Nalmefene

Campral is not designed to drink with. It is totally different to Selincro. Campral controls cravings so the number of pills a day is designed to cover a long enough period to ensure you are always getting the relief from cravings that it gives (8 hours per pill).

Any deviation from abstinence is a risk for somebody who has alcohol addiction UNLESS they use Nalmefene or Naltrexone to block the opioid receptors.

Persist with the Selincro Flat9 It can take 2-3 months to achieve it's aim.

Come to think of it Paul, what would be the likely risk involved, for someone not inclined to get DT's, to not-take camprasal for maybe 2 doses, have a moderate amount of drinks and then return to their dosage as recommended?

Regards,

b9 :-)

 

By DTs I suspect you mean withdrawal symptoms. DTs are a serious medical condition in which people suffer hallucinations and can die. The vast majority of people suffering shakiness, sweating, agitation and all the other alcohol withdrawal symptoms don't get DTs. There is a tendency for people to think that any shakiness is DTs ::

There is no connection between taking campral and drinking. It has no effect on the level of drinking you do if you DO drink. It doesn't have a reaction with alcohol. All it does is controls cravings for people who want to remain abstinent. You seem to see Campral as similar to Nalmefene. It is not the same at all

 

Hi Paul,

yes, by DT's i meant delerium tremens, which I thought meant severe shakes and other symptoms associated with sudden withdrawl from heavy alcohol use, but it seems that it refers to more serious cases than that. Really I meant that the people that have significant withdrawl difficulties from drinking, would appear to be the ones that generally have the worst of the undesirable side effects that can be experienced in the first week of taking nalmefene, not that it matters a whole lot after the first week's side-effects are over with!

I'm now two and a half weeks taking selincro every day and intend to continue taking it for at least the three months, being the duration of time that you mentioned it can take to fully normalise one's desire for drink. I am sincerely hoping that to be the case.

As to camprasal, I don't think that it works like nalmefene or naltrexone but apparently does also work with the opioid receptors, from what i can remember (having read about a month ago) not blocking but pacifying them as to their need for stimulation, or something like that?

Whatever it is that it does, I just was wondering, if after the three months on selincro I happen to be one of the few that it doesn't manage to reduce craving for, could camprasal be taken to remain off drink (i know you're supposed to be already off it, that's not a problem, i can stay off a few days) and occassionally [not of course recommended!] perhaps once a month, not take the medication for say a day, so as to have a few drinks and then next day, to resume taking the medication and abstinence? I know that is not the ideal usage of the drug, but from what you say and from what i read, i can't see any great problem with that type of approach?

To re-emphasise, I hope to be one of the success-stories from nalmefene/selincro usage and am only asking about camprasal as a plan B if  the nalmefene doesn't work for me.

I came across a lot of praise for camprasal (4.5 out of 5, type of thing, from around 80 reviews, i forget the exact figures) and, only for the desire to be able to continue having a drink, I would most likely be trying out that drug now, especially since my doctor was recommending it, though he wasn;t against nalmefene (had no previous patient on it).

To finish this extended mail, no offence whatsoever, but what inspires you so much about nalmefene having, apparently,not used it and since in certain trials it seems that the placebo users had similar success/failure rates? I'm hoping that your reply will be in relation to all those people that you have seen cured of their alcohol problems from adhering to it and perhaps some other reassuring sources!

Many thanks again Paul, best regards and keep up the excellent work!

Flat9

i.e. apparently (having) not used it oneself, how come so sure of it's effectiveness?

I am an independent alcohol treatment practitioner, Flat9. A number of my clients are using The Sinclair Method (with Nalmefene) and the results are beyond anything achieved before. In Finland, they have a 78% success rate (where success is either a return to controlled drinking or a decision to stop drinking altogether after finding out that the desire is no longer there.)

It is the best treatment available in the world today.

Hi thanks for your info.

have taken my second tablet today . To be honest I had no plan or want to drink today , but as I am seeing my therapist tomorrow I thought I would take it 2 hours before drinking, which I did . Now 3 hours later I am still drinking , but still on my first bottle of wine , which for me is good . But I still keep thinking, once that is gone I can walk up the shop and get more .

so far the tablet has slowed me down , but not taken the want for more away. Is it just too early to expect that to happen ? 

 

2-3 months is what the research showed to be the average time it took for Nalmefene to reach the point of 'pharmacological extinction' (the point where you have unlearned your addiction. You still have to take a pill before drinking after this point, though, as you could very easily relearn the addiction of you drank unprotected.

Thank you so much. I feel like this forum is going to help as much as the tablet may. It's just good to hear other people talking about how they are coping with things, and I think long term I now have the confidence to battle through this.

it may take a while and I am sure there will be good days and bad days.but feeling much more positive. 

Most of us who drink too much have personal demons to battle , big or small they are our on demons. Which most of my family and friends don't seem to understand, they just think , we'll just stop 😔

Thanks again for the advice Paul, much appreciated. My reason for asking about camprasal was due to the fact that one of the main reasons that I'm now 3 weeks taking selincro is due to my partner having a problem with my drinking, which came to a head recently, of course i also feel the need to curtail it myself.

In being asked lately, how is it going with the medication, I said that it seems to be going okay, but really I'm not as yet finding much if any a reduction in my desire to drink excessively. I'm hoping that things will peter-out over the next couple of months and that I'll then be able to reply: 'back to the way i was before i had my first drink'. But am a bit worried that i might be one of the 22% (Finland statistics) that it didn't happen to work for.

I guess I'll have to wait and see what happens, but you can perhaps understand why i was looking into the camprasal avenue, to see what might be the case if i had to try that out, after fully trying out the nalmefene course of treatment. As said previously, i will stick with nalmefene for at least the 3 months and probably another month or two, even if it then still does not appear to be reducing my tendency towards over indulgence.

I guess you won't be answering the question as to taking a day off camprasal to indulge and the go back on the medication, but i suppose. if it comes to that, i'll find out myself through experimentation.

As to the nalmefene and the half-life business, i started drinking today at around 1pm and have been drinking at a relaxed rate through the course of the day and now into the early hours (almost 2am now). Should i have taken another tab at 12 midnight, or am i okay until the next day? 

Also, I've seen a number of mentions of not taking nalmefene if you're not going to subsequently drink. However, as happened recently, I thought that i would be going for drinks at a particular time, took the pill, and then it turned out that I wasn't going for a drink, situation changed. Should one still get a drink to complement the tablet that has been taken or is it okay not to have any alcohol at that point?

Many thanks again for your much appreciated assistance,

regards,

very flat9..

 

You are misunderstanding Campral, Flat9. It is not designed to take on days you do or do not drink, with the aim of getting some sort of reduction in what you drink. You take it and it helps you to abstain totally by reducing the craving. You are on the best drug (Selincro) for what you are trying to do (controlled drinking).

If you are finding that your drinking is not reducing as much as you would like, you may be drinking too soon after taking it (recommendation is 90 minutes to 2 hours after taking the tablet but some people need the full two hours or the first couple of drinks will slip through while you are unprotected and your opioid receptors will get the reward that you are trying to deprive them of.) The same applies if you drink after the drug is no longer active. This is 8-11 hours (although, again, this varies and it is best to regard it as 8). That means that you have a six hour window in which to drink, only.

Now it is obvious why Selincro isn't working for you It WILL work if used properly. One of the guidelines is that it is only prescribed with 'psycho-social' support. We don't delve into people's minds but we DO offer support with regard to taking the pill and all the issues that need to be considered. Unfortunately, the knowledge of this drug among health professionals and alcohol counsellors is extremely limited and, it appears, very few have bothered to find out enough information to pass to their patients/clients.

I can't tell you to take a second pill because the recommedation is one per day. However, I can tell you that, within the trials, they gave multiple times the daily dose to subjects with no adverse reactions.

If you take a pill and then don't drink, that is no issue. The pill just won't do anything. It is not essential to have a drink after taking a pill. However, it IS essential that you don't have a drink without a pill or outside the time period when the drug is active.

Stick to drinking within the 6 hour window and I am pretty sure you will see a vast difference. We have had a number of clients who have had the same issues as you, and this is the first thing we discuss with them. In EVERY case, an adjustment of the time they leave between the pill and the first drink and the length of time they drink for (ensuring they are still protected by the pill) has resulted in a large reduction in drinking.

I believe that the 22% failure rate in Finland is down to people not persisting with taking the drug because they didn't like the side-effects or not sticking rigidly to the time period in which the drug is active. We haven't seen it fail in ANYBODY who used it the correct way.

You are misunderstanding Campral, Flat9. It is not designed to take on days you do or do not drink, with the aim of getting some sort of reduction in what you drink. You take it and it helps you to abstain totally by reducing the craving. You are on the best drug (Selincro) for what you are trying to do (controlled drinking).

If you are finding that your drinking is not reducing as much as you would like, you may be drinking too soon after taking it (recommendation is 90 minutes to 2 hours after taking the tablet but some people need the full two hours or the first couple of drinks will slip through while you are unprotected and your opioid receptors will get the reward that you are trying to deprive them of.) The same applies if you drink after the drug is no longer active. This is 8-11 hours (although, again, this varies and it is best to regard it as 8). That means that you have a six hour window in which to drink, only.

Now it is obvious why Selincro isn't working for you It WILL work if used properly. One of the guidelines is that it is only prescribed with 'psycho-social' support. We don't delve into people's minds but we DO offer support with regard to taking the pill and all the issues that need to be considered. Unfortunately, the knowledge of this drug among health professionals and alcohol counsellors is extremely limited and, it appears, very few have bothered to find out enough information to pass to their patients/clients.

I can't tell you to take a second pill because the recommedation is one per day. However, I can tell you that, within the trials, they gave multiple times the daily dose to subjects with no adverse reactions.

If you take a pill and then don't drink, that is no issue. The pill just won't do anything. It is not essential to have a drink after taking a pill. However, it IS essential that you don't have a drink without a pill or outside the time period when the drug is active.

Stick to drinking within the 6 hour window and I am pretty sure you will see a vast difference. We have had a number of clients who have had the same issues as you, and this is the first thing we discuss with them. In EVERY case, an adjustment of the time they leave between the pill and the first drink and the length of time they drink for (ensuring they are still protected by the pill) has resulted in a large reduction in drinking.

I believe that the 22% failure rate in Finland is down to people not persisting with taking the drug because they didn't like the side-effects or not sticking rigidly to the time period in which the drug is active. We haven't seen it fail in ANYBODY who used it the correct way.

Ah , that's what I thought , I did not plan to drink but thought I should take a tablet just to see how I got on with it because I am seeing my therapist tomorrow . I have now drunk nearly all my bottle of wine but want to go to the shop for more just so I can test I don't need it 😱

As Paul thankfully said, once you give sufficient time, taking the tablet preferably 2 hours before drinking, second best: one and a half hours and minimal one hour, thereby giving enough time for nalmafene to kick-in ( it's unfortunate we can't breathalyse/monitor ourselves to see what level of the drug is active in our systems, maybe in the future..).

Then apparently, 8 to 11 hours after taking it, we can consider it to no longer be effective in our bodies. At that point, if we wish to keep drinking and still be protected by nalmefene, we should (even though not publicised by Paul or manufacturers of Selincro) take another tab, i think probably 8-9.5 hours after the first would do, although each person is different, of course! :-) 

I have not as yet been going by the necessity to use another pill if drinking longer than 8 hours or so (having only become fully aware of this in last couple of days), and so cannot give accurate overall  impressions as to the effectiveness of the drug,but will do soon.

However, best of luck Kathryn in giving it a go, it's definitely worth giving it a shot and our very best efforts!

Cheers,

Flat9

*Not exactly what Paul said (as to the 'hour minimum' ) but more or less the general jist.. Also forgot to mention the need to stick at it for two-three months in order to give it time to, apparently, work fully.

I'm only 3 weeks into using it and have so far, mostly at weekends, been drinking for extended periods on just one tablet, i should have taken a second after 8-9 hours, will do next time.

If it does what it says on the tin, as I suspect it may well do, it will be well worth any side effects or inconveniences experienced. I'll relate how things go over the next few weeks,

Best wishes,

Flat9

Hi Paul. Sorry to interrupt this's discussion - but I lost my way abit.  Decided to give Nalmefene another go. Tuesday watched one little pill DVD. Wednesday got brave and took 1 Nalmefene waited 2 hours ( just to be sure) but had already started to feel odd. Poured out lovely glass of white  wine looked nice tasted different unbelievable! Where's my buzz ???? Spent rest pay in zombie land no more wine -too ill. Yesterday same procedure but went shopping with husband called in nice pub for lunch,ordered lovely glass of wine despite feeling rubbish!!! Looked magic tasted o k  no hit the spot though- so disappointing.Don't think I will take pill today - want to feel normal not drunk though ! ! !  Gone off smoking to is that normal ???

There are some strange side effects the first few times you take Nalmefene. They do wear off and it is worth persisting. People report them subsiding over the first week if they take the pill daily and being gone after that.

Susan, the way nalmefene works is that it is SUPPOSED to block the 'buzz'.

Without the buzz hitting the spot, the compulsion to continue drinking is gradually unlearned.  Your brain will slowly adapt to no longer craving this buzz so much.  Eventually, you should be in a position to either take or leave your drink.

A drinker without a drink problem does not crave that buzz either - they enjoy the taste of the drink but after a couple of drinks often stop.  That ability to stop is what people like you and me are often missing because our brain has adapted to needing more and more of the buzz - ie craving.

When you take nalmefene, the receptors in the brain are blocked to the buzz.  They respond by creating lots more receptors in an effort to get the buzz, but they do not succeed because the block is too 'big'.

However, if you then do not take nalmefene and drink the buzz will be bigger because the endorphins are hitting many, many more receptors.

This is not ideal and is only serving to reinforce your addiction to the buzz even further, and it could serve to make your addiction even harder to break.

If you are not committed to taking the nalmefene as prescribed, then please discuss with your doctor about stopping taking it.  It is not helpful to you if you take it sometimes, then don't take it sometimes.  If you are not completely compliant to taking it, you will not be one of the 78% that this method works for.

Put it this way, a course of antibiotics has to be taken AS PRESCRIBED and to the end of the course to get a recovery from an infection.  The same is true of nalmefene.  To get a good, solid recovery you MUST take it as prescribed - which is 1-2 hours before EVERY drinking session - and not just on those drinking sessions where you feel like taking it.

You must be committed to taking the tablet before EVERY single drinking session begins.  To not do so is only hindering your chances of finding success with it.

 

I could not agree more with you Jonanna. 100% of the clients we have used it with, it has worked for. There have been blips, there have been occasions where we have needed to suggest that they leave it two hours after taking a pill before they drink because, in their case, their body takes that long before it has fully processed the drug, but these adjustments have worked in every single case.

I believe that the reason for the 78% success rate (rather than 100%) is that some give up and don't persist through the early side effects and some are not disciplined enough to ensure that they are protected for EVERY drink they have.

Also, some drink AFTER the active period of the drug. Nalmefene is active in the body for 8-11 hours and taking a pill at 11am may not be enough if a person is having another drink at 8pm or later.

I know you probably know all this Joanna, I am saying it for the benefit of others who may be reading it too

I am guessing that the C3 after your name is related to the C3 Foundation

Sorry, I meant 'Joanna' When are we going to able to edit our own posts moderator?

Yes, the same.  At least I am getting my name known for good things now, and not all the falling about stupid and downright embarrasing (not to mention dangerous!) things I used to get up to in drink 

We really must manage to pin down some time when we can chat together properly.....  I have loved to be reading how you are so informed on the medication and method, it's wonderful.

Absolutely agreed on the 78% success rate.  In my experience, it's all down to the compliance issue.  I am SO insistent on getting this drummed into people from day one.  Of course, it doesn't really help that often doctors are not completely knowledgeable on how important it is.  I have a horrible fear that in another 6-12 months, doctors start believing it isn't working because they are getting patients reporting that back to them because they weren't initially told how VERY important compliance is, and then stop prescribing it.

In my opinion, the initial press reports about nalmefene didn't help either.  I even took part in a Canadian (CBC) news report about it.  I went to London to be interviewed by them a week or so prior to the official announcement in November, spent about 90 minutes being interviewed on film by them, and then when the actual report made it onto the news, my bit was about a minute and they completely focused on calling it the anti-binge drinking pill!!  I was so upset that they had totally mis-represented it as a miracle pill that needs no effort.  Like any recovery, it does need a clear commitment to wanting to reduce drinking and commitment to compliance.

You are doing really great work on here, Paul!

 

Thanks for the nice comments, Joanna

You are right about doctors prescribing it and then believing it doesn't work. That is already happening because some are prescribing it and expecting it to help their patients abstain totally. They just don't get the concept and the guidelines given for Nalmefene don't help too much. Most doctors prescribing Nalmefene have never even heard of The Sinclair Method.

I am sending you a private message with my contact details.

 

Hi joanna.Thanks for starting me off on this journey. I hope I don't fail.feeling quite optimistic today after reading your replys. Still seem to want to know more about Nalmefene though.After 3 months this medication -to keep the demon out of my brain will i have to continue taking Nalmefene for the rest of nmy life or will  my addiction to Alcohol be gone

Ipad just went funny on me. I hope you received first part of my question if not let me know.the other question was -will I ever taste food again, enjoy a cigarette feel normal etc.Thanks in anticipation of your reply.Susan

You continue to take one nalmefene tablet before every drinking session, for the rest of your life.  If you do not, then the buzz will return and your brain will 'relearn' the addiction all over again.

This is not as daunting as it initial seems though - when the extinction of the cravings have happened (which may take more than 3 months, especially if you don't remain compliant to how it should be taken) the importance of alcohol becomes less and less in your life.  Though you may not be able to imagine a time when you are driven by alcohol, it can and does happen.  So the end result is that you are no longer obsessed by either drinking or the thought of drinking.

Therefore, if you only drink say one per month for example, then that is only 12 tablets per year!

In terms of food, yes you absolutely will taste food again!  This is just part of the initial side effects for you.  I am not sure about a cigarette because I don't smoke myself.  Maybe someone else who smokes may be able to answer that?

There is lots of information about Selincro on the Lundbeck website.  Lundbeck are the manufacturers, so you will know it is accurate information.

And also lots of information on the C Three Europe website too.

Read as much as you can about it - knowledge of what is happening and why it works will only make your recovery smoother

 

Thanks 

Hi Joanna   Some very interesting remarks you have made . So I have to take a tablet for the rest of my life 😒 I thought it was going to retrain my brain to be just like my friends . A few drinks and then I would know when to stop . I have had 14 tablets prescribed which have lasted me just over a month and just stared second course , but I have been away for the weekend with friends and taken a tablet every day just to be in the safe side . Also some days I am taking a tablet just incase I may drink and then drink because I have taken the tablet , it's almost like giving me permission to drink when I wasn't going to , my head is in a whirl , I don't know what to do anymore 😞

It DOES retrain your receptors, Kathryn. But after doing that, you are back to where you were before you started drinking. You STILL have that vulnerability. Just as you got into difficulty the first time, you could get into difficulty again if you drank without the protection of the medication. It's better to always take a pill before driking.

As you say, sometimes, you may take a pill in case you drink. It doesn't matter if you take one and then don't drink. It won't do any harm. You don't HAVE TO have a drink because you took a pill. It is most important that you don't drink without a pill.