Greetings all...I finished up my thread "Journaling a Year Without Alcohol" in June. It shouldn't be any surprise to any old timers here that I started drinking alcohol again after 16 months or so of 100% alcohol abstinence. It was a great 16 months, but I chose to drink again (without Nal) quite deliberately. We're in Florida now and it just seemed to lend itself to drinking. I had some really nice experiences, and I guess I'd say it helped the transition. But...things progressed as they always do. First it was two vodka minis...then two vodka minis and a beer...then two beers...then a half pint and two beers. First it was three times a week, then "every other day," then six days a week. No shame here, as I very much understand the progression and my own dysfunctional drinking (thanks to TSM, personal experience, and this board). But, most of my old problems returned = zombie dad at night, drunk driving, and erectile dysfuction...all in exchange for an hour or two of endorphin heaven. I have so many positive experiences of my 16 months fully sober that I know the trade off really isn't worth it. It's a very animalistic pleasure getting a buzz on, but it always comes with a cost (usually in the form of decreased energy and cognitive powers for hours after the high).

Anyway, took my first Nal today since Feb 2014. 50mg, waited an hour, and had two vodka minis. I'm hoping to do that tomorrow and Wednesday, and then just start another stretch of abstinence. I just really don't seem able to drink in a reasonable way -- I'm compelled to do almost all of it in secret. I think I just equate "drinking" with "sneaking alcohol," as I started so young (age 13). It's a bit stupid, but it is what it is.

Man, I know, I feel.

Why do we do it?

Who knows? We're wired wrong, is my conclusion.

But we do. That is why Clarion is so tough about The Golden Rule. He knows. Barry knows. We all know.

But with us, knowledge isn't always enough, is it?

I am glad you are back Barry. I did the same thing. It gets better again, -but never as good as the first time.

Our brains are smarter than we are.

It gets better again, -but never as good as the first time. Our brains are smarter than we are.

That last part about our brains is a curious statement. Are you suggesting that our "brains" are on to us -- fool me once with Naltrexone, shame on you; fool me twice, shame on me? I know what you're getting at, though...our subconscious / id / hindbrain / "lizard brain" / beast is the driving force behind the irrational part of drinking...there's also the TSM idea about resuming drinking without Nal having all these bad effects, etc...

That's never really been my experience, which is partly why I like to post here every once in awhile...similar to an ongoing research experiment. I like to emphasize that drinking was my deliberate choice, I don't regret it, but I'm ready to fast again from alcohol -- picture a fitness buff on vacation who gets off his diet during the vacation and when he gets home feels bloated and unhealthy, because that's the natural effect of eating poorly (just as alcohol has all manner of side effects). He has good memories, maybe a chuckle or two about it, but then gets back to his previous lifestyle.

One of the main insights I've had through all this is this. Most drinkers (including here) picture a big wall between "drunk self" and "sober self." Each brick has to be removed piece by piece in an heroic effort -- maybe even via years of following the "Golden Rule." All along, there was really just a wispy curtain. For me, Naltrexone allows me to step through the curtain and stay there. However, having been on both sides, I can say that the "feeling" we have, our subjective experience of being "sober" versus a "drinker," is very, very subtle. So, if anyone here is waiting for some momentous feeling wherein you know..."Ahhh, I feel cured!"...you might be waiting a long, long time.

Hi Barry,

Welcome back.... I think? It sounds like you were going to do TSM (Nal + one hour wait + drinking) for just a few days and then you're planning to go cold turkey? Is that right? If so, I'm wondering why you aren't going to do the FULL Sinclair Method to try to extinguish instead of going the total abstinence route? Are you afraid of the ADE again, which it sounds like happened to you when you returned to drinking again after your 16 months AF? Sorry so many questions.... I just think it helps those of us who are struggling through the process to see what long-timers or people who consider/considered themselves "cured" are going through. It's a little bit like a crystal ball into our future. Thanks so much... looking forward to your posts.

It sounds like ADE to me too but I don't know what your numbers are/were. TSM is most certainly a safe route to abstinence but it only works if you follow the program. You think that drinking was a choice you made but on a biochemical level it very well may not have been a choice. If your neural networks that make up the opioidergic system were still super highways to your receptors from where you left off last time then your brain was constantly shooting signals down them telling you to drink. TSM is a wrecking crew and will go in and demolish those highways and your triggers will no longer be effective.

Anyway good luck to you on your next try. There really is no reason why it won't work again as long as you stay fast to the program.

I'm a little confused here, too.
Do you credit your 16 months of abstinence to TSM? And you still craved an endorphin release so you drank without NAL intentionally? And the plan moving forward is what exactly?

Well, like I've mentioned before, I'm not really into TSM but am a fan of Naltrexone. I'm not "into" TSM for several reasons.

(1) I had a debilitating drinking problem that was almost instantly snapped with Naltrexone. "Extinction" is only an evidence-based hypothesis. That is, it's a term Sinclair used to describe the phenomena of many people eventually cutting down (or out) their drinking after awhile on the method. I like to remind people that there's no such "thing" as extinction -- it's not something that can be visualized on MRI or, I assume, even upon autopsy; one can't pinpoint an exact time when it's "achieved." It's a phenomena that, even when achieved, can just as easily be un-achieved, that is, by just choosing to drink again. TSM doesn't give one a strong aversion to alcohol, but merely a subtle disinterest that enables them to either stop or reduce drinking. Having both participated and lurked here for years, I developed my own "aversion" to a lot of the mentality around here (e.g. AA self-defeatism, mystifying alcohol, disease mentality). It seems like a good percentage of people keep going on and on and on and on (and on), speaking of their drinking (or "units") as in the control of some magical force outside of themselves. In other words, Naltrexone can achieve only so much in the neurochemistry of the brain -- at some point, YOU are going to actually have to (gasp) stop drinking so much! I'm convinced (by personal and anecdotal experience only) that Naltrexone "does its thing" fairly quickly in most people (remember, the average lab rat was cured after 5 doses!). Its a tool that simply empowers your self-control, one way or another.

(2) I really don't like how Naltrexone makes me feel. I'm just now (18 hours later) starting to feel normal again after taking one last evening -- mild nausea, terrible "stretchy" feeling, general yuk. I really like how alcohol makes me feel -- euphoric, helps me look at things in a new way. To me, drinking on Naltrexone is just...pointless. It's like making an ice cream sundae and sprinkling garlic powder on top and saying, "I can eat all the ice cream I want, as long as I smother it in garlic powder first!" Now, I'm not saying TSM is pointless...I'm a big proponent of it for some people because it actually works. But, to hold the analogy, I'd rather eat no ice cream at all than eat ice cream with garlic powder. I'd rather drink no alcohol at all versus drink with Naltrexone. I chose to drink in June (absolutely NOTHING akin to an ADE was experienced) because it made things better for awhile -- more fun, less stressful, helped me and wife adjust. To use my previous analogy, it was like cheating on one's diet while on vacation. As I pointed out, the drinking took its natural progression as it always does (and how eating a junk food diet naturally does), and I'm now ready to go back on my "diet" (i.e. 100% sobriety, which I also greatly enjoy, but in a different way, just as flabby vacation man also enjoys getting back into shape). I'm settled into my new job, my new location, my new reality, and alcohol no longer serves any useful function in that milieu.

(3) Call me lucky or whatever, but I can use Naltrexone more as a precision strike than a carpet bomb. I'm ready to quit...generally can't just quit "on my own"...so I will use minimal Naltrexone to usher in abstinence. Trust me, I will have absolutely ZERO desire to drink tonight. I can't wait to just feel normal and sober tonight. If this doesn't work, I'll bring out my big guns (I shudder to even think of it), which is to get drunk and THEN take 50mg Naltrexone. The last time I did that was when I easily (and gladly!) did 16 months AF starting that next morning. Whenever I even began to think of alcohol, I just had to conjure up that feeling in my head, and I easily drove past the liquor store, ordered tea at the bar, etc...

Do you credit your 16 months of abstinence to TSM? No, to Naltrexone. I've probably only had about 10-15 "extinction episodes" in the past three years (i.e. taking a Nal + one hour + alcohol = cure), most of which were in the first two months of 2013. Still, the method itself is awesome but I just refused to drink regularly after taking a pill that makes me feel less than awesome. I reduced my drinking by 90%+ in the past three years.

And you still craved an endorphin release so you drank without NAL intentionally? Well, in my mind I wasn't "craving an endorphin release," just as when I want to have sex with my beautiful wife I don't "crave an endorphin release." I intentionally drank, created some fun memories, let alcohol serve its purpose (geez, it has a lot of good purposes people), and now I'm ready to move on without alcohol because the negatives are starting to outweigh the positives.

TSM is a wrecking crew and will go in and demolish those highways and your triggers will no longer be effective. Bullshit. Simply not true. That's why my favorite word for TSM is "subtle." Ever so slight, but just enough to where you can actually do what you couldn't do before. I reject your analogy because it makes a TSM practitioner wait for something "big" -- a demolishing of neuropathways and a smashing of triggers!!! -- before they activate their self-control and claim what was actually right before them the whole time -- the "non-act" of not-drinking.

I'm wondering why you aren't going to do the FULL Sinclair Method to try to extinguish instead of going the total abstinence route? Again...no such "thing" as extinction / extinguishing. If I can go 100% abstinence with zero cravings or desires for alcohol, what's the point of drinking on Nal over and over and over again in order to achieve something that can neither be measured nor felt? How do I know when I reach it? How would it feel any different than the joy I feel with being not-drunk (sober)?

I hope some of this helps someone reading this. It's not me saying "TSM doesn't work." It's actually me suggesting to you that, well, TSM might have already "worked" for you -- i.e. that dumb little pill has done all it can do, which is quite a bit but not everything. There is not a giant wall between your current relationship with alcohol and where you "want to be," merely a wispy curtain and a few steps that seem scary but really aren't.

P.S. Sounds like self-promotion, but you can search back and read all of my voluminous posts starting with barryb, barryb2, barryb3, and barryb4. I read over my initial one every once in awhile to remind me where I was prior to ever starting.

First, it is good to hear from you. Thought provoking. Here's what I take issue with. You claim that there is no extinction and yet you also claim you've only drank on Naltrexone 10-15 times over three years. The text claims that extinction occurs through ongoing drinking on Naltrexone over a period of 4-6mo. and that each occasion is serving to rewire your brain. How would you know if extinction is real having never followed the protocol? And you buoy that assertion by stating that you experienced zero cravings or desire for alcohol while abstinent and yet you picked up. Clearly you had a craving or desire then and I highly suspect it wasn't just that one time.

I have been abstinent for the prior 11 months through aa from a devastating position prior. While I don't pull into liquor stores and wrestle with the notion of picking up a drink or spend the day obsessing about the notion of a drink I find there are plenty of opportunities where cravings arise. Maybe preparing for the party we had last week where I was mixing Sangria. Or, a particularly stressful day at work and I think of alcohol as a mechanism of perceived relief. A scotch commercial on tv... So even while fairly peacefully abstinent I am susceptible to constant triggers that I attribute to these neural super-highways that have developed over years. And as I read the book it purports the ability to return to a pre-alcoholic state - extinction. Anyway, from your description is seems like you have developed your own fear-based abstinence practice:



And like a fear based abstinence practices you picked up again, things got bad and now you're setting a new sobriety date.

Just my thoughts...thanks for sharing.

Welcome back, barryb4.

I agree with some of what you say, and disagree with some.

I agree that TSM is subtle, at least for many of us. I agree that extinction can't be measured on an MRI screen, etc.......it can only be measured in terms of honestly observing one's behavior. That's why I think tracking is so important.

Too bad that nal makes you feel really bad, so that it is like putting garlic on ice cream. I wouldn't want to drink on nal either if it made me feel that way. But that is not true for everyone. For me, it makes drinking less fun but still fun enough. And the fact that I am more in control when I take it makes the sacrifice of the "super rush" well worth it. But it doesn't make me feel yucky. I know that it does for a lot of people, though.

I disagree that there aren't people who have "breakthroughs" LONG after the 3-6 month period simply from following the Golden Rule. I am 9 months in, and WAY better off through following the Golden Rule in Month 9 than I was in Month 3 or Month 6. And there are lots of other threads here that attest to folks who have had success after a year or even 2 years.

Having said all of that, I hope you get what you want out of TSM this time and, if we can support you in doing so, so much the better.

XOXO Newlife

Bardo...you're just mixing AA ideology with TSM. I didn't say "there's no extinction," I said there's "no such 'thing' as extinction." By saying that, I'm simply saying that there's no measurable event that occurs as there is with other medical / physical phenomena. It's just Sinclair's hypothesized phraseology to describe what happens in the process. Although, to backtrack a bit, I suppose you could say that in the experiments with rats there is a measureable event, i.e. the cessation of drinking in non-rational animals where they have no other reasons to stop drinking other than they just don't choose it anymore.

I'm also positing that even the most cured of the cured doesn't have a palpable experience of extinction. Since it's not aversion (which is "palpable," you can kind of feel it via imagination) but "indifference," it has to be subtle. Indifference can never be an extreme sensation.

Clearly you had a craving or desire then and I highly suspect it wasn't just that one time. Meh, hard to tell. Again, I enjoy alcohol and feel that it does serve a useful function now and then. What if I just say, "I wanted to temporarily enjoy the benefits of alcohol." I mean, it is an overall "good" thing (until it isn't). I never grew up in an anti-alcohol environment, so I really don't have a bias against it.

Anyway, from your description is seems like you have developed your own fear-based abstinence practice: Hey, whatever works. I think it's more of an "aversion therapy" akin to Shick Shadel (sp?). As time progressed, it would only be every few days when "mmm alcohol" would enter my brain, and then the feeling of Naltrexone would enter my brain, and "poof" it was gone. It wasn't really "fear," just aversion like one might have to a gross food. I don't think Sinclair would ever claim that "extinction" means one never thinks of alcohol again and, if one does, one thinks of it only in the most neutral way possible. Again, I return to the junk food analogy (similar neuro mechanics). You grow up enjoying pizza -- lots of fond memories of pizza and the events surrounding its consumption (after ball games, at birthday parties). You may give up pizza for health reasons, lose any real "craving" for it, yet you will never be able to think of it as neutrally as you would, say, African goat stew.

And like a fear based abstinence practices you picked up again, things got bad and now you're setting a new sobriety date. Straight out of AA. Counter-productive thinking that I reject. See how the language is so value-laden? What if I just say, "Chose to add moderate alcohol consumption back into my diet to enjoy its benefits; the negative side-effects began to weigh against the positive benefits, so I removed it from my diet for the foreseeable future with the help of Naltrexone." Describes the same event with a less defeatist tone (at least to my ears).