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Hi Everyone / Dr Eskapa,
I'm writing from New Zealand and have been prescribed Naltrexone through a community alcohol program (it has effectively been subsidised by the government). I am kind of confused about the drug so I'm hoping you can help.
Let me give you some background to how I got to the point of wanting to take Naltrexone. I am in my 20's, single and all of my friends drink. I love going out to bars and nightclubs on the weekend and do not drink during the week at all. I do not crave alcohol on a regular basis and can go abstinent when I want for weeks on end. However, Friday and Saturday night rolls around and the lure of going out with my friends to bars, meeting girls etc. proves too much. At this point this is my motivation for drinking as it is a social thing and everyone is doing it and it also gives me confidence and makes me more outgoing. Then it seems like a switch in my head turns on and I find it hard to stop drinking. I usually start at the same speed as everyone else and then I seem to speed up while they slow down, from this point it seems that the alcohol has taken over and not much else matters at this point. From this point on I am prone to drinking the next day which leads to drinking binges that can last up to a week. I then either need to take valium to stop drinking or sometimes just stop because I am sick of it. I'll then need 24 hours to get over it and the urge to drink stops and I won't think of alcohol for another couple of weeks or so (I am lucky that I have been able to keep my job and I'm running out of excuses). I'll start drinking the next day because I either wake up and I am still drunk and want to keep the feeling going or feel like having a drink to help me through my hangover which can then lead to a binge. If I make it through to the afternoon and evening without drinking then I won't and then it won't lead to a binge.
In light of all of this, my goal is not complete abstinence as I don't think I've reached that stage yet, it is controlled drinking and being more responsible when I drink and I think this is where the Naltrexone will help, as I'm hoping that it won't lead to that 'switch' in my head turning on and I can get to the point where I can basically drink to socialise, rather than what happens now where by the end of the night, I am socialising so I can drink (I hope this makes sense).
I have become sick of the binges as they're ruining my life and I want to get to the point where I have control over alcohol when I do drink and socialise. So I did some research which lead me to Naltrexone and the Sinclair method. I have now been prescribed Naltrexone through the local community alcohol and drug service and have been given a three month dose (currently have one month's dose which is refillable given that I undergo one of their counselling programs). I have been taking it for a week and haven't drunk on it yet as I had other commitments over the weekend. I was given the Naltrexone and I actually haven't seen the doctor who prescribed it to me (it was given to me by one of the nurses as I went through a home detox program through the community service after my last binge and she had been monitoring me). The only people I have seen are the nurse and a counsellor who are only vaguely familiar with the Sinclair method. The community counsellor does not have a PHd so I'm unsure of his credentials.
The literature I have received along with the Naltrexone is that it is a drug that leads to eventual abstinence (which is not my goal) and the counsellor has recommended that I stay abstinent for 3-4 months in order for the opiate receptors in my brain to realign. However, this seems to go against the Sinclair Method which I think makes a lot of sense. My Naltrexone prescription states that I should take it every day for 3 months. While they have recommended abstinence, they do say that I can drink if I want to. Therefore, I am confused about what I should do and have a few questions.
Please keep in mind that I don't drink every weekend. Does the Sinclair Method recommend that I take a 50mg pill every day (which is what I have been prescribed) or just take it an hour before I drink? What would be the best way to stop the binges? If I have taken it for 12-13 days without drinking and have a few drinks should I be able to notice the difference, bearing in mind that everyone has different reactions to it?
I am confused and since the counsellor does not hold a Phd or is particularly qualified I feel that he might not have the necessary perspective and just preaches what he is told to. If anyone could shed some light on my situation or answer some of my questions then I would be very grateful. When I asked some of these questions to the counsellor it sounded like he was quoting from a text book.
Thanks in advance.
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