Hi Mtka1 and welcome!
I'm sorry that you have had painful withdrawal, are you being followed by a doctor? When you say "program" do you mean The Sinclair Method or are you in Rehab? I am asking you this because TSM does not require detox. You take 50mg of Naltrexone one hour before you drink, every time you drink and if you don't drink, you don't take Naltrexone. This is not the same as the traditional way of using Naltrexone which is to first do detox and then after a number of days of abstinence Naltrexone is taken daily. To do TSM you need to continue drinking.
If you want to do the Sinclair Method I would strongly advise you to read the book The Cure For Alcoholism by Dr. Eskapa. You can down load the ebook from amazon here:
http://www.amazon.com/Cure-Alcoholism-A ... ETQFSWU1YMIt has all the information you will need. How the treatment works, what you should do, all the clinical trial results and a letter that you can print out to show to a doctor.
Here is an extract from Wikipedia which explains the theory of TSM:
Quote:
The basis of the Sinclair Method is that taking naltrexone changes some addicting behaviors into non-addicting behaviors. When an alcoholic consumes alcohol, the desire for alcohol increases. When naltrexone is used during consumption of alcohol, the desire to drink is decreased because of naltrexone's interference with the brain's reward system.
Endorphins are part of the body's reward system for performing healthy behaviors. Sex, exercise, eating, and risk taking generally result in the release of endorphins. The endorphins "teach" the body that the behaviors that were performed prior to the endorphin release are behaviors that should be repeated. Alcohol triggers the release of endorphins into the system, reinforcing drinking behavior. Continued consumption of alcohol strengthens this reaction. The theory suggests that for those with a strong endorphin reaction (generally due to genetic factors), the pro-alcohol conditioning exaggerates the strength of arguments for drinking, and perpetually keeps drinking in the person's mind as a favorable option.
Operant conditioning suggests that, should you perform a behavior and be rewarded, then the urge to perform that behavior becomes stronger. Furthermore, if you perform a behavior and are not rewarded, then the urge to perform that behavior gets weaker. This effect is referred to as the extinction of that behavior. This was demonstrated in the research by Edward L. Thorndike and later, B. F. Skinner.
In the case of alcoholism, the behavior is the consumption of alcohol, and the reward occurs when the neurons involved with the drinking behavior receive a flush of endorphins. By this theory, if the drinking behavior occurs and the neurons do not receive their flush of endorphins, then the pro-alcohol conditioning should be extinguished. In practical terms, if you drink and the endorphins are blocked from stimulating the neurons, then you lose interest in drinking. By this means, the urge to drink that is the cause of alcoholism is eliminated and the alcoholic regains control of their drinking.
http://en.wikipedia.org/wiki/Sinclair_MethodTo answer your question "does Nal work the very first time you take it?" it depends on what you mean by "work" What are you expecting?
The thing is that we all react differently to Naltrexone, generally speaking, the longer and harder we drank, the longer and harder it is to regain control of our drinking, so someone in their 40s or 50s who has been drinking daily for 10 or 20 years will take longer to regain control than someone in their 30s who has drank less and less often. It can be a slow process and you probably won't feel a marked reduction in your drinking straight away, though you should feel some difference like a greater feeling of control or a greater ability to stop or less interest in drinking. But, you may still drink a lot and the alcohol will still effect you physically the same way, so you should never drive or operate machinery while drinking with Naltrexone.
If you tell us a bit more about yourself and your drinking: number of units, what drinks, how many hours a day/days a week, how long you've been drinking etc... people with a similar history can tell you about their experience.
Take your time, read the book and find a doctor to follow you if you can.
Best of luck.
Curi.