I'm about 2 wks into the program. My mode of drinking is to have no interest at all during the day, but cravings --> binge drinking in the evening (around 10 shots or so). I do notice the initial buzz is decreased and delayed, therefore the meds seem to be legitimate (I ordered from Mexico), but I do get a little bit of euphoria still. The book says that at 50mg, "100%" of the opioid receptors are blocked. So why do I still feel some buzz?

I guess my question is: for someone who drinks large quantities like this, is there a possibility that I need a higher dose of Naltrexone? Is the fact that I still get some buzz from the booze a bad sign?

Also, has anyone found something to reduce the *amount* of binge drinking while on Naltrexone? I haven't had much success with Campral or Baclofen (or L-Glutamine, etc.), and wonder what else there is.

As I understand it, the opiod blockade taking place is something entirely different from the 'disorienting' or 'buzz' effects of alcohol. What is being blocked is more some deep, neural signals of 'satisfaction' or 'pleasure' that comes when opiods bind with their receptors. The effect of TSM is effectively invisible on a moment-to-moment basis. Over a period of many, many interactions, one's body and mind eventually divorce the act of drinking from the sense of satisfaction and completeness that we typically got from drinking.

Some of us find we actually get MORE buzzed form LESS alcohol as time goes on, but that we simply don't enjoy it the way we did. This has been true for me. I was addicted not to the slurring and drunkeness, but to the sense of completion and fulfillment that drinking gave me. Now that that relationship has been broken, I get my satisfaction otherwise - I don't miss getting it from alcohol.

Many people also report that even though they are getting well and truly buzzed while drinking, they retain more awareness of that fact, and are less out-of-control, sloppy, or embarrassing. Still drunk, just with more self-awareness.

Alcoholics often seem to ask, "Why would I do this if it removes the satisfaction/pleasure of drinking?" - the answer for me is "why indeed?" I don't know. Before TSM I could not imagine NOT wanting alcohol. I just couldn't. Now I can. The framework of the original question no longer applies, so my previous assumptions about I would or would not want or tolerate have completely shifted. I'm not describing this well, sorry!

Long story short - the quality of your buzz as you drink may change noticeably as you continue to drink on TSM, but it does not prevent alcohol from having many of its more obvious effects. TSM is a process of conditioning, not a direct, immediate effect.

PV is entirely correct: naltrexone works by blocking the endorphin rush in your brain when you drink. This happens at a subconscious level and is entirely separate from the buzz you get while drinking. As stated above, almost everyone still gets buzzed drinking on naltrexone, although often in a slightly modified way. 50 mg does fully cover you. The relevant issue is not how much you drink but how long you are drinking. If you have ten shots in one evening on 50 mg you are covered; if you are drinking 24/7 then you should probably take another dosage as explained thoroughly on another thread.

BTW, I really appreciate the thoughtful, articulate, patient responses !

Also, regarding my question about Baclofen (to reduce the *amount* that I drink while on TSM, not frequency), it seems that according to Olivier Ameisen, I may simply need a higher dosage...
http://www.olivierameisen.com

Check out my graph. The link is in my signature below. My consumption started to reduce when I added high dose baclofen.

Hola & welcome paulster -
I am no expert either, but go with the advice & recommendations in the book as far as trying the 50 mgs for at least 6 months & see how you do. A few of us (myself included) upped the dose at 6 months - but I am solely an evening drinker, averaging around 35 - 40/ wk & now taking 100 mgs.

If you catch up on other posts, I am seeing minimal changes, but not giving up. Probably never will. Try it and see how you do. If you get nauseus & stomach upset after 25 mgs those first few days, chances are it will work for you. I have just observed those who get an initial strong reaction on NAL mostly get the expected benefits. Others of us, it takes awhile.
We are a work in progress. Good luck to you and hope to hear more as you get into it!

GO HORNS!!!!!!!!!!!!!!!!!!!!! DAMN - McCoy injured!!!!!!!! OH F****** CRAP!!!!!!!!!! C'MON HORNS!!!!