Naltrexone/Nalmefene (Selincro)/The Sinclair Method Hints and Tips

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Since many of you are now either using, or considering using, naltrexone or nalmefene (Selincro) as per The Sinclair Method, I recently wrote the following short 'hints and tips' article that provide a guide to working with the medication, therefore helping to ensure the method is as smooth as possible for you.

A second link is also included at the end of the article, specifically for those in the UK.  Hopefully, this will help you navigate requesting a consultation and assessment from the NHS, to see if this medication might be suitable for you.

Many thanks, as always, to Paul Turner for fact-checking this article with me, and also to our moderator for pre-approving the link!


Sinclair Method UK

20 likes, 140 replies

140 Replies

  • Posted

    Great post Joanne. I am going to refer this article and link to some people I have in mind. Very interesting and relevant for many people. Thanks. Robin
    • Posted

      I'll second that! Very useful indeed. 

      "1-to-many" for those that have had "one too many"!

      Well done, Joanna and C3E, with thanks to Paul and the Patient mods!

  • Posted

    So according to this article...both pills work 10 to 12 hours.

    ​So if I would have to resort to this treatment...I think my suggestion of taking upon wakening would avoid me from skipping the pill.

    cause if I wake at 8am...drink at 10....till would cover the 10-12 hours...and it appears it would be the only way I would be assured to take the pill EVERY DAY. 

    ​I hope I never binge again...but if I ever did....I would have to use this method..which is why I am interested.

    • Posted

      I think you basically have it correct, Misssy. You would likely still feel the relaxing/warm and fuzzy feeling from the alcohol, but the Naltrexone would stop your brain from "remembering" that drinking results in the endorphin release that it's going for. The relaxing feeling is caused by the action of alcohol on the GABA and Glutamate receptors, I understand you know something of that already. I think your "Plan B" is a good one, for you want to ensure that if you have a sip, that you've got protection from the endorphins solidly in place. If you drink beyond the 12 hours, you would need to take another dose and wait an hour before drinking any more. 
    • Posted

      If you ever needed the method, then you could reach out to me and I would work with you to help.

      I could show you literally 100's of messages, posts and emails, from people in your situation who have always found it difficult to stop once they begin. That is a binge, after all.

      But what each of these would tell you, is that once you give just a little bit of confidence in HOW the method should be worked, then the need to drink disappears after a few hours. 

      It has been clinically proven to work this particular way for almost 80% of those who tried it.  Instead of trying to 'fit' taking the pill around when you think you would take it based on fear of skipping the pill, you would need a little trust that getting started on a solid foundation as above would mean that you can lose that fear of skipping the pill very quickly.

  • Posted

    Hi Joanna. Just going through email and came across this post that is very useful for me as seeing doctor Wednesday. I think I've previously explained that I have been taking naltrexone, which was prescribed to me whilst in rehab over a year ago. Stopped taking them after a few months as they weren't working for me,but since joining this site, I've started taking the remaining ones I had left correctly now. And it has definately worked for me. However I only have 2 left so I have to ask my new NHS doctor for a new prescription. The above link I will print out but if there is anything else could you send it to me please. Obviously I don't want to go loaded with pages of stuff as she won't have the time to read it!

    Thank you for all the help and advice you(and Paul) have given me in the last few months 😀

  • Posted

    Actually Joanna, I've just read that link, which is very useful for me, but not for my GP ! Could you send me a suitable simple link to show my doctor please x
  • Posted

    Me again..ha ha !!! I've just found a link you sent to someone 6 days ago, who was also going to her gp for it. So it's ok as I can print that out.

    p.s. Not drinking at the mo and don't intend to until the weekend. Going to go to the gym around tea time so stop any cravings x

    • Posted

      I've been away for the past 4 days and didn't have much of an internet access.

      There are printable resources to hand to your doctor on both the C Three Europe and C Three Foundation Website (for either you or anyone else who might be reading).


  • Posted

    Hi Joanna,

    I'm really at a loss with what to do.  I was perscibed Silencro by our local alchol support centre nearly 2 years ago.  I live on an island near the UK where alcohol help is primative and no one seems that knowlegable.  I had no idea what to expect from the drug but seem to recall being told to take a full tablet daily.  I lasted 2 days.  I get the worst side affects, it's like living in a nightmare.  I totally trip, hear things that arent there, see things that arent there, the insomnia as well makes it really awful, I can't function, I can't work out what's real, I get all the cramp and feel incredibly anxious and confused.  I couldnt possibly drive!  I've tried many times to start taking it, to the extent over the years that I've got through nearly all the pills I was given to start with (which were quite a lot!)  I've even tried half dose but it's so bad I reget taking it and have considered inducing vomit to get rid of the horrendous feeling I get.  I have 3 children and a hotel I run and own and a husband and dog.  I'm 40 next year and drink an awful lot.  My question is that I'm keen to do the Sinclair Method but not sure which pills to have with it.  Is Nalmefeme different because as I understand you only take it before drinking?  Does that mean the side effects are not so bad because what I've been trying to do is get used to the Silencro but serviously, I have to admit defeat.  Facing day 3 of living in a nightmare unable to sleep or look after myself is just too bad for me to be able to cope with.  I would love to talk to someone about the differances in medications but I don't trust anyone on the island where I live to actually have a clue what they're talking about!  Any tips would be so gratefully received beauce this had really been worrying me for years!

    Very kindest regards xx

    • Posted

      Hi Alexandra,

      Your experiences with Selincro are no uncommon.  The side effects  can be bad, but reduce and then disappear once you are on about the 6-8th tablet.  Then, the long term benefits far outweight that short term gain.

      If you really can't get through the side effects then I would suggest that you go back to the prescriber, explain the sitiation and ask for a medication called naltrexone instead.

      There are 2 medications that can be used for The Sinclair Method - nalmefene (Selincro) and naltrexone.  They both do the same thing in blocking the endorphins that are released when you drink 1 or 2 hours later.

      In the UK, naltrexone is approved for treating alcohol use disorder, but usually only to help with cravings when someone has already stopped drinking.  But if you have a conversation with the prescriber and point out that naltrexone and Selincro are pretty much the same medications (both are called opioid antagonist medications) then you may be able to swap - the advantage being that naltrexone seems to be so well tolerated by the vast majority of people and does not appear to involved the same intensity of side effects.

      The alcohol support people will wish to do some blood tests firsts no doubt, as naltrexone should not be taken by those with liver issues.

      Let me know how you get on, and if you need anything else, please feel free to PM me.



  • Posted

    Unfortunately for me, Camprel and Naltrexone never worked for me, I would drink wright through it. I'm not saying that these medications don't work, I'm saying they didn't work for me. It was imprtant for me however, to identify the reasons that I drank alcohol in the first place and there we're several. To determine this " began seeing a Psychologist which helped me significantly. Realizing the reasoning behind my alcohol abuse and attending meetings regularly was my answer to my addiction to alcohol. Good lick to you JoannaC3Europe. 

    • Posted

      Keep it in mind for the future, dreamweaver. The abstinence approach works well for about 10% of people with Alcohol Use Disorder, the remainder will relapse at least once within 4 years of starting abstinence, so you might see that it can be good to have a "Plan B" to deploy should you run into problems. If you're one of those that manage ok with abstinence, just keep doing that and you'll be fine. If not, then it's good to be aware of the available options. 

      There's a way of taking Naltrexone while drinking (an hour before your first drink) that, over a period of months, erases the urge to drink. It basically uses the drink against itself. This differs from the traditional manner of using Naltrexone, wherein you take it every day while abstinent. Just this one change of taking the pill only on drinking days and not on dry days makes a huge difference. The traditional method doesn't seem to work any better than placebo over the long run. Taking it an hour before drinking, only on drinking days suddenly ups the success rate to around 80%. 

      Again, if you're having success with straight abstinence and therapy/meetings, etc, all is well and you should keep that up. I just wanted you to understand that there's a different way of using Naltrexone that can be very effective indeed, should the need arise.

    • Posted


      I am a doctor in New Zealand, can you pass me the details of any reliable online source for buying naltrexone, that I can use, sincair method unknown largely here.

    • Posted

      It is not in keepig with the terms of conditions of this website to encourage online pharmacies.  In the UK (where this website is based) naltrexone is a prescription-only medication so seeking online alternatives are against strict UK regulations.

      What I would suggest, though, in the first instance, is that you check the New Zealand customs regulations with regards to the importing of this medication.  It was certainly the case that reputable companies would not look to ship to New Zealand due to strict customs regulations.

    • Posted

      From my experience, the reputable online companies are the ones that will say 'NO' we can't deliver to New Zealand.

      The less reputable are the ones who say yes they can, knowing full well that once they have your money, if your package gets stopped at the border, then that is tough. 

      There are some doctors in Australia who understand TSM.  Is that a possibility for you?  (not sure if the customs rules are as strict for Australia to New Zealand post?)

    • Posted

      I have a slightly different view, having ordered prescription only meds from abroad. It is not illegal to import prescription only meds (certainly not UK wise). I have ordered Campral from Europe and North America.

      It is not illegal for me to be in posession of them without a prescription.

      However, benzos, such as diazepam, that are a controlled substance and a class c drug, are both illegal to import and/or be in the posession of without a valid doctor's prescription.

      I could easily get Naltrexone, from a well known a couple of pharmacies in the States, with a choice of Nodict or Naltima, I would obviously go for the latter.

      It is an unfortunate symptom of the lack of support with the UK system that drives people to do this. They should be able to go to their GP and say 'please help me', but for most people they are turned away. I have been there myself, as you know. It is the fault of the system not the person, that drives people to take alternative action.

      PS The Campral I got from Europe, I was able to choose the brand makers and I got exactly the same stuff that the ARC eventually gave me.

    • Posted

      Whilst I agree with absolutely everything you say here, and yes, I have ordered naltrexone from abroad too (after my initial prescriptions being from a UK private doctor), people from countries such as Ireland, Itally, Australia and New Zealand can easily fall victim to some less resectable online pharmacies who take the money and run because they know that the delivery will never be made due to very strict customs regulations but they don't have to provide a refund if that happens.

      When I need naltrexone now (maybe once every 18 months I need to order 30 tablets) I have no choice but to order from abroad because I (according to the UK medical authorities) no longer have a 'drink problem' and so don't meet the criteria for getting the medication on prescription in the UK.  Sure, I no longer do have a drink problem.  But if I were to drink without the medication on occasions, then the evidence shows that I would most likely learn the addictive behaviour all over again.  I don't want to ever take that chance of going backwards, especially when I do take a drink it is sometimes to 'buddy' those beginning TSM.  I am helping loved ones understand that it is constructive to drink on the naltrexone because I will take a drink with their loved one on skype.  But I need to protect myself by taking the naltrexone first, just like their loved ones do.  If this is required to help loved ones, then I will do it with them.  Otherwise, I barely drink at all anymore.

      How totally daft is it that I can't get access to a £20 NHS cost of generic naltrexone one per year for 28 tablets, just because according to their criteria, I don't quailify for it as I show no sign of alcohol misuse anymore? 

      The system is backwards.

    • Posted


      We live in NZ.  My son is a 24 yr old alcoholic.  He has been prescribed Naltrexone - but not in the Sinclair Method.  He and we would like him to be on TSM.  We are really taking a DIY approach right now.  2 weeks - so far so good.  

      However, one thing the studies show is that TSM should be part of an overall support program.

      Do you know of any patient resources, Doctors, or therapists, counselors, etc who work with patients on this method in New Zealand

      We would be ost grateful for any information.

      Thank you,


    • Posted

      Hi Jennifer,

      I don't know of any in New Zealand, no.  But I can tell you that many of us did TSM without any real help at all.  The science is the science and as long as someone is compliant, the treatment should work.

      Having said that, I am a counsellor and can provide support for your son via Skype if that is an option for him?

      If so, google 'C3 Foundation Europe' and then he can get in touch with me via the contact page on the website.

      Kind Regards


    • Posted

      Jennifer, I found a doctor that uses TSM through the C3 foundation. I am on TSM and after 30 years of pretty good beer drinking i can say after 2 months my consumption has decreased 50%. What I have also learned is that TSM is effective on its own, without therapy. The MD a psychiatrist I saw prescribed me 12 months of naltrexone with no mandatory follow up. He is 3 hrs away and did not see the need to drag me back. He only asked for a updated phone call. TSM if affective as a stand alone. If your son has other issues he may need counseling but if the only issue is addiction to alcohol, TSM may be all he needs. I see my results in two months and 4 days already w/o alcohol is extremely rare for me. Good luck, I have 100% confidence this is going to work for me.

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