Starting naltrexone today

Remember to always take the first drink after the pill slowly and allow yourself to recognise that something is missing from the experience.

Then, as you drink ask yourself if you really want another.  If you do then fine, begin another drink.  But at some point, you will hear the signal that you are satisfied and decide not to drink any more.  At that point, get up and do something different.

We call that drinking mindfully and it makes a big difference to the majority of people.  This isn't a magic pill and if someone decides to keep drinking when they really don't want to, then it won't stop them downing the drink even though it is no longer rewarding.

The pill is a tool to aid you in making better decisions about your drinking.

Taken a naltrexone at 3.30. Just drinking my first beer now.

You are ever so slighty back-to-front on the drinking though.

The tablet is not a reason to drink for the entire 8 hour window.  Many people accidently misunderstand that.  It's quite common actually. 

You are looking to use the tablet as a tool to help you stop long before then.  If you aim for this the majority of time, hopefully you will soon find yourself stopping earlier and earlier. However we are only human so on those occasions in the coming months when you aim for that but don't quite make it, the 8 hours is the period of time that you can safely drink whilst protected.  It's a safety net limit, not a target to hit! 

How you look to achieve this is to take that first drink or two as slow as you can.

Taste it, savour it.  Allow your brain to recognise that it isn't the same as it used to be - the thrill or rush or whatever you wish to call it is missing.  Please do not chug the first few drinks.  It is very important you don't do that, as you will find yourself getting under the influence of the alcohol which makes it hard to listen and act of what your brain is telling you.

The tablet is not a magic pill and will not stop you drinking through it if you chose to.  It is a tool to break the compulsion circuit in our brains.  With that broken, you must act on the fact that it is helping you have the ability to make better decisions.  It gives you the ability, but you must act on them.

Between drinks, ask yourself if you are really wanting another?  Will it give you any more satisfaction that the one you've just finished?  Is drinking the same, or worthwhile, with that rush of endorphins missing?

If the answer is yes, then mindfully drink another and repeat the above questioning process.

When the answer your brain gives you is no, that's the craving has been satisfied, and you've had enough, then get up and remove yourself from the alcohol.  Do not keep drinking through the medication.  Do something else.  I remember doing something as simple as moving from one seat to another and reading.... next thing I knew, I had a read a few chapters and had forgotten about the drink.

It is a brilliant experience when you get the glimpses of how you do forget about the glass next to you, or you put the top on the wine bottle and put it back in the fridge!  I know it might seem impossible to imagine now, but when you work with the tablets and start to see that light at the end of the tunnel, the positive success of it just breeds more and more success.

Paul or Joanna will tell you which one and why.

Nalmefene is the (most recent) medication approved to be used by those currently drinking.  Naltrexone it the older medication that has prescribing instructions issued way back in the mid 1990's which means it should only be prescribed to those already abstinent but who need help to manage their cravings.  That is why more people are on nalmefene rather than naltrexone.

There are a few private doctors who will approve naltrexone on a similar basis to nalmefene, but they are usually quite rare and quite costly. 

Having said that I successfully used naltrexone to achieve the eventual extinction on my AUD.

Naltrexone does seem to cause fewer side effects for most people though, and I can have weeks inbetween drinks.  The only thing I feel on the naltrexone now is a slight bit of tiredness, but that might be the naltrexone or the sedative effects of a couple of drinks or the full tummy from a lovely restaurant meal!  It's hard to tell.  Of those I support through the method though, none have any side effect issues with the breaks from the tablet/drinking inbetween.

In the early days though, don't try to stick to any type of regime in terms of when you drink eg weekends only.

The way TSM works is that you take the tablet when you feel a craving for alcohol beginning, no matter when that is.  After the time is up, you drink slowly and mindfully until you feel satisfied.

This 'session' taught the brain that when it has a craving, it will get what it wants but not the reward.  Your brain will then slowly start to realise that because the reward isn't there, there isn't much point in wanting the alcohol and the cravings lessen.

That is TSM in action, right there!

So, craving=tablet=drinking= no reward = unlearning of the behaviour of drinking.

If you start on a Monday thinking I won't drink today, and you don't crave, then that is great.  Go to bed and move onto Tuesday.  If you make it to the following with no cravings, therefore no cravings and no tablets needed, that is briliant.

However, the danger of trying to whiteknuckle through any potential cravings that may happen during the week is that (1) you are unwittingly preventing TSM from doing it's job and extinguishing that craving long term and (2) you might be so desperate to drink by Saturday that you find it impossible to drink mindfully and start knocking the drink back too quickly.

So, try relax, forget what day of the week it might be and then answer a craving with the tablet and the drink, and disappoint your brain in the process.

Eventually, over the coming weeks you will find abstience during the week easy and with no cravings because your brain has learned that craving is pointless.  This will then leave you free to take the tablet and drink socially at weekends with no problems at all.

However, no one can tell you how long it might take to get to that ultimate goal.  It might be 2 months or 3 months or 6 months..... it'll happen when it happens :-)

Don't feel bad for sleeping - at least your not drinking during that time and our bodies need that sleep to heal.  So sleeping is good for you at this point.