My husband has completed 3 months and 2 weeks of TSM. From the very first week, Nal allowed him to cut his consumption from 110 units per week down to 50 on average and his AF days from 1 day per week up to 2 days on average. I was was encouraged by this!

Three months later, the charting shows no additional progress. He is still at 50 units and 2 AF days per week, the same drinking level as in week 1.

I reread the book thinking I was misremembering something and expecting too much, but time after time, it says most people who are compliant with the program see their levels dip down to 15 units per week followed by 9 units per week within 4 months. For a few stragglers, it can take 9-10 months.

I have seen a very slight increase in overall consumption in the last 2 weeks, but nothing concerning.

I'm curious if any of your drinking charts found something similar. Is this as good as it gets for him? Are these typical results for someone for whom the program takes 9-10 months? Should he be seeing additional progress? Is this evidence that he needs to attack the psychological and habit portions of this addiction because the pharmacological extinction has done what it could?

Am I being naive and not seeing something here? He is diligent in taking his Nal as far as I am aware. The prescribing doctor is several hours away, so he has not been back since the first visit. (That is going to be my next suggestion to him unless I get other advice from you.) I'm open to hearing the good, bad, and ugly and any advice you might have.

- The Still Supportive Wife

Dear Squash - in fact it can take up to a year or two for people on this forum. I am five months in and JUST starting to see results but they have been amazing. Please do not let your husband give up. This works miracles, and if it takes a few months longer than ideal,what is that alternative?

Maybe encourage your husband to come to this forum? Hugs from Newlife

It has to be asked/stated when a 3rd party is doing the reporting: He may not always be taking his NAL, which could account for all you have observed. Failure to take the pill every time will result in failure. Perhaps you could surreptitiously count his pills and monitor? An alcoholic will never have a qualm about lying if it involves alcohol...

No follow-up with the Doctor is a little weird too, -usually they all want a follow-up blood test to check liver function.

On the bright side, -he could just be a slow responder.

This is weird - I replied to this post and yet my post is not here! Squash - welcome - I know that it is hard for the spouse but this is hard enough for us without a non-drinker 'helping' us. I am further along than Newlife - I started in January and still am not 'there' yet! The units will go up and down - but there comes a point where your husband has to also help himself - the Nal is not a magic pill.

I agree with newlife - have your husband maybe come to this forum and chat with us - it is really helpful to 'talk' to others going through the same thing. Oh - my doctor gave me a 3 month RX with 3 refills, so a years worth - and has not told me to go back at all - so that to me is not odd - I will go back at the end of the year to ask for more ! I think the liver thing that Clarion mentioned is when Nal is taken in higher doses. I read somewhere that one needs to take 300 mg continuously for it to need ones liver testing.

Hang in there, Hugs, Maggie

I'll keep being supportive and do my best to recompose my patience. He's still enthusiastic about TSM. He hasn't mentioned noticing the lack of progress, and he has told me he feels like it's working. Knowing this is normal for many people allows me to give him encouragement rather than share critical speculation, if that makes sense.

It kind of feels like winning the lottery. Seeing TSM working had me so excited. Now that 3-4 months has passed, it feels like I went to the lottery office to pick up my check, but when I got there, I was told I checked the box for annuity payments instead of a lump sum. Sure, I'm ecstatic over the progress that's been made, but since I expected much more, it's a let down too. Knowing more annuity payments are coming is good.

He is already here on the boards. He knows I come here to read up on TSM too. I don't know how active he's been recently though. If he expresses any doubts, I'll remind him to come here.

I appreciate the suggestion, Clarion, but I cannot count pills. As the wife to an alcoholic, I have fallen into that trap too many times, and I hate who I become. If he is lying and this all fails, I am prepared for that.

I think I will ask him when his doctor wanted to do a follow up. I do not remember if he was supposed to set a schedule or if it was on an as-needed basis.

Thank you for taking the time to reply twice and for the warm welcome!

Would you give me examples of "helping" that has made this harder for you?

I also wonder if my husband's expectations were for a magic pill. He mostly keeps things to himself, so any internal or mental work he is doing is on his own and has not been shared with me.

He does go in for liver testing a couple of times per year for another medication, so the doctors may be sharing that information too.

Hi Squash - I think the main thing that I do not like when a non drinker says anything is that they have no idea what it is like to have this addiction - the old adage about walking a mile in my shoes comes to mind. My mum always used to make me feel so guilty about the drinking - if I did or didn't! If I went to stay with her she would make a point of saying 'why don't you have a drink?' and basically if I did or didn't drink, it was wrong in her eyes - I think it is so hard for a non drinker to understand and it pretty much boils down to the point that I do not want her to say anything about it ! I have recently told her about TSM and also when I was having some measure of success a couple of weeks ago, did tell her about that and she was pleased for me - so that is good, but otherwise I really do not want her to say anything !

What is your husbands name on here ? Who is he ? So we know ..... I am so glad that you are supportive of your hubs - I do understand how hard it is for you. I remember seeing my mum and dad and he used to drink - my mum doesn't and he often had too much - so I do know how it is to live with ! Also my hubs drinks and more than me and I do not like how he is when he drinks - so I really do understand where you are coming from - you just want your husband back! And I totally got the lottery winnings analogy - nicely explained !

Hugs, Maggie x

Squash, I SO understand your disappointment, and your husband's. Every one of us here was secretly hoping when we started that we would be one of those lucky few that was cured in a week or two. Some by as few as three or four pills. I know I felt that way. But it looks to me like they are the exception rather than the rule, far more of us have taken longer, and again, many of us are taking longer than the book says, but STILL being helped, sometimes even two years in. It is a shame to think that many people probably give up before they get there. Patience!! But I know it is hard to have patience. I also think you are wonderful to support your husband. Personally, I would NOT want to live with someone with an AL problem, as ironic a statement as that may seem coming from me. But I just wouldn't want to: it must be so hard to see someone you love doing such destructive things and know that you are powerless really to do anything about it. Keeping my fingers crossed that your husband will see some real results from this, and SOON!! Nal on!! Newlife

Hi Squash,
I think it is easy for us all to get too caught up in thinking about that 3-4 month time-frame or what our drink numbers look like from week-to-week, when really there is a large variance with each of these quantities and a lot of inherent randomness. I think the fact that your husband's consumption was cut in half right away is the most important sign that Naltrexone does have an effect for him. As far as breaking the habit and reducing further, I know for me an effective strategy was to intentionally try to achieve various goals, like "I'll try for 4 AF days this week", or "I'll see if I can have only one drink today". And the good thing about that is knowing there is nothing wrong with not succeeding as long as you are taking the pill. I saw it more as a little experiment with myself to see what was possible.