My husband and I, after much prompting from me, have been prescribed nal for our alcohol addictions by our doctors. Both Drs have heard of nal but not the Sinclair method. We were advised to take nal and quit drinking while seeking out support thru a 12 step program. Ive been doing as much research as I can in what little spare time I have and came across TSM. Now im horrified to stop drinking while we are taking nal. Im about ready to cry because I feel like I have no idea what we are doing and I dont want to mess up a possible cure for us by taking this med wrong. I took 50 mg the first night and it nocked me on my butt. I felt high and super drowsy into the the next night. So the next night I took 25mg, and still felt the strong effects. Since then I have taken 12.5 mg each night so I can function the next day. We have continued to drink because we are afraid not to while taking the nal. I have no idea what we are doing. Can someone please help.

kle4143, I'm only on my 4th week so I can only speak for myself outside of the professional world but it doesn't sound like your doctor is educated about nal; it's GREAT that he perscribed you the drug though!

Nal only works if you take it one hour before you drink, if you are not going to drink then don't take a pill.

I started by taking a quarter of the 50mgs - you can find pill cutters in your local drug store. Others on this forum said that nal can cause tummy issues and headaches so doing the gradual for me helped alot.

12 step programs are all our US doctors seem to understand, for me AA did not work - not even close and being that they have a 98% fail rate it's no surprise.

Get Dr. Escapas book as well as Claudia Christians - those will help this all make sense.

It's awesome that you and your husband are teaming in this together! Keep posting, there are alot of experts on this forum - I'm not in that catagory yet but am working on myself daily.

Good luck to you and looking forward to watching your progression.

Marianne

Marianne,
Thank you so much for the reply. I will buy the books, I think that will be instrumental in learning the proper use of nal for success. And you are right about the Dr. Not knowing about the Sinclair method. I am hoping my experience can help them help others.

Good to hear I can start out slow with the nal, I'm still taking 12.5 mg and I don't have any other side effects except it makes me super loopy and drowsy. I may up it in a few days if It seems like that subsides.

we usually drink every night. But we want to quit! So, if we decide to try abstinence, don't take the pill? But if we stumble, take it an hour before we drink, this is what I gather? So far we have been taking the pill while continuing to drink and it has really curbed the amount, but we both really want to try to go without, even though it will be hard. Is this ok? This is where our Dr was confused, prescribing it so it would kill the craving so we could not drink. Very confusing on knowing the right way!

How are you doing with 4 weeks in? Do you feel like it is helping?

Thanks again for your reply, and I wish the best for you!

kle4143,

TSM is a gradual method yielding reduced consumption or abstinence from alcohol. But less/no alcohol is the byproduct of removing the addiction. TSM wants to curb/remove your desire to drink and that's done by removing the reward alcohol gives our brain. Nal blocks the rush alcohol gives us, in turn our brain does not get the reward, drinking becomes less rewarding, we do a little less of it. And we repeat that loop of Nal, drink, get no reward till one day we can abstain without even giving it a second thought. This does not happen overnight - it's gradual - taking many, many months.

So that being said you are actually suppose to drink and follow the rule Nal + 1hr before consuming alcohol. There is suppose to be no "willpower" or "white knuckling" to reduce/abstain from alcohol. If you white knuckle you are not following TSM.

This whole process is way more complicated than just removing alcohol. Most of us have other issues that must be dealt with at the same time. But TSM (through reduced consumption) gives us the opportunity to deal/manage/plan with the other issues in our lives.

If you choose not to drink because you just don't want to then don't. You don't need to take the Nal if you don't feel like drinking. Some times I take the Nal planning on drinking but then decide not to drink - that's ok too (well at least I believe it is!).

That's my Cliff Notes version - Note to TSM guru's - Don't shoot the messenger.

Rich

kle,

Absolutely the nal is working for me, I was drinking from 15-20ish ounces of vodka a day! I'm now averaging around 4 shots a day and sometimes 6 if I 'loose control'. I believe that nal is saving my life actually, my liver is fatty and my doctor won't do a byopsy until I stop drinking for 8 weeks straight - that won't happen anytime soon - so at least I can severally reduce my intake with nal and work towards that. I've been drinking since I was around 15 very hard and daily - I just turned 45.

Rich is right about how to take the nal - maybe you can educate your doctor. Part of the issue is that doctors don't tend to like to perscribe a pill and then say that you must continue to drink when using it - that is a little off for them unless they've educated themselves on the nal and tsm.

I do recommend this method and know that if you continue nal 1 hour before drinking you will notice a big difference.

Marianne.

Rich,
Thank you for the cliffs notes! I very much need a basic outline right now until my book arrives. I feel like I'm winging it since my Dr did not give me info about TSM. when we talked and it was prescribed, we were both under the impression that it would help with the cravings as I stopped drinking immediately and joined a 12 step. I think she will be open to hearing about this method when I go in to see her next week. I was going to white nuckle thru tonight but I took 25mg and am having a drink instead. A little strange to shift your mindset. Ok, a lot Strange! But it makes sense physiologically.

Marianne,
I'm so glad it is working for you! I hope to have some time behind me soon so I can say the same thing! I drink about 1/2 a fifth (750ml) in an evening. I don't know what that equates to in ounces, but I have been drinking that much nightly for 10 years. before that it was every weekend since my teens, I am 39. I'm hoping to live my 40s without alcohol. I hope you continue to do well and progress is steady.

I still feel a little lost but I'm sure the books will explain it all.

Thanks again to both of you, Kelly

Kelly,
Just wanted to say Hi and congratulations on finding this method.
I've been doing TSM for 9 weeks and am happy that there's been a definate reduction in my drinking.
Rich has given you a very good explanation of how this method works. The book will explain it all in more detail and is very easy to read. By the end of it you should feel very confident that you know what you're doing and that you can explain it to your doctor.
From what I understand there are two ways that Naltrexone can be used in relation to alcohol. The first (which is what your doctor is doing) is to take a pill daily to help reduce cravings and then follow a program of abstinence. I'm not sure about the effectiveness of this approach. The second (The Sinclair Method) is to take 50mgs one hour before drinking with the goal of blocking the endorphin receptors in your brain and slowly over time bringing about the extinction of the reward that is associated with alcohol. This then leads to decrease in intake or abstinence.
As you read over the posts on this site I'm sure you'll get more info and advice that will help you along the way. In the meantime, remmeber to track your alcohol intake and record your doses of Nal. That way you'll have some evidence to take with you to your doctor when you go back and explain TSM.
Good luck, and keeps us posted as to how you get on.
Ruth.

Thank you Ruth for the encouragement. I'm feeling very blessed that I found TSM and extremely blessed that I found this forum! I took 25mg last night and it caused me to feel pretty drowsy but I only had half of what I usually drink, then went to bed. I feel pretty good this morning, meaning not so drugged from the nal. Im assuming I need to work up to the 50mg so ill do that as I feel I can handle it.

It has been a blessing a curse that my husband and I both are alcoholics who strongly desire to quit. We can be a great support for eachother but we are realizing that after years of sharing the experience of drinking in the evening as our social time and nightcap, when it comes to quitting we are very different. Even though we are both very committed to sucess the differences in the process for each of us brings a whole new element of challenge. For example, last night I was ready to call it quits long before him but I stayed up because he wanted to stay up and typically we drink on about the same time schedule and go to bed at the same time. Time for a new routine I guess!!

Thanks everyone for the support. I appreciate any tips as I move forward !

Hey kle

Yes you are lucky you have your husband alongside you in this. Some people do experience a reduction in cravings by taking Naltrexone and not drinking, but most find success with TSM-which is simply taking 1 x50mg tablet 1 hour before drinking. You may experience a honeymoon period, then go back to previous drinking levels. So long as you always take the tablet before drinking you have the best chance of success. Side effects generally improve within a week or so and starting with 1/4 or 1/2 a pill can help you get used to it.

I lost my cravings after 6 months but did have a few spikes in my drinking which I just didn't enjoy so around the 2 1/2 year point(2 years without cravings) I decided to stop drinking alcohol full stop. I've been AF for over 50 days now without much problem and certainly no real battle.

Hi and welcome,

Until your book arrives, here are some excerpts that will be helpful:

viewtopic.php?f=3&t=6

The last one, for Medical Professionals, provides a concise overview of TSM.

Good luck and be patient; it's working for most of us!

Sheryl