I hope this isn't a stupid question.

As I understand it, TSM is a way to "reprogram" the neural paths to eventually not want/care about drinking. A number of people on this board talked about using abstinence and then breaking down and binging even more than before. TSM seems like the way to go.

I've never bottomed out - but noticed that I was drinking pretty much every day and that I would sometimes "binge". I tried abstinence a few times with failure. I recently read Allen Carr's book on Stopping Drinking and since then, I've been successful at not drinking (we're talking 7 days right now). I've purposefully put myself in a number of situations since I don't really want to change my environment nor my friends and I've been successful so far.

Since I do like the taste of food and wine together (we live near wine country), I'd like to create a situation where a glass with a meal (at least special meals), doesn't put me in danger of spiraling back. Would taking naltrexone one hour before the meal serve my purposes? Or do I need to expect to use it all the time? Since it would be the first time - do I take the reduced intro dose? Or should I just stick with my current abstention program unless it fails and then try TSM?

Thanks for the advice?

cwxcw-

Your situation sounds a little complicated. I am not aware of the book you are read. The one you would want to read is The Cure for Alcoholism by Roy Eskapa (there is a link to the book for free, but I don't have it right now if someone wants to post that). Or just do an internet search for TSM and you'll find articles, etc. With TSM you would take 50mg Neltroxone 1 hour before you drink, always. 25mg the first couple of times is common just to see if you feel any affects. Most people don't. I couldn't help but notice:



The answer to this is YES. If you start TSM you can never drink without Naltrexone again. The results can be devastating.

Anyone disagree?

Yes, you can definitely combine the two.

As long as abstinence is working for you, there is no need to take Naltrexone. However, since you have a history of binging and also want to have the opportunity to enjoy a nice glass of wine with a good meal, it is very unlikely that you will be abstaining forever. So you should order some Naltrexone as soon as possible and have it on hand for the next time you choose to drink.

You don't need to "bottom out" or fail at abstinence in order for TSM to work for you. Just take your Naltrexone an hour before drinking, anytime you drink. If you are not planning to drink, don't take Naltrexone. If you change your mind, take your Nal and wait an hour. If you change your mind again and decide not to drink, no harm done.

Your question about what initial dose to use if you are planning to drink only sporadically is a good one, and there is no simple answer. People often take a lower dose initially in order to reduce possible side-effects (nausea and dizziness are the primary side effects, and they will diminish if you continue to take Nal regularly). Some people have no side effects with the full dose right away. I would advise taking a half-dose of Nal soon after it arrives (on a day when you have no work or social obligations) just to find out how your body responds. If you are still abstaining and want to continue to abstain, then take the half-dose at a time of day that you wouldn't normally be drinking anyway. There is no harm in taking Nal while abstaining, and some people find that it reduces cravings. Then after you know whether you have side-effects from the Nal, you can continue abstain and not take Nal for as long as you chose. If and when you start drinking (moderately if at all possible) again, then take your Nal and let TSM do its thing.

The book is just a perspective to help drive abstinence (quite useful actually), it helped me approach not drinking as a thing one would WANT to do rather than a hardship. Really just a way to change perspective. It's the first time that I've been able to stop drinking for this long a period of time.

As I said - the one situation that I would like to drink again would be wine and fine dining - more for taste complements than the buzz. Seems to me that Naltrexone might be a way to handle that issue without sliding backwards from the craving. I would just pop a tablet one hour before dinner.

I'm certainly not a TSM expert, but it doesn't sound like it would hurt you to go this route. I would just be sure you do it every time. If you find yourself in a situation where there is dinner and wine and you didn't take Nal, you should skip the wine. Too risky.

You're describing a very valid reason to use NAL. Much better to have an occasional glass of wine with a good meal, than sit at home and pound down a bottle or two mindlessly, with all the expected bad consequences.

It is entirely possible to go from excessive daily drinking to occasional wine with a good meal. With TSM, you don't have to struggle to do that, because your desire to drink goes out the window after a while, as it doesn't bring the reward it used to.

As it becomes clear that drinking doesn't bring any coherent reward in any form or fashion, you become okay with it not being the center of your life anymore.

I'm with you, I wouldn't want to miss out on a good glass of wine with dinner !

PS. Abstinence after reading that book is a choice, you may certainly use it to change your perception of alcohol, and change your life for the better.

I'm a new poster and wanted to push this topic up because it more or less describes me. I'm AF for 3 months (rather than 1.5 years), have tried AA but feel like it's not a good fit for me.

Have known about TSM for a while and likewise would enjoy the occasional glass of wine or beer or cocktail for special occasions without relapsing into daily excessive drinking, which I was certainly doing before. I'm so glad I'm not doing that anymore; I would like to keep abstaining for as long as I can, the physical mental and emotional benefits have been huge. But think I will probably drink again at some point.

I've been lurking here for a while and am glad you folks exist. Thanks for reading

From my experience Nal works really well. One loses desire to drink, but still enjoyed a glass of wine here or there. I am only 10 days in, but feel that huge change has happened. I simply do not desire drinks any more when I am home and when I am out I have a drink or two. I feel great in the morning and sleep also well at night. I am only taking 12,5 mg of Nal. This allows me to be without side effects. Keep good work! I envy you such long period of being AF.

Hi there - yes it could help you, but it doesn't work overnight - as you have probably read it can take a year or more for some - I have been taking it for 6-7 months and am still not 'cured' although this past week I have actually not wanted to drink - RARE for me ! SO, if you did start drinking again you might find yourself in deep again unless you could control it while the Nal did it's thing .... if you follow ?

Hugs, Maggie