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Dear Em
Binge drinking reflects the Alcohol Deprivation Effect in action. It's in the book (p 17) and is one of the main contributions Sinclair made to addiction and de-addiction science. It explains why abstinence does not work for most people.
To get to your question.
The treatment calls for ALWAYS taking naltrexone an hour to 30 minutes before drinking (if you start in the early morning and are still drinking late at night you can take an additional dose at night though the normal dose is 50 mg / 24 hours)
The treatment calls for ALWAYS NOT TAKING naltrexone when NOT drinking.
Thus pharmacological extinction can be expressed as:
Naltrexone + Drinking (over 3 to 6 months depending on individual response) = Cure
and
Naltrexone + Abstinence = Failure (Relapse back to heavy drinking - naltrexone had no anti-craving effects on its own.)
If you stop for a few weeks you may want to start 25 mg half dose if you initially had side-effects such as nausea -- if you tolerated it easily then you would probably do fine starting after a few weeks with the full dose.
Sinclair suggests one 'drinks normally' - not too much of course if you can - while always on the Golden Rule: never ever drink without Nal even after years. Otherwise the addiction can be re-learned in the brain.
Best wishes,
Roy Eskapa, PhD
Dear Dr. Eskapa,
I am a binge drinker. I can go days and weeks without drinking and not think about drinking. For the most part I try very hard not to drink during the work week. When Friday night comes I will drink until Sunday night. This past binge was 90 units in 5 days.
My Question is:
If I take my Nal on the days I know I'm going to drink then stop drinking on Sunday night and go M-F night not drinking and not taking NAL do I still take 50mg or do I take the 25ml again. What if I don't drink for a few weeks?
Thanks,
Em
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