I just purchased "Targeted Use of Naltrexone Without Prior Detoxification in the Treatment of Alcohol Dependence: A Factorial Double-Blind, Placebo-Controlled Trial" from Journal of Clinical Psychopharmacology Vol. 21, No. 3.

After reading through this journal article, I believe Robert is drawing the wrong conclusions from it.

This study followed 121 individuals who were addicted to alcohol. These people were divided into 4 groups:

Group 1: Treated with the Sinclair Method, but not given supportive therapy.
Group 2: Treated with a placebo, but not given supportive therapy.
Group 3: Treated with the Sinclair Method, but given supportive therapy.
Group 4: Treated with a placebo, but given supportive therapy.

For the first 12 weeks, all individuals were to take their respective tablets every day. After 12 weeks, individuals were to take medication only before drinking. The primary measure used in this study was frequency of relapse to heavy drinking, which was defined as:

"The primary outcome measure, chosen before the study,
was the rate of relapse to heavy drinking, defined as having
five or more drinks (12 g of ethanol each) on one occasion,
having five or more drinking occasions in 1 week,
or arriving at a visit intoxicated."

Robert is correct in that this study did find a plateau at 8 weeks, but he was incorrect about what this plateau represented.

FIG. 2. Percentage of patients not relapsing to heavy drinking, from the study, shows that the relapse to heavy drinking plateaued for most in the study at 8 weeks(unfortunately, I can't paste the figure in my post here). For those in the group being treated with The Sinclair Method, but not provided supportive therapy, this plateau was about 40%.

This measure (i.e., the relapse to heavy drinking as defined in the study) is an entirely different measure than extinction, or the reduction in alcohol consumption over time while taking Naltrexone. In fact, this study did not directly look at Pharmacological Extinction, but a by-product of it.

The maintenance phase that Robert suggests is the Selective Extinction phase of The Sinclaird Method presented in Dr. Eskapa's book whereby one takes Naltrexone only on those days when one feels the craving to drink, but tries to avoid taking Naltrexone everyday (see pages 120-121 of Dr. Eskapa's book)

I'm happy to email this study to anyone who would like to see it. I hesitate to paste the study in here for copyright reasons, just PM me your email address.

I am not very good at deciphering research studies, but common sense tells me that I will not unlearn my addiction in a matter of weeks. It took me decades to get to this point, and I would be very surprised if even 3 months cuts it. I am looking at 6 months.

You are exactly who belongs here and your opinion is completely welcome by me(us).

Agreed!

Right now, the most significant study is underway in determining the efficacy of the Sinclair Method. I would advise that we all pay very close attention to the results. The data will be irrefutable and not open to challenge. That study is us and as far as I am concerned, it is the only one that matters.

I assume you are referring to Naltrexone. This is absolutely incorrect. Naltrexone is NOT a potentially deadly neuroinhibitor. On the contrary, Naltrexone is a very safe medication with mild side effects. All facts show that this medication is well tolerated by the vast majority of those taking it. It is approved by the FDA here in the US for treatment of alcohol addiction.

The only situations reported by Drs Eskapa and Sinclair and the manufacturer of Naltrexone where Naltrexone could be seriously harmful or deadly is in overdose (not uncommon with just about any drug, even tylenol) or when combined with large amounts of opiate drugs like heroin.

Robert, you've been making some very powerful statements to these boards with some authority and using medical terminology in a fashion that implies you are an expert. The issue I'm having is that much of what you are saying is incorrect. I am not a medical professional, but I am a technically minded person and no stranger to scientific journals and technical papers. You either have not read Dr. Eskapa's book or do not agree with it, otherwise you would not be making statement like you've made in this thread.

As previously stated, I am not trying to cause any conflict in this forum, but there needs to be some accountability (i.e, where is the proof) to statements such as what I've quoted above.

Q

Oddly I am now going to defend our friend, Robert Rapplean - when I was the one who got angry with him in the first place. From what I've read, he knows his stuff. The "deadly neuroinhibitor" he is speaking of is alcohol...and to imbibe it the way many of us do is, indeed, potentially deadly.

As I've said before, my eyes cross at much of the scientific jargon, but I read it very carefully...and thankfully, am not alone. What it all boils down to is we are all different in how we respond to this drug and this method. I stumbled across the book in mid-January and felt the most incredible sense of hope...and continued to up until a few nights ago when I suddenly realized I was 2 months into the "program" and have not had any major take it or leave it moments...and that at that point, I should have had some real changes. For me, nada mucho.

Everything else said, I am still going to keep on but my spirits are at an all-time low...well, except Marbella's post over there made me feel a whole lot better. It's just everything...I am alone in this, I am alone in basically everything and it is really hard sometimes to be positive and stay focused when no one really knows what I am doing as far as trying to break my addiction to drinking. No one. Chardonnay has been my best friend for years and I am relying on some crazy magic cure for this addiction and it hasn't happened in the last 8 weeks.

I'm afraid I will be one of the unlucky ones. I just have gotten that message in the last few days. That's what I'm feeling and hearing. But it's ok - I will delude myself and continue taking this stupid pill everyday...or of course, only on the days I drink, which except for 2 last week will probably be everyday...until June when I hit the 4 month mark. Then I will reassess.

Carpe diem

I disagree. What Robert said was:

"What's more, the Sinclair Method DOES involve consuming a potentially deadly neuroinhibitor on a regular basis."

The very basis of The Sinclair Method is Naltrexone. The Sinclair Method states that we must take Naltrexone to be cured or our addiction. To say that Robert was referring to alcohol is naive at best.

Even if Robert was referring to Alcohol in his comment, it is still an extreme exaggeration to say that alcohol is a deadly and The Sinclair Method involves consuming amounts of this substance that would be deadly. Fact is, Alcohol is not a deadly neroinhibitor. Yes, a person can drink themselves to a point where health is at risk. I can also take 10 1000mg Tylenol tablets in a 24hr period and put myself at risk of liver failure and death.



There is no need to understand the scientific jargon. The details are for those who enjoy looking at and/or discussing details. What you, and all of us, need to focus on are the bottom line results. These results say that 78% percent of those who are addicted to alcohol and follow The Sinclair Method will consume 9 units of alcohol per week or less after 4-6 months. This means 8 out of 10, alcoholics will be cured of their addiction, period.

This is not my opinion, but the facts from the results of nearly two decades of clinical trials.



I've felt the same way at times since starting this treatment. houtx, this is normal. We all have felt this --- look through the various posts on these boards.

You are not one of the unlucky ones. Yes, the stats say 78%, but remember that many of those in the 22% who failed, failed because they didn't follow The Sinclair Method. That is, they stopped taking their Nal.

Keep taking your Nal. This will work for you.

There is no mention of these various forms of Alcoholism in ANY of the Scientific Studies or Clinical Trials performed with respect to The Sinclair Method.

The results presented in the clinical trials are from groups of individuals who generically have an addiction to alcohol.

I disagree Houtx! I am not trying to bury my head in the sand here, but I think it is all going on beneath the surface, at a level you cannot perceive at the moment.

I too have my doubts over my progress!

I know my results have been excellent, but I AM in a non-drinking atmosphere everyday- how would I be doing if my situation was the same as a year ago, and I was out and about at 7pm instead of working? Would I have seen the same results? The answer is NO.

Just keep at it! I don't believe 8 weeks is long enough to tell.

Please sent me a PM when you feel miserable, I log on at least twice a day x

I will give my blunt assessment of Robert. I see the gentleman as a voyeur and fraud who takes delight in trying to impress others around him with what he does not know. In the day of Wikipedia, WebMD and any a sundry internet source, any two-bit hack with a laptop can try to pass themselves off as an authority just by cut & pasting.

Other than a fetish, what is the purpose of Robert for being here? He does not express an alcohol addiction and is not on the Sinclair Method. At a cocktail party he would be known as a blow-heart at best but more likely regarded as a whacko.

Remember, a lot of people have put their lives on the line here. We are making a major investment in a 50 mg pill and a 319 page paperback book. The day we swallowed the first pill, we are committed for four to six months on the method. Once we made the leap we ain’t getting back in the plane We are going for the full ride. Questioning whether the parachute will open serves no purpose at this point in time. There are very few on the ground waiting for us and cheering us on. That is the truth of the matter. But that day will come.

Come June or July there will be a wave of us in this MB that will have hit the six month mark. That will be a water-shed moment for those behind us will have the advantage of knowing living, breathing individuals who have succeeded (or failed). Yes, there are studies but we are the real deal. As I said on the MWO board, I am committed to going wherever the Sinclair Method takes me, this side of sanity, for six months. At that point, I will clearly sound a clarion call, one way or the other. So far that call is tilting to Sinclair’s favor.

As far as I am concerned, Robert should be posing his questions to Dr. Sinclair via Dr. Eskapa. Why anyone else is engaging him is beyond me. I also believe if any of us have a question of scientific or medical nature, we should be seeking the same source for answers. Your mileage may differ.