Folks: I'd like to get some discussion of what it means to "drink through the nal" and what to do about it.

I take 50mg 1+ hours before drinking vodka or bourbon. I don't really enjoy the booze and don't get the same buzz/pleasure as before Nal, but I still pound away 6-10 units a night and still lose some late evening memory and still wake up tired and blah.

So I've upped to 75 mg and will see how that goes. But the cravings are still strong each evening.

I'm just curious what people mean when they describe "drinking through?"

The easiest way I can describe it as one foot on the brake and one on the gas. I don't feel anything but the harsh alcohol buzz and I start drinking like a machine. I am after the warm buzz, but I can't get there because the nal is blocking the endorphins that give the warm feeling. Then I start drinking longer. At some point, if my duration is long enough, I get the hint of a warm feeling. I don't allow myself to get there anymore. I will take us a moderation technique to slow or stop myself.

What I am doing is I am eliminating things in my life that aggravate me to that point. Secondly, ElectraLou told me moderation techniques may help. And she was so right. I am still in the midst of a prolonged extinction burst, but I haven't once drank to black out during it. The moderation techniques are to limit how fast I will allow myself to drink. Change activities, i.e. go on a walk. Don't drink on an empty stomach. Drink other things with my alcohol.

I think of "drinking through the Nal" in a few different ways...

1 - When I take a Nal early in the day and drink reasonably for several hours...but by the end of the night, I still end up hammered. In this case, my drinking outlasts the effects of the medication. The only way I can see getting past this would be to double dose later on in the evening. This backfired on me the first time I tried it, and sometimes I'll find myself cheating by not taking Nal during the day, drinking anyway and then taking a Nal before drinking later on (NOT recommended).

2 - When any number of external circumstances lead to me drinking hard alcohol quickly (i.e. shots). In this case, it's not so much that my cravings for alcohol are causing me to drink extreme amounts, it's putting myself in a situation where I can't moderate (not turning away communal shots; playing a drinking game where the rules are such that I have to drink quickly to keep up). HF's advice above would help in this situation.

3 - Those bizarre nights where the Nal seems to have no effect. I'll feel myself trying to drink like I always did: I'll feel euphoric, I'll want nothing but bourbon, drinks are going down at a rapid pace. The biggest problem I have with nights like these is that my tolerance has started to weaken since I started TSM, and this manner of drinking becomes even more of a disaster. I think I've had maybe two nights during my entire treatment that were like this, which is far better than getting sh*t-tanked every night. I've also noticed that there were a lot of other external stimuli occurring during these few bouts and the euphoria may have been tied more to the stimuli (being in Chicago, drinking with my dad and his college buddies) than to the physical need for alcohol itself.

I have a feeling that "drinking through the Nal" is tied to the "binge drinking" trigger. I think this would explain how many of us at various stages in our treatment still experience this phenomenon, since as we have discussed elsewhere - binge drinking is likely the last trigger to go.

Anyway, that's just my two cents.

-H

I'll echo what the others said. In one case, there's drinking for long periods of time (more than 6 hours, for me), where I feel the nal start to wear off and not be effective anyways. In an other, there's hard alcohol. If you are drinking hard alcohol quickly or taking shots (which should be a no for all of us!), then you can biologically surpass the nal, I think. If you are pouring enough alcohol into your body fast enough, your body cannot process it, and the nal doesn't even stand a chance. I am also a bourbon drinker and GENERALLY, as long as I sip, the nal will kick in. But it's a good idea for me to use moderation techniques and not do things like order doubles for instance. Just the act of having to order another drink and wait for it gives me a chance to regroup sometimes.
But once in a blue moon I will also take the nal and then just be DETERMINED to get drunk. It won't feel good, but you can get there eventually if you just drink enough.

Interesting responses, thanks.

The thing that puzzles me is what seems to be contradictory wisdom on what kind of alcohol to drink. My poisons are vodka and bourbon. While I have less appetite for them on nal -- they don't taste as appealing -- I still get strong cravings each evening and still drink too much for my own good.

Meanwhile, beer and wine are far less interesting to me. Upside to them is I can't drink as many as I can the hard stuff.

So one school of thought well expressed here and elsewhere on the board is to switch to beer or maybe wine.

The other school says drink the way you drink and let the nal do the work.

Thoughts, friends?

I class it as blasting through the nal effect, in my mind's eye I imaging the nal being kicked off the receptors. I doubt it works that way, but that's how I see it.

I know if I drink strong alcoholic drinks, quickly I can just go on and on into double digits - although I always stop way before pre TSM levels. If I take my time drinking, and either use mixers or drink beer of less than 8% then within 1 or 2 drinks I am bored, do not want to continue and it's easy to say "I don't want any more", put the bottle away, even leave the drink unfinished and go to bed - or do something else.

I purposely, actively do things to make sure I stay on the right side of Nal. This means making sure I am well fed, often if I'll make something to eat with whatever I am going to drink. I actually find strong alcohol distasteful, I also hate hangovers so I add lemonade or soda to wine. I also make sure I have something else to engage in and a lot of my drinking is actually in a social setting now. Talking to someone takes my attention from the drink and it's amazing how my attention is now fully on that person, or on the show we are watching. I never go to the pub to just drink, it's always for a specific purpose and I actually prefer coffee shops, or restaurants to meet friends. This actually represents a change in my drinking, because in recent years I simply could not drink when socialising - because I'd be such a mess. I didn't however drink this way in the intial phases of TSM, I carried on drinking at home when I felt like it.

I use ALL the techniques picked up from AA, rehabs, 12-step centres with Nal/TSM and I believe that is how I've acheived such success with it so far.

For me anyway, drinking through the nal is when I overconsume to the point where the nal is no longer effective. For me right now that limit seems to be six units. It's almost like the very determined alchoholic in me is still trying for that good buzz I used to get. It happened last night, major trigger= beautiful warm fall weather at sunset on my patio overlooking the mountains. I love nothing more than to sit and watch the sun go down while having a nice glass of wine. Now that the sun goes down an hour earlier that means I start earlier! Such a confusing time right now. At week 24, I thought I would be further along and on my way to freedom. UK blonde, I envy you..... Congratulations and thank you for continueing to post even though you are cured.

I've continued to drink the type of alcohol I most want, but I have mixed in some moderation techniques so that I don't overdo it as easily on hard liquor. Making sure you eat before or during, drinking water, waiting between drinks, drinking with activities rather than just drinking alone, these are all good tactics. However, I still have had a handful of blackouts and otherwise stupid drinking escapades since starting nal.

So far, I've only felt like I drink through the Nal once. Its funny how when it happened to me, I knew exactly at that point what everyone else on here had talked about. Basically it suddenly felt like I had never taken Nal. I got that happy buzz euphoric feeling, it was enjoyable but I remember not acting like myself. Its funny when I drink with Nal, I feel completely like myself whereas when I drank without it, I got that Dr. Jeckyll / Mr. Hyde thing going on.

I have on occasion drank through nal. Its usually on high alcohol content, in a stressfull sittutation or if I drink on an empty stomach. I hate when it happens but from once I can explain it or its not often I get over it,