I have read more than a few posts on www.thesinclairmethod.com about the different effects that TSM has on people in terms of drinking less and achieving sobriety. Basically there are three distinct groupings of people.

There is one group of people for whom TSM seems to work right off the bat. These people report their consumption of alcohol drop dramatically upon starting TSM and gradually continue to abstinence over the next couple of months. Interestingly, these people also seem to be the ones who report that TSM robs alcohol of an "euphoric" feeling. They also report getting an endorphin rush when exercising after being off naltrexone (and of course alcohol) for a couple of days.

The second group of people (of whom I count myself one) start TSM and their alcohol consumption gradually goes down over the course of several months. These people never really got that euphoric feeling from alcohol in the same way the first group reports. Often times after the first few weeks they will question whether TSM is actually working for them because the progress seems to be slower than they anticipated. This group also does not seem to receive the endorphin rush after having a few alcohol (and Naltrexone) free days under their belt.

The third group are people for whom TSM (sadly) does not seem to work at all. Their drinking levels stay about the same both before and after starting TSM. I assume they are being fully compliant with TSM (i.e., always taking the required does at least one hour prior to their first drink in a 24 hour period).


What remains unclear to me is why TSM would be effective for the first two groups. I can understand why TSM works for the first group. They became addicted to alcohol because it induced this euphoric effect. Because Naltrexone blocks this euphoric effect they gradually become less interested in alcohol after starting with TSM. The second group, however, does not seem to experience this euphoric effect. Although the fact that TSM does seem to work suggests that there is some kind of effect (perhaps a less noticeable euphoric effect) that is noticed on some level once Naltrexone blocks the endorphins. If this is true then it would seem logical that the third group (the people who do not find TSM effective) is probably further towards the non euphoric end of the spectrum.


So the question then arises, why do these non-euphoric people drink in the first place? The answer that comes to my mind is that an effect other than the euphoric effect invoked by alcohol is to numb out anxiety. Accordingly, those who drink primarily to numb anxiety rather than to achieve an euphoric state will probably be those people for whom TSM is not relatively as effective especially in the short term.


I welcome the insight of anyone who has a different perspective on this issue.

I'll have to give this some thought when I'm less tired, but my first posture is this. Why do people with long-term abstinence near always respond immediately when resuming drinking on Naltrexone. Such that they have organic control. I have my theory. How does it strike you?

It must have something to do with the neural connections that a drinker makes in his or her brain. After long term abstinence the pathways become weaker but always still remain to some extent. With Naltrexone blocking the endorphins there is a reverse training going on that further disrupts those previously existing pathways.

That's my guess anyway...

Great post. I got 'massive' amount of euphoria from even one drink and nal worked straight away

"So the question then arises, why do these non-euphoric people drink in the first place? The answer that comes to my mind is that an effect other than the euphoric effect invoked by alcohol is to numb out anxiety"

Sounds like the above comment could be spot on? not that I'm an expert on non-euphoric drinking.

I think for me it was the GABA/Glutamate effects (mood elevation, calming, relaxing), along with the numbing/anxiolytic effects. Still, there was enough in the way of endorphins released that while I don't recall being euphoric, the craving and urge to drink were still burned into my "lizard brain".

Once the beer hit my lips, I switched into laid back mode. Not much more was going to get done for the night and I really didn't feel like going out and living it up.

I just started reading Dr. Eskapa's book. One nugget I thought was interesting was that the endorphins also work on a subconscious level in training the brain to become alcoholic. As such, the conscious feeling of the endorphin rush is only part of the process and why Naltrexone can be effective on those people like myself who never really felt that endorphin rush from alcohol the way other people describe.

Right. It's my understanding that part of the addiction process involves a part of the brain that has no feelings at all, but uses the dopamine triggered by the endorphins to "remember" the steps needed to compel you to drink.

Right. It's weird because we get into the territory were I wonder whether the personality I associate with my self is real or whether it is just some bio-mechanical, chemical illusion. I guess it is what it is but it is difficult to think about it one way only to find out that it's another.

It's a virtual certainty. Just look at what happens with stressful stuff your frontal lobes don't have a satisfying solution for. It gets tossed to the unconscious "reward system" and in the case of AUD, ends up in chasing booze endorphins and the resulting dopamine. There are certainly other mechanical responses tucked away in there and it's an area that's worth exploring if you feel hindered by such unconscious imperatives.

Reading "The Future of the Mind" by Michio Kaku and "The Compass of Pleasure" by David Linden, I have come to suspect that we are just an interacting set of electrochemical reactions and that addiction is soft wired in the brain. I almost wrote hard wired, but it seems that naltrexone may help rewire the addiction circuit.

I think you have pretty accurately categorized the group response to naltrexone. I fall in the second category. I never got the euphoric rush I see described. I was, however a daily drinker for many years. I didn't have what I would describe as intense cravings, but I had regular expectations to have drinks every day. And I did get to the point where I would have withdrawal symptoms if I didn't have drinks. Naltrexone seems to be helping me gradually reduce drinking with a long term taper.

I guess those in Cat3 are the 20 percent or so that don't respond in clinical trials.

Interesting observation - enjoyed your posts.