I see a similarity in a lot of posts made by new starters with TSM and so I wanted to start a thread which contained many of the basic tennets, dos and don'ts of TSM.

I hope this is useful and perhaps others can contribute to it too;

First do is do take the pill every time you drink
Do take half a dose if you think side effects will be an issue, 50mg is however the optimal dose for most people
Do realise it takes 6-12 months for TSM to work, that doesn't mean it might not work quicker for you but it is the most realistic scenario
Do drink as you want
Do keep a track of units, very useful for gauging progress
Do always keep a supply of nal, once you start drinking without nal is not helpful
Do realise that feeling tired is also a normal side effect of alcohol, not limited to nal
Do try to become self aware, do I need that drink?must I drink?can I say no?
Do recognise that you are doing something to save your own life


Don't expect to be fixed immediately, it's a process not a magic cure
Don't drink if you don't want to
Don't force yourself to drink your usual amount if you don't feel like it
Don't drink without nal, either make sure you always have it with your or just don't drink
Don't be afraid to say "No thank you" to alcohol, after all we are adults with a choice and you wouldn't force someone to consume something if they didn't want to?

Exercise and sex;
Some people think removal of endorphins will spoil enjoyment of both these activities. Generally the relief from lowered alcohol intake means ability to engage in these activities is enhanced, and further into the TSM process comes the ability to have alcohol free days which gives relief from the endorphin blocking properties of nal. Generally anecdotal evidence on this forum is that other life pleasures are not affected.

Very good list UK!

The only thing I would add is that when you get to the point where you have AF days substitute healthy behaviors for bad ones. Learn something new and healthy.

Thanks UKB. My nal out to be here tomorrow from River Pharmacy, but I'm waiting until I get back from an upcoming trip before I begin. Your dos and don'ts are appreciated.

UKB - that was a great idea and I thank you so much - really good to have on hand for newbies !! We shall keep having to bump it - or add to it to keep it front and centre !!

Hugs, Maggie x

Well said UKB.

I would add one more:

DO change your drinking behavior. You are here because of that behavior.

Your goal is to change your drinking behavior for the better, or stop drinking , whatever works.

So drinking less, leads to drinking less, as you escape the alcohol muddled fog of addiction.

NAL takes away the illusory joy of drinking, but there is indeed a great joy in being truly clear- headed. YOU need to limit drinking in order to get there.

Use NAL as a tool, but remember the future consists of a life without daily drinking, and very little or no use of naltrexone.

That future is going to take an entirely different mindset than exists now, so why not work on that as you go through the process.

What appears scary starting out (what the hell will I do my with myself if I can't drink, there'll be huge gaps of time to fill, the parties over!, how will I ever relax now? , etc etc) becomes moot.

It ends up great because now you have a life! (Look at BarryB4)

What's really scary, is returning to that dark place where drinking WAS your life.

Thanks Guapo - more really good stuff to read and digest!!

Hugs, Maggie x

Great post. Thank you.

Great post, thank you. These guideposts are very helpful.

Great Post, thank you UK!

My contribution:

DO:

* Gear up for the marathon, not the sprint. Think about how best to keep yourself healthy both physically and mentally during the process. Do everything you can to keep yourself healthy and strong as you go through this time - and do those things as much as possible.

* Reach out if you need help, especially at first. This is new to most people, including healthcare providers, and the information you get from others here is invaluable. Educate yourself on what is normal so you don't get discouraged or ask others on how they dealt with challenges that come up for you.

* Be gentle with yourself and let yourself drink, especially at first. Just try to protect yourself by ensuring you are safe and trying to limit damage if you are still messy. Drink at home if you can, make sure you have a ride, ensure your children are safe (physically, mentally, emotionally) so you don't have any regrets or amends to make because of this time. After a couple of months you can start thinking about willpower and control, if you need to.

* Consider ways to slow down your intake, once you are a couple of months in. Chose beer or something that has higher volume over wine or a martini if you are at the place where you can make those choices. Once you are out of the initial stages, if you can add double the mix or make a wine spritzer instead of a straight wine, why not do it and give yourself more of a chance to be satisfied (the alcoholic's version of chewing every bite 40 times!)?

* Tell your family, close friends, and doctor, if you feel you can. I had been sober for 18 months and then slipped up and then started TSM almost immediately. Along with my husband I told my kids, my parents, my brothers and closest friends what was happening ( I also started seeing a therapist again to help me deal with the pain I had around drinking and how it affected how I was feeling about myself). I sent them all copies of "One Little Pill" and sent them links to books and forums and information. Although I have seen some disapproval on my father's face at times, at least they know I am trying what looks like the best possible chance at getting better and they are giving me the room to get there. I told my kids what to expect (they are 11 and 13), that I would likely be a bit drunk sometimes in front of them at first (my husband is always around, they are safe) but I explained how this works and how I am moving towards being sober and healthy and that it won't last forever and it is the best hope for me to have a normal, healthy life. It helps those around you support you and helps alleviate their fear and discomfort when they know what the plan is and what to expect. Let them know it is 3-6 month process so they know it isn't an instant fix and try to be as understanding with them as you want them to be with you. If they love you, they are suffering too. Be gentle.

* Share your story on this site and be a resource to others as you get some time clocked on TSM. You are needed. This site, along with Claudia Christian's site, may very well have saved my life. I needed others who had made it through this to give me hope and strength. Sometimes it was reading old stories about how much people struggled and then seeing where they were now. Sometimes it was having my questions answered. Sometimes it was meeting someone else who had the same number of weeks in as me and knowing I wasn't alone. Pay it forward....it is good for the soul!

DON'T:

* White knuckle it. In the beginning, just make sure you are safe and then allow yourself the freedom to drink your way to a cure. It is definitely messy at first for most of us, but it will get better. Why torture yourself when you will most likely just binge as a result anyway? Once further in, instead of focusing on abstaining, start focusing on new activities to fill your 'problem times' with. Change up your routine - can you go for a walk with a friend during that time of day that you would habitually pour a glass of wine? Have the wine later if you want, but just break the routine of it if you can. Focus on positive distractions....

* Expect the honeymoon to last. I learned this the hard way - a week of controlled drinking and I went out with some new friends and got messy. Then I had to deal with the shame on top of the hangover and had to explain myself. Honestly, I would drink privately as much as possible if I could go back - avoid situations where you are at risk in any way until you are 100% sure of how you will react when you take that first drink.

* Take on anything new in your life. Give yourself a break. You may have side effects and you will have some adjusting to do and it likely won't all be smooth sailing. Maybe you could move in 6 months or start the new project in 3 months. Give yourself a chance to focus on getting better and rebuilding your health and wellbeing before diving into something that, even if positive, will add stress.

* Allow yourself to be made to feel like this is your fault and that you aren't entitled to choose TSM as a treatment option. Everyone makes mistakes, I'm sure you have too, but no one would chose alcohol use disorder if they had a choice. You did the best you could, you made mistakes, and you have the right to have the best shot of getting your life back and if you decide that TSM is the best chance you have, you should have that option. Don't allow other's ignorance or judgement keep you from getting the care you deserve. Advocate for yourself and if you aren't strong enough, find an advocate.

* Give up. I had all the information - I had read everything and knew it should work - but I still kept worrying it wasn't working for me. Every hangover felt like an announcement that it was just some false hope being peddled to the desperate. Every week I considered trying to go cold turkey because I was so scared it wouldn't work and I would be more addicted in 6 months than I had been when I started. But things are really starting to change in significant ways lately and it is so crystal clear that I am being cured - I am so close that I can see it is real. Don't give up until you get here too. It is the best, most amazing feeling when you are sure that it is working and you are going to be cured. You deserve this feeling so do not give up until you have it too.



Jephiner

Wow, amazing thread!! Great idea, UKB, great post Jephiner, thanks to all of you. I'm not really a newbie anymore but I still need to hear it. XOXO Newlife