I need serious advice!!! My boyfriend started on TSM about 2 months ago, I guess in the beginning he experienced the honeymoon phase because his alcohol consumption reduced significantly. Then everything went down south because he drank without Nal for a week and of course the drinking went back to normal. Now, he just started to take the Nal one hour before drinking, it's been one week now but his drinking is still very much the same. He is a very heavy drinker. He drinks everyday, 24 hours a day. The only time he is not drinking is when he is sleeping and that is only about 4-5 hours a day, then he gets up at around 2 or 3 am and drinks what is left over. When morning comes he buys more. Right now he is drinking 8x 500ml cans of 7.5% strong beer every single day, Monday through Sunday through Monday through Sunday. The cravings and withdrawals (withdrawals not extreme) are through the roof. He has been an alcoholic for roughly 18 years now and has been drinking excessively 24/7 for about 10 years. Is TSM not right for him? He wants to cut down and/or eventually stop completely but he can't control it. What if I controlled the buying of the alcohol for him? For example, I only buy a lower grade of beer OR same grade but only 4 or 5 cans instead of 8? Would that help him at all? I am completely lost right now because I just don't like it when he gets drunk. Okay, he doesn't get wasted like before without Nal anymore but it's there. When drunk, he gets me frustrated and he disturbs me and the children. He's rude, selfish and says mean things to us and about us. I am willing to help as much as I can, I don't know anymore what I should do. I read and read and research about TSM and I can see how it works but I'm not sure about it working for my boyfriend anymore and I'm on my last straw to calling it quits.

I apologize for the rant but I am at my wit's end. From being a happy go lucky person, I have turned into a sour and angry one who feels depressed most of the time now; alone and discouraged.

If he is the same kind of alcoholic as I am, then he will only do what he wants to do with regards to drinking. If you try to control his drinking in any way it is very unlikely to work unless he is completely compliant to that idea.

I've tried to sober up alcoholics many times over the years and it usually ends in frustration and anger. Restrict access and he will become sneaky. If he chooses himself to buy weaker or less quantity, then it might work. It is very difficult because he is physically, mentally and habitually addicted. The pill will probably help him not drink when it isn't "needed" to make the withdrawal calm down, but the habit and the physical need to drink when feeling unwell is going to be tricky.

Personally I would decide if you are willing to put it with it anymore, make a reasonable ultimatum and stick to it. i.e. cut down one can in his daily consumption each week for example and otherwise prepare to move out. If you agree a method for him to cut down that isn't too extreme then it might work. At that level of consumption he probably is withdrawing even when very drunk.

the verbal abuse of you AND your kids can't go on forever....consider them as well as yourself. you're in our thoughts.

He has been semi compliant to the idea of weaker or less quantity but in the end after a few days he will have some kind of excuse such as since it's weaker grade, then he should get more etc so I am starting to see, as how you said, he will only do what he wants to do with regards to drinking. I'm not trying to sober him up, just trying to help him gain control of his drinking and get his life back. And I agree with you totally, he is addicted mentally, physically and habitually. Nal works mentally, I've seen it and he has seen it too but the physical part is where he gives in and once he gives into the physical aspect of it, the habitual part naturally kicks in and the whole process is rolling again. What I would like to know is that, for someone who is drinking like this around the clock, how should the Nal be taken? I mean, does he need to take an extra 50mg every few hours? I told him that he needs to try to change his diet (start eating, take vitamins etc) and he refuses, even water - he says he's hydrated enough from the beer. Am I wrong for trying to help? But all in all, the emotional abuse is so hard to take and at the end of the day, it's the children who are hurt the most. I read through all the different posts of people on their way to recovery or being cured...I just wish my boyfriend was among them.

On another note, when he first started with TSM and was drinking only weaker beer (5,2%), about 6 cans per day, he managed to have a 1-3 AF days per week but I don't know if that was because of the honeymoon phase. He didn't have any of the physical withdrawals at all. But once he went back to the 7.5% beer, the withdrawals started. Does higher or lower content of alcohol play a role in whether TSM works better or not?

Should he try Campral together with Nal? Antabuse is out of the question, done that...AA and sobriety - went through that over and over, in and out of numerous rehab centers and back to drinking... I don't want to betray someone in need of help by throwing in the towel when they need you most... So confused

No, it can't go on forever, but I feel I would betray him for not being there for him, because he says that he would never leave me, his friends or family if they had a problem like this or anything (his friends and family have all stepped away coz of the lying etc) but I don't know if that is the manipulative side of his addiction. I hate thinking bad of people....Anyhow thank you

I was sort of hoping someone would weigh in about the TSM a bit as I have only really just started on it and I am coming down from a ridiculous amount per day as well but I don't have an awful lot of experience of TSM itself.

For me the pill is a tiny aspect of the solution at the moment as I am too far gone at the moment to wait for the pill to do its thing. I think it will be more helpful for when I have come down in my consumption to a point where it is possible to choose not to drink without fearing having a seizure.

I am very highly motivated to change which is necessary to detox as it is extremely painful. I only drink when the withdrawal becomes unbearable, i.e. shaking, sweating, nausea, panic racing heart and all the other lovely symptoms. My point being that if he is relying on the pill alone to just slowly take his consumption down that isn't going to happen. His honeymoon period most likely was just him being compliant and wanting to change.

So to answer your questions and hopefully other people will give harm reduction techniques as well.

The pill is very likely not doing anything at 3am when he awakes desperate for a drink to take away the symptoms. So it needs to be taken before the first drink. Maybe precrush one so it gets into the system quicker and wait as long as possible. Realistically he will feel like crap waiting for the pill to kick in but isn't going to drop dead by waiting an hour, that needs to happen. Then perhaps only the amount of alcohol needed to take the withdrawals away might occur.

Drinking 24/7 he is going to need at least another pill. I would suggest that he stops drinking at about midday and waits for the withdrawal to start kicking in then take another pill.

It's really more will power than anything else at the moment in my opinion.

If he doesn't cut down quite significantly he will die. Not going to sugar coat it, and before that he will lose you.

I also would extract yourself from the problem, it isn't your problem. Praise the good, ignore the bad. Don't let his alcoholism run your day.

Other thoughts include trying to change how he drinks. i.e. the cans have to stay in the kitchen so they are seen as medicine rather than drinks. Possibly pour measures out into a cup of which one is allowed per hour etc. Basically break as many behaviours as possible. But it really does come back to him being compliant and wanting to change.

I hope other people offer advise as it seems to me you need it and aren't ready to give up on him.

there is some useful stuff on HAMS regarding tapering down/off:

http://www.hamsnetwork.org/taper/

I've been where you are, & I'd definitely agree that Nal isn't going to do the job on its own whilst you're stuck in the physical dependency. once you can break out of the "drunk - feel awful - drink to feel better - drunk again" cycle, & have some clarity of thought rather than being stuck in a constant AL fug, then the Nal will have more chance of helping you

it's not easy, but it's do-able - best of luck!

-badger

despaired me, you are such a good person for wanting to love and help this man. BUT you have to take care of yourself and your children first. It is devastating for children to be around this kind of thing. You can move out and still see him and support him, but not have to live with it. In the end you cannot control him or do this for him, he has to WANT this to work and this level of addiction is going to go through hell to get there. You can support him, but only do what you can and number one is look out for yourself and your children.

Thoughts and prayers with you, XOXO Newlife

Only he can do this, and it sounds as if he doesn't want it. . The excuses sound so familiar.

If he does get to a point where he want to do this I'd recommend making sure he has 50mg nal before his first drink of the day, then part way through whatever his drinking session length is. Otherwise there's no targetting of the medication and it's just ebbing and flowing.

I remember always having cans around, it's so sad.

I am not physically addicted and am a binge drinker, so I can only speak from my perspective. I do think there are degrees of addiction, and your boyfriend sounds like he is pretty far along in the progression of his. My experience is that you have to really want to change for Naltrexone to work. It is a tool to help, but you have to do the work. Your bf is going to have to make very drastic changes to his life. Has he considered finding a doctor who is familiar with the Sinclair Method and will work with him? It sounds like having medical attention to help with the physical withdrawal would be a very good idea. It can be very hard and dangerous to attempt that on your own. Also, being part of some type of therapy or support group would be very helpful as well.

If I were you, I would sit down with him and have a serious talk. You and your children deserve better and you don't have to put up with this forever. If he is not willing to do the work and change, then you will need to think about what is best for you. I grew up with an alcoholic Father and I can tell you it is very damaging for kids to grow up that way in fear and shame. Good luck to you and please let us know how it's going.