selincro/nalmefene and alcohol

Please google 'C Three Europe' and 'Options Save Lives' forum.  These are 2 websites which have tons of information about this method, and the forum has plenty of people posting about their experiences at different stages of the treatment (you don't need to register on the forum just to read).

There is also a documentary about this method, made before Selincro was approved and so it mostly discusses a slightly different medication that can also be used.  To see about that google 'One Little Pill documentary'.  On that website page 'about' and then 'cast and crew', along with featuring in the documentary is a lady called Pat who is actually a winemaker - so you can see that this method can be used by anyone to unwind the addiction, and enable them to continue in their employment.

I operate the C Three Europe website, so if you need any more infomation or support, please just get in touch.  Everything we do and provide is free of charge.

Joanna.

There is another medication that can be used instead of Selincro, and that is called Naltrexone.  It works the same but with the added advantage that (for the largest majority of people) the side effects are nowhere as strong as Selincro.

I will PM you the details of a doctor in Australia who runs an online clinic and prescribes as per TSM.

It will far less expensive for you, and ultimately you could really use a provider in Australia because with this method you must never drink without the pill first and if there are any issues with shipping then you may be at risk of doing so.

Please check your PM's.

Joanna

I am also from Australia (53 Yro Male) and have battled bad addiction for over 10 years. A few years ago tried naltrexone without much success.

After that went to AA in desperation but hated it with a pasion.

Over the last 6 months through this forum i have researched selincro and decided to try it but wham, not availiable in Australia.

I have managed to get a hold of some from abroad (rather not say where) and took one 5 days ago as recommended, Waited the 2 hours had 3 drinks then felt like death for 2 days. LOL. Havn't had a drink or a tablet since. ( I don't think thats how it's suppose to work) Might try a smaller dose put inside a capsule this weekend and see if the side effects are less severe.

Can you please send me the link to the Australian doctor as you told abigail30936 on some PM's. I would love to have some local support as i feel isolated and flying blind at the moment. But i really feel i need to try this medication and keep going. Your thoughts or anyones thoughts would be appreciated. Regards Chris

Yes, eating first will make a big difference.  It won't negate the side effects completely, but will reduce them.

The idea is that you ONLY take the pill at the first signs of a craving.

You then wait 2 hours, and drink mindfully, allowing your brain to recognise that special 'something' is missing from the experience.

Each time you do this, you disappoint your brain by it not receiving the answer to it's craving.  Over time, your brain stops craving so much as it learns it isn't going to get what it wants (ie the rush from the alcohol).  Eventually, it stops craving completely.  This is called Pharmacological Extinction and can take varying amounts of time for people.

So, no, if you are not getting a craving then do not take the pill.

Instead, drink lots of water and try eat.  Did you eat about an hour before taking the pill?  If not, do so until your body has got used to it as having a full stomach helps reduce the nausea and other side effects.  Each time you take the pill from now on, the side effects should lessen a little.

I took one and it made me so ill I never took another. Didn't fancy a drink for about a fortnight, then back to normal. But I didn't know about eating first and drinking lots of water with it or taking it at the first sign of craving. It sparked a recurrence of vertigo which I'm still on medication for over a year later, so reluctant to try it again even knowing what to do.

It's a bit confusing because they say that if you continue with them the side effects wear off, but only to take when you are going to drink, so if you don't fancy a drink for days after how do you get used to the side effects?

Let us know how you get on.

Not sure how you build up a tolerance if you only take one every fortnight and Id rather face the after affects of a big drink than the after effects of a selincro

Hi Roger,

Your experience is not uncommon.  The side effects get a little easier each time (the first is the worst) and they can be lessened by eating a good meal about an hour before the tablet and drinking lots of water.  Reducing each time they are usually gone after the first 6 tablets or so.

Even if you don't feel like drinking, it is usually suggested that you do have a tablet, wait and then even just one drink until the side effects are gone.  If you leave it too long, your experience the next time will be like day 1 again.

If you find you absolutely cannot tolerate the Selincro and if the side effects aren't reducing, you can ask your prescribing physician to change you onto a medication called naltrexone.  This medication does exactly the same as Selincro but is not the first line medication prescribed for this particular treatment.  Side effects are often much, much less than with Selincro and the tablet can be broken in half to allow the body to adjust a little slower.

I hope that information helps just a little.

In your previous response to me you advised that I should only take a tab when I had a craving, it now appears you are suggesting to take a tab without a craving. Can you clarify?

Ive also heard that the tabs were not to broken in half, presumably due t the film coating, are you saying that this is ok?

In the beginning, in order to get your body used to the side effects and get the horibble bit out the way as quickly as possible, a lot of doctors recommend taking the tablet and having a drink as often as possible.

Once you are able to take the tablet and find side effects either gone or lots more managable, then you revert to TSM which is to take the tablet ONLY when craving or if you know a drinking situation is going to occur.

If you are taking Nalmefene (Selincro) then it says on the Patient Information Leaflet that comes with the tablets that the tablets should be taken whole and not broken.  The manufacturers state that skin irritation may occur if the tabet is broken.  This is probably part of the reason that side effects are often more sever with Selincro - someone is going from zero to full dosage without being able to tritrate up.

If you are taking naltrexone, then the tablet can be broken in two.  This allows the body to go from zero to half dose, and then half dose to full dose, therefore meaning the body often finds the tablets easier to adjust too and hence side effects seem to be easier to manage for the largest majority of people.

Wish someone had talked this through with me before. Had i known this I wouldnt have started this week as having a drink every night for a week isnt an option for me as Im going in for surgery on Friday.

Id actually got the selincro to help me stay off the drink in the run up to the surgery and during the convalescence.

Ill give it another go when Im out of hospital.

Thanks again

It's very important that you let your surgeon know when you took the Selincro, as this can affect the efficacy of any opiate based medication that might be used during surgery.  I think you will be fine because it is usually suggested that 7-10 days pass between opioid antagonists such as both naltrexone or Selincro, but please let them know to be sure.

On the other side of surgery, it is very, VERY important that you do not take Selincro or naltrexone until all of any opiate based medications are well out of your system.  Again, 7-10 days is usually suggested.  If you have any traces of opiate based medication in the body and then take an opioid antagonist, it will push away the opiates from your brain's receptors and put you into an opiate withdrawal situation.  You will be very sick.

So, to recap:

If you need opiate based medication and you have Selincro in your system, the opiate based medication may not work, or may not work so well.

if you take Selincro with opiate based medication in your system, it will put you into opiate withdrawal and make you very sick.

Please let your medical team know the day you took the Selincro, and please ask them when they will consider it safe for you to begin Selincro again.

Hopefully, your surgery will not involve opiate based medication at all, and then everything I have written can be ignored.

Hi Joanna - I was prescriped Selincro about 18 months ago by a private GP (it cost a fortune!).  I actually never took the tablets and still have them.  Over the last year or so my drinking has become heavy.  I'd say on a bad week I consume around 60 units maybe more.  I find it's my way of release and I cannot just have one drink.  Often a bottle, followed by 2 large G&T's or just 3 very large G&T's most nights.  I am lucky if I manage one night off the booze.  My drinking is making me feel so awful now, self loathing and I really want to cut down dramatically or stop altogether.  I also take 40mg Citalopram daily and have been for around 10 years. (on and off, various doses, lowest being 10mg).  I want to start Selincro again.... Reading through this forum - I eat a large meal, drink lots of water,  take the tablet (do not cut in half) and go from there.  Sleep is so important to me as I have 2 young children to deal with and I panic thinking it'll make me have insommnia.  Could I take it at the start of each day after a big breakfast?  I always can do 1 night without booze - did that last night, tonight I will hopefully manage a 2nd night.. but by  tomorrow will be chomping at the bit again and really want to break this cycle.  What would be your advice? Alternatively I try sheer will power but have been trying to do that for years without success.  At the time the GP I saw said I should go 5 days without alcohol before I start the tablets..... 

A lot of people do have sleep issues in the first week or so of taking Selincro, but you may be someone who doesn't!

You should take the tablet as you say, but 2 hours later you should have a drink.  Only 1 drink is needed to activate the process and you will be covered for approx 12 hours.  So, if you took if after a big breakfast then you would need to have a drink after 2 hours but then you would be free to drink again that evening, as long as you don't exceed 12 hours after you took the tablet.  (eg tablet at 11am, covers you to no longer than 11pm).

Once you are fully used to the tablets, then you would switch to only taking a tablet when you have a craving and then drink 2 hours after.

You don't need to be drink free beforehand though, not sure where the GP got that sparkling bit of information from!!

Having said all that, be prepared for the fact that you may well feel quite off-ish.  Do not drive if you feel strange, and keep drinking lots of water.

IF you get side effects, then just rest assured that the short term discomfort for a week or so more than outweighs the long term benefits that this medication can give you.

Thanks Joanna.  Ok so I would never drink at 11am !  Evenings is my tricky time whereby I'll say I'll just have a glass then end up having the bottle and sometimes more.  So realistically like you say I just have plan to take it when I know I'll be drinking.  I find it easy to do the first day or 2 without alcohol then the cravings are there again.  I'll give it a go and just be mindful to the side effects... 

General rule until you get used to the tablets - eat a good side meal first and drink lots and lots of water!!  That helps reduce the side effect issues.