I'm hopeful.

Naltrexone really worked well for me the first time. I started in december 2015 and noticed an immediate increase in control. It was remarkable. I am working under the supervision of an addictions medicine doctor, a neurologist/psychiatrist. Anyway, things were going really well for the first six weeks, but I was getting lots of extreme nausea. I started taking only a half pill. In hindsight, that was a bad idea. I could literally feel that I was getting some of the control that Nal seems to provide, but also a lot of the buzzed, spacey, centered feelings that are part of what I'm addicted to.

Anyway, long story short, after a while I just stopped taking it altogether. I know, I know....never without nal. The interesting thing is that at first my drinking was okay, but it crept back up slowly. By summer last year it was back to big binges (12-15 drinks) separated by dry days and occasionally stumbling upon some times of drinking with control. I have rarely ever thought, "okay, that's enough". Even when Nal was working for me in the first six weeks, I really had to fight myself to 'leave it'.

I got myself back in gear about a month ago. But it doesn't feel like its working the same as it did before. I'm following the directions of TSM but each drinking occasion is a pretty big to-do. I can feel a difference, but I'm almost even more compulsively overriding it. The (addicted) mind is a mysterious thing. I'm trying to feel optimistic. I would be greatly helped in this if there are any stories out there where second time was a charm

Hi, tdhd and welcome back!


A few have been on/off/on TSM and generally have good luck. Are you having the same issues with nausea this time? Are you using any other medications?

TSM works best if you wait till you have a genuine craving, take the pill, purposely delay for an hour, then slowly take the first drink. Don't gulp it, best if you don't even keep it (or subsequent drinks) with you. Pause, delay, distract between sips. Do one or the other 10-15 minute task and wait till you want another sip. Don't drink out of habit, drink because you want it. When you feel moved to retrieve your drink for another sip, witness and feel that feeling so you're conscious of it being there. Witness and watch it pull you back to the drink for another sip. Slow it down, be mindful and aware of what's happening in you.

When you get the notion that you've had enough for the evening, switch to a soft drink/NA drink and cut off the booze for the night. Notice when you start drinking more quickly (like when you're watching TV, smoking or talking on the phone) and switch to a soft drink during those times. Afterwards, you can go back to your regular drink if you feel the need. Don't sit in your chair and drink mechanically, bust that up.

This is based on the latest guidance from Dr. Eskapa and CThree Foundation. This is especially important if you're a binger, as it gets to be difficult to control the quantity if you numb your frontal lobes beyond a certain point. See if you can find out what that point is for you.

The "Honeymoon Effect" still applies here too, so if you were getting better control in the first couple of weeks or so, then your drinking jumped up, that's to be expected.

Thanks for this. All good advice to incorporate mindfulness and be very deliberate about it.

To answer your question about nausea....interestingly, no. Almost none of the same feelings as the first time around. That said, I'm careful to always take with food - a complex carb.

If you've started any benzos or SSRI's, that might have an impact on how effective the Nal is.