Alcohol influences a lot of neurotransmitter systems, not just endorphins. I have problems understanding how selectively blocking the opioid receptors can result in extinction when the action of other feel-good chemicals is not being blocked.

The whole "pharmacological extinction" concept is very clearly too simplistic and is not based on sound experimental science. But why does it matter to you? TSM seems to work for many. At the very least, there is, at present, certainly nothing out there that works better. And it's as safe as any medication treatment goes. So there is nothing to lose - why not try it and see if you are among lucky ones?

I know it's safe and worth a shot, in general I prefer to have a somewhat decent understanding of the mechanism of action and this question came to my mind.

I already have ReVia® at home. Does the procedure work if I "just" drink every two or three weeks (but then a lot obviously), if I take the naltrexone before consuming the alcohol? Or is the method more suited for people who drink daily (with NAL obv) and their brain therefore should be able to unlearn the endorphin-mediated reward at a much faster rate? Hope this makes sense.

Hi Antagonist,

The program should still work, although your results may differ from someone that drinks more frequently. I guess one way to look at it would be to consider the analogy that pharmacological extinction converts those neural pathways in your brain that are associated to endorphin-mediated reward from "super highways to country roads." Someone that drinks more often may have more opportunities to work on that conversion, but since you are someone that only drinks once every few weeks (albeit heavily) your super highways may not be as embedded, and thus may be dismantled easier. I suppose this is a long way of saying that you should still see results.

Best of luck to you, and keep us posted!

-H

It's nice to know but decidedly not required. Mechanism of action of quinine (that was critical in enabling European exploration and colonization of equatorial zones) was not known for centuries. Precise mechanism of action of penicillin was not know for few decades. And so on.

My guess is that opioidergic system plays dominant role in addiction in some people - and those are that benefit from TSM most. For others, it's a mixed bag. In my case, for example, the addiction is not gone after 2.5 years but, rather, settled down for a much weaker version of itself. Still beats all the alternatives I am aware of...

Hopefully your binges may become much less wild after nal in the first place.