I have a question relating to the TSM as it would be used by an all day drinker. I lost many friends to alcohol because they finally just wore out their livers and kidneys and hearts. There are a certain number of people that drink non stop from the time they awake, if they sleep at all, until they fall asleep, these are people that may be retired or whatever but do not have to work. So if a person like this could find the opportunity to take Nal one hour before that first morning drink but then his routine is to never really stop throughout the day, would he take another pill 4 hours later? Would that first and subsequent pills have any effect on this person who is already pretty much drunk or half drunk all the day long. I can see him having to take 5 pills a day if he is up 18 hours a day. I just wonder if this cure can somehow be used in conjunction with a severe alcoholic like I described above. Believe it or not there are entire communities of people like this that have nothing to worry about but except where is the waiter with my drink, I was one and maybe I still can find one or two old friends that have not died that I might be able to help. Any replies would be welcome.

Dr Sinclair suggested that in cases of 'all day drinkers' probably they should take naltrexone 1 hour before the first drink of the day - say at 8 am then start the session at 9 am and if they find themselves drinking at say 8 pm take another 50 mg tablet naltrexone. More naltrexone is not important - though the maximum daily limit is 300 mg / day - but as long as the opioid receptors are blocked there should be no reinforcement coming from the endorphins released in the brain as a result of the presence of alcohol.... this will enable pharmacological extinction to take place gradually. In 8 out of 10 cases one can achieve success - drinking down to safe WHO limits or abstinence and reduced craving. This has not been put to the test in a controlled trial as far as I know but this is what they recommended at clinics in Finland where TSM was researched. Remember no treatment is 100 % successful for 100 % of cases (unless you are a lab rat!) but anything above 70 % was unheard of until TSM. [b]TSM requires meticulous following directions.. even a single day skipping naltrexone can reignite the addiction in the seriously addicted .. this is not always the case though.[/b]

Dr. Eskapa,
Thank you very much for your response, I certainly was not expecting that you would be the one to answer my question. So if I am understanding your posting correctly I could perhaps hope that if I can pass on this information to someone that is as deep into his drinking as I described and if he can begin the treatment in earnest then it might help him eventually to get back on a somewhat normal routine. It is such a pity that this treatment did not have the positive press in the past that it enjoys today, it might have helped some dear friends that are no longer around. I thank you very much for your posting on this subject.

Interesting thought!