Hi all. I'm relatively new to TSM (started about 2 months ago); since beginning the process, I have been avidly informing myself as much as possible. I check this forum every day (even though I only registered today), and I feel like I have a handle on how this is supposed to work. And yet...in its simplicity, I am currently feeling adrift. At first, I felt a high sensitivity to the naltrexone and enjoyed a marked decrease in consumption (had to start at 12.5 mg/day for the first week, and I've been taking 25 mg/day since).

Lately, my drinking is climbing upward, and I'm a little scared. I don't enjoy drinking when I take nal, so I know I'm experiencing a psychological craving rather than a physical one...and still, I drink. I drink without knowing what it is I seek, and I drink while knowing it will make me feel worse. Meanwhile, the knowledge that the craving is for more for escape rather than for the alcohol itself is not enough to initiate change in behavior.
I feel like I've got one foot in both worlds: wanting to get better, and having the tools at my disposal to do so, yet fighting it with all I've got. It's discouraging to feel like somewhere inside is a part of me that wants to stay fucked up.

I follow the golden rule, and I feel like the medication is doing what it's supposed to: I do not enjoy drinking. So why the hell do I still do it? I'm exhausted all the time since starting the nal; I'm depressed, lethargic, and especially irritable. Rationally, I have every reason to not drink.

Besides venting, here's my reason for posting: should I increase to 50 mg? (caveat: I know that there are behavioral changes I need to make, as in scheduling my time to create accountability for not drinking. I do not think nal will wipe away my substance dependence entirely).
Also, has anyone else experienced this double-minded thing (stubbornly drinking without enjoyment)? Is this part of the extinction process, in which my inner adolescent has to dig her heels in until she's finally so defeated that she gives up? Am I perhaps one of the 20% who won't respond? Do non-responders of TSM have any shared characteristics or patterns?

Sorry for the long post. I appreciate any input!

From what I understand your inner addict is rebelling against not getting the buzz from alcohol and is trying to compensate by drinking more.

Yes, Meltus. Exactly. I know. However, I'm trying to get to the heart of what that means and where to go from here. Increase dosage? Be patient? Both? Is there still hope?
Anyone experienced the same thing?
I just don't know if this is par for the course.

"I do not enjoy drinking. So why the hell do I still do it?"

You probably could have said the same thing before you discovered Nal. Patience is the key. Of course you still want to drink! Don't beat yourself up. You didn't get in this mess over night, and you won't get out over night either. If you are no better after 4 months, then it might be time for concern. Not now. Just relax and follow the Golden Rule, drink as you normally would.

As far as the dosage, once I quit and got to the other side, I find that 12.5mg is all I need to maintain. But for the initial cure, I used 50mg, and so did everyone else I can remember here, plus the good Doctor, who has done an incredible amount of research, says 50mg. So I would say go with whats proven, and up your dose to 50mg.

Have you read any of Guapo's posts?

Nal will not stop you pouring alcohol down your neck. You are taking a depressant drug and putting more of that in the form of alcohol on the top. You are still drinking to chase that ellusive high which is no longer there.

If you take action to reduce and have some AF days then this depressant effect has chance to lift, and enjoy other things in life.

Formation of new habits, activities which don't involve drinking, and their enjoyment on non-drinking days will provide a new way of living.

Yes 50mg is the optimal dose for most people, but if you continue drinking mindlessly nothing will change.

This +1.

I'm about six weeks in, and I know around weeks 2 - 4, I was where you're at. No, it's not half as fun to drink anymore, but no, I don't want to face all these hours sober, either. I will agree that some is just patience. I'm just starting to have times where the "ugh, but I'll feel like hell in the morning" outweighs the "but I so want to drink" feeling.

In addition to what others have said about finding non-drinking things to do, I'd also raise: have you considered why you want to escape? Something in your life you're avoiding thinking about? Lonely? Self-medicating pain? I'm finding that as I consider what I'm "running from" in seeking the muddled fog of drinking, it makes it much easier to think about not drinking through it.

Edited to add: not that I'm saying everyone needs some sort of melodramatic, TV movie-of-the-week reason to be drinking too much, like some long-suppressed memory of abuse. I know often it's just a habit from no real source and it's really more waking up to the fact its habit.

Thanks for the input, guys. I appreciate it. It seems as though I should try a multi-pronged approach: increase to 50 mg and see how that goes, but also find ways to make myself accountable to AF days. I think I got sloppy when the nal became available to me (I'm fortunate enough to have stumbled upon a doctor who offered it to me without my asking and basically said that I've got a prescription for life, if it works for me and I continue to need it). Once I had my hands on the nal, my brain slid backward into magical thinking and I started keeping booze in the house all the time.

UKBlonde, you provided the reality check I need: nal can only do so much for me. I have to make the behavioral changes and do the hard thing to get myself out of this inertia. It will only take one or two AF days to get me feeling more positive, proactive, and less victim-minded. I can't allow this inertia to continue.

And Jackson, I've thought a lot about why I want to escape, and I won't go into some sob story, but for various reasons I have adapted to losing a complete ability to just sit with myself and be in the moment. I get stuck in feelings like "is this all there is? really?" and other existential crap. It's my responsibility to step up and show up for my own life; life's not going to fulfill me without my own participation in the process.

I've got a long way to go. Bottom line: nal isn't going to be a magic fix. I have to do the work.

Dear NAPG, what comes as the biggest surprise with TSM,is the change in your perspective as you move along. Visualizing life without alcohol, especially holidays etc. seems IMPOSSIBLE.

Over time , as new patterns of behavior occur, your whole attitude about drinking changes.
You won't change if you keep drinking, even with naltrexone. Your mind cannot change if drenched in alcohol constantly.

It can be very difficult to like or respect yourself while drinking to excess. It's much easier to like yourself when there's nothing to hide, feel guilty about, or feel ashamed of. That's not to say you can't drink sometimes within reason, but not mindlessly.

It might take a few months, maybe six or eight months, maybe a year, but it happens.

That's when you have real control, and can decide how to live your life and what role alcohol will have in that, if any.

Amen to this. Until cutting my drinking the past few weeks with Nal, I had no idea how much energy I used feeling guilty for getting late to work, or not being able to do anything once there, or having to cover for times I blacked out and don't remember a conversation, etc.

Make sure to take 50 mg as is recommended for TSM! I read this on another Thread and this may apply to you and many:

An 'extinction burst' is when the primitive reptilian brain (the part that controls our breathing and our most basic emotions) notices that it is not getting the buzz it expects from alcohol. Even though the conscious parts of the brain understand that the reason the buzz is missing is because we are taking Nal, the primitive parts of the brain don't understand what is going on. So they respond by trying harder to get that same buzz by doing more of the thing that used to work (ie, drinking more). This is actually a really important part of the process, because this is when you (the thinking being) can really teach the primitive parts of your brain that drinking more still won't work, so it might as well give up.
Nal On!