Hi, I started TSM on Nov. 19 after 6 1/2 years sober through AA. I had reached a point in my sobriety where I either had to throw myself back into the program and get a sponsor again, go to meetings every day, and do all the "suggestions', or to try something else. I had watched "One Little Pill" in October and ordered Naltrexone online through a Canadian drugstore (without prescription). It had been sitting in my bathroom cabinet for weeks while I struggled with what to do, and finally on Saturday, I took one, bought a beer at the bodega across the street, and drank it. Just the one beer, and I didn't even finish it. I didn't feel any cravings to have any more.

I drank again on Tuesday - I was in Epcot in Disney with my sister and had a beer an hour after taking Naltrexone. I felt extremely relaxed, almost tranquilized, and I'm not sure whether to be concerned about that or not. However, I didn't have any cravings. I had a glass of wine at dinner, which my sister finished along with the rest of the bottle. (she's an active alcoholic). It was such a strange feeling to have the glass siting there and to barely want to even pick it up and drink it.

It seems as though it's working for me so far. Ideally, I'd love to have extinction, where I just don't even care about whether I'm drinking or not. I just want to be comfortable in situations where people are drinking and not feel so on edge. I feel like that's actually starting to happen now, but I'm afraid it's too good to be true. I've only told one friend in AA so far, who is not supportive and tells me I'm playing with fire. I'm upset that this means I will probably lose all of my AA friends because it's so threatening to them. It's like leaving a church or a cult, where the person who leaves becomes a pariah. It's an awful feeling, and I wish there was an in-person support group for people who were trying TSM. Does anyone know of any in the NYC area?

Anyway, I am grateful that this online group is here. I have the support of my parents, who I told last night and showed them part of "One Little Pill." They are still scared for me, though - and truth is, I am also scared. I'm afraid that the pill won't work at some point and I'll find myself in a blackout again, and I never, ever want to find myself back there.

Welcome to the community, Nichartbk! Thanks for sharing your story with us!

It sounds like TSM is working well for you right off the bat! Side effects like you describe generally pass within a few days to a couple of weeks.

Some have suggested a meeting from time to time, but people that use TSM mainly stick with the online communities. No sponsors, no regular meetings that I'm aware of. I understand you being uneasy about this, as the nature of AA seems to require binding to the group.

You might want to check to see if there's a SMART Recovery meeting near you. Some are more open to TSM, though not all. I've heard of reports of AA meetings that were more progressive and figure even harm reduction is a good thing, if one can manage it. I would imagine that in NYC there are many AA meetings and even secular non 12-Step meetings. Moderation Management might be another idea and they have a couple of meetings going in NYC:

http://www.moderation.org/meetings/?language=en&mid=21

One thing you should know about TSM is that you don't need any more than one drink per session to move the extinction process another notch forward, so use all your habit control techniques to keep it down to that, if you can. There have been a number of people that started TSM while abstinent and they tend to get control rather quickly (as compared to those that start while still drinking). From what I've read of your initial experience, I would expect you will have little problem getting to your goal.

welcome and good luck to you! your initial experiences show some promise. with Nal, I'm not on edge about NOT drinking, but more than one drink is less and less the norm for me. all the best to you.

Keep posting with your progress. I am very interested to see how it pans out. Of course I mean this supportively and in the hope that you get the result you are looking for.

Hi, just wanted to post an update. Since I had been sober for 6.5 years, my lifestyle had changed and I'm used to "not drinking," so I have rarely been drinking at all since starting Naltrexone. Since that post last month, I drank 4 times. The first time, I got a bottle of wine from the liquor store, just because I could. I came home and had one small glass, not wanting anymore. But in the middle of the night (I was having some insomnia issues at the time), I got up and poured the rest of the bottle down the drain. There was just something I didn't like about having an open bottle of wine in my apartment. It felt gross in a weird way - I can't describe it. The next day I also had a glass of wine at a party.

Then I didn't drink at all until last Thursday, which was my office Christmas party. I had a glass of red wine about an hour after I got there and took maybe 5 sips, and that was it. I wasn't really enjoying the party, so I left the (nearly full) glass of wine and went home.

Now I am home and opened a bottle of beer that I had in the fridge for the past month. I've barely drank past the neck and I'm thinking of pouring it out.

So I guess you could say that, at least as of now, naltrexone is doing what I want it to do - I'm having zero cravings to drink more once I've had some alcohol. All I want to be able to do is have a drink if I feel like it - or go to an event, or on a date, and be holding a drink and look normal! I think that is what's happening here, but it's hard for me to understand how this could be after being sober in AA for so long.

The only thing I don't like is that the naltrexone makes me feel pretty spaced out. It's kind of a good feeling, in that I feel really tranquil, but I also feel "drugged." Not ideal if I'm out on a date or something. I take 50 mg and wondering if I should try 25mg, though I'm nervous that at a lower level it might not keep the craving at bay.

Welcome to the community, Nichartbk!

Sounds like the Nal is blocking the endorphins that would normally accelerate the re-addiction to alcohol (by increasing the strength and number of booze-loving receptors in your lizard brain, aka the Striatum). I can identify with your feelings about drinking, as since I hit Phamacological Extinction of my cravings it seems my experience of drinking is not anywhere so positive as it used to be.

It's the Lizard Brain that "falls in love" with booze, as it's job is to compel us to run from pain and towards pleasure (it's part of the "Reward System", a survival mechanism and an unconscious part of the brain). Alcohol causes such a huge release of endorphins that the addicted part of the brain is greatly impressed and duly notes the steps needed to get that booze down our throats. Without the endorphins, we're left with a more conscious appraisal of how alcohol feels in our body and the Lizard is more or less mum on the subject, so it's not pushing out any hearts and flowers for the stuff. Fortunately, most of the population doesn't have this problem with alcohol, it's only about 6-7% that has the exaggerated response to the endorphins from booze that result in the programming of the Striatum, which then generates the airbrushed "booze porn" that leads to the love affair with the bottle (that then leads us to ruin).

Dr. Sinclair found that 50mg was the dose that blocked the endorphins completely, though some need less and some need more. The spaced out feeling is a common side effect and that generally goes away within a couple of weeks if you're using TSM in the classic way, while still drinking. It may well be that 25mg would be enough for you, but you take a chance that the programming would re-establish itself. I suppose if you kept good records of your intake and noticed it climbing or noticed your attitude towards alcohol changing, you could bump your dose back up. But I'm just another ex-boozer on the internet and that's all a guess on my part.

Hi, Nich. You might find reviewing some of my experience from abstinent to extinction interesting. There's a few others who've posted within it also having success. I think you'll be pleased with the results. The full pop/extinction took about five months. For me though like you I was always in control. Keep us posted.

http://optionssavelives.freeforums.net/thread/190/alcoholic-anonymous-member-seeking-feedback

Hi Nich, good to hear this is working out for you. I'm always interested in how long periods of abstinence works with starting on TSM. In theory it should work just fine and it seems that it is for you. I'm curious about a couple of things, one is what kind of drinker were you? Daily? Binge? 20 drinks a day or only 5? and also I'm curious what was going on through your mind that made you want to drink again after 6 years. Or perhaps it was always on your mind?

In Eskapa's book he compares AA to the prison treatment method. If you are an alcoholic and you break the law, say kill someone in a DUI accident, and then get shipped off to prison for 5, 10 15 or however many years you still remain an addicted alcoholic. You simply flip the switch and stop drinking but leave the brain in the same alcoholic state from the very first day in prison ready to be switched on again. That's exactly what AA does, it simply cuts off your drinking and tries to force abstinence. TSM actually causes a physical, biological, chemical and as such psychological process in the brain that literally rewires it, as you saw in the movie. Read the book too it's got some great incite into how this process works.

I can only speak for myself when I say it works 100%. I still drink and my levels go up and down on occasions but I have not once hidden drinks, had severe cravings, withdrawal and in fact can honestly say I've only been sort of drunk a little bit once in the approximately 20 months I've been doing it. That's compared to being pass-out, black out drunk about 350 nights per year.

It's so incredibly wonderful to have a glass of wine with the family on Christmas eve and not have to supplement that with 8 shots of vodka, several pounded glasses of downed wine, and probably a few beers too I mean seriously even after all this time I have to pinch myself just to know that it's real.

It's not too good to be true. It just is true.

Good luck!