt described previously ....... I started again last week with much more knowledge gained from this forum ...... and "fingers crossed" all is going well althought only six days in !!.   I have received contact from my GP who is interested to hear if I am persuing this treatment and if so can she discuss the implications/effects a request which I found positive.  I currently but my Selincro off the internet and the product as far as I can see is authentic ..... reputable pharmacy web site.  I am sure that after an further discussion with the GP she will still not be in a position to prescribe however it is interesting that she is asking the questions ........ if she prescribed my prescriptions would be free !!! .... I continue to hope ....... Good luck to all !!  
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    • Posted

      That's very interesting thanks Anthony. I have a feeling I may get a similar response as I mentioned it to another doctor last year and she said it wasn't available to prescribe.

      I'll find out on Wednesday if things have changed.

      Good luck with your progress.

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    • Posted

      I would suggest that, if you are willing to pay for the medication, you ask your GP to write you a private prescription which you would have to pay the pharmacy for, in full. It's about £100 for 28 tablets.

      At least that way, you can be 100% sure that you are getting the genuine thing. I don't trust online pharmacies.

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    • Posted

      Thanks Paul ...... went along that route and again she declined to issue a Private Perscription on the basis that dhe was not covered by her insurance to do so !! ........ fact ??, well you tell me, .... I thought it was a bit of a "cop- out" ...... in fairness she was quite young and the fact I had even got her to accept the principle of Selincro and that it may be a way forward was in my view sufficient as not to push too hard !!
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    • Posted

      I doubt that her insurance would not cover her to do a private prescription. The only difference with a private prescription is that the patient pays the full cost. Nalmefene is fully approved and even recommended by the National Institute for Health and Care Excellence (NICE) so it's not as if she would be doing anything which isn't acceptable to any of the governing bodies. A cop-out, I think smile

      Hopefully, after you put the idea in her mind, she will look into it more and consider its use in future.

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    • Posted

      Anythony, I think given what Paul says, you have grounds for complaint or at least review by another GP. The days of doctor knows best are long gone. Ask the GP exactly why they will not issue you the presciption and if you're not happy with the answer, ask them to put it in writing and tell them that you intend to go down the practice's complaints procedure.  
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    • Posted

      Hi Paul

      Could I ask you a question - I have been drinking for many years and it crept up on me and I found myself drinking 2 bottles of wine every evening, sometimes starting at lunchtime.  I wasnt working, I felt depressed and unhappy generally.  Two years ago I wasnt in a good place and was given diazapam - I went on an AA course and was abstinent for 80 days each day I was breatherlised.  They called me a habitual alcoholic - after the course I started drinking again and I went back to where I started.  I have drank for the last year and then I came across Campral recently I went to my GP and asked about it and why I hadnt been prescribed this before to no avail!  Anyway I started this 43 days ago and didnt touch a drink - It is my choice not to drink but I feel I am being punished - I drank on Sunday, felt ill on Monday back to feeling deprived today ..... Am I on the right drug?  Would really appreciate your help - Kind regards

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    • Posted

      It really depends Radley. If you want to abstain totally, Campral can help reduce your cravings but it doesn't work well for everybody.

      The most effective treatment method is The Sinclair Method which uses Nalmefene (or Naltrexone). Nothing has ever come close to the massive 78% success rates this treatment method is achieving in Finland. It also means that you don't have to abstain, although many people find that they automatically become occasional drinkers, without trying, when using The Sinclair Method

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    • Posted

      Thank you Paul, I will speak with my GP and get a prescripton for Nalmefene.  I would just add that that the GP's have never suggested this medication and more than happy to send you to AA.  I just dont understand, as counselling isn't for everybody.
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    • Posted

      It's down to a serious lack of knowledge about alcohol problems among health care workers, Radley, also to a seriously bad attitude to what many of them see as a 'self-inflicted problem.' It will get better but it's going to take some time.
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    • Posted

      I've just come back from seeing my GP. He has been helping me manage prediabetes, cholesterol and blood pressure over the past eight months.

      Today I saw him to talk about my drinking levels and using Nalmefene to reduce them. He didn't know anything about it but seemed very open minded. He has booked me an appointment for just over ten days time to give him chance to research Nalmefene. I am pleasantly surprised by his attitude I have to say.

      Will report back when I've seen him again.

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    • Posted

      Also, it is recommended that Nalmefene is prescribed two weeks from the initial appointment. That is ridiculous to me but I think it is recommended so that a drinking diary can be kept during those two weeks so that there is a reference point to start from.
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