This is a quote from "the missing chapter" of the book The Cure For Alcoholism (in our own FAQ's link here: http://www.thesinclairmethod.net/community/viewtopic.php?f=5&t=19&sid=94bab1b768d3a4c1876f0b4d8ac478f3), pay special attention to the last paragraph:

"Q: You actually say that the Sinclair Method is a cure for alcoholism. Isn’t it going too far by using the term “cure.” After all, many claims for cures for addictions turned out to be unwarranted – too good to be true. Why and how is the Sinclair Method actually a “cure” for alcoholism?


A: The term “cure” is not used lightly, or without deep consideration. Sinclair’s method is equivalent to a cure because it actually restores the brain to the condition such that the craving and interest in alcohol are similar to the way they were before alcoholism was learned. The fundamental neurological scaffolding - the biological pathways causing craving and drinking, which are slowly yet deeply established by reinforcement from the drinking, are actually dismantled. Even after naltrexone has left the body, the reduction in craving and drinking remains. De-addiction occurs because the neural system that has been super-strengthened by reinforcement from endorphins – the wiring driving the addiction - is dismantled over the course of extinction treatment. In other words, if Bill Wilson, one of the founders of Alcoholics Anonymous in 1934 had been through Naltrexone + Drinking extinction treatment he would have not have found himself experiencing periodic spikes in his craving for alcohol - even after his profound mystical experience which led to the founding of AA.

That was of course 1934. It would be another fifty years until naltrexone was approved by the FDA for alcoholism in 1994. The correct way of administering naltrexone - by prescribing it together with ongoing drinking - is only truly becoming recognized as the treatment-of-choice for heavy drinking and alcoholism since the turn of this century.

A treatment may only counteract the symptoms of an ailment. A cure is distinguished by the fact that it removes the underlying cause of the problem. AA is not a cure and has never pretended to be; it says instead that the people in it remain alcoholics. Antabuse was not a cure: the cause for the craving and drinking were stil present, and Antabuse only tried to establish a barrier against drinking. It is no more a cure than physical barriers when incarcerating an alcoholic provide a cure. In contrast to these and all previous treatment procedures, the Sinclair Method does remove the thing that is causing the alcoholism - the neural pathway that when it fires causes craving and drinking.

To be precise, pharmacological extinction does not remove all of the pathway causing drinking nor even return all of it to the level prior to the learning of alcoholism. In order for drinking to occur, firing must proceed all along the pathway. When alcohol then is drunk and endorphins released, all connections (collections of synapses) in the pathway are made stronger. Similarly, in the beginning of extinction, all of the connections are made weaker each time one drinks while on naltrexone. The pathway is, however, only as strong as its weakest link. Once the state is reached where one of the connections is too weak to fire the next neuron in the pathway, then the drinking stops at least for the time being. Many other parts of the pathway may still be considerably stronger than they were before drinking ever began, but this remnant of previous alcoholic learning is apparently only if you start drinking again without naltrexone. At that point, the remaining strengthened portions help make relearning of alcohol drinking behaviors be faster than the initial learning had been."


I'm going to be a little presumptuous and go out on a limb here.

The neural networks in our brains are bewilderingly interconnected.

Once we've burned out the 6 lane superhighway that used to be our addiction as you have, there is still the opportunity when you're at the stoplight on the off ramp (you got off the freeway because you saw the bridge ahead of you was burnt out and didn't see any reason to go there), to get back on the freeway instead of turning left or right. And when you do you might revisit all those places on that neural superhighway that are still as strong as ever and hit the cruise control button 'till oblivion comes.

But you'll never get off on that particular exit again. You'll never have to break that weakest link again. There might be a couple more roads to try, another link or two to break...who knows, who cares. So you made a bad turn, at least you're not driving in circles anymore.

Great post. I see your point (although I had to read it twice to get it).