The reason "taking nal after drinking is a no-no" is that it means you have been drinking without nal -- a HUGE no-no. If, once in a blue moon, you forget, by all means take the nal if you are going to continue drinking. But you should scrupulously avoid non-nal drinking. Dr. Eskapa says the dose of nal covers you for about 12 hours. If you are a morning-to-night or 24/7 drinker, Eskapa has suggested taking another dose to be sure you are covered.

The ONLY constant in this program is to take nal one hour before you drink. If you do that, you'll succeed. That's why Eskapa calls it

The Golden Rule

It should be good for a full 12 hours. The half-life of Naltrexone is 4 hours, meaning that your bloodstream should have about half your dosage left in it after 4 hours. So if you take 50mg, 3 hours later you'd still have more than 30mg in your bloodstream.
I wouldn't play with the 1 hour rule. I know sometimes it is very tough to wait. Over the course of the treatment I developed some personal time-wasting distractions that get me through that hour. With regard to taking the Naltrexone after you started, that's a no-no; you're progress gets erased to some degree if practiced.
You're not "getting nowhere". Significant changes did not occur in my case for over 15 weeks. However, I do understand your discouragement. Most of us have expressed that view at least one time in the course of our treatment. Stay the course, it eventually does work.

Bob

D2M: just take the nal every morning with your vitamin. End of story. You are covered for 12 hours. If you are going to drink later in the day after those 12 hours, at some point in the middle of the day take another one-half, 25 mg dose. We only have one rule to follow in this method: take the nal before you drink. It simply shouldn't be that hard my friend. There is improvement going on in your brain every day that you drink on naltrexone that are not perceptible. You'll get there, SO LONG AS YOU TAKE THE NAL ONE HOUR BEFORE YOU DRINK! Keep you chin up, we are all rooting for you!

And BTW, HOLY CRAP! 125 (UK) units pre-TSM to 56 units (UK) in 8 weeks is getting you "no where"?? This is a HUGE reduction!

Agreed, too much Nal is better than not enough or none at all. I am about as absent minded as they come. There have in fact been times where I've taken my Nal, forgotten about it, then took another dose --- at least, I think this is what happened.

You shouldn't play with the 1hr min wait time if at all possible. There have been times when I was in a situation where I hadn't planned on drinking (e.g., went out for drinks unplanned), then took Nal and started drinking less than one hour after taking nal. Kind of hard to tell friends "I can't drink yet because my Nal hasn't kicked in..." However, these events have been rare, as they should be.

I agree with Nick. Your progress is REALLY good. Think about it like this: If you had started at the same drinking level as the test subjects in the clinical trials and had dropped by the same percentage, you'd be well within safe drinking limits right now. The end isn't far off my friend!

Q

No, don't change anything. Just keep following the Golden Rule: 50mg NAL + Drinking = Cure.

You are at a VERY hard place in the treatment. 3 months in, I had a major backslide. I too doubted TSM. It will get better. Your cure is right around the corned.

Q