Hi all,

I'm new to this board, and have been attempting TSM for the past ten weeks. I have two questions. 1) If you expecting to be drinking alcohol on two occasions in a day, eg, at lunch, and then in the evening, are you better off taking half a nal at 11am, then the other half at, say, 4pm?

Second question: My understanding of TSM is that I take nal when I'm going to drink, and then drink as I normally would. But does that mean I should not try to reduce my drinking? What I mean is, from reading posts here, many seem to make an effort to reduce there drinking throughout TSM. Is that necessary? I was under the impression that you need to continue your drinking behaviour in the same manner you always have.

Thanks everybody. Sorry if they are stupid questions. Haven't been able to get my hands on a copy of Dr Eskapa's book yet, but one should be on it's way by now ...


c

You can take two 1/2 doses a day if you like. But 50mg will cover you for the full 24hrs. At first you should indeed drink as normal in so far as you drink to answer a desire/craving to drink more or more often. Overtime you will desire less and become more satiated by the alcohol. After you have been doing TSM for a few months or so you can try to cut down a little in order to assess how easy it is to do so. You might try an alcohol-free day or two. The trick is to answer the call that represents more physiological cravings and resist those situations where you are drinking merely from habit. These naturally tend to separate anyway. You can read most of the book online at Amazon.com. Good luck!

I agree with what digetic said above. At first, I wouldn't worry too much about controlling your drinking. After a month or two on TSM, though, you can probably try and exert some effort to curtail the drinking.
My one caveat with taking just one 50 mg dose earlier in the day...although nal stays in your system for 24hrs, I personally have found it is only fully effective for about 6 hours or so. If you plan to drink for much longer than that, I'd top it up with another 25mg or so. If it's only going to be a glass of wine at dinner and a few more drinks in the early evening, then disregard what I said.

thanks to you both. I really appreciate your taking the time to respond.

As I said, I've been doing this for almost eleven weeks now, which I know is not a lot of time, but feeling pretty despondent - not noticing any change, really. hope things improve soon...


c

Hang in there Android. I'm only a couple of weeks in myself, but looking at posts in this forum, that seems normal. Are you seeing any changes at all? If so, focus on those as real and true measures of success. I'm rooting for you.

EoB

I drank as I desired at first, which because my intake reduced pretty quickly did mean I drank more often - as opposed to the extreme binge incidents typical of my drinking pattern. In other words because it became safer for me to drink, I would let myself drink more often.

Over time I did actually start using the dulling mechanism of Naltrexone to actively help me willingly reduce my intake. I also found that if I drank like a mad woman, then I could override nal. So I did use mental techniques, I don't actually care if that's not strictly TSM - I just want to do everything I can to make it work.

I now have zero physical cravings and am able to enjoy a drink or two, even spend the afternoon in the pub with friends drinking steadily and be able to stop (not that sitting in the pub all day is an activity I choose very often). Usually 1/4 of the way into whatever I'm drinking I do get the urge to get drunk, but I know if I slow down for ten minutes Nal will help me overcome this feeling and the urge will disappear. Leaving me to enjoy the drink and stop at some point - which is sooner than later.

Hope this all makes some sense ie you can drink over it, but if you stop and think I think you can enhance Nal's effects, or give it a better chance. I'm now used to controlling my drinking, and haven't been drunk for 4 weeks. Not been in blackout since the start 5 months ago.

UK, what you say is spot on. You can fight the nal or you can help it along. At a certain point, you'll realize that the smallest amount of effort will really go a long way. I find that sometimes, let's say I've had three drinks, I really want to keep drinking and get drunk. If for some reason, however, I am prevented from drinking for a twenty minutes or so (taking the subway, going to another bar, walking home, whatever) but that time I no longer want to drink and usually feel kind of full and gross. I think it's helpful to mix in some moderation with TSM but it is certainly not necessary.