on TSM but relapsed

Thanks Joana

I was without protection twice beaucse i havent followed the golden rule to have a Nal on me, i just was overwhelmed by the old craving. I dont have alot of suport available though will take care extra care to always have a pill on me ad take it once due

If you are willing to send me your address by PM, then I can send you our a C3 pillholder to put on your key ring.  It really helps to prevent that happening.

Also, it might well be worth you getting back into the swing of things by taking the tablet and drinking after the time have passed a few times during the next week.  You only need to have a minimal amount of alcohol to release the endorphins that the nal blocks, and I think it will help you to get back into the habit of pill, wait, drink on your terms.

Thank you so much Joanna, i will get myself a sixpack and start

hi Phil..i join late and notice how many good replies...go steady and not too heavy drinking and I think that you can do it! Robin

Hi Joanna

Thought I'd jump in here as have a query with TSM. Am about 11 weeks in now and really pleased with the ways it's going. I don't fancy alcohol much lately , in fact taking the pill followed by alcohol 2 hrs later is beginning to feel now a bit like a medicinal process which I guess it is LOL I take a pill etc 2-3 times a week mainly because it's still early days and because I think I should to keep the process going regularly . Is it too soon to have longer gaps do you think say a week or so. The other issue would be return of side effects, I would imagine people who have reached the point of only occasionally taking a pill would have this issue. Does complete pharmalogical extinction mean you would no longer have the craving/desire to drink alcohol at all ?

Glad things are progressing well for you, Nat

Yes, it's fine to look at each day as a 'do I or do I not feel like drinking?' day.  When you don't feel like drinking, then this is how you will get days going into weeks and eventually then months without thinking of drinking..... and then yes, one day in the future you will realise that you haven't thought of alcohol in the longest time and that would be extinction.

The only way to know if the side effects return would be to try it.  Some say they do, others don't seem affected.  If you are affected then this is where naltrexone seems to have the advantage over Selincro for many.  But of course, like always, everyone is different.  Cross that bridge when you come to it.  You might find that a drink every 2 weeks or something is the limit to which you can go without side effects again.

For me, if I go months without naltrexone now, I tend to get tired quicker.  But I can never tell if this the naltrexone, or the sedative effects of a couple of drinks and a good meal!

Thanks Robin, i will try my best

Hello Joanna

I chamged my tactics now. I dont wait for a week until the craving overwhelms me and than  take Nal. I got myself some booze home and take Nal every day and have a drink after one hour. I normally binge in frequencies of a week to 2 months. lets see how this attempt goes

thanks

Phil

That sounds good for the time being as it is reinforcing in your brain that you are in charge of when you drink!

As you are getting back on your feet and feel confident in the Nal compliance again, try switching back to the usual way of this method which is to only take the nal when you get a craving.

So, what you are doing is mostly just a short term thing to get you back into the swing of compliance :-)

Hi Joanna

I have tried the one pill + 1 drink a day with the result that the craving after 4 days was out of control and i went for a bender. I struggle a lot with the habitual side of the drinking mainly  lonliness and boredom

Did you respond to the building cravings by taking the pill and waiting the hour before the bender started?

If you didn't take the pill again, you went non-compliant again.  That will partly be why the bender happened.  That first drink you had hit the increased number of opioid receptors in your brain and had a double-whammy effect of feeling super good which is hard to counter.  Taking the pill, then not taking the pill, is not going to benefit you in the long run.  This 'upregulation' of receptors happen and it will actually make your cravings worse in the long run.

If you remained compliant before the bender, then the bender likely happened before you drank too quickly and got drunk quickly, instead of answering the cravings with a few mindful drinks and then interrupted your usual habit by making a conscious decision to interrupt it.  It's hard to make conscious, rational decisions when you drink too quickly to knock it back and got yourself drunk.  That is easier to deal with because you can accept it happened, and learn from it.

Yes i Joanna I did take the pill and as you rightyl say i drank fast, i will stay the course ,,

Well done, taking the pill was the most important thing :-)

You now stand a chance of learning from the experience and figuring out what you might be able to change to prevent it next time.

Dear Joanna

I am 5 months in and it is as for most of us an up and down ride. In the moment i am down since i cant get control of the desire to get blind drunk, Nal doent take this way, once i start to drink i want to get drunk...its aweful

Yes, the naltrexone doesn't affect that.

What the nal does is work on weakening and eventually completely breaking down the pathway in the brain that has been strengthened by repeated drinking.  This pathway has become stronger than all the others, hence why your brain's first response to any trigger is alcohol.

That is ALL it does.

The rest is up to you to work on.  So for example, you may need to learn new coping techniques or to work on issues in your life that often cause a trigger.  So, that may include looking at why you have the desire to get blind drunk, and working on that.

The nal does stop the compulsion to continue drinking based on the endorphin rush that alcohol used to give you BUT it works much more smoothly if you work alongside it.

You don't want to be trying to change everything about the habitual side of your thinking/drinking overnight.  That would be unachievable.  Nobody ever ran a marathon without some careful training etc.  You need to look at chipping away at how you normally respond, that usually works best.

Your number 1 goal is compliance.  Remain compliant NO MATTER WHAT and your brain will eventually give up the alcohol.

Your number 2 goal is to make this process as smooth as you can by working with the tablet.  It won't make it happen any quicker as such, but, boy, it will make it feel much smoother overall.

I will also add that technically, although you started TSM 5 months ago, you are not actually 5 months in because you went on a couple of binges without the protection of the tablet, and this sets your progress back significantly.

Thanks Joanna, I am a fighter,,,will get back on my feet

Hi phil...keep fighting the fight. I have seen you struggle but the important thing is you keep trying...never give in to this horrible condition as you know it will take us down, age us quicker and make life more difficult.

I just wanted to say hi...I'm reading your posts...and in your corner.