i emailed dr. cox


> Hi Dr. Cox, my name is Larry Najor and i been emailing Dr. Roy Escapa with a few concerns im having with TSM.He has been very helpful. I would really appreciate if you can answer two questions for me please. The first one is, I been doing TSM for 3 and a half months, and i experienced a significant drop the first week, then from there it went back to my usual drinking. My question to you is, i been taking Naltrxone two hours before my drinking session NOT one hour. DID I RUIN MY CHANCE FOR TSM WORKING FOR ME? I'm starting now and sticking with one hour before drinking but worried i ruined my chance for TSM working for me.I did this because on page 205 in the book THE CURE FOR ALCOHOLISM, it said you can take it the morning.
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dr. cok emaile me back


Larry,
I am glad you are working on this problem.
I am not suppossed to answer direct questions from people who are not my patients becasue a lawyer would twist my Good Samaratin gesture as delivering medical care without examining a patient and suck me down into malpractice. What a world!
I will say that early responses that reverse can be a placebo effect. The studies show that for the bulk of patients naltrexone works like having a baby, it takes 9 months to work on average to completion with lots of ups and downs in the clinical course in individuals




WHAT DOES HE MEAN?
"I will say that early responses that reverse can be a placebo effect"

Probably just what it says. If you see a response quickly after starting TSM (as you did), it is likely caused by your wanting it to work and expecting it to work. Not unlike taking a medicine for a cold and immediately thinking, "I feel better already" even though there is zero chance the medicine has even hit your bloodstream yet.

Larry, Dr. Cox said that it could be (conditional) placebo, and while that's possible, just because it might be a placebo effect, does not mean that the medication isn't working. Most people experiences placebo effect whether a medication is genuine or fake.

Your reaction is fairly typical of what a lot of folks on TSM experience: The Honeymoon: A rapid and marked reduction in consumption followed by a return to previous drinking levels, followed by a slower and permanent drop in units. Dr. Eskapa covers this in his book too. Try to relax and just follow the treatment, it's working but you need to be patient.

Curi

CuriousOne, thanks so much. sometimes i dont understand what i read. i should of went to college. let alone high school. who cares i still do ok for my family.thanks again my teacher.