Hello Doctor
Before I start I wish to drive my liver function readings down and get rid of the steatosis . When that is done .....
My question really pertains to how much effort at moderation should be attempted
while practicing the sinclair method . I really don't like the idea of drinking more than three times a week , I worry it might push my liver into cirrhosis . No one has ever yet told me the true dangers of steatosis . I reckon loads of people who drink too much have elevated readings . Anyway for example , if one applied a certain discipline and then started with two or three days with max 4 bottles of wine per week( me a male age 50 ) would this mean the whole process might take longer . Or indeed if one drank only once a week even but say max two bottles of wine would the extinction kick in ?
I thankyou , if you're able to answer such a question .

Extinction will occur if you drink while an opioid antagonist (naltrexone or nalmefene) has been absrobed into your blood-stream and you drink. Drinking + naltrexone sessions add together gradually until you notice the change - and this takes time. Naltrexone itself is merely a tool unlike say a painkiller or blood pressure medication which act all by themselves - without you having to make a behavior you notice the difference rather quickly. Use 'willpower' to moderate - IF you can by all means. However, the crux of the addiction is that there is a loss of control over the drinking and the Sinclair Method is all about restoring control - by correcting 'learned' physiology through blocking reinforcement to the opioid system ...

PS --- think billions of receptors and trillions of networked connections which have become super-highways as a result of getetic predisposition and learned drinking - extinction cuts back the super-highwaya, as Sincalir calls them, so that they are restored or corrected to a state of normal pathways...

That has been a question many of us have asked among ourselves. The phase, "drink normally" had some of us confused, if normally for us was to drink until unconsciousness. Thanks for the clarification.

quite right Springrider,
We'd like our drinking to become extinct not ourselves !

There was a patient who went 'nal-drinking' to 'null' her drinking. Nal-drinking is drinking with nal-trexone. The whole point is to bring things under control (biological) control so that there is a reduction in harm. Pharmacological extinction is 100 % effective in addicted lab rats: every single one of the AA (high alcohol preference bred) rats learns the addiction to show high addictive / compulsive drinking levels - and every single one out of thousands reduces drinking to zero or near zero levels with the opioid antagonist (naltrexone, nalmefene, naloxone). We humans are, well human and do not live in cages. Some people say they take the medication but in reality do not. Others take the medication and report that they drink when in fact they are not drinking. Others 'sometimes' take the medication....

Higher success rates - meaning drinking withing WHO safety limits at the least - or not drinking at all - would be achieved with meticulous compliance with the physiological rules for pharmacological extinction.

Hence, Naltrexone + Drinking (over 3 to 4 months) = Cure

whereas

Naltrexone + No Drinking Allowed (over decades) = Failure .

"Not rats in a cage ", true , true .
And here I'll just add what has happened to me to give an example of how one might differ or dither !:
my short experience over six weeks may mirror what could happen to others typically so :
1was prescribed NAl to accompany Abstinence.
2. Got first info on SM and when i mentioned it addiction specialist said no more NAl for you !
3. took a few with abstinence
4 Drank witout it
5 awaited book
6 Attempted continued Abst.
7fell offthe wagon
8 seriously consider it the right way but need to assure supply
(What I intend next i'll put on another thread)
So that's to just show ,as Dr said ,we may not do it as the caged rats and particularly so with these typical teething problems of supplies and info needs.
until we get to NAl + ALC = cure the clock ain't tickin right .
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Don't give yourself so much credit.

Okey, I am not the doctor but the point that your character started to fall off the wagon was the point the Nal started working.

You are pretty smart. You have read what is available at this site. You know how it works and how it does not work.

In AA there were all kind of rituals you had to follow to "fake it till it works". That ain't what's happening here. It's like throwing your dirty undies in the laundry and adding the soap and bleach. You can sit aside and wish that they get cleaned and you can wish that the skid marks remain. Don't much matter because the Whirlpool is simply operating as designed. And so is your biology.

Follow the protocol and accept the results. See you on the other side.