I drink 1/wk, 2/wk max, but overdo it, and don't want to develop a more severe problem. I drink at least 8 beers, usually F night. I've been on nal 4 wks now, and am drinking 10-20/wk. Should I "train" by drinking more frequently (but moderately) on nal? Would this speed up the extinction? I don't recall reading anything about this in the book.

This is a can of worms that I'm probably gonna regret commenting on I'm sure there's a lot of opinions on this question, but ultimately it's up to you and whatever you find works.

Personally, I say NO-- don't drink more in an attempt to speed up extinction. Because the "cure" you propose (drinking more often to speed up extinction) is worse than your problem. It increases your risk of getting drunk (since stopping once you start is your #1 problem) and will make you suffer the negative side effects of NAL more than you already do.

I do believe NAL can be a tool to help your problem. Keep taking it when you drink-- it will help slow you down. But people use TSM because all other, non-medical methods have failed. Try some of those other methods! Start drinking later, stagger drinks with soft drinks, take set breaks throughout the night, etc... If drinking a few ginger ales throughout the night accomplishes your goal of drinking 5 instead of 8 on Friday night, why bother with the cost and side effects of increased NAL use?

I'm pretty much with nemo. Drink as you normally do. Which to me means in the times and places - not necessarily the same AMOUNTS - as you normally do.

I would certainly not give myself a new bad habit (frequent drinking) in order to break an old bad habit (sporadic drinking).

Yes, it may take longer to accumulate the number of action-inaction iterations necessary to accomplish counter-conditioning. It is what it is.

Just my unscientific opinion!

Dr. Eskapa's book clearly states:I would not suggest or recommend doing otherwise.

Bob

Drink as you normally do. You will see that repeatedly in Eskapa's book. If you're confused after reading some threads here, it's because some have suggested that it helped them to vary this basic tenet of TSM by forcing alcohol-free days. You may want to give that a try several weeks or months into your treatment if you feel you are ready. But as you begin, it's probably best not to reinvent the wheel. And I don't recall anyone claiming it helped to add drinking sessions just to hasten extinction.

Best wishes for success and let us know how you're doing.

Those comments are several months old, and consist of a sentence or two buried in long posts. In recent weeks there has been a spate of threads devoted to the topic of forcing AF days. Hence my assumption. Frankly, I don't care exactly where spinedoc got the idea so long as he is provided the information he sought.

Eskapa quoted Sinclair: "Large volumes of alcohol do not help (do not hasten de-addiction) [interjection by Eskapa] and can be dangerous. But drinking frequently while on naltrexone is beneficial since each time drinking is an extinction session." Eskapa, p. 107, fn(*).

Based on this, nick and others have experimented with adding drinking sessions. Others, such as you, AJ_, have found it worth the effort to aim for two consecutive AF days in order to practice the "selective extinction" Eskapa discusses at pp.120-122.

The overarching principle of TSM, as Eskapa asserts passim, is to take the naltrexone and drink as you normally do. Much beyond that, it's possible to overthink it.

Yep; overthinking it! Thank you all for your replies.