I'm so tired and demoralised by being a drunk

Why would you say AA wasn't for you but say the Fellowship is essential. You are dropping AA lingo all through your post... disclaimer....I don't believe AA is very helpful at all...

I had anti depressants when my marriage broke up.  I drink when I feel good.  The happier I feel the more likely I am to drink.  I drank on anti-depressants which isn't good.  I am very vigilant about letting myself fall into a depressive state and usually a couple of days off booze, with sunshine makes me start feeling good, which makes me want to drink.  I can be depressive.  I will not know until I am alcohol free what I true self or mood is. I intend to use exercise to make sure I don't fall into a depressive state. I am going to get to the Dr as soon as I can to get naltrexone.  I don't think AA would help me, as I am a scientist and do not believe in a higher power, nor do I think it would be condusive to me to give up my responsibility to something I don't/can't believe in.  I also don't want people in my community knowing I"m an alcoholic - I am a health professional.  Going to the Dr in my local community is hard enough.  Also, drinking in my local pub is the worst decision I could have made - only done it twice so far - so hopefully haven't damged my rep too badly.  Luckily, I know people tend to forget drunks pretty quickly if they don't keep showing up.  Yes, I need to do this to not ruin my life completely and I don't want to take my daughter down with me.  Thanks for your reply. 

AA wasn't something I could be part of for the rest of my life. There are people that have been AA members for decades. I didn't want to be a part of that. I didn't want alcoholism defining me for the rest of my life. Something AA offers though, that I think is valuable is fellowship with other people dealing with similar problems. I found that helpful. I guess what I was trying to say is AA is helpful, but it's ok to take what you find helpful and cast aside what you may find controlling and cultish.

I'm not sure naltrexone has ever been proven to help people stop drinking. I think the only evidence is anecdotal. I don't think there is any hard science backing it up, or any controlled experiments to prove its efficacy. However if you are going to be taking the naltrexone orally and not as an implant, it probably won't do you any harm. Baclofen is now being used as a pharmaceutical aid to curb the desire to drink. It is proving to be effective, more so than naltrexone. Unlike naltrexone there is hard science that shows how and why Baclofen works. It's horse for courses I suppose. 

Good luck.

JackDM,

For someone who said they have worked with many alcoholics, you have an incredble lack of knowledge about medications that can help with AUD. 

There IS hard science about naltrexone!  There have been over 120 clinical tests on naltrexone and nalmefene (naltrexone's sister drug) ranging all the way back to 1978. 

Naltrexone was approved for use in AUD by the FDA in 1994.

Naltrexone was approved by the Australian regulartory body for use in alcohol dependence in July 2009.

Naltrexone has been used for treating alcohol dependence for DECADES in Finland which a clinical proven success rate of 78%.

Naltrexone is used on the UK NHS and guidelines were amended to read such in February 2011.

Naltrexone's sister medication nalmefene was approved on the UK's NHS back in November 2014. 

The list goes on....

My point is that this doesn't just happen without a significantly large amount of clinical trials and evidence-based results.  Opioid-antagonist medication, which is what both naltrexone and nalmefene are, have been proven to be safe, non-addictive and efficient.

 

Thank you for that information on naltrexone and for so aggressively putting me in my place! I made no specific claims about naltrexone. I didn't say naltrexone doesn't work. I pointed out that Baclofen is now being used and ended the comment by saying 'it's horse for courses' making it clear that something may work for someone and not work for someone else. I was making the point that naltrexone is not a guaranteed 'cure' for alcoholism. Perhaps I should have been more articulate. As I'm certain you know naltrexone is used to help people with opiate addiction problems. In those cases naltrexone is guaranteed to work, it will stop the drug binding to opiate receptors in the brain. The point I was lazily trying to make was that naltrexone doesn't work that way when used to treat alcohol dependence. I take it you're the top dog here? Message received and understood!! You obviously have everything covered here. I shall look for support and help elsewhere!

Nobody is top tog here, we all have areas that we are particularly knowledgeable as well as a general knowledge. Naltrexone just happens to be one of Joanna's areas of expertise. I don't think she meant to belittle you, she is however passionate about it and doesn't want to see people reading this who might be given bad advice. There are a lot of people who don't join the forum, but just read it.

I could type out a stack of research done on naltrexone (links get modded), but the gist is there has been plenty, to prove its efficay.

Nothing is guaranteed except death and taxes and even if you cheat the former, the latter will always still be there.

There are four main medications being used to help with alcohol dependency, nalrexone, nalmefene, acamprosate and baclofen. They all have their advantages and disadvantages. Baclofen has a high success rate, but it needs titrated up to very high doses for 2 - 3 months, with quite harsh side effects, because of the doses involved, Also it is not on label for alcohol dependency in most of the world, therefore you are very unlikely to get prescribed it.

I don't mind, but not many like taking the risk of buying from an IOP, so it is hard to get.

No, I am not Top Dog here.  Far from it.

But I wouldn't comment on something that I know nothing about, as it might lead some to believe that what you are saying is correct and that there really is no evidence-backed treatment for naltrexone.  If you are so fundamentally incorrect on something as important as that, then of course someone (in this case, me) is going to respond in such a way.

Naltrexone binding to the opiate receptors in the brain is exactly how naltrexone works in alcohol dependence - it stops the endorphins that are released from drinking attaching to the receptors in the same way that an opiate addict finds that opiates can't attach to the receptors.

No, it isn't a guaranteed cure, but then nothing is.  There is no treatment or method guaranteed to work for someone.  But naltrexone or nalmefene used as per The Sinclair Method is the most successful treatment in clinical trials so far.  And yes, even better than Baclofen which is showing some great promise in some trials, but is still not as safe and efficient as naltrexone or nalmefene.

I apologise if you feel I was 'getting at' you.  That was not my intention.  My intention was to clearly put across, for anyone reading this thread and not commenting on it, and without linking to anything because we can't link here, that you were absolutely, 100% wrong in the assumption that naltrexone has no evidence behind it's efficacy.

I understand now that it is important not to make a sweeping statement on this forum, which is what I did. I should have made it clear that this was my subjective experience

Please take actiion NOW. I had my kids taken away from me for a time whilst I was in hospital - it was the worst thing that has ever happened to me, and them.

The whole family is older now and back together, but I still feel the guilt that it was my fault that our family were split up when the children were little.

They all say they have forgiven me now, thank goodness.

I really hope you don't get to the point where your child/children are removed from your care. All the best!

Tre -

How about you? Are you getting the support you need to get the drink under control? Sounds like you dry out then relapse, it doesn't have to be that way. You can use the drink against itself to cut down to sane levels or even stop altogether. There are other options too, something for everyone that will help them get the drink under their thumb. 

Hi Ade,

Yeah something like that, though i wouldn't say i dry out. I drink everyday, and often to excess, with no real problems. I get by at work well and feel alright with myself, Unfortunately every now and then I lose control and something bad happens. . 

There seems to be little in the way of help though. I have called three places today and all offered to see me.....in the middle of the working day. I work full time and can't leave at 11am! But I feel if you have a good job and are fit and healthy you will struggle to get meaningful support. One even told me i should quit my job, claim benefits and then seek treatment!!

There's got to be a way. Are you UK or Oz? 

In the UK you have an absolute right to attend medical appointments during work hours if there is no possibility of having an appointment outside work hours. Talk to your line manager - you don't have to say what the appointment is for, after all. It sounds like you've been reliable up till now so there shouldn't be a problem. Keep trying, as ADE says.

Quite right, ADE. My addiction is to diazepam, not alcohol, but the principle of cutting down WITH SUPPORT is a sound one. Hope you're doing ok yourself - you helped me so much the other night. My husband has agreed to go to the Liver Unit and is really trying to cut down to about five cans a day, which for him is almost nothing.

Yes, there is hope. Love Tess.

Glad to have been of help, Tess! You've made a huge shift in your approach to the problem and that seems to have made a big difference for both of you. 

"My husband has agreed to go to the Liver Unit and is really trying to cut down to about five cans a day..."

Thanks for that excellent news! Keep us filled in on how it goes, maybe there's a Moderation Management meeting in the area he could plug into? NB, he might well run into the Alcohol Deprivation Effect. I did when I tapered from 12 beers per night down to 3 over a couple of weeks. I shot back up to 15, then dropped down a bit before I started TSM. So don't be taken aback, it does happen, though I'm not saying it will in this case. 

I'm hoping that his liver will be in good enough shape to start Nalmefene or Naltrexone, if he isn't willing to go to detox again, but one step at a time. Just the change in his attitude is wonderful news indeed!

Best luck to you too with backing off on the benzos! Good move, Tess!

Thanks. I don't know how good/bad the guidelines are for starting naltrexone or nalmefene. I imagine that this will be discussed at the Liver Clinic.

I don't think his liver is in very good shape, since our GP was very reluctant to give him metformin for the diabetes, but since he only takes it occasionally (don't laugh) I doubt if the GP needs to worry about that.

Generally, when looking at the risks of taking naltrexone vs the risks that come with continued drinking, naltrexone carries the lower risk by far. From what I've read, where there's liver damage, the active form of Naltrexone isn't broken down as quickly (to 6-beta-naltrexol). But yes, the docs must be consulted first. Getting the drinking down/eliminated will help with the diabetes too, of course. 

Because the person is Child-Pugh C, it is unlikely that naltrexone would be given, because of the possible impact on the liver. Naltrexone although licensed in the UK, is classified as an anti-craving medication like Campral. Which of course it is not, but the medical profession will follow the guidelines. They don't have to, but if something were to go wrong, it wouldn't be good for them, so most wouldn't risk it.

Most people on here who have taken naltrexone have bought it online, either from abroad or with one of those online private consultations.

If you go to the NHS, you will get prescribed Nalmefene/Selincro, because it is licensed and the guidelines are pretty much the same as for naltrexone in the US. Also because it doesn't really have any impact on the liver, the doctors are far more likely to prescribe it.

Correct, RHGB.

I fear that naltrexone nor nalmefene are an option on the NHS for Tess's husband, at least not unless the prescribing physician is very open minded and/or has seen these medicaitons working for people.

It's the NICE guidelines, you see.  That is what will likely cause a problem.

For naltrexone, there appears to be significant current liver damage AND the person isn't currently abstinent so falls outside current guidelines.

For nalmefene, Tess's husband drinks too much AND is likely to be at risk from withdrawal symptoms.  On both those points, he does not meet the NICE guideliness for prescribing nalmefene.

That isn't to say that these medicines won't be of long term benefit, as in drinking much less and eventual abstinence, but that the he falls outside the initial prescribing guidelines.

Add to this that he finds it dificult to stick to a routine of tablet taking, I can't imagine that a physician will be willing to take the risk.....

Sorry, typo... that of course meant to say 'are NOT and option in the first sentence

Well, at least there is some progress as Tess's husband has cut back and Tess has come to a new understanding of the situation, which seems to have been beneficial to all concerned. New information may yield new opportunities and options to move things forward.

Oh agreed, just didn't want Tess getting too enthusiastic about the possibility of medication for him, and then get her hopes dashed..

You would think that if they were worried about withdrawal symptoms, they could supply a benzo to go with nalmefene, even if it was anxiety level doses.

The trouble is, there has to be a want and I still get the impression that there is a feeling of 'you brought this upon yourself', so I don't feel obliged to got out on a limb to sort it.

Yes, and a very good point. 

Yes, RHGB. The level of ignorance in the medical community about the realities of AUD generates massive damage on a daily basis. The word is getting out and attitudes are slowly changing, but leagues and leagues to go...

That would be the common sense thing to do, RHGB  

Just wish there was some common sense in these alochol recovery organisations!!  It certainly appears to be lacking in a lot of their mind-boggling decisions....

I'm not too enthusiastic about any possibilities, if I'm honest, but just the fact that he's agreed to go to the Liver Clinic is a huge step forward for him. And he really has cut down his drinking, from 12 cans plus, to five or six.

Tomorrow, of course, he might have a bad day and just go and get twelve cans AND some whisky. I think I'm playing a waiting game here and naturally I'd like a good outcome, but I am very well awarre that it may, in fact, be too late. I'll keep you posted.

Thanks for your kind words!  Yes, I've done plenty of stupid things while drunk.  I hope I haven't wrecked my reputation already.  I have got a prescription for naltrexone and fully intend to work the sinclair method for all it's worth!  When my energy comes back, I fully intend to show everybody at uni/work that I CAN and will do whatever it takes to pick up any slack and change myself and show them.  these people don't know me - I'm new here and in this city. I moved for the opportunity and I've been practically skating on thin ice since I got here!  I'm changing that pronto.  I don't want to fail.  I've given up too much to get here and want to make this work.  

My best wishes to you too!! x

sinclair method is great! Best of luck!!

Bronize,  you have a fantastic attitude and conviction to get yourself healthy again !  Be patient and relentless with the process and you will see huge results from your efforts with the sinclair method !  Best to you.

Hi tess and thanks for the advice. I have now booked an appointment with an agency. Its not for a while but it's something. Will also be joining a new doctor soon so will see whats available. I often find it funny that smokers that wish to quit get all sorts of help but with drinking the options are quite limited. 

 

It's an old attitude that we have to overcome, but things are indeed changing, Tre. Have a look too at this info from Joanna:

https://patient.info/forums/discuss/nhs-primary-care-alcohol-teams-512652

Might give you an edge and speed things along if one were available in your area.

Best luck!

I like your attitude, Bronize! 

Stick with us and keep us updated on how it's going. I think things are going to improve for you in short order!

Agree with ADE...you can do this Bronize. Stay strong and stay focused. Wishing you all the best in a new life free from the poison. Stay safe, sane, sober and listen to Joanna. X