Several folks have been sunk in gloom the last few days because either there is no change in drinking with Nal, or their drinking has increased. I dug out the quote below from Dr. S from the Ask Dr. E thread, in which Sincair simply restates that Nal does not work for all, and that there could be an increase in drinking for some.

"As to the pattern of drinking over time, this is somewhat variable. The extinction curve is the average shown in the book, and the most likely pattern. But some individuals may have their drinking go up at one time or another (is he saying that this is temporary, just to wait it out?). If you compare the individual results with naltrexone with practically any other behavioral measure, the surprising thing is how little variability there is with naltrexone. But it is true that people differ. And there are those rare individuals who do not benefit from naltrexone."

But I notice that he refers to "average" results in his study. Can we not assume that there were some who quit, some who drank moderately, and some who had no change/increase in drinking?

I'm just feeling so bad for those in despair right now. Any chance in getting a more specific answer? Should those who after 6-7 months with no difference/increase in drinking give up? Should they hang in? Fix their other problems in conjunction with Nal? View the "habit" as a separate issue and work on that while Nal works in the background? IMO that issue is not addressed. The book says that Nal works even in the absence of counseling, or other intervention, but this may not be true for many. When the honeymoon period happens should we not take advantage of it and attempt to break the habit while we have a chance - most advice here seems to be "keep drinking as you usually do." When milage varies so greatly here that may not be the best advice.

I'm just throwing all this out there. Does anyone have a pipeline to Dr. Sinclair? Would he address the issue specifically that Nal for some will take a year, two, three and that they should be patient? I sure hope so!!! Hope is all we have!!!

None of these thoughts should be taken as a criticism of anyone, of course, I'm just sitting here in my pj's feeling sad that others are in despair and not being able to help them.

EDIT: There have been posts where habit was addressed but not very deeply. I think that's because we're told to continue to drink normally. Is this a key to Nal that some MUST use? I certainly believe (trust) Dr. Sinclair and I know that his method is a lifesaver but but but but.....how can we help those who are crying out?

Hi WTE,

I raised this question back in April of this year. Please see the following thread:

viewtopic.php?f=15&t=300

My best.

V.

so we're to take away from what Dr. Eskapa said that it can take 4-6 months...but obviously that means people at the upper end of the scale will take 6, or 7, or 8 months? That means to me no one should panic and quit - unless they want to try baclofen instead or with Nal. And remember Dr. Sinclair said benefits accrue for 1, 2, or even 3 years after treatment. That sounds good!!

so please, those of you who are struggling along and not seeing the light at the end of the tunnel hang in there!!

I think I am "hanging in there" I just am choosing not to drink. It's not too bad, I feel better than I feel when I am drinking.
I have some cravings but not enough to allow myself to have a drink because once I start I just seem to not stop. It's that first "Oh just a small one," then it's all over for me.
So as I said before on another thread, I think I am still on TSM because if I do drink again, I will take Nal 1 hour before. Can not believe it's day 4 AF!
But I am using my will power. I found this will power because of fear, because of an assortment of drugs and AL.
I want to be healthy.

AsRealityTurns can you explain how you're doing it? Are you white knuckling it? If not do you think it's habit why you didn't do it before now? Could you explain.

I went to a psychiatrist this past week and he was "no nonsence."
I told him what I was doing, Nal, Bac and a slight use of Zanax. (More zanax recently as my emotional life is in turmoil and I have depended on it as a last resort to sleep).
I also just added Wellbutrin to the mix.
He told me that I could have a seizure with some of this combined with AL.
He scared me.
I did not get all the final answers to my questions as our time was up. I will see him again soon.
I decided to just stop drinking at least until I can be sure I am not playing with fire.
Oh, of course, my 35 year Al use, has been completely healthy
Seriously, I just do not accept the fact that AL is ruining my health. I am healthy, have good energy, but AL makes me lazy and sometimes lethargic.
It's a big pretend game for me.
I heard what the Dr. was saying, he was very clinical and straight forward.
SO I am not drinking.
The first day is the hardest.
And I do have urges, but I somehow got a loud and clear message.
I do not think I am white knuckling because when I want to drink, I drink.
We shall see what the future brings!

And: Last year I went to rehab for a month. I was prepared and organized and well packed, not "dropped" off with a suitcase as many people are.
I was in a yoga class ten minutes after throwing my luggage into my room.
I had no need for detox. I did not miss AL during my time, except for maybe four times, I wanted a glass of cold dry white, but that passed.
I looked at rehab as a learning experience. It was interesting, but much too centered around AA. I am not an AA fan.
I have no idea how I am doing this. I have done it a few times in the past. Maybe this is the final round for me.
But I feel proud of myself, and I was starting to have dreams where I am "sneaking" drinks in my dream.

I have been sneaking drinks in my life since this February.

That is starting to wear on me. Stopping at various places to unload my bottles so they are not found in the recycle.
I just need a break. I am really deceiving myself.
And as I said, I AM SICK AND TIRED OF PLAYING THIS GAME WITH AL

So dear friend and friends, wish me luck, I do NOT want to be a "dry drunk, or white knuckler.

Hi BGH,

That's why I decided to wait until the end of the year before delivering my final verdict. At that stage, I will have been on TSM for exactly 40 weeks.

BTW, many thanks for starting this thread - very considerate of you.

All the best.

V.

Virgil, will you try baclofen then?