Hi, first time poster on this site. I've tried finding an answer to our question in previous posts but so fare with no luck. Reading the experiences are great in figuring out what to expect with TSM.

My spouse went to an additions rehabilitation facility for 30 days. When my spouse came home she was on a daily 50mg naltrexone treatment. She initially said it was working at stopping her cravings but that was short lived and she began drinking two days after her return home. She did say she did not feel that good drinking, but she still drank. She drank less than when not on naltrexone. I was confused about her drinking which was now 3-4 times a week and it continued to interfered with her work and leisure activities. While surfing the net about naltrexone I discovered TSM and brought it up with her Dr at the rehab facility and he said if she stick with taking the pill 1 hour before drinking every time she drinks that it's worth a try.

Last Saturday was the first time she tried TSM after being off naltrexone for 2 days and she felt totally different and acted totally different then when she was on the daily dose. She got drunk and felt like going out partying again, although she did stop drinking earlier than pre naltrexone treatment. We both agreed that things did not go so well and she was concerned that it was not working like it should. 3 days later she tried TSM again and got drunk again and is concerned TSM is not working.

So we are wondering is this normal? It is like the 6 weeks on a daily dose of naltrexone was preventing the alcohol buzz, but TSM is not preventing the alcohol buzz. Should the effect of naltrexone not be the same with TSM as it is on a daily dose?

BTW, she also suffers from depression and is on an antidepressant.

Thanks

Hi Cab-

Welcome to the community! You've come to the right place!

There are 2000 studies and reports together that confirm Nal doesn't work when taken daily while being abstinent. Even placebo did a better job in delaying the time to the first drink. When used per TSM and sticking to the Golden Rule (Nal 1 hour before drinking) it will indeed work in over 80% of the cases. The book mentions a 3 month timeline, but many folks take rather longer than that to get where they want to be.

What's your wife's drinking style and history? She should keep up with the Nal per TSM and keep a drinking diary (just number of standard units consumed) on a daily basis. She can also use mindfulness techniques to speed her progress along. While some are quick responders and cut their intake by half or more when they start TSM, others won't see their consumption drop until they've been on TSM for a while, it just varies from person to person. Don't lose heart, your wife will get there as long as she sticks with the Golden Rule and doesn't wash the pill down with the first glass of wine.

Did you read Dr. Eskapa's book? Is your wife taking any other meds at the moment? Some of them don't work too well with Naltrexone, like benzodiazapines (Xanax and the like), so let us know.

Again, welcome and come back soon!

Naltrexone does not stop one from getting drunk and instead blocks the rush of endorphins and as such the buzz we are accustomed to. The key to Naltrexone is to drink slowly, and mindfully in order to recognize that you are not getting the reward you are accustomed to. Therein there is a moment once this is realized where one should put the drink down and not continue. Doing otherwise is referred to as drinking through NAL. That's the ideal scenario. By and large through strict adherence to the Golden Rule - 50mg, at least one hour prior to drinking, for life- consumption is halved by the second/third week.

One thing that could be occurring is the 'alcohol deprivation effect' whereby periods of abstinence prompt a furious compulsion to drink more than you typically would though I'm not sure this applies given what you have described above.

Curious? Have you read the text,"The Cure to Alcoholism" by Dr.Eskapa? If not I really believe it is key to understanding what you are doing and those who do typically have better results.

https://www.dropbox.com/s/60fs7gmvbyzs1kk/Cure%20for%20Alcoholism.pdf?dl=0

I would also encourage you to rent the documentary, 'One Little Pill':

https://vimeo.com/ondemand/onelittlepill

Lastly, you will find additional help on the optionssaveslives forum where the are free skype sessions offered by the councilors/moderators there:

http://optionssavelives.freeforums.net/

Welcome to the group! I'm sure others will chime in with some suggestions.

Thanks for the warm welcome and the much needed encouragement! My wife's drinking style is binge drinking in the evening, she often used to black out and then pass out prior to being on Naltrexone. She is 49 and here drinking has gotten worse the last 7-8 years. She used to binge on weekends but that has progressed to at least once during the weekdays the last few years. We did get Dr. Eskapa's book and she is reading it. I will read it too to know what to expect for sure. I'm the web person in our relationship so I'm on the web trying to find help too, which is why I'm here . The antidepressant she just started is Zoloft (sertraline), she was on something else but I don't know what it is of hand.

Thanks for getting back to us, Cab.

Did you notice any difference in her drinking since starting the Zoloft? Antidepressants often don't go well with alcohol and can deliver widely varying results from person to person, even when no alcohol is involved. If you google antidepressant and alcohol cravings, you will see reports of increased cravings, decreased cravings and no change at all, so it can be something of a wildcard.

A Skype session with a Cthree counselor, as Bardo suggested, can be very helpful indeed. You can email joanna@CthreeEurope.com to set one up, she and Moyra are certified alch abuse counselors and offer free informal sessions for TSM'ers.

welcome Cab---

glad you both are reading the book to see what you are in for. TSM really does work. I am a similar age to your wife and my drinking had stepped up markedly in the last decade too. the key is BE PATIENT and stick to the golden rule. it really won't happen overnight, but staying the course will get her there. good luck to both of you.