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 Post subject: DR. Dombecks article, Opiod upregulation and drinking
PostPosted: Mon May 10, 2010 8:18 pm 
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Joined: Mon Sep 14, 2009 2:53 pm
Posts: 511
Location: Massachusetts
First of all I want to highlight a part of the hyperlink I will post

There is a catch here, of course. The brain isn't stupid, and it doesn't like change. When you take a pill to suppress pleasure, the brain doesn't like that and fights back by increasing the total number of opioid receptors in the brain; a process known as up-regulation. The brain's strategy is basically, that it tries to turn up the sensitivity it has to opioid agonists so as to restore normal functioning. This is no problem so long as you stay on the pills, but woe be you if you go off them and drink. If that happens, well, each drink is going to be better than ever before (magnified as its impact will be by the increased numbers of opioid receptors), and problem drinking will set in again in record time. So, to be clear, once you go on the Sinclair treatment, you are foolish to go off it if you plan on continuing to drink in any way shape or fashion.

The full article http://www.mentalhelp.net/poc/view_doc. ... c&id=11132

I think it important because I was terrified that I would be a raving lunatic off Nal and drinking.

I drank (i've been tsm 8 months though) and I was not affected for the week at all. Yes, I enjoyed some non NAL drinking sessions BUT, I didn't drink more than I have been. Maybe it was because I am cured and just have a habit to contend with (which was exciting to think about) but equally important the whole "Woe be to you if you drink without NAL" mind you, maybe it will effect some that way. It didn't me though. I feel obligated to report as we're the guinea pigs. No one is here checking our BP and etc etc etc. So I just want to share my experience as I know there will be more people here that will go for surgery and need to get off NAL so as not to be in extreme pain after surgery. Pain meds are needed unless you are a masochist. Anyone have any Q's regarding upcoming surgery and NAL, TSM, pain meds, etc...feel free to email me. I have personal experience,..best, Jim


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 Post subject: Re: DR. Dombecks article, Opiod upregulation and drinking
PostPosted: Tue May 11, 2010 12:33 pm 
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Joined: Thu Feb 05, 2009 2:07 pm
Posts: 929
JC -- As Eskapa says repeatedly in the book -- the upregulation is temporary -- it lasts only a few days and the receptors return to normal. With more new people coming on board every day, it's important that if we post information, it be accurate. Also, as you yourself now know in light of your recent knee surgery, we do not need to live in fear that we will turn into a pumpkin if we are required to skip naltrexone due to a medical situation. I think it's a bit dramatic with all the "woe" business and while I assume you are taking artistic license, it may not come off that way.

On the other hand, it stands to reason that we of course will get re-addicted if we resume drinking without naltrexone. It does not happen overnight, or even after a few sessions but it does happen.

The article in that link is one I recognize from last year that seems to be circulating again lately. The author admits not knowing a great deal about TSM, then makes the partially accurate statement about upregulation. I suppose by and large it had some useful information, and the shrinkrap radio podcast, which is linked in the article, is IMO the best interview with Sinclair. As you read the earliest comments to the article you may recognize some stories from a couple of the original members here, including some (ahem) "late night" posts.


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 Post subject: Re: DR. Dombecks article, Opiod upregulation and drinking
PostPosted: Tue May 11, 2010 8:29 pm 
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Joined: Mon Sep 14, 2009 2:53 pm
Posts: 511
Location: Massachusetts
Thanks Lena,

You're the best,

TO read your post makes my day.....

I guess the most important part is that OH MY GOD...if you drink off of NAL you're screwed.

I guess I just wanted to dispel that myth....

There is nobody helping us here,..so its up to us to inform everyone...

However, if you're early on, stop, and drink without NAL, you may backslide...I don't know.

It really stinks that here we are trying to save each others lives (I'm sending medicine to a fellow member) and nobody knows,....sad days indeed...Jim


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 Post subject: Re: DR. Dombecks article, Opiod upregulation and drinking
PostPosted: Wed May 12, 2010 9:03 am 
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Joined: Thu Feb 05, 2009 2:07 pm
Posts: 929
JC -- I think I may have read your first post wrong. :? Yes, I agree that it is a myth that "you're screwed" if you drink off naltrexone a few times and I'm glad you're trying to dispel that.

It truly is a drag that so few know of TSM, but the word seems to be spreading. New folks are coming on at a faster rate. We not only have the rehab people shooing us off other boards; we also must contend with the misinformation about proper use of naltrexone that starts with the prescribing information for doctors.

When it still had the naltrexone patent, DuPont apparently decided it could sell more naltrexone by touting it as an anti-craving drug, even though the science at the time showed it is not effective when used that way. Dr. Sinclair actually patented TSM in order to have some input into the package insert/prescribing info. DuPont chose to end-run him by keeping silent about naltrexone+drinking. Sinclair has expressed regret that his patent strategy backfired. Eskapa details this in the book. There simply is no pharmacological basis for any claim that naltrexone works with abstinence, beyond a short honeymoon or a placebo effect. Naltrexone is perhaps the most misunderstood drug in the history of pharmacology.

We see people over at MyWayOut swearing by naltrexone, especially in the 30-day injection called Vivitrol (which IS patented), as an abstinence-promoting drug. In some cases, they have paid thousands for the injection and thousands more for therapy to treat their addiction. Then, they complain when naltrexone "quits working." Dr. Amiesen himself is practically contemptuous of naltrexone, which didn't "work" for him (i.e. keep him abstinent).

So our mission is doubly tough in that we must not only educate; we also must RE-educate. It's a frustrating process. But we gradually are getting there. Eskapa's book, Ben's Youtube project, ToxicGirl's blog and of course this board: We seem to be growing exponentially. TSM is too rich of a secret to be kept for long.


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 Post subject: Re: DR. Dombecks article, Opiod upregulation and drinking
PostPosted: Wed May 12, 2010 9:26 am 
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Joined: Thu Feb 11, 2010 6:32 pm
Posts: 472
I wonder would there be any point in printing off as much information as is available on the net and phsically posting it all doctors in our own areas. It seems that some at least bite when someone goes to them well prepared with tsm information and asks for naltraxone. Maybe if they studied up on the info that there is a chance that they would suggest it to patients.

It may not be of any use but its something that I planned on doing when Im closer to a cure along with the story of how TSM worked for me.


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 Post subject: Re: DR. Dombecks article, Opiod upregulation and drinking
PostPosted: Wed May 12, 2010 5:01 pm 
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Joined: Wed Jan 06, 2010 7:05 am
Posts: 159
.


Last edited by DOMD on Sat Dec 24, 2022 3:48 pm, edited 1 time in total.

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 Post subject: Re: DR. Dombecks article, Opiod upregulation and drinking
PostPosted: Wed May 12, 2010 5:11 pm 
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I think that is a great idea, Mario. We just need to keep hammering away.


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 Post subject: Re: DR. Dombecks article, Opiod upregulation and drinking
PostPosted: Wed May 12, 2010 8:28 pm 
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Joined: Wed Apr 15, 2009 8:39 pm
Posts: 872
Well, although it didn't work for me in the miraculous ways it has for others, I still believe in NAL. As you are all saying here. I am taking 80 mgs. of Baclofen daily now plus 50 mgs of NAL and so looped at this time every night I can barely see...thus I can hardly post...

Keep your fingers crossed for me. I'm worried -

_________________
Began TSM 2/09 ave 35 - 50 units/wk
Months 6 - 12 @ 100mgs
2/10 Dropped to 50mgs; units same
4/10 stopped NAL & started BAC thru River
6/10 up to 120 mgs BAC w/ MAJOR SEs
7/10 titrating off BAC
8/10 starting Topamax w/ Dr.


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 Post subject: Re: DR. Dombecks article, Opiod upregulation and drinking
PostPosted: Wed May 12, 2010 8:52 pm 
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Joined: Mon Sep 14, 2009 2:53 pm
Posts: 511
Location: Massachusetts
HOUTX, Looped from Bac? drinking both?

Just saw American Masters on PBS about the Doors, can't say that Jim M inspires me to drink less,...but then again, I'm not 28 anymore....tough nonetheless aS I play their music and sometimes wish I was around in the 60's (I was just a kid though),... 4 units in....NAL works to put the brakes on....Going out with Mrs...NOT loaded!...Thank God


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