Hi,

My brother started TSM two years ago with 'some' positive benefits. His progress thread from back then. It was far from a cure, but it helped tremendously in slowing down his drinking (if not reducing actual units) to the point where he would rarely seem intoxicated. His wife liked that.

But, we are having some difficulty getting supplies of Nal into the country (Saudi), as its not an approved med and he has seen his supplies confiscated at the post office. So he's basically relying on his wife who orders it from her home country (Taiwan) and brings it back with her once a year.

In the past few months though, there was a major interruption of supply (about 8 weeks). But when he got it, he went thru the 'honeymoon' period again where his cravings dropped dramatically for 2 weeks then back to pre-TSM levels if not worse. It took about 5 1/2 months last time for TSM to kick in. And I fear this 8 week interruption of supply may have put back to square 1.

I was wondering if anyone else had interrupted TSM for whatever reason and got back on it. Would an 8 week interruption completely unravel almost 2 years of consistent Nal usage? If so, I was wondering about the honeymoon period and perhaps some tinkering with the dosage days. For example to take Nal for 2 weeks, stop for 2 weeks (or some variation of that sort) with the idea of experiencing roughly 50% of his time as on the honeymoon period indefinitely. I realize it may seem unusual and perhaps wishful thinking, but this is only being considered as there are serious doubts about consistency of supply.

Would appreciate any comments from anyone who has gone on/off from TSM for whatever reason and their experiences with the effects of that. Thanks.

I used Nal and eventually went alcohol free for a year. See some of my posts. I am an early bird.

I decided to drink, using Nal after a period of time where I did not drink or use Nal. I seem to experience what your brother is experiencing. It would seem that there is not a continuity in the treatment. Having said that, I suspect that there is something physiological different about us to normal drinkers. That is why I have "intuitively" stated on posts years ago that you should use Nal until the train slows down enough to "jump" and get away from alcohol. The idea that we will become as our non-alcoholic counterpart is a fallacy.

Drs. Eskapa and Sinclair, I love you both for all that you have done but I think that that promise is one that will not be realized. TSM is a path to sober living but NOT to social drinking.

I was on TSM for over a year and felt "cured." I went about a month or two of drinking without Naltrexone because I missed the old euphoria. I began drinking at unhealthy levels after a month or so. In January I went back to TSM and regained control almost immediately. I did not start from square one.

SR, I agree with you entirely that TSM is not a "cure" and should not be advertised as such. Even if we continue drinking on Naltrexone "there is something about us" that is different than non-alcoholics. However, I disagree that one cannot successfully drink socially on Naltrexone. With the exception of my time off of Naltrexone, I have been drinking regularly at healthy levels -- about 15 units a week -- and have been for over a year. Several other people here have had the same or similar experience on this board. For me, the train comes to a slow, controlled pace, so long as I always take the pill one hour before.