Thought I'd celebrate day 1 of TSM by starting a thread. The Nal arrived yesterday in the mail. I'm starting unit 4 for the night, I took a half-dose (25mg) of Nal two hours ago on an empty stomach, then ate dinner.

I've never taken naltrexone before. I don't really notice any effects. No nausea or any of that. Next time I'll take the other half-dose, after that 50. Always one hour before drinking. Every time I drink, no matter what.

There's this scenario that plays out a lot. I get a good buzz on, and I find myself ordering/pouring another drink, or opening another bottle, while thinking "I'm really buzzed, I don't need another drink" (and more recently "by the time I finish this bottle, I'll be more drunk than I want to be. But I'm going to do this anyway.") Something subtly takes over, intending to drink as much as possible. Something will not be satisfied. In the best case these nights end up just stumbling off to bed. In the bad case, I start at the local bar, I wake up in bed and don't really remember what happened... in the worst case I remember only a few flashes, and they aren't good ones, like I was on the ground wrestling around with somebody.

There's this... tipping point. Once I go past it, it's bad. It has seemed to be much less likely to happen if I don't go out; as a result I've become very isolated; I stay home. I'm afraid to go to the local bar and have a few drinks; who knows what will happen. If I stay home the worst case is I don't remember surfing the web for hours.

I don't feel like anything is blocking my buzz, really. The naltrexone effect is very subtle. I'm ready to go off to bed, I have a 750ml bottle of 8% ABV beer in me. Normally I would be opening another bottle, but I don't really feel like it. Is that the Nal? Maybe. For some reason The Beast hasn't awoken tonight... that's a good thing.

hey neural!
I have had a good result on nal. And it does help me stop before I go over the edge.
I am able to attend functions and actually see other people way out beyond me, but I am still having a good time and I am in full participation.
I still drink much more than I feel I should, and it still affects my everyday creative energy, but the good is outweighing the bad.
So hello and bon voyage!
ART

Hey Ned,

Use these early experiences (honeymoon) to help you through the patience part 3 and 4 months out.

Whenever you have good results, post, because you will get on a roller coaster most likely and perservearance(Damn can we add spell check) will begin to wane. That's where I'm at but I find strength in all of my friends here. They're like fellow soldiers in a war, and they all love you unconditionally. (Unless you're a hater,..then those folk usually just bail from the forum). My Best to you, Jim Clark

PS I've had some good and bad results but as other older members have told me, I'm only at 3.75 months out. So I need to relax, but I feel glimmers...I really do. That being said, I've been drinking too much lately,...Best to all, Jim Clark

Good Morning Internet! All the best for the new year, to all who happen to receive this transmission... in whatever year you happen to be in, on whatever day it happens to be. Here on the sending end, it is the early morning of January 1st, 2010.

TSM has started auspiciously, thought the story is not all polka dots and moonbeams. It is now the end of the night, and I'm sober enough to type. That's good. I took 50mg Nal @ 5:45p on an empty stomach and poured the first drink at 7p. This is my second dose of naltrexone ever; originally I had planned to take 25mg (a half dose) out of fear of side-effects.... but due to the big-drinking special occasion I just took the full 50mg. For those tracking side effect data: I've had zero side effects, this stuff is really, really easy to tolerate. Don't be too afraid of the reports of nausea and so forth.

By my calculations it is (looking around the room at the empties) eight hours and 7 U.S. drinks later. I have drinks 8-10 in a glass in front of me, vodka with pomegranate juice. Compared to a typical bender, this is nothing. Very good.

Several interesting things happened tonight. First of all, for the first eight hours or so I averaged under one drink per hour, without trying. It is New Years Eve and it is only my second day on naltrexone. I didn't leave the house, so there were no reasons to be careful about how much I drank. If I'd been blotto drunk by 9pm it would have been fine, I could have slept on the couch. This is where it gets interesting. Between 7p and 10p I had three drinks... I was busy playing with a new laptop and didn't pay attention to my drinking rate. Then the girlfriend and I congregated in the kitchen at the stove, chatting about the viscosity of the fondue we were working on and drinking some good champagne. Chat, sip, stir, chat, stir, sip, chat.... then a very strange thing happened:

SHE ASKED ME TO REFILL HER GLASS

and I realized I'd completely lost track of mine. I was absorbed in animated conversation about TSM. I'd announced earlier that I was taking my new "drinking medicine" and would be ready to have a drink in an hour. We discussed the internet, the approval process for new drugs, the democratization of emerging scientific knowledge, finland, baclofen, blah blah blah... where's my drink, again? Stirring the fondue, she points out that our glasses are empty, and that the champagne is waiting patiently in the open bottle on the counter not more than 30cm from my elbow.

I refilled the glasses, she continued stirring, our discussion continued, the fondue was ready. I put on oven mitts and moved the iron vessel of molten cheese to the table where we dipped in bread and broccoli, continued our wide-roaming discussion, and then she then pointed out "you forgot to bring your drink". Whoa.

FAST FORWARD

At about eight hours since I took the 50mg naltrexone, she was fading.... and I was starting to think I wanted another drink, that I wanted to "finish the job". Uh oh. That's The Beast talking, the thing that Will Not Be Satisfied. I now sit in front of the empty glass that the beast poured, and I'm considering pouring another. This is just not the same individual that forgot to bring his champagne from the kitchen to the dinner table. Well, maybe I'm schizophrenic... I don't think so. Neither do I.

THE $64k QUESTION

is whether "just take 50mg naltrexone before you drink, every time you drink" is the whole story. The naltrexone was sufficient for the first six hours, for sure. The important thing is pharmacological extinction. Ideally you'd have a display on your wristwatch that showed when the naltrexone was wearing off and your opioid receptors were freeing up, and you'd e.g. take another 25mg. I got the feeling that the nal was wearing off. In fact, I'm going to go pour a drink right now that I don't want. (it is now 4:30 am)

I'm wondering about some of the longer-drinking, tougher cases on the board, who aren't seeing results 4 or 5 months in, but hopefully I'm doing so for scientific reasons. If one usually drinks from noon to 2am, and 50mg naltrexone is good to keep your opioid receptors plugged from, say, noon until 8pm, then pharmacological extinction isn't going to occur. It might actually cause the late night drinking to be especially brutal, as the endorphin-starved neural pathways finally start to get a little taste of what they crave and demand more.

Just thinking. Happy new year, internet.

Good Morning Neural Ned,

Great writings - if you are not an author, you might consider it.

Your thoughts about the longevity of Nal are correct. There are other posts regarding this in other areas of the board by TSMers that drink for longer periods of time. For those, the elders (LOL) suggest taking another 25 mg of Nal later on in the day. Search around the board and I'm sure you'll locate some or someone more experienced will respond.

Best of luck to you, keep writing as I am enjoying your posts! Happy New year!

Hi
You might be interested in the comment made by Helsinki who comes from Finland. I don't remember anyone following it up
but you may like to do so.

"I take Naltrexone Vitaflo 50 mg one hour before I drink and only then. It lasts for 6 hours. If I drink longer during the same day, I take another pill."

Chris

You should search the board, but off the top of my head, it goes like this: 50 mg certainly covers your opiate receptors for twelve hours and theoretically covers you for up to 24 hours. However, its effectiveness may diminish as you get closer to the 24-hour mark so taking another 25 mg might be advisable if you are having stretches of drinking that occur over several hours. Search Lena's posts -- she wrote about this within the past couple of months.

My experience the first few times I took naltrexone was just like yours: instant reduction in consumption. For the first time in decades, an hour would go buy and I would not pour another drink with no effort or second thought. The great news is that this means naltrexone clearly is affecting you and I have not read of a single person here who experienced this who went on to report that TSM does not work for them. The bad news is that this is certainly the "honeymoon effect"; true extinction takes months. Many of us have an immediate decrease in our interest in drinking after starting TSM but it does not last. After a few sessions or days, our drinking goes back up to pre-TSM levels. This is why it's called a "roller coaster" and your improvement almost certainly will not be linear. But congratulations, you are well on your way to more control and less consumption.

[quote="neural.ned"] Well, maybe I'm schizophrenic... I don't think so. Neither do I.

THAT IS SOOOOOOOO funny! Thanks!

neural.ned, I just took my second dose tonight also. After my first dose (two nights ago) it took about 30 hours before I started to feel the effects of alcohol, so about 11 pm last night I took a sip and I got that rush. I had only taken 25 mg the night before, but due to the incredible nausea I felt I could not take another dose the following night (last night). If I am this sick tomorrow I will only take 25 mg every other day. I am having to force myself to sip from the glass of wine in front of me, it tastes disgusting and so do cigarettes. I went for dinner tonight and I usually would have a beer or glass of wine and just the thought of having to take the pill the hour before had make me so sick to my stomach that I didn't take the pill and I just didn't order any booze. Took the pill with a soda and cranberry juice after dinner. Glad you are getting the benefits without this awful nausea. gag

The nausea goes away after the first few doses almost as a universal rule.