Ok, I'm reaching out for some advice here. I am into my 5th month of treatment and am becoming very discouraged. Up until this point I had felt as though the Sinclair method was really working for me. When I would drink I would drink responsibly and never black out! I was decreasing my units and was down to about half of my pre TSM units. However in the last two weeks it seems as everything has changed??!!

I have started blacking out again and my units have increased substantially. I have really strong cravings which had really subsided over the last previous months. I am scared and feel out of control again. This was something that I thought I was getting under control! I'm so confused! I have been religious in never drinking without takng my Nal one hour prior. Is this normal? Does anyone have any suggestions for me?

My husband keeps telling me that I am being fooled by the sinclair method and am just using it as an excuse to continue drinking. I don't know what to do? I had so much faith in this method and wanted it to work so badly. Should I abandon it and go to AA? Or stick with it and see what happens? Any suggestion or words of advice would be greatly appreciated!

Kassandra, I am sorry to hear about your confusion and frustration. I have however heard a number of people on this board say they were cured in months 5-6 or more. It is becoming a theory that extinction can take longer for people who drink more. I have seen more than one person say they were cured in week 21. I don't know if you are new to the board but a lot of people experience a spike in numbers prior to extinction called the "extinction burst" I've been told it is like the pigeon pecking harder at the lever to get birdseed that's not there anymore just before he gives it up.

I am no doctor, but if I were you I would keep it up and be cautious, and if sinclair doesn't work for me, I'm trying Baclofen. I've done AA with minimal success, but not permanent success. Relax, you're not the only one. I too have seen a spike in binge drinking lately and have puked a few times which I hadn't done in the first 2 months f TSM. Worries me, but I am hoping it is an extinction burst. I hope yours is too

If you are long-term drinker of over a decade, I would give TSM at least a year before I gave up. Most of the long-term drinkers are not regaining control sooner than six months so your schedule is fairly typical. TSM works, but we should be thinking 6-12 months minimum.

Hi Kassandra,

I am new here I and just saw a doctor who has treated several people using TSM. She said in her experience, it has taken up to a year for people to get back to "healthy" drinking levels. Some people never got to "healthy" levels, but maybe down to two drinks a day (which is okay for men, but not for women.) She actually said she increases the dosage over time, up to 200mg if needed. Are you working with a doctor, or doing this on your own?

BTW - My husband has the same concern and uses almost the exact same words. He is afraid any gains on Naltrexone are due to placebo effect, and that my desire to try TSM is just an excuse to keep drinking. I keep trying to explain it, but he is very skeptical. I also told him, its not that I want to keep drinking because I want to drunk all the time. It is because my life is a minefield of alcohol, and I want to become indifferent to it. He is one of those lucky "normal" drinkers, so he doesn't understand the addictive drive at all.

I think you should hang in there at least a year, and possibly increase your dosage.

Good luck! -Kim

Thanks for the advice. I just had some more questions for those of you who have experienced this "extinction burst". Does it feel as though the NAL is no longer working? I know I felt differently before these recent cravings. Now I feel out of control again. For example I would buy two bottles of wine finish about 1.5 bottles and leave the rest and I would do this over the course of 5-7 hours. Now I drink 2 bottles in two hours and sometimes open a third! Is this typical "extinction burst " behaviour? Also I was wondering about how long does the extinction burst last? I'm sure it varies but anyone who is willing to share thier own personal experience with me I would find helpful. Has anyone found that uping their dose of NAL during this period is helpful? Thanks

Hi Kassandra,
I think a lot of TSMers are on the frustration train with you, so you are not alone. I'm one week shy of 5 months and my units go up and down and up and down like a seesaw (I've had good days and bad days). I've corresponded with Dr. Eskapa and he has stressed that this process is truly subtle and subconscious and it takes a long time for the addiction superhighway to turn into a back country road in your brain. So don't analyze things too much, just be good to yourself, be patient, and keep following TSM. We'll get there one day!

Kassandra, great question.

I think and I hope that I am on the downside of my extinction burst but feel as though the grip is loosening and yes, I had a huge uptick but in doing so I also added pot (I am not a pot user at all normally). And it seemed to amplify the effects of alcohol making me want to drink less.

As Nick says, I'm planning on a year but think I'm well on my way.

Last night I had three drinks throughout the night (I had to perform so I wouldn't get smashed anyways), and drove home VERY tired. Normally I would catch up when I got home. Instead, I tried an experiment. I went to bed....It was easy to fall asleep but to stay asleep is always the problem without a sufficient amount of booze (but htat goes away after a week or two). Adding pot has helped me sleep as well.

I feel good today and usually that encompasses drinking more. One day soon, I want an AF day. Haven;t had one yet. But if I can simply have less than 6 that would be an accomplishment (for days in which I feel good). We shall see. My best, jim

I can relate. I've been using Nal since March 26th. Just when I think I'm getting my drinking under control, I go on a bender. ToxicGirl summed it up with the "see-saw" analogy.

I guess all we need is patience!

Yes, patience. I've been on Nal 16 months and while my drinking isn't down to "safe" levels, it's certainly down to much "safer" ones. I'll take that! There are so many components to the drinking patterns of alcoholics. . .it's not only about addiction, but also about why we feel we must mask our feelings, what situation(s) trigger us to pour a drink just out of habit, about how we relate to our drinking friends, the activities we normally enjoy most when drinking. . .the list goes on.

So once we get the addiction under control - the point where our cravings are none or minimal - we need to consciously analyze these other factors and find ways to make them ineffective at triggering us to drink too much. We also need to find friends and activities to replace those we lose when we cut down on the hours we spend hiding in a bottle.

Good luck!

Goin4