My Situation:

I’m a nearly 35 year old male with Bi-Polar Disorder Type 1. I’m medicated with Lithium, Gabapentin, Hydroxyzine, and Ambien. I was given a prescription for Naltrexone a few days ago.

I’ve been a drinker since I was 15, an addict of some/any type of drug from 16 until 26, I drank very heavily off and on during that time, but by 26 I fairly quickly transitioned to 100% alcohol.

Having spent the better part of a decade a very heavy drinker, I’ve also spent much of that time trying rehabs, AA, counselling, therapy, various psychiatric drugs (which help with lots of other things, but not drinking). At most I can get 90-100 days of sobriety before I have one “happy” day where I want to go out with friends and celebrate, the weather changes and I feel like a glass of wine to compliment a great meal, or the release of one of my favourite beers comes out and I just want a couple pints. That day leads to the next day being heavier, then the next one heavier, and so on until I’m drinking the cheapest thing I can just not to get the shakes. Eventually I’m drunk 24/7 and on the verge of suicide. I require medical detox to save my job because it becomes obvious I’m not just a little hung over here and there, but either I smell like booze all the time or have severe hand tremors and sweating the first day, and by day 2 I can barely walk from the muscle cramps and twitches.

I just medically detoxed and am now sober after 4 days in the hospital. While I was there I read more in depth about the Sinclair method, something I’d skimmed over a few times in the past. I also watched the One Little Pill movie in full and felt a great deal of hope for someone like me.

I’m very interested in trying The Sinclair Method, but I’m unsure how to go about it from a state of sobriety.

Should I just wait until I have a significant urge to drink, take the pill 1 hour before I drink and then attempt to drink normally?
Should I make sure I put as much time as possible between myself and my next drink to ensure that I’m more completely detoxed?
Is there some risk that I’m starting back into drinking when I am currently, albeit very briefly sober?
I worry that I would jump back to a high level of drinking, develop a physical dependence again, and would then have to taper that down or detox again.

On the other hand, I don’t see me being able to ever be 100% abstinent from drinking.

Suggestions? Help?

Wow, Benjamin, you have so much going on and have been through so much. I am very very sorry. I am still a Newbie (coming to the end of Week 6), so it probably be better for those with more experience to guide you, but from reading the book The Cure for Alcoholism, TSM does not work unless you are drinking. If you take naltrexone while abstinent it will not be effective. Sending healing thoughts your way, Newlife

I'm still pretty new myself, but I know they've found that while you abstain, the craving/addiction just builds and builds so when you do go back to drinking, it's going to be a big bender most likely.

You sound pretty sure alcohol will be back in your life. I would say it would be best to get nal and get ready for that next drink. I wouldn't drink just to try out the nal though, let that part come naturally.

Hi there!
I had exactly the same concerns as you about starting the Sinclair Method after detox and a short period of abstinence. My drinking pattern for the last several years has been exactly as you describe yours, and I also wasn't sure how to go about the method since I was worried about quickly going straight to very heavy all day long drinking requiring detox after just a week or two. What I have found so far, to my amazement, is that when I take Naltrexone and drink, I can drink a moderate amount at night (moderate by my standards, still a lot) and when I get up the next morning I have no interest in picking back up and starting to drink during the day. So I have effectively become a 'functional' night time drinker. Over time my goal is to quit completely once I hopefully get to the extinction phase, but for now I can drink so much less on Naltrexone that my life isn't falling apart around me. I'm still very early in the process, but so far it has been miraculous in that way.

Understood. I plan on taking naltrexone only if I'm drinking, and always an hour before.
I'm sure I'll probably want to drink soon, the changing weather always makes me want some white wine or cold beer, so that'll happen... already is happening, I just resisted today because I want to sort this out first.



This sounds hopeful.

I also look at some of the units of alcohol that people post as pre TSM on here, and I'm shocked at how low they are
Moderate for me was 50-70 a week, at my high 24/7 (but still working) rate I was at 150-200 a week. Those numbers scare me when I break them down like that.

Wow BenjaminB sounds like you may have found a lifeline just in time. Keep posting and let us know how you are. Newlife

First let me say that I think you're making wise choices, especially with regard to keeping your bipolar condition under control. That is an all-important first step!

Second, if you do start drinking again , follow the golden rule, and be prepared to do it for as long as you continue to drink. That takes committment, but from the sound of things it might save your life. When you start the TSM there are a few things you can do to to help. Hesitate between drinks with something non-alcoholic, don't drink more than you feel is necessary, keep tracking, be patient, and do something healthy like exercise when you get to the point where you can have AF days.

Best of luck!

I agree, seeing that most people here were in the 40-50 per week range before TSM worried me. I would consume 200-300 per week during a typical 'round the clock binge. I just hit the end of my first week on TSM and I only had 34 drinks, including 2 alcohol free days. This may partially be the honeymoon effect, but obviously something significant has happened. I wish you the same good fortune.

Benjamin and j3625 - I just starting reading the book over the weekend, and the beauty of it is that TSM appears to work for people who want to stop or cut back on their drinking at all levels. My numbers look low compared to some BUT first I am small boned and petite, and secondly it was the obvious progression of my drinking and the blackouts and bad behavior that made me realize the slippery slope that I was on. I may not look like an alcoholic on the outside, but in my heart of hearts I have known for a long time that I approach alcohol differently than those who do not have a problem - the bottle calls to me. You guys are just a little further down the road, but if I kept going the way I was I would eventually be there too. Aren't we lucky to perhaps have a chance to regain control and take back our lives? Wishing you both the very best with this. Newlife

Hi Benjamin,

Glad you posted. My alcoholism is also pretty far advanced. I try to abstain from alcohol, and then when I know I'm going to drink, I take Naltrexone 45 minutes to an hour before. I've found that I often have a "tug-o-war" between the idea of abstaining or drinking with Naltrexone. It's a trade-off like everything else in life. If I do abstain, I'm not hungover the next day, but if I do drink and take Nal I'm one drinking session closer to extinguishing my craving/obsession. I'll refrain from giving advice but your pattern sounds a lot like mine. I stay sober for 3-4 months then "fall off the wagon." I ultimately think abstinence is the best way to go for me. If and when the voice in my head gets too loud and incessantly cries for a drink then I take Nal and drink and try to drink at home. The Sinclair Method does work it's just making sure you don't hurt yourself or someone else during the 3-12 months it takes most people to find a cure. I'm single and live by myself and can walk to bars, so I'm not driving but it's still not as safe as someone doing the Sinclair Method at home with support from a family member or spouse. I tend to drink more at bars than at home. Just my $0.02