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 Post subject: Moderate Drinking: The Moderation Management Guide
PostPosted: Wed Sep 19, 2012 8:54 pm 
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Posts: 309
This book by Audrey Kishline is another resource, in addition to "Over the Influence" by Patt Denning, Jeannie Little and Adina Glickman, that I recommend folks to take a look at while working on their tsm efforts. The author has started a Moderation Management network of support groups and if you're lucky you may live near one of the few groups running in the US. It's an alternative to AA that doesn't require abstinence (but does recommend 30 days AF to sort out your drinking priorities). While I don't live near a support group, there were snippets in the book that were helpful. Moderation Management is really for people who haven't totally lost it yet but are sliding down that slippery slope. And for those of us who are thinking about including some alcohol in our lives down the road, there are some guidelines for how you can return to moderation and control. Here's the web site, fyi http://www.moderation.org

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Gotthegene

Started TSM Aug 2012. Had some success but over time the Nal SEs were so awful that stopped taking Nal. Managed a 30 day (Sept 2012) and 46 day (Feb/Mar 2013) AF period which also contributed to getting drinking under control.


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 Post subject: Re: Moderate Drinking: The Moderation Management Guide
PostPosted: Thu Sep 20, 2012 1:51 am 
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Joined: Sun Apr 17, 2011 5:29 am
Posts: 420
Thanks for posting this Gott.

More and more people, including professionals are embracing Moderation or 'Harm Reduction' (though to the die hard Abstinence devotees, HR is a something to be belittled and dismissed) due to the dismal success rate of abstinence and abstinence based treatments.

Stanton Peele is someone who has been promoting moderation for decades
http://peele.net.

I started a thread about him a while ago here:
viewtopic.php?f=20&t=2930

The thing is, Moderation is something that the vast majority of us are capable of doing, our greatest obstacle is ourselves and our beliefs about addiction/alcoholism. Because of AA, most of us believe that we are incapable of controlling our drinking, so it becomes a self-fulfilling prophecy ...

Cognitive Behavioral Therapy (CBT) is also helpful tool.
http://en.wikipedia.org/wiki/Cognitive_ ... al_therapy

Curi

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Pre TSM 50u/w Started 24/06/11
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 Post subject: Re: Moderate Drinking: The Moderation Management Guide
PostPosted: Thu Sep 20, 2012 8:36 pm 
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Joined: Thu Jul 26, 2012 9:02 pm
Posts: 166
Location: Vancouver, BC, Canada
Thanks for this info, Gott

I just downloaded "Over the Influence"....Kobo seems to be the only eBook carrier. It looks very interesting and I'm looking forward to devouring it (as I do with everything that might help to free me from my alcoholism).

As for Moderation Management, I'm quite familiar with it, having "tried" it prior to starting on the Nal, and it didn't work for me--then. The concepts might be more applicable now, however, thanks to the Nal giving me (us) some freedom to CHOOSE (contrary to AA of course).

CuriousOne commented on "CBT"; Cognitive Behavioural Therapy. I spent two years with a CBT trained therapist. It didn't help, not then, before Nal. In fact, my drinking increased during that time. HOWEVER---I can see now, thanks to the Nal giving me that freedom to choose, I can now, and am, apply what I learned then.

Good stuff. Thank you again.

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Started TSM: July 24, 2012. Quit TSM in March 2013. Kept drinking back up to pre-TSM levels.
Restarted July 3, 2015.
Pre-TSM: Average of 80 units/week, 0 AF/days
Craving:5.


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 Post subject: Re: Moderate Drinking: The Moderation Management Guide
PostPosted: Thu Sep 20, 2012 8:47 pm 
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Joined: Fri Feb 10, 2012 5:39 pm
Posts: 309
Admittedly I think many of us may be too far gone for "Moderation Management" alone. But with TSM, it might work. As I've revealed in other posts, my father was an alcoholic and there's no way in hell he could succeed at "moderation"; it was all or nothing for him. I'm just now suggesting it as something to work on in conjunction with naltexone and maybe baclofen. I personally, liked "Over the Influence" more as a reference. Moderation Management essentially is another resource and reinforces the "Over the Influence" book.

Good luck everyone!

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Gotthegene

Started TSM Aug 2012. Had some success but over time the Nal SEs were so awful that stopped taking Nal. Managed a 30 day (Sept 2012) and 46 day (Feb/Mar 2013) AF period which also contributed to getting drinking under control.


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 Post subject: Re: Moderate Drinking: The Moderation Management Guide
PostPosted: Thu Sep 20, 2012 9:47 pm 
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Joined: Fri Aug 17, 2012 8:04 pm
Posts: 26
I'm a big believer in CBT, as I feel it pretty much saved my life after being diagnosed with clinical depression a few years ago. But I haven't been able to make it work with alcohol. Whether that's just my failing or that of the technique I don't know. Tried MM as well, but it was a dismal failure for me. And, it seems, for Audrey Kishline, who started Moderation Management.

http://reason.com/archives/2000/11/01/after-the-crash

As the article mentions, she bailed on MM before her relapse and went back to AA, so it could be argued that her problems showed a failure of AA and not MM. But I tend to stick with things that work, and even though TSM worked only partially for me the first time around, I'm determined to take whatever dosage will rid me of this back-monkey, which I've carried around for far too long.


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 Post subject: Re: Moderate Drinking: The Moderation Management Guide
PostPosted: Thu Sep 20, 2012 10:32 pm 
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Posts: 309
Thank you very much, Thatsameguy, for posting the dismal news about MM's author. I really appreciate this contribution and knowing more of the "story" around the author's struggles.

The news supports my gut feeling that "just practicing moderation techniques alone" isn't enough to help most people with a drinking problem.
My thinking on alcoholism is a journey in and of itself and having witnessed my father's struggle and, now very concerned about my own fate, my current thinking is that most people with a dependence on alcohol can only succeed with "moderation" over a long term if they have some help to change that chemical imbalance that makes them/us crave alcohol. Without Nal and Bac (and whatever else is out there) to help extinguish the cravings, it will be a constant struggle every time you have a drink....we're just wired to want another...and another.

Here's wishing everyone success with TSM!

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Gotthegene

Started TSM Aug 2012. Had some success but over time the Nal SEs were so awful that stopped taking Nal. Managed a 30 day (Sept 2012) and 46 day (Feb/Mar 2013) AF period which also contributed to getting drinking under control.


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 Post subject: Re: Moderate Drinking: The Moderation Management Guide
PostPosted: Fri Sep 21, 2012 8:33 am 
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Joined: Mon Sep 26, 2011 2:52 pm
Posts: 547
Location: midwest, usa
Yes, I'm glad that TSG posted that link...I, too had read the Kishline book several years ago and then subsequently heard "the rest of the story" which of course is just cannon fodder for abstinence advocates. I didn't want to rain on anyones parade because the book does have valid ideas, still the dramatic story of the founder is a major downer...In fact, having that story in the back of my mind when I first heard about TSM contributed to my hesitation (one year!) to try TSM, even though as a stay-home drunk my story had little in common with hers, still...it just reinforced what I'd heard about all my life about alcohol and addiction, and the "ONLY solution".

But I agree w/ GG that we TSM participants are on a greatly improved playing field - even short of being "cured" - Nal knocks down our compulsion quite a bit and I appreciate the moderation ideas that GG has brought up. I'm glad to have a new title for it, "Harm Reduction", which doesn't have the sad connotations of MM. Good conversation, folks ;) !

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Chrissie
Pre-TSM: Daily Drinker, 35 - 40 au/wk, 0-1 AF days
Regained Control @ Week 52
TSM WORKS!!!


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 Post subject: Re: Moderate Drinking: The Moderation Management Guide
PostPosted: Tue Oct 02, 2012 6:34 pm 
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Posts: 16
I would like to give 3 cheers for Baclofen. Early in my Nal experience I got much worse than I was without it. I know this is normal and haven't given up on Nal, still take it every time I drink. But I was afraid I was going to die before the Nal saved me. I started off with Topiramate, which had helped my cravings before but didn't last, and switched to Baclofen as soon as I could get it from River Pharmacy. The Topiramate did help, but the Baclofen is a miracle. I practically never feel a craving and usually only drink because people around me are drinking. I have more AF days than not. I even stopped keeping my drinking diary because 0, 0, 0, 0, was getting boring. Please try it people, but be careful of the dose. I titrated up to 75 mg. per day and it was too much. Titrated down to 50 and now I feel fine. Probably sleep a little too much, but if I have a reason to get up early, I can do it and be perfectly alert. I take 25 morning and 25 night. The book is The End of My Addiction, by a Dr. Amiesen. Well he's a bit of an extremist and the dosage he was taking for awhile was scary. But the man does have a point.


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 Post subject: Re: Moderate Drinking: The Moderation Management Guide
PostPosted: Tue Oct 02, 2012 8:24 pm 
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Joined: Fri Feb 10, 2012 5:39 pm
Posts: 309
Thanks for the book referral Pam. Just put a hold on it at my library!

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Gotthegene

Started TSM Aug 2012. Had some success but over time the Nal SEs were so awful that stopped taking Nal. Managed a 30 day (Sept 2012) and 46 day (Feb/Mar 2013) AF period which also contributed to getting drinking under control.


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 Post subject: Re: Baclofen
PostPosted: Tue Oct 02, 2012 11:01 pm 
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Posts: 166
Location: Vancouver, BC, Canada
I tried Baclofen, off and on for over a year. There are a LOT of side-effects compared to Nal. I discontinued it due to those. It's one of those drugs, the side-effects from which, vary quite widely depending on the individual, and withdrawal from it can be especially problematic. Check it out online.

Baclofen works directly on the "GABA" receptors, used originally as a muscle relaxant for people with MS...but over time physicians heard reports from their MS patients that it also coincidentally reduced their craving for alcohol. Dr. Oliver Amiesen took that information and used it to effectively treat, and totally control, his own alcohol addiction. He wrote a book entitled, "The End of My Addiction", the US edition called, "Heal Thyself: A Doctor at the Peak of His Medical Career, Destroyed by Alcohol---and the Personal Miracle that Brought Him Back."

The key word here, however, is "control". As Dr. Amiesen describes very well, Baclofen helps one to CONTROL their drinking. Indeed, once the lucky one (as it works for some, but not all, like Nal) finds the dosage that works for them, Baclofen does stop the craving. It does NOT, however, as our dear Dr's Sinclair and Escapa have discovered with Nal, CURE you! In other words, if you stop taking the Baclofen, you go right back to where you were, which is smack dab in the middle of what Dr. Sinclair described as, "The Alcohol Deprivation Effect", which in a nutshell means that the more that an alcoholic is deprived of alcohol, the more he/she is liable to crave it. Baclofen can help with the craving, but it will NOT CURE your alcoholism!

Some people have effectively used Baclofen along with Naltrexone in order to temporarily and immediately help with the craving to drink. So it does help some to deal with that aspect of their drinking. In the long-run, however, it is the Naltrexone that slowly but surely "extinguishes" the craving -- to the glorious point where one simply has no craving or desire to drink at all. When that point is reached, you don't need to take any more medication! For those committed to TSM, then, the Baclofen may help with the immediate craving, which may in the short-run help to reduce the amount that you are drinking....but only while you are waiting, in the long run, for the Naltrexone to work it's magic, eventually CURING you of your alcoholism -- giving you and all of us the incredible gift of ZERO craving or interest/desire to drink any alcohol at all. And so, therefore, no need to continue to take something like Baclofen. When we are CURED, we don't need ANY medication to keep us that way!!! Well, not unless we want to drink moderately, in which case we continue to take the Nal before drinking so that we do not become re-addicted (see the forum member and moderator "Q" for his rich and varied experience with just that).

I hope this helps those here to understand where Baclofen fits into the Naltrexone equation. Good luck to you all.

_________________
Started TSM: July 24, 2012. Quit TSM in March 2013. Kept drinking back up to pre-TSM levels.
Restarted July 3, 2015.
Pre-TSM: Average of 80 units/week, 0 AF/days
Craving:5.


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