Hi - I have a follow up appointment with the doctor who prescribed Nal for me...I told her I was taking it to help with cravings but I did not mention TSM...

Any suggestions about what I tell her at the next appointment? I can continue lying, but i don't feel comfortable saying I've been AF every day - what is a reasonable answer?

Appreciate any and all help on this one. I am terrible at lying so I need to prepare before I go back in.

I guess I'm going to have to tell my doc. something too. But it just occurred to me that we were told this drug was for cravings - ok - so we were not able to withstand our cravings - so we drank - so we need another month on the drug to see if we can do better. How's that?

My doc. said I could have the drug for a month, then he said "after that you should try for a month on your own." I never even suggested to him that I was going to actively continue drinking. I'm going to say that I am still having trouble and that I need another month. Good luck with your doctor.

I would say that it's helping with cravings and my drinking is slowly tapering down, but I'm not where I want to be yet. I would like to continue to have the support and reduction in craving that Nal seems to provide.

S'truth!

These doctors are hired to serve our best interests. We know within reasonable medical certainty that taking naltrexone while drinking serves the best interests of our health. Our doctors -- somewhat ignorantly and in violation of their Hippocratic Oath, IMO -- are doing us a major disservice by even hinting that they will not continue to prescribe naltrexone if "it isn't working" or if we continue to drink. Under these facts, I feel absolutely zero responsibility to be fully truthful with my physician.

For people who simply cannot lie under any circumstances, simply not revealing information is not a lie. You could simply say, "I'm taking naltrexone and it is helping to reduce my cravings. I believe it's working for me and want to give it more time." Say nothing about drinking. Is this a lie? No. If the question is posed, "Are you drinking?" you can evade the question with "naltrexone is really helping me with my cravings and I want to continue taking it." If they persist, personally, I would absolutely twist the facts and say whatever has to be said to ensure that my prescription is being refilled. You owe yourself a duty to obtain the best possible treatment -- IT'S YOUR HEALTH. This obligation to yourself dwarfs any responsibility you might have to fully disclose the full truth by, I'd say, a factor of one-million. I mean really, let's do a cost/benefit analysis here: be completely honest with your physician and run the substantial risk of not getting any more naltrexone and thus destroying your life or simply not disclosing the whole truth? It's not a close call in my book. Personally, I'd tell my doctor that I'm the King of England if it meant she'd refill my prescription.

Just my two cents. As you can tell, I feel strongly about this subject. These doctors are doing us a disservice and are not deserving of full disclosure given that they are clueless about the best standard of care for our addiction.

i let my doc think i am abstinent.......he makes me come once a month, i get weighed, blood pressure and temp check...it says in my chart, the patient is abstinent and going to meetings.........i don't feel bad about evading the actual circumstances in order to get my scrip. like nick points out, it's YOUR HEALTH, and YOUR LIFE!

Thank you everyone for the responses - I fully intend to lie, I was just not sure what was reasonable for people who take Nal for cravings only (which is what I told her). I think I will tell her the cravings are reduced dramatically. Last time she did ask how much I drank and I said 6 units a week on most weeks (which was true for a few months) when I took Nal but that I wanted to switch from an online drug to prescription. I will stick with that and hopefully she will not press too much. She was actually very nice and did not think AA would be the right route for me or threaten to not re-fill. But it helps me to be prepared so I don't start telling her about TSM and risk blowing it.

Someday this will not be an issue and we will be able to just say 'I'm following TSM', but right now I am not willing to fall on my sword by telling the truth. Someday...

Thank you again for the help!

I concur. I have thought about telling my doc the truth, but he already said if I was drinking he wouldn't prescribe. I think he knows but was giving me a heads up of what to say. He asked me how long he should give me the nal. I said indefinitely. He said I thought you'd say that. So, I think ghe is in on it, just not willing to put it all on the line. It sucks as what I need is a champion/ backer of this method w/ credentials on my side, mostly because of my job. The questions will come up. It would help ease my worries so much. But like nick said it is my health and life, pretty much more important than my job.

In my opinion, it's not worth the risk to be truthful if it could jeopardize your ability to get a prescription. I'd also like to add that you shouldn't give the impression that the Nal is a short term treatment option. I'd present it as a life long maintenance program. You don't stop taking blood pressure medicine. My psych doesn't know I'm doing TSM, but he doesn't have a problem keeping me on Nal for as long as I choose to take it.

Since it's a very safe and non-addictive medication, I don't see why a doctor would force someone to 'try it on their own' after taking it for a short period of time. JUST SAY NO! If you say "this is keeping alcohol from destroying my life and I want to take it for the rest of my life if that's what it takes", would your doctor still refuse? If so, I'd tell him/her you'll need to find a doctor who is intersted in saving your life instead of taking the risk that you might go off on a bender and get yourself killed!