Yeah there is nothing wrong with taking the pill and not drinking. What would be wrong is to follow the erroneous medical advice and take Naltrexone every day and remain abstinent. Pharmacological extinction will only occur if you drink one hour after taking Naltrexone otherwise you will simply be wasting a pill or worse, building up your alcohol deprivation syndrome.

Your husband sounds a lot like me too. I never would drink in the day or morning. I could not understand how anyone could do that. For me the first drink lead to constant drinking till blackout and finally sleep. So if I drank a beer for lunch I'd be passed out by 4pm probably. So I trained myself to wait till I get off of work. I think it even made that first drink so much better.

The comparison to adrenaline junky is very apropos. I've been involved in much of that stuff myself from mountaineering, caving, bike racing and more. All those sports and activities seem to involve people who like their alcohol. But then again alcohol is everywhere so I guess it's just as simple as that. Thanks to TSM though we don't have to be afraid of it anymore we just need to always remember to respect it and never forget where we came from and always follow that golden rule.

I'm confused. I thought taking nal, blocked the receptors that what the alcohol, and over time the receptors shrink where you don't want to drink as much or not at all. I also understood that the longer you drank the receptors might be larger or more ingrained and it might take more time to shrink them.

So I don' understand this drinking beyond the nal thing. It sounds like being back in AA to me. Please don't take any offense.

If I could control my drinking, I wouldn't need to be here would I?

So confused.

Tamara,

I am unsure about receptors shrinking, for I never heard of that.

There comes a point to the nal. will no longer benefits you, but it is still blocking your receptors. It is when you no longer feel the medicine working. If I have more than 3 drinks I will want to continue to drink until I pass out or have no more al. left in the house (or both). After that 3rd or maybe 4th drink I no longer have control, and I can no longer feel the nal. working.


I read something in the options saves lives forum, but now I cannot find it. If I find what was posted there I will post it this forum.

Jaba

it's nothing to do with receptors shrinking/enlarging

what drinking on Nal does is break down mental pathways in the brain which associate AL with a pleasurable endorphin rush. the brain gradually un-learns the association between drinking & reward when we drink with the receptors blocked by Nal

the longer you drank for, the more established the mental pathways are as they've been learned & re-learned over & over again every time you drank, so it may take longer for them to be broken down

-badger

I don't have the same experience as jaba but it can be different for many people. I've only so far drank up to 5 drinks on Naltrexone and had no desire to drink anymore. No desire to drink at all really but I just did because it was an all night party and that's just what ya do. So in that case it's just wrote memory and habit why I drank up to 5. Still didn't get drunk though. But anyway...

The science as I understand it is as such. Extinction refers to the reversal of conditioning. In TSM it refers to the reversal of structural changes in the connections between neurons that occur when exposed to endorphin's. You have to think of everything we do essentially comes down to the firing of nerve cells. That includes removing your hand quickly from a hot tea pot to the decision you make on weather or not to drink. I think the book describes the reflex test that your doctor will give you. When that hammer comes down on your knee your leg jerks.

What happens is that there is a sort of chain of nerve cells and gaps between them that become stronger through reinforcement. An upper nerve cell communicates with a lower one which then is in direct contact with the decision or reaction that you make. Sounds kind of crazy like we are not rational thinking creatures but rather react on the little chemical reactions in our brain but that is the whole point. Drinking alcohol as an alcoholic is indeed not a rational decision. Prior to being an alcoholic an upper nerve cell would need to send a lot of signals to the lower one that triggers you to make the actual decision to sip alcohol but after reinforcement it only takes one single signal which can be triggered by the mere sight of alcohol.

Reinforcement happens because alcohol causes other nerve cells in the brain to release endorphin and that endorphin attaches itself to the opioid receptor which in time (the process of learning) produces more receptors and can be thought of as building a super highway or high voltage electrical grid. Extinction is the opposite of that. When drinking alcohol produces endorphin as usual but then is blocked at the opioid receptor instead of building more powerful highways that infrastructure starts to go into disrepair and ultimately becomes an abandoned road and withers away. Now you are back to when it took many many signals for the upper cells to trigger the lower ones into your decision making process.

It's pretty fascinating stuff really. As a sort of side effect when endorphin's are bound to the opioid receptor it produces that pain killing pleasure and rush. That is a reward and as such compels us to drink as part of the reinforcement but when you become an alcoholic you are not so much drinking for the pleasure but because through time you have wired your brain in this process of learning to where it is simply a reflexive action. When you see alcohol or some other trigger and have built such a super highway cell structure the upper cells fire off a signal to the lower ones and you drink. It almost sounds like an excuse but that's the way it works. You simply cannot control it once it's done except to go through the process of extinction.

what drinking on Nal does is break down mental pathways in the brain which associate AL with a pleasurable endorphin rush. the brain gradually un-learns the association between drinking & reward when we drink with the receptors blocked by Nal

the longer you drank for, the more established the mental pathways are as they've been learned & re-learned over & over again every time you drank, so it may take longer for them to be broken down

-badger[/quote]

Thanks Badger, that helps make more sense.

Fascinating stuff!

Yes as far as I'm aware all it does is block the receptors which take up endorphins = no pleasure from alcohol (do still get drunk) which over time results in reduction in the drive to drink.

Increasing dose is not thought to make any difference.

There has to be some habit change from the person, the pill will not stop you putting hand to mouth with glass of alcohol. It also won't stop you swallowing the drinks!