I have a friend whom I convinced to try Naltrexone. I set up the appointment and the doctor did prescribe Nal. He is an addiction doctor but not really familiar with TSM. I left him a copy of the book. Anyway, he prescribed the Nal with the instructions to take one each evening. I did not attend the next appointment with my friend, but basically the doctor said he read most of the book and it was a bunch of hooey and he did not believe in it. Anyway, my friend took the Nal with great success from the first time and cut back drastically on his drinking. However, he took it every night. I showed him excerpts that explain why he should try to not take it on days when he is not drinking. After a month, he agreed to try it the TSM way. But he said he is not having as much success and has more craving. The other night he drank and went to bar, had a blackout and does not remember coming home. He said he did much better taking it every day. Is that possible, or should I keep on him to take it only on days he drinks? He says the Nal is working but he is suspicious of TSM. He tells me I read a book and now I think I know more than the doctor (true...I do have not personal experience with NAl). Help me! What should I tell him? I appreciate any advice you can provide.

EDIT: I didn't realize you posted this in "Questions for Dr. Eskapa" section. So, hopefully, He gets you the correct answer. My comments below are simply what I have experienced and what my brain has retained from reading on the board. I look forward to hearing the Docs comments also.


As you stated. Taking everyday is not TSM protocol, for days when you don't drink.

I don't believe there would be any harm done to the TSM procedure by having the Nal on non drinking days. I interpret that you are simply subjecting yourself to unnecessary Nal in your system that will be blocking otherwise healthy endorphins that you may get from food, sex and exercise.

Take Nal when you need to block the endorphins generated from drinking. I don't think it is the intent of Nal to be a crave blocker all by itself. I have experienced taking the Nal and the crave going away, so I did not drink. Not sure how that works, perhaps it is part of the extinction.

I have heard others on this board have similar comments from their Doc that was not familiar with TSM.

Me personally, if it meant I HAD to choose between taking it daily, even when not drinking, or not getting the Nal at all. I would choose to take it daily. But thats me. I've been a daily drinker for years. So that would only be affecting me zero, or 1 or 2 days a week right now.

I plan on following protocol, but my vote regarding your buddy would be, at least in the beginning, to say, "If you feel better listening to your Doc, go ahead and take daily". I would follow up with saying, "Please be ready to experiment when you start stringing a few alcohol free days in a row together. Be ready to not take Nal for a day or two when you KNOW that your not going to drink."

You may want to try and explain the endorphin blocking thing in detail. Because I can attest, it does turn a horny 42 year old perverted husband, (per my wife), into a not so horny, not so perverted husband. Which I believe is directly related to my Nals being mostly daily.