Hi Folks,

Well, I have now completed 26 weeks on TSM and I've been taking 100mg naltrexone (one hour before drinking) for just over two weeks. I did not record my units for last week because I'm finding it increasingly more difficult to do so. However, if anything, I suspect that my units were up a tad last week. I was suffering crippling anxiety earlier this week but I saw my therapist yesterday and that has helped me.

I am coming round to thinking that TSM is not going to work for me. After all, I knew from the very start that TSM did not have a proven 100% success rate. So, I have been trawling the internet and have made some very significant discoveries. The following article is a good starting point:

http://www.dryoutnow.com/alcohol-rehab- ... tment.html

This article introduces something called the Asp40 allele and its relevance to naltrexone treatment. Carrying out a Google search for 'Asp40 alcohol naltrexone' yields a lot of relevant material, many of which are scientific papers. Having read several of these papers, the general consensus seems to be that presence of the Asp40 allele can predict naltrexone treatment response in alcoholics. Note that I use the term 'general consensus' because I am aware of one researcher who has published a paper challenging this. See http://www.galloresearch.org/index.php/ ... ermitchell. I should perhaps point out that I know next to nothing about genetics!

I have now learned of a laboratory that can do DNA tests to establish the presence of Asp40. I am giving very serious consideration to going ahead with this test, even though it is expensive. I am growing weary of all this uncertainty and I want to know if it's time to pull the plug on TSM. Incidentally, my doctor has not been able to find a laboratory that can carry out the 6-beta-naltrexol blood test to which I have referred in an earlier post.

So, that's where I'm at.

V.

I'm so very sorry to hear this V. We know that naltrexone does not work for everybody and there is, of course, the unfortunate chance that you are in the small group it doesn't work for. I sincerely cannot express how disappointed I am for you. All I can say is that you are a true gentleman and I'm still holding out hope for your recovery, regardless of how or when you find it. Your strength, patience, sincerity, kindness and thoughtfulness are truly an inspiration to me.

All my best to you.

Nick

Virgil,
We are all so pulling for you. Nick couldn't have said what we all feel for you any better. Hope springs eternal and I look forward to your future posts.

BB

Hi Folks,

Many, many thanks for your very kind words. I feel honoured to be a part of this community. There is warmth in abundance here.

All the very best to all of you!

V.

Virgil

Not much I can add to what Nick put so well. Your disposition and forebearance is an example to us all. You have, IMO, done a very difficult thing by recognising your problems and making an honest and sincere effort to address them. This method MAY not have worked for you - don't give up just yet though, but your attitude will make you a winner sooner or later. You just need to find the right toolbox for you.
I hope that you'll stick around or at least drop in - regardless of what method you're trying to achieve your goals. Till then - keep this speech by Old Ted in mind.......

I'd go ahead with the genotype test if you could afford it. But Virgil, if indeed you needed a higher dose for whatever reason (Eskapa and Sinclair posited it could be for many reasons) then that means your endorphin system has been active all this time. Two weeks at a higher dose wouldn't yield results yet. It would seem to me that you'd almost be "starting over."

I feel for your situation greatly and I certainly don't want to trivialize it by probing, but I have a question. Do you feel the FDE (the first drink effect)? The endorphin rush?

Don't forget there's always baclofen too! -E

Hi Lo0p,

I know this might seem strange but I'm not sure how to recognize the FDE, as you call it. Is this what is meant by 'the buzz'? What are the special characteristics of the first drink effect? In what way are its effects different from the second or third or Nth drink? Perhaps you could clarify this for me.

Thanks.

V.

Great point Evan! I had not thought of that. If, indeed, the receptors weren't blocked all this time, and now they are at 100 mg, it would be like starting all over again. This is great news. What do you think V.?

Hi Nick,

It's a bitter-sweet situation if indeed Evan's analysis is correct, which it may well be. The prospect of going back to square one is disheartening, to say the least. I will have wasted at least six precious months. However, if I get the green light having done the Asp40 allele test, then it would make sense to continue with TSM. Trying times.

All the best.

V.

I can try to describe it from my own subjective POV. When I get home from a long day of work and take that first big swill of whatever, about five minutes later when that nasty **** hits my bloodstream and reaches my brain I feel this: An enormous sigh of relief, I exhale as though I've been holding my breath all day long. It's a very comforting feeling. And then intoxication ensues.

This for me now, while drinking on Nal, is gone. All I get is the intoxication, and as I get further intoxicated it does feel comfortable, but the "rush" has disappeared.

I used to be a pill popper (vicodin, opioids) when I was 18 and since that addiction and Al are essentially the same addiction I recognize that feeling immediately. For you, if your endorphin system has been only partially deactivated all these months even if you are experiencing the FDE (endorphin rush) it may be blunted, so that you might have a hard time identifying it.