Hello everyone, from Jsnizzle in San Francisco!

I just learned about Naltrexone a few days ago, when reading about the surgical implant that is purported to stay effective for up to 6-12 months. Next I researched the once/day oral practice, and that seemed worth trying to me. I immediately went to my doctor (well, a PA) and since we have a ten+ year relationship he prescribed it for me based on my own research (he had not heard of it). Before I took it, something I had come across briefly in my research was floating in the back of my mind...The Sinclair Method. The night after I filled the prescription I studied up on TSM for hours, and decided to go this route than the simple once/day that the pharmacist told me to follow. Day 1 I took it at 3 p.m. (before my usual craving), and around 4 p.m. drank at a bar and noticed immediately I wasn't getting much pleasure at the bar by the drinks. I stopped after 3. Day 2, same thing, tried more to see if I could get a good buzz on, stopped at 5. Just not interested. Day 3, today, went for a long run at 5 a.m., felt great, have not taken the Nal nor have had a drink today. It's Superbowl Sunday and I'm watching the (albeit lame, given the Seattle stomping) game without drinking! (Unheard of for me.) This seems like an early honeymoon period, and I know to expect my drinking on Nal to regress upward toward my norm at least during the early phase of extinction.

One thing that is nagging me is that to be healthy I really need to exercise and run, and if I'm on Nal I still want to do that; I think that the displeasure my body will experience w/o exercise will make me not want to take Nal. I did read a few posts in the Questions section, where readers tended to agree that I should not be worrying much about selective extinction at this phase, that I should concentrate on the Nal+drinking only. I hope others can attest to that.

At any point, I'm unbelievably excited about TSM, and am really glad I found out about it, as well as this community!

Thanks,
Jsnizzle

Glad to meet you.

Some people do avoid exercising on nal days, so they don't accidentally extinguish the desire to exercise. Others follow a simple system of exercising first, cooling down, then doing nal + al. If you already have some days that are alcohol-free (AF, as we say around here), then those are an extra-great opportunity to teach your body how great exercise can feel.

IIRC, a three-day cycle is optimal in terms of training your brain:
1. Naltrexone day
2. Day off
3. Exercise

In theory you should be sensitized on that third day. But, yeah, I wouldn't try to get too cute with it until the addiction extinction is in the bag.

It's great to hear about your rapid response. I do love a good success story!

I know to expect my drinking on Nal to regress upward toward my norm at least during the early phase of extinction.

I'd banish that thought from your head, as it's just a self-fulfilling prophecy. Many people NEVER go back to their previous levels while on TSM. I can think of one guy I talked to offline that drank 10 liquor drinks every day for twenty years and, once he started TSM, has never once surpassed 2 in the past two years. I also never even came close to my daily average while on it. Remember, your drinking is under your control (though it doesn't always seem that way, right?) -- your "levels" don't rise, you "choose" to drink back to your normal levels or not. It's a subtle difference, but can be empowering.

Also, I'd also personally ignore any idea that somehow Naltrexone can extinguish the pleasure of exercise. I've had some intense runs and weight sessions while fully loaded on Naltrexone and never had anything approaching a "loss of pleasure." In fact, I'm usually so happy and glad to be sober and feeling clear-headed that I work out extra hard and really just enjoy the simple pleasure of sobriety and normality; it's especially awesome with some inspiring music. Personally, I think activities like sex and exercise and being with loved ones affect so many different hormones and parts of our brain, that just blocking the opioid receptors has a minimal effect at best. Alcohol, on the other hand, is just a dumb pleasure. DURRRRRRR.

Thanks so much to Melissa and Barry for your quick replies. I'm feeling better already about the exercise factor. And as for the regression...makes sense--on nal seems like there's no way I could come close to my normal weekly (approx 60 units). I'll get back to you all after I've had a few more days.

Agree with barry and melissa. Assume the best and you get there quicker. 3 pills and i have been AF since then.

Now after the honeymoon. Following golden rule. Now drinking after two drinks. Now moving on to cocaine and drinking more. Honeymoon period over apparently. That week I had with 2 drinks per night and no blow was the best week of my last decade. Hate to feel this way when following golden rule. Should I follow up first dose after an hour or so or try something else? Thanks in advance. Jeff.

Hi jsnizzle! No, don't take more. If you remember from the TSM book you are covered pretty much for one drinking session. If you were drinking all day and all night you should take another pill half way - but in your case you have called it right - the honeymoon is over!

Don't dispair. This happens to most of us on TSM. Especially as you aren't getting the pleasure and buzz you used to get. You brain is simply trying harder to get those things.

Keep working the plan. Take The Darned Pill. As you were a quick responder all you may need now is patience. I would advise you to keep on doing what you are doing. BUT, and it's a BIG BUT - watch yourself very carefully at this point.

If you don't really feel like a 3rd or 4th drink you might try to let yourself stop. This slight 'forcing' may help you feel more in control and that will give you some confidence.

As for the cocaine, I don't know much about it, but really it's not about the substance, it's the need. This is just an extension of your need to numb out on whatever's handy. Compulsion doesn't depend on what you 'use' whether it's alcohol, or cocaine, or food, or sex, or shopping, or gambling.

This is well understood in research circles. Once we recognize that we are escaping from something we see that it is possible to stop using destructive substances and substitute something healthier.

Sorry to preach! But I'm making huge strides myself and I want to share this. If you are interested in reading more about this check out Lance Dodes book The Heart of Addiction, and you might like Gabor Mate's videos via youtube on addiction - Mate works with hard core heroin addicts and alcoholics in Vancouver - enlightening and empowering.

Babs

Yeah, that's basically it. The rat is pressing the button more frantically, hoping that it will go back to releasing peanut butter. This is commonly called "the uptick." It happens to a lot of people, although certainly not all.

I don't know what to tell you about the cocaine problem. Mu opioid receptors are involved in cocaine addiction, but its main action twiddles around with dopamine, so I wouldn't think it would do much for cocaine addiction.

I don't subscribe to the theory that addiction is completely and 100% separate from the target of addiction. Something drove us to drink in the first place, but that addiction-vulnerable state is not identical to the conditioned impulse that is the addiction itself. If it were, deconditioning via TSM couldn't work (it does) and solving life problems would blow active addiction out like a candle (it doesn't). If we get rid of the addictions then we are more able to find good solutions to the pre-addiction problems, but that doesn't mean they're the same thing.

I believe this distinction is relevant to the displacement of addictions. It's probably not important at this early stage, though.

Are you keeping a journal, or using some other tracking method? Sometimes the act of writing down that we're going to get a fifth drink is enough to make us realize that we don't actually want it.

Thanks Babs and Melissa. I feel like I'm getting back in control. Just had 2 AF days in a row. The rat pushing button notion makes total sense. I started trying to recapture the buzz and forcing it. Now I'm realizing that's pretty pointless, and backing off, so feeling pretty good. Btw I've never done cocaine without being solidly drunk, so when alcohol goes away I have no interest in that. During my last two AF days I didn't take NAL and felt no interest in alcohol whatsoever. Babs, thanks for the book ideas. And Melissa, thanks for the reminder to start keeping a record.

I used to have a bad coke habit. In over 10 years I only ever done it a handful of times sober. Sounds like you a bit like myself. In my first stint at TSM I didn't touch it for 6 months.