I understand that it's good to aim for some alcohol free days on this method. And also understand that you're not supposed to take the nal on the AF days.

So here's my quandry -- I'm half way through week 3 on naltima and, due to side effects it has taken me 2 weeks to get comfortably, more or less to 37.5 mg/day.

I am worried that if I stop taking the nal for 3 days while I feel like trying the AF exercise that when I start back up on Day 4 I'll be back in the same boat -- unacceptable side effects to start with on doses higher than 12.5 for a couple of days. In which case, I'd be back to slow titration up. Which probably slow over all progress?? On the other hand and now that I think about it, when I've gone alcohol free in the past for a few days without nal, I usually drink less when I start again.

I guess I'll just have to experiment with that and will report results.

But has anyone else tackled this problem and if so how did you deal with it.

Thanks in advance for any input.

Actually I might be able to answer my own question after reading the last 3 pages of the Eskapa book. First of all, he suggests waiting until around week 8 to do an alcohol free weekend. So nal and drinking on, say, Friday night. Then Saturday no drinking or nal while the nal gets out of your system. Then Sunday, particularly in the afternoon and evening and possibly Monday as well, continue no alcohol or nal and be sure to do some activities you find pleasurable and that are not already associated with alcohol. I'm thinking of treating myself to a deep tissue massage and maybe spending some time clicker training my dogs as examples of things I never get around to because I have alcohol for fun instead.

The difficult part may be going back on the nal at the end of this break. But I'll have to experiment and see how much I can handle without significant side effects after taking a 3 day break.

Any comments or suggestions for others who may have at some point found themselves in a similar boat?

Thanks for this forum and all the kind and supportive people here. It will really make a difference I know.

Hi Optimist,
I take Naltrexone so don't know if it is any different with the SE's. I had SE's pretty bad starting out. Nausea, tiredness, dry mouth, etc.
I haven't had all that many AF days unfortunately, but I have had them. Usually just one. I think maybe twice I have had two in a row. Starting back on the Nal. has not brought back the side effects at all. I have a feeling that once your system gets used to the drug it doesn't matter if you've been off it for a few days.
But, I am not an expert, so...
Good luck,
Susie

Thanks so much for the input. That is encouraging!

By the way. Naltima is a non coated, Indian-manufactured brand of naltrexone which I ordered over the internet. So we're taking the same thing.

Hi there - I do not think that stopping Nal for three days then starting it again would bring back any SE's. I also would not worry too much about having AF days yet either - I eventually did after a few months and only then because I used a teeny bit of Antabuse - I could not do it otherwise! If your SE's are that bad you can always titrate up even slower by dissolving a 50mg tab in 50 ml of water - it dissolves very quickly - but that was you can take however many ml (or equivalent mg) you like with a dropper ....

Hugs, Maggie x

Optimist I would not worry about AF days just yet. Keep plugging away and let your body get used to the medicine and let the side effects will go away. And after 8 weeks you may not have to think awful hard about an AF day as you may just not want to drink one day. Everyone is different but around that time there were days that it just did not appeal to me. Of course the next day I did want a drink - so I took a pill and waited an hour. Both options are part of the process of extinction.

Thanks for the input, reboot. (like that name, by the way).

I just took a close look at the last chapter of Eskapa's book where he discusses 'supplementals'. This is where he talks about AF days. To refresh anyone's memory who is interested, he suggests that AF days should be carefully planned. Because they have a purpose beyond just seeing if you can cold-turkey it for a few days -- which is what I thought until I went back and read this part more closely yesterday.

Here's his suggested scenario for AF periods:

Last nal and drink, say, Friday night.

Saturday, nal free day. (This is because this 24 hours will allow the drug to get out of your system.)

Sunday afternoon and evening, still nal and drink free, have planned and take part in dopamine releasing activities -- watch a great comedy, have a massage, eat a great meal, have sex, play with your kids or your pet, exercise -- whatever used to ring your bell. But it should be something sensual that also releases dopamine and not something work related or that requires focus and concentration.

The effects of nal are presumed to be out of your system after 24 hours so the idea is that any new, pleasurable activities you sub in where drinking used to go will seem doubly pleasurable and thus be 'reinforced.'

He says you COULD continue you this one more day doing the same if you want but definitely by Monday night, back to the nal and drinking schedule.

In short, a single free day for nal/drinking apparently won't cut it since the effects of the drug may still be in your bod for up to 24 hours.

I guess I don't have to worry about AF periods just yet, as you say.

Right now I'll just try and get up to 50 mg w/o SE which I'm going to try tonight. Wish me luck

Thanks for posting that, T.O.

I had remembered Friday being Nal-free as well, but you're correct. Last Nal Friday afternoon, Saturday and Sunday Nal-free.