My husband is at the point in his addiction where there is basically never an hour when he is not drinking, except when asleep! (he is not working at the moment)

He'll take a naltrexone as soon as he wakes up, but I know for a fact that he is not waiting an hour--we are lucky if it is 10-15 minutes before the first drink.

Are we wasting our time?

We are almost 2 months into the treatment, initially I noticed a change in the quantity of alcohol consumed, now I am not sure if there is any improvement.

Thank you! I appreciate any feedback.

You really need the naltrexone to be on the receptors BEFORE alcohol is drank. Only thing I could suggest is is there a way of waking him in the night, giving him the tablet, him going back to sleep for an hour?any chance at all?

In the early days of this forum, Dr. Eskapa posted some. The following is an answer he gave to a similar question:

Q: If I "forgot" to take my naltrexone before drinking should I take it as soon as possible?

A: Yes. Absolutely. You should take the medication right away - even if you have already begun drinking. It is better than simply allowing the endorphins another chance to reinforce and strengthen the opioid system in the brain. Of course it also depends on how long you have been into the drinking session and how many units you have consumed. Taking naltrexone at the end of the session - after many drinks - will probably not produce extinction but if you catch it in time so to speak you may prevent the 'consolidation effects' - that is during the period after the drinking session when the reinforcement from endorphins settle into the brain. There is very little research on this - however I heard about a researcher in Finland who was investigating the effects of giving naltrexone to addicted lab rats very soon after the animal had already started in on their drinking sessions. Extinction occurred. Despite this, you should take your medication BEFORE drinking and if you are serious about deleting, removing, extinguishing the biology driving craving and addiction please remember to take the medication properly - exactly as described throughout The Cure for Alcoholism - in much the same way as diabetic patients must take insulin or other medications according to the proper schedule. If you have a drinking problem, have lost control over your drinking, crave excessively .... remember Step 5 .... THE GOLDEN RULE: NEVER DRINK ALCOHOL WITHOUT NALTREXONE

(Of course taking naltrexone when you abstain is totally ineffective as over 35 clinical studies showed - including one large one involving over 600 VA hospital patients published in the New England Journal of Medicine by Krystal et al, in 2000)

You might also have him take another pill about 12 hours after he takes the first one. In response to a 24/7 drinker who asked a similar question, Dr. Eskapa had this to say:

If you are drinking throughout the day take 50 mg an hour (or as soon as possible) before you start at 9 am. If you are still drinking at 9 pm take another dose of 50 mg. It is possible that there are variations in metabolic clearance and individual differences among opioid systems. If you start at 9 am it is possible that by 9 pm - if you are still drinking - that the naltrexone may have washed out of your system to some extent therfore you might not be covered by opioid antagomism (blockade).


One thing I learned in AA is that "it takes what it takes."

Your loyalty and compassion are wonderful to see. Best of luck.

Hi Jafant and Welcome!,

Taking Nal only 15 minutes before drinking is better than not taking it at all, as you know the ideal is 1 hour. As UKBlond says, try waking him before he'd usually wake and give him the pill.

I remember reading in the book that Dr. Sinclair said that people who drink all day should take Nal twice a day, the second one, half way through the waking hours. This is because Naltrexone, like every medication, slowly wears off, so if he takes his first pill at say 10 am, by 2 to 4 pm it's only half as effective as it was when he first took it, so by evening he hasn't enough to block enough endorphins. You know, like when taking something for a fever?, you have to take it every few hours as the effects wear off.

You said that you thought you saw an improvement in the beginning but not so much now, I think that's probably a good sign, many people experience a Honeymoon period, when they see an improvement quite quickly but then drinking levels go back up again, and plateau before slowly dropping again. If that is what your husband experienced then it is a sign that he is responding to treatment, so don't get disheartened.

Other things you can do to help would be to get him to drink a glass of water at regular intervals, not too much as it will only put him off, he might even gag, but say the equivelant of 3 big gulps every few hours. And the same with food, get him to eat a small protein snack every few hours too, things like a drumstick, a hardboiled egg, some carrot sticks and humous, beef jerky, or protein bars. Just leave the food lying around close to him and let him graze, gently reminding him now and again if he tends to forget. Hunger and thirst are THE two biggest physical triggers, I cannot emphasise how important they are! Avoid sugars and refined carbs as they often create alcohol cravings. Basically meat, fish, eggs, fruit and veg and as much as he can eat. A daily multi vitamin and omega 3 capsule would be good too.

Finally, look after yourself too. You can only help him if you are in good shape yourself. Seek support here or around you and prepare yourself psychologically for a long haul; TSM works for most people, there's no doubt about that, but the longer and harder we drank, the longer and harder it is to gain control.

Best of luck and stay in touch.

Curi

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