Tapering off with beer?

I was totally honest with the GP. He seemed to want me out of the room so that he could get his next patient in. He said that if I didn't feel any better by next week to come back! I lay my heart on the line and feel a bit let down at the moment. I have social phobia because of my PTSD and it took a lot to get me to the surgery. I'm not sure if I can go again.

I've looked up Selincro on the internet and can buy it. It's expensive but worth a go. Hopefully they are a genuine supplier. I'm going to order some today. Fingers crossed.

My GP wasn't overly happy, but I'be been prescribed it twice in the last seven months. Unfortunately, if you are the non confrontational type, that is of no help to you.

Selincro (nalmefene) and naltrexone are almost identical. Before you order, wait for someone to comment on here on online pharmacies they have bought from. Or at the very least, list which ones you are thinking of buying from.

Later on, you may want to go to an alcohol recovery service, where they may give you a prescription for it.

You are right about taking the Naltrexone 1 hour before drinking. Did you get your Naltrexone from the internet? 

I think you can do exactly what just talked about, get the alcohol under control and drink only a little at the end of the week, that's what The Sinclair Method is all about, it's about bringing back your ability to choose when you drink and how much you drink. If you have any questions, please let me know. 

Take care. 

Please do so and you will receive much support

I was sober for five years when I had my daughter. I was in hospital for four months with her and didn't have the time to drink. I didn't even think about it. I stayed sober after that until my mum got Alzheimer's. I picked up a bottle to numb the pain of what I was going through. My dad had already passed away and I helped myself by drinking.

Now I can't stop.

PM me. It would be nice to know if you drink as much as I do. Just the thought that I'm not on my own would help. I do try. I had a day a couple of weeks ago when I only drank one unit. I was so proud of myself. The next day I treated myself to two bottles of wine.... The cycle goes on. I have a bottle of my favourite red wine next to me now. I'm trying to take it slowly but keep thinking, sod it.....

It really made her into a bit of a zombie, didn't mix with alcohol at all. She was always passing out and falling down. So she came off of it after two months.

There's plenty of bad publicity on the internet about it. Last time I looked it was withdrawn from being given to adolescents because of suicidal thoughts.

Sorry you're still getting hangovers. Hang in there, it sounds like you've gotten a good reduction in your drinking so far!

We've exchanged views in the past so you'll know I've been sober for a long time but we never know what will happen. Thanks.

The two medications are Selincro (nalmefene) and naltrexone.

(Seroxat is an SSRI anti-depressant and not an alcohol dependency medication).

They are very very similar, both having their own pros and cons. One is easier to get hold of throught the NHS, doesn't require an LFT and olny takes an hour to work before drinking can start.

The other generally ends up being bought privately, does require periodic LFTs, requires a two hour window before drinking, but seems to have less side effects than the other. Both generally initially have side effects, but they tend to subside.

They basically work on the opiod receptors and in layman's terms they dull the sense to alcohol, therefore taking that 'hit' or buzz away. This over time trains people's brains not to expect that 'hit' that they previously got and alcohol starts to lose the fascination it once held.

This allows people to drink in moderation like a normal person would. The medication is only taken on the days they are going to drink. I belive it has an 80% success ration and 40% go on to be abstinate.

As I said, Paul & Joanna are the experts on these medications, both in the field of working with these two medications. I myself use Campral (acamprosate) which is for abstinence. Where we diasagree is that I use Campral because for my circumstances it is best, and whilst I would give anybody any advice/help on the subject, I would not try to preach it to anyone else, just because it works for me, doesn't mean that it is a good route for others. Also, after decades of drinking, I believe that alcohol changes the body and mind, and that a drug (medication) is required to reverse the problems that a drug (alcohol) has introduced.

I don't believe there are many that can just get up one day and quit alcohol. There are probably many who say they managed it, but they are the vocal minority. The majority that lived short lives decimated by alcohol, don't tend to come on forums and shout and boast about it. At most they will read quietly from the side lines.

In a post to Paper Fairy you mentioned that you had read and studied a lot of information about using medication to reduce and cope with alcohol abuse, so I am quite suprised that you have not heard of either naltrexone or nalmefene (Selincro).  They are not new medications and naltrexone in particular was approved for use in AUD back in the mid 1990's - but just not the way people use it here.  Nalmefene is just as old, but has recently been approved across Europe (2013) specifically to help reduce drinking, though of course that reduction can continue until abstinence is achieved if someone wishes to do so.

It is the same type of opioid-antagonist medication as naloxone, which has recently been approved for use to give to those who have experienced an opiate overdose, and can reverse the effects of the overdose if given quickly enough.  Opioid-antagonist medications are literally life-saving medications.

Over 20 years of research into using these medications for AUD was made by Dr David Sinclair, at the worlds top alcohol research factility in Finland.  Dr Sinclair, an American native, moved his family to Finland in order to be able to research at this institution.

His research led the way to show that alcohol relapses are due to the Alcohol Deprevation Effect (ADE) which means that a change has taken place in the brain in response to alcohol consumption.  The longer someone suffering with AUD is detained or tries to keep away from alcohol, the worse the cravings become until the mostly inevitable relapse occurs.  This is a suitable explanation for why so many people relapse so soon after leaving a rehab facility.

His research (and subsequent 120+ clinical trials) also showed that if drinking took place after an opioid-blocking medication was ingested, the endorphin rush given by the alcohol was removed from the situation.  Without this endorphin rush, drinking loses it's appeal as it is no longer rewarding.  Over some months repeated drinking on an opioid-blocking medication, the brain is reversed back to its de-addicted condition.  This is called Pharmacological Extinction.

At this point, someone can chose to go completely abstinent, if they wish, or continue to drink socially/occasionally (always after taking a tablet so that the endorphin rush is not re-established).

More information can be found here https://patient.info/health/sinclair-method-for-alcohol-use-disorder

I can use myself as a practical example:

I began this method in October 2013.  During the first three months I experienced some improvement in my drinking (though that includes a period when it was up and down) and it took approx 8 months for me to reach that extinction point - I literally could take it or leave it, and it no longer bothered me.

Now, I drink perhaps one every two or three weeks, usually when out with family. I take my naltrexone tablet one hour prior to protect myself from every sliding backwards again, but it means I can enjoy not only the taste of an odd drink or two, but also the social aspect of it, too.

It's also interesting that recently we have become aware of several long-term AA recoverees who have stumbled across this method and decided to try the method as they are sober, but still often uncomfortable with cravings.  This is purely annecdotal at this point, but it appears from their time on this method they are finding it much easier to adjust and for it to work.  We suspect that it might be because they do not appear to have a current drinking 'habit' to fight against.

I now took one Friday one hour before I started to drink. I noticed that I did not drink so much as I use to. I am going to contiunue.

Once the receptors are blocked it is like a locked door, so no matter which of the two medications you take the endorphins will not attached to the receptors in the brain - the reward circuit is broken, the wire is cut.

With that circuit in the brain unable to connect, the part of your behaviour that causes the 'more, more, more' message just doesn't happen.  Hence you can learn new ways to manage your drinking and drinking less is much easier without that incessant drive to continue.

Thanks again.