Starting week 5 and feeling better because I'm drinking quite a bit less than I was last month as you can see from the signature below.

I've been struggling with mild to moderate SEs and so titrating up my dose slowly. When I reached 50 mg without initial SE's I found it easy to move myself down from 2, 2 oz bourbons/night (3.3 units if you multiple .845 x 4 oz) to 2.5 units. So instead of 2, 2 oz of bourbon drinks I got it down to 2, 1.5 oz drinks.)

Before starting on the nal and the CBT workbook for addictions, I was never able to reduce that much. I would vow to do so but my resolve would crumble completely half way through drink 1. We've all been there, right?

In the past if I stopped drinking for a week or more as I did occasionally when I wanted to diet, I found I could get by just fine on 4 oz or so/day. But after a week or less, those numbers would start to creep right back up--to double or more that level.

Now I'm not seeing that and I call it progress! Yah!!

I continued to be mildly/moderately plagued by SE at the higher doses of the naltrexone (naltima is the brand I'm taking). I was hit by a day or two of unpleasantness on days 4 and 5 when I switched from 25 mg to 37.5. Not on the first days, mind you. But on days 4 and 5. And the SE's showed up the next day -- not noticeable the night I took the nal.

Had the same thing happen when I bumped up to 50 mg. All was hunky dory SE wise for the first 4 days. Then I woke up on the morning of day 5 (I always take nal at around 6 PM) very dizzy as in head spinning and afraid I might fall over.) This continued all through that day so I decided to go back to 37.5 for awhile.

Now on 37.5 for the past two days. No next morning SE's to speak of. And so FAR, no cravings for more than the 2, 1.5 ounce bourbons I hope to allow myself. I plan to stick with this dosage long enough to see if I can stick to this drinking regimen without cravings. If I can, then I'm not going to put myself through more SE adjustment by going up to 50 mg. Maybe 37.5 -- or even less -- is the right dose for me.

I will report next week if I'm successful at 37.5 mg/day. If I can keep to my drinking goal without any cravings, I'll be a very happy camper. Because, despite what the new US and British guidelines are on units per week for men and women, I think I'm drinking moderately even for a woman if I can stick to 21 units or under per week.

I would like to also mention that the book The Addiction Recovery Skills Workbook: Changing Addictive Behaviors Using CBT, Mindfulness, and Motivational Interviewing Techniques (New Harbinger Self-Help Workbooks)
by Suzette Glasner-Edwards PhD (Author), Richard A Rawson PhD (Foreword)

was an immense help to me in getting a good mind set before beginning this method. I went through the process of creating spreadsheets that helped me to examine the situations and thought processes that triggered me to have a drink, the rationalizations I made to myself to allow myself a drink and the new activities I could start to think about using sometimes as a pleasurable replacement. It really got me thinking and I suspect it may be an important reason for my initial success with this Method.

I hope it lasts, needless to say. Because I'm feeling better about myself mentally as in proud of myself for finally taking intelligent action in regards to this drinking problem. And I'm also, aside from the SE's that still haven't totally gone away, feeling much better physically. More energy specifically.

I do feel that the nal has dampened down my usually very optimistic and happy personality just a bit. So there is a slight depressant SE still in evidence I believe. I hope this will pass with time and for now taking deep, mindful breaths and gently ushering discouraging or sad thoughts to the side is doing the job for me on that front.

Other than that, I'm content.

Before Starting Naltrexone average per week--40-45 Units and sometimes more.
Week 1 -- Titrating up from 12.5 to 25 --29 Units
Week 2--25 mg--36 Units
Week 3 -- half week at 37.5, half week at 50 mg -- 29 Units
Note: SE's on starting dose of 25 mg so backed down to 12.5 and titrated up.
Week 4 – 19 units.
Note: started the week at 50 mg but began to experience uncomfortable SE's on days 4 and 5 so backed down to 37.5 mg. So far cravings for more than 2.5 units/day are still under control at end of week.

Coming along nicely, T.O.!

I too notice my energy levels up and I'm more willing to take care of things around the house instead of sitting and drinking.

Nal on!

Still waking up with very mild but still annoying nausea after 3 nights backed down to 37.5. It was a bit of a bore all yesterday. I'm not going back to 50 mg until one of two things happen.

#1. I start craving more to drink than the current limit I've set for myself that so far is working fine.

#2. I completely stop having any SE's for at least a week.

This really is a balancing act, isn't it? At least it is for those of us experiencing SE's. I mean, it's not fun at all being low energy and sickie all day. But it's so encouraging to see the drinking habit starting to get under control. So soldiering on I go.

I occurs to me, however, that this might POSSIBLY be an alcohol withdrawal symptom. Because I've noticed the nausea completely goes away when I start my evening drink session. But this could also be because of the nal I took the hour before. Hard to say at this point but I'm observing carefully and taking notes.

I do know that in the past when I stopped drinking completely for awhile I didn't have any withdrawal symptoms at all. But the last time I tried to abstain was at least one year ago.

Yes, it's really a hard one to pin down. It seems the less I drink, the fewer/shorter the SE's, though it just feels better in general to drink less.

I totally feel ya, Optimist. Experiencing quite a bit of nausea and emotional SEs. It's hard to tell what's from the alcohol, the gradual withdrawal and the Nal. I'll keep hangin' in there if you do!

I figured out something new to try re SE's after reading a bunch of older nal over posts.

Drink lots of water when you've finished your drinking period. It flushes the nal out of your system faster at a time when you don't need it.

If you drink from the time you get up until you go to bed, this would be counterproductive I would guess. Because you'd want the chemical in your system as much of the time as necessary.

But if, like me, you are able (most of the time anyway) to limit drinking to the evenings or at least the afternoons, try drinking 2-3 big glasses of water after your last drink and before you go to bed. Then another 3 or 4 the following morning first thing when you get up along with your caffeine of choice.

I tried that last night and this morning and am experiencing zero SE's today. Now, this could be because I've adjusted to the 37.5 dose after a couple of days. But it seems like it might be related. More water, faster flushing out of chemicals in the body.

Downside is you'll have to get up and pee once or twice during the night. But in my book that beats walking around most of the day trying to get along with SE's.

But as everyone knows and few people -- including me -- generally do: you're supposed to drink like 8, 8 oz glasses of water per day. So what harm can it do in any case.

I'm definitely doing it from now on. Starting right now because I forgot to have the water this AM.

T.O,

I do not think that drinking water will help speed the process of metabolizing of the nal or help it flush out of your system; however, I am not a doctor or a pharmacist.

It sounds similar to an old hangover remedy that was to drink a lot of water before bed (to keep hydrated) and take two aspirin.

Water is something that I found to help slow down my intake, and I would go through two 16 oz bottles of water and one at bedtime/during sleep, but I have always drank a lot of water. I hated waking up feeling like my eye-lids were sticking to my eyes because I drank too much the night before.

I am very happy to read that your side effects are lesser today and I hope this continues!

Jaba

a pint of water between drinks will be your friend for a zillion reasons. trust me!

Water sounds good!

I like your CBT stuff too.

Keep it up!!
MD

Here's my updated progress report. As you'll see, at week 3 once I bumped up to 25 mg and 37.5 mg I halved my intake. Now I seem to have steadied out at 4 oz of whisky/night which equals 21.5 units/week. So that's progress in my book and I'm heartened. I'd like to see those numbers go lower but right now that's what seems to satisfy me and that's what I'm sticking to.

I plan to bump up to 50 mg this week and see if I can adjust to that. If not, I'll stick with 37.5 as it has caused a marked reduction in desire for:

A. late afternoon cravings as I look forward to the evening drinking session and

B. Uncontrollable desires to have Just One More after the self imposed limit I've given myself of 2, 1.5 oz bourbon drinks following by a 1 oz bourbon drink.

Trying to stretch the 'light' drinks to last minimum 1.5 hours. I feel the relaxation effects towards the end of drink 1. But I'm not getting the buzz and I'm reminding myself of this. "You're not getting that buzz, are you, Clown" Ha Ha. So maybe that will sink in after awhile and I'll decide to stop after ONE drink when I'm already relaxed. Not there yet.

At some point in the not too distant future I plan to try to take a 2 week period of AF days. I need to lose some weight and the South Beach works for me. But it requires two weeks of total abstinence at the start to work properly for me. (I know this from past experience.)

After that, I can add alcohol back in at a moderate level and continue to lose weight, albeit more slowly.

When I do the AF two weeks, I'm going to continue to take the nal even though I'm not drinking. I think it will help with cravings. But most important for me, I don't want to have to go through adjusting to the SE's again once I begin drinking after the two week's off. But I will probably bump it down to 37.5 during that period.

Will report when I get to that place. Which isn't yet. Not ready. And not pushing it.

Wish someone would tell me the secret of adding the progress report to my signature. I've gone to my profile and tried to add it. Says it added it. But then nothing shows up when I post. Anyhoo--

**

Pre Nal 40-60 units/day

Week 1, 12.5 mg, 33.6 units
Week 2, 12.5 then 35 mg 34.6 units
Week 3, 37.5 mg than 50 mg for 3 days but back to 37.5 because of SE's, 29 units
Week 4, 37.5 mg all week, no SE's, 19 units
Week 5, 37.5 mg all week, no SE's, 21.5 units.