This is mainly a modification of what's I posted over on OSL, as I now have a few weeks to report on:

4 weeks in, so past time to create my own Progress thread.

This all started when a friend disturbed my fruitless ruminations about getting sober by falling into a state of abject bingetude. He was in fairly bad shape and needed to go into detox, so I volunteered to help him pull it together, gave him a ride and sat with him till they were ready to take him in. A little over a week later, I got a text that he was being released and needed a ride home. Picked him up, got him back home and we both cleared the booze out of the place. He was ready to swear it off. I loaded up my car with every last drop and hauled it away. He's determined to stay clean, no matter what, didn't need the expensive outpatient program they were pushing on him, no longer had the desire for drink.

Being the kind of guy I am, I started looking up resources for him, he seemed resigned to AA, but I knew he wasn't the "higher power" sort and I could identify with that. I'd been to an AA-type meeting some time ago and wasn't that impressed. So many there were serial relapsers. I sensed an odd sort of masochism in the way they almost seemed to revel in their failure, that's really the best way I can describe it. I found a secular/humanist 12-step group listed online and shot him the info. Then I ran across SMARTRecovery and sent him the links on that, thought it might be the sort of thing that I could plug into myself, I sent him that info and let him know I'd go along if he was interested.

I don't really recall how I came across it. My friend was given an Rx of Naltrexone "for abstinence", perhaps it was during a fit of research on how the stuff worked that I first stumbled across The Sinclair Method. It clicked fairly immediately for me. I like the rest of you had heard of family and friends, read reports of both celebrities and "nobodies" that time and time again ran afoul of the Alcohol Deprivation Effect, with each relapse worse and more damaging than the next. Careers destroyed, families ruined, innocent people killed, year after year, decade after decade. We've seen it, we've heard about it, we've read about it since we were kids. If you were lucky, then you kept the damage contained and your life force simply disappeared into a mist of booze. That was the State of the Art.

A wise person once said:

"If we can't seem to find a good answer, maybe we're not asking a good question."

Well, many years ago, Dr. Sinclair asked a few rats a very, very good question. The rats did not disappoint.

This explained how (after a 30+ year habit), an attempt to taper down from 12 beers a day to 2 ended up in, uh, let us say... in my (ahem) successfully demonstrating the shortcomings of that particular approach. I'd been planning to go from 2 to zero, then get a Rx for Nal and cement my sobriety. My taper collapsed into a 15-beer backlash that left me holding down the sofa for a few days.

You got my pride,
Hangin' outta my bed
You're messin' with my life
So I bought my lead...

Fortunately, C3's website listed a Doc that was fairly close and his website confirmed that he was familiar with TSM. I set an appointment online, got my bloodwork, had my prescription in hand and "So I bought my lead", starting Nal on January 6th.

Fast-forward to today.

After no small battle with side-effects, my numbers have dropped from 12 per day to the 4-6 per day range. The side-effects are fading, it may take me a month at this pace before they've passed. They have been difficult to deal with (primarily dizziness, lack of balance, fuzzy thought processes) but I'm a really odd case as far as that goes. Most folks are done with the side effects in a week, if they have any at all. I may be in the Honeymoon period, time will tell, but I've yet to ramp up to 50mg. I'll be doing that in 12.5mg steps.

So, here we go:

From a typical pace of 84 units/week, I start with part cramdown / part Nal for the first week, about 50/50.


Week / Units / AF Days
1 /58.6 / 0
2 /51.9 / 0
3 /36.6 / 0
4 /31.3 / 0

So there you have it. Over a 50% reduction from Pre-TSM with not much effort (aside from the side-effects, which really cramped my style). No AF days yet, likely coming this month though.

Many thanks to all the good folk who have posted their trials and tribulations and thanks for the encouragement and suggestions! It appears I'm on my way!

Way to go JSP!!! Glad you're having success (despite the SE) and keeping on track.

In the short time I've been here, you have given me and so many others support that I'm glad to see a thread where hopefully I can return the favour!!

After 4 weeks, do you feel that your drinking out of habit or are you getting something from the 4-6 beers?

Keep strong & know we are all here in your corner!

Hey ttc, thanks!

I'd say I'm still getting the "warm and fuzzy" lift in spirits from the beer, likely from the effect alcohol has on the GABA and Glutimate receptors in the brain, but the effect that Nal has on the opioid receptors seems to be coming through despite the fact that I really don't seem to feel or notice it so much (aside from the SE's). NB, I felt that way the first night too, when I took 50mg. The taste of food doesn't seem much changed for me either, but I'm not up to the full 50mg yet, so I'll have to see how that goes. There is a habit component for sure, as I've noticed I still reach for the beer out of hunger, as I usually have in the past. I'll be working on moving dinnertime closer to a more traditional hour this coming month, I expect that to cut my volume even more.

Hi Joe - good to see your progress thread! You are so great at answering other's posts that as TTC said, it is nice to return the favour! I was curious as to why you think food is going to taste different? I have had no issues with food at all - and it is not something that I have heard others having much issue with either. Please do not look for things to attribute to the Nal. I know that you have had a lot of problems with SE's - but, as you admit, you are in the minority! Hopefully with you going up so slowly, your SE's will dissipate and you will get up to the full 50mg. Some people have not needed to go up to the full dose, but I think that it is best to initially - but that is just my opinion!

Things are going well for you by the sounds of it - and I am so happy for you that they are.

hugs, Maggie x

Thanks, Maggie!

Yes, I'm pleased with the results so far. Not much of a problem with SE's after this evening's dose, so maybe I'm getting close to done, though I've had it show up after breakfast the next morning, or after the first drink... I think they're kind of breaking up and dissipating on the whole.

I've seen other people mention that Nal affected how food tasted to them but I'm seeing a number of posts on OSL too (actually on various sites) so I'm seeing a larger sample size, though I haven't seen anybody that mentioned that was a lasting side effect. It did initially quash my appetite, I just felt an odd kind of "fullness" in my stomach, but that only lasted for a few days. Mainly it's been the strange quasi-feverish feeling and the lack of balance, like I'm walking in shoes that are two sizes too large with 1-foot thick foam rubber soles on 'em. Hopefully I won't have to get used to it again after the first AF weekend!

Mr. six pack

I see that you are having and are concerned about side effects. They will fade away, they do for almost all medicines

You also have a good concept of how TSM is supposed to work and are doing it well.

You may wish to consider staying at a low dose of the naltrexone, perhaps 12.5. Myself and others on here have found that that dose works just as well as the 50 mg, with far fewer side effects, plus you get more bang for your buck by cutting the pills.

I did the 50 for quite a while without knowing any better, and was surprised to find 12.5 did work very well.

Anyways, be mindful, be optimistic, believe in TSM. You'll find you are no longer a slave to alcohol, you can be in charge of yourself, and much good follows. It's good to be in control of yourself, not to mention regained self esteem

Thanks, Guapo!

I didn't really expect the SE's to last this long, in 5 days it will be a month. If they persist, I will indeed drop down to 12.5mg and see how that goes, as I have some construction work to get done around the place and I have no hope of using power tools feeling like this.

How much are you taking?

Keep in mind, another benefit of AF days is : No NAL = No SEs

I'm taking 25mg presently.

Consider the 12.5 mg dose. I'm not sure where the gospel as 50 mg came from, but it's not based on hard science.