Hi all,

I've been doing TSM for almost six months now (in my 23rd week), 50 mg of Nal. I never miss a dose when drinking and usually wait at least an hour (but sometimes only 30 min). As you can see in my signature, my drinking has been pretty flat - few spikes, a few "better" weeks. Overall, my drinking (and associated problem behaviors) are down from pre-TSM, but I can't say for certain if it is the Nal, or is it just because I'm counting drinks, am more aware of my drinking, and/or using a bit more willpower.

I'm feeling a bit discouraged that I'm not making more progress. I'm not going to give up yet - but what do you think about dosage - should I bump it up to 75 or 100 mg - or should I keep riding it out at 50 mg? I'm not asking for a "medical" opinion, just some advice from fellow drinkers/TSMers.

Thanks!

LC

Just my opinion; incorporate more AF days. Use the second of two AF days in a row to reinforce good endorphin related behavior (exercise, tasty food, sports, sexy times). This is just advice based on the method not from personal experience..
Wish you the best,
Phil

Yes, I agree with Phil that AF days, if you can swing them, will propel you to the next level of TSM. You'll get your units down faster, and you'll be proud of yourself and gain more confidence. Also, you'll discover how awesome it feels to not be hungover, which should be an incentive
Short of that...I think you have nothing to lose from upping your dose to 75 mg if you are not having side effects. 50 mg is already pretty toxic for me so I would not do it, personally, but people have (I think yogagirl even went to 100 mg?) and it's well within the safe limits.

Yeah, I'm going to try harder to get a few more AF days in. I know I can "white-knuckle" it - I did one month AF last year just to prove I could do it. Of course, I had a full drinking relapse (this was pre-TSM).

I'll try to do two AF days in a row each week for a while and see if that does anything for me. Other than the first week on Nal, I haven't had any side effects, so I'm also going to bump up my dosage to 75 mg this week.

I just got a new motorcycle, so I think I'll go AF (and Nal-free) on Friday to flush out the Nal and go on a long ride on Saturday. Also planning on doing 2-3 jumps (skydiving) later on Saturday. Maybe with the upregulation, I'll get a sweet endorphin reinforcement with the riding and jumping this weekend.

Thanks!

LC

With motorcycle riding and other risky activities, you should definitely carry a medical alert card that states you are on naltrexone. Otherwise, if you are unconscious and they give you a pain killer, it won't work if it's opioid-based. You'll be in agony with no way of telling the doc.

I've got that covered - I have my Nal usage on the back of my driver's license. I will probably get a bracelet made as well to wear when doing some of my higher risk activities, like motorcycling, skydiving, and scuba diving. Thanks for the advice.