Hi everybody.. I have been lurking since February and am FINALLY getting ready to start on TSM. I read almost all the posts several times a day, so I feel like I already know you all a little .

I think it was Lena who mentioned jumping on a moving train- this definitely feels like it.

I am a wine drinker like several of you (chardonnay). I didn't drink much at all until about 6 years ago when I started drinking wine every night to deal w/ unresolved depression/anxiety (have had pretty severe anxiety and depression since college) and the daily stresses of parenting strong-willed and challenging now-adolescent kids. I am now up to 2 bottles a night and am miserable. I am definitely caught in the vicious cycle of medications not working like they should bc of drinking, but can't be honest w/ my Dr. for obvious reasons...

My husband is supportive but he wants the person he married back. The crazy thing is that I am mostly a fun and active Mom when I am drinking, but other times, I'm stressed and swirling and can't concentrate and am depressed. I am a "shell" of my former self.

I have never had much willpower or self control so the thought of traditional methods like AA panicked me. Before I found TSM, I would often say to my counselor, "I just wish I could go back to the way I was before I started drinking like this." SO excited when I found TSM...

I think wine has caused me a 25-30 pound weight gain in the past 2 years, and that sure doesn't help the mood either. I am so ready to be done with it, feel better and get my life back.

I have my NAL in hand. I want to start today, but I may have to have some dental work done next week. (I know NAL interferes with regular pain meds- does anyone know about dental anesthesia?) I don't want to start nal and then have to stop...

There are a few things I am worried about, if anyone has comments:

I already feel sick/nauseous every day bc of "last night's" wine. At first I thought I was reading some comments that nal lessened hangovers, but more recently I think I am reading about worsened hangovers. Ugh..... That is not going to be fun.

Also, if I am basically ONLY a wine drinker at home, (margaritas if I'm out for Mexican) is it important that I continue that because it is the problem? I've thought of trying to switch to something lower calorie due to my weight gain ( and not wanting to keep gaining while waiting the months for TSM to work). In my case I am assuming that I have to extinguish this LOVE of my chardonnay (hi chard gals..) not just alcohol in general. Does that make any sense? My other problem is that I drink FAST. I am not a "sipper". I don't know whether I should try to modify that behavior and drink slower or do what I've always done..

Has anyone started at 12.5 mg and worked up to adjust to med better or should I just start at 25?

Also, if I am generally depressed unless I am drinking, once the endorphins are blocked, I am scared to "never feel good". Even though my current method of feeling good w/ wine is artificial and harmful, at least I feel ok at night. I am hoping that as my endorphins are reset that life in general will just feel better, but it's scary.

Sorry so long.. So excited to be part of this community and get started on getting well!!!! What a great group of people you are!!!

AmyGrace

Hey AG,

Welcome! Individual responses to naltrexone vary. For me, hangovers are worse -- I typically get worse hangovers drinking less than I did pre-TSM. However, this is not the case for everybody and probably varies a lot based upon what type of drinker you are. You'll just have to try the nal and see what happens.

The general rule is "drink as you always drank" while on naltrexone. The issue of whether you have to drink the same type of booze has been openly discussed here with no conclusive answers. The most important thing is to have your receptors blocked in your brain regardless of the type of alcohol.

Some people here who are sensitive to meds started at 25 mg and dropped to 12.5 mg after having severe side effects. This is just my lay opinion, but I would start at 25 mg and see what happens, keeping in mind that 50 mg is the goal and what all of the studies are based upon. 50 mg blocks receptors for 24 hours; 25 mg presumably blocks them for about half that. I would be very cautious about dropping all the way to 12.5 mg and wouldn't do it unless the side effects at 25 mg are intolerable. And then if I did go to 12.5 mg, I would make sure that my drinking occurred within a few hours of taking the nal as 12.5 mg won't last for long. And of course, this is my non-medical opinion and my two cents and just my lay opinion -- you should not rely on me for questions that are best answered by medical professionals. You should re-read Eskapa's thread for an answer to the dosage question -- he has answered a similar question like that here on the board.

As someone who has been mildly depressed (no meds) for years, I have not found that naltrexone has blocked my endorphins to the point my mood has changed at all. And no where in the book does it say not to take naltrexone daily because the endorphin blockage will make you generally depressed. What will happen on TSM is that as you drink less and less, your moods will generally be a lot better, because all of that daily wine you're having is definitely wreaking havoc on your moods. IMO, daily drinking definitely contributes to increased depression, and I haven't met a doctor yet who doesn't entirely agree with this conclusion.

So, great you dove in to the board! And remember, make sure you take the nal on a full stomach. Try 25 mg first and see how it goes. Also, although the side effects can be severe, they almost always go away after three or four doses of nal.

Good luck!!

Nick

Welcome AmyGrace!

Jump right on in the water is warm, and cold, and warm again, and sometimes even hot. So it makes for an interesting experience. Im glad your hear, now Im not the "new guy" anymore! Just kidding.

Im only, roughly, 3 weeks into this and already seeing great progress. (from my perspective). For me initial side affects were not bad at all. My problems was the day after. AL seems to affect me ALOT more on less consumption now. But so far all side affects are subsiding nicely.

Im not sure about your dental question, but I think, your concern regarding pain killers should be reversed. Depending on what type of pain killers you will be on at your dental appointment, you should certainly be aware of how that may affect your Nal effectiveness if you intend to drink that day. There are some threads on here regarding such.

And, as usual Nick, I concur in spades.

Hi, Amy I am older but we are similar. As everyone has said jump right in. A hangover after 2 bottles of wine, I think would cause stomach problems in and of it self. Start with the 25mg. at first. I would suggest that you try a bit to control the amount of wine in the beginning for the nausea aspect, if you can. Two bottles of wine is a lot! I know have been there. Wine is my poison choice also and also the worst hangovers! I will pm you with more! Good luck!

P.S. just had dental work done but if you need pain meds they will not work properly and are counter indicated. If it is just novacaine you will be fine. Make sure you check this out. You might want to wait to sart. It would take at the very least 3 days to be free of naltrexone and I would actually not take the chance and wait a week inbetween. You won't want to be in horrible pain with nothing to help you!

Hi AmyGrace, lovely to meet you here

I've only just started TSM too, so it'll be interesting to follow each other's progress in the coming months!

I agree with what's already been written, and as someone who's suffered from depression for some years, I truly believe that once you're cured of the drinking you have the best possible chance to be free of that too.

For me the hangovers are no worse on Nal...just different.

As for the dental work, I have a friend who had a tooth pulled recently and who couldn't have opiate-based medication. It had to be arranged in advance, but he had a shot of diazepam. Now, benzos have their own effect on TSM, it seems, in that they may hamper its success, but as far as I understand it (which may not be much, granted) that is use in the longer-term, and not as a one off. Probably best to put that question to Dr Eskapa or someone with more knowledge than me, and I would definitely speak to my dentist, but at least there may be possible alternatives.

All the best to you, I look forward to following your progress

8

Oops, sorry, I forgot to address the pain medication issue. And I agree with everyone above, this board is just packed with the enlightened. Oops, except Hapful, I have to disagree with you a little bit. The concern here is that naltrexone will render pain medication that is opiate based ineffective. Which is why we should all be carrying medical alert cards which state that we are taking naltrexone. The risk is that you'll be unconscious after an accident, the pain reliever you get will be ineffective because of the naltrexone, and you will sit there in unconscious agony, unable to tell the doctors that the pain meds you are on are not working.

My limited understanding is that naltrexone blocks the effects of opiate-based pain medication only. There are other, non-opiate based pain medications so the correct solution is to (1) make sure your doctor/dentist knows in advance that you are taking naltrexone and how much and (2) make sure that your pain medication is not opiate-based.

I am confident that I am correct about this, but I am not positive. I am positive that you absolutely need to disclose to your dentist in advance that you are on naltrexone and give her/him the pamphlet that goes with it that explains that it's an opiate antagonist. I would assume that a competent professional would understand the implications from that and proceed accordingly, be it with an alternative pain killer or with instructions to stop the nal. But I'm pretty sure you shouldn't have to stop the nal and should be able to get an alternative pain med, but let the health pro make this decision after full disclosure.

Ahhhh thats what I get for not doing research before I post. Disregard any of my above post that has anything to do with pain meds and nal. But please regard any welcome conveyed.

AmyGrace,

Welcome. You are in the right place. I would not worry about your weight at this point. Just concentrate on getting cured of alcoholism. I had gained much more weight than you over the years and for the first three months, I didn't think about it or try to cut down. Once I began to feel better because I was drinking less, I started to watch what I eat and I joined the local YMCA. Since I have more time, I have been going to the Y in the evenings. Since alcohol is a depressant, less of it (for me at least) means less depression. I take my anti-anxiety meds and my anti-depression meds as I should because drinking is not getting in the way. The fact that I am now exercising regularly also helps my mental well being. If you stick with TSM , you will probably get back to the way you were before alcohol took over your life. That's what happenned to me. There are ups and downs, but stick with it and stay optimistic. If it worked for me, it can work for anyone.

Naltrexone + Drinking = CURE !!

Best Regards,
Tom

Cured WK 17.

THANK YOU for the friendly replies. It really is encouraging to see people responding to my posts. I need to learn how you do those quotes from others as you respond. I wanted to respond individually, but am getting lost.


I haven't decided what to do about the dentist. I'm on the list to be called if anyone cancels this week. I REALLY want to get started.

Thanks thanks again for the support. So great to talk to people who "get it!"

Hi AmyGrace & Welcome!

Glad you are almost ready to take the plunge. I have been waiting to get my wisdoms extracted until I could go a week AF (which I can now..) simply because I do not want to tell the doctor anything and I want to be safe. But if it's just novacaine & WTE has done that safely, then go for it. You may want to search on 'dental' here - I seem to recall a few posts about it awhile back.

Don't alter anything because of weight - when your drinking starts to go down everything will start to come together. Depression subsides a bit (a lot for me), weight can start to come off as well because you may feel like exercising more + fewer wine calories. Number one is get started and drink as you normally would. Some people switch their drinks, but as a wine lover...for me, it was important to extinguish my love affair with wine, not just with drinking.

Let your husband know it's going to be a long ride and that he needs to hang in there with you...it may be even harder for him as he will need to keep supporting you and keep your spirits up. It's a long process when you are going through it. I was (am) very lucky to have a hands off, supportive husband. I told him what I was going to try, he said it sounds like that would be perfect for you...I promised him I would quit for good if it didn't work...then at around 4 weeks or so, I said, 'you know...I've got to keep drinking on this stuff in order for it to work, aren't you worried I'm just lying to you so I can drink?'...he said, 'you said it takes 4 months, right? seems like it's working to me.' And that was the end of our discussion. And he bought me wine every week without comment. Now, the flip side of that is that I just had a ZERO week and he didn't even notice . So now I feel like an attention starved kid as I'm continuously pointing out to him how good I'm doing, what a miracle it is! And he just looks up and says, 'yeh - it worked. that's great!...I haven't been watching what you drink - now what do you want to have for dinner?' Sometimes you can't win either way...they don't understand the addiction and they don't understand how monumental it is to be free of it.

My levels dropped right away so it was awhile before I had any hangovers. They weren't worse than before, just different (just a bad headache). Everyone reacts differently so no telling until you try...

So happy again that you are ready to start! Welcome!