Hi Everyone,

I am new here and wanted to introduce myself. I have been struggling with unhealthy drinking levels for over 20 years, and have tried too many times to cut down or quit... all to no avail. I have a pile of self help books, addiction and alcoholism books, have been to a therapist + acupuncturist when I quit for 4 months last year (only to go back to prior drinking levels as soon as I started again, can you say deprivation effect?), have tried all the tricks (maybe only beer! maybe only on weekends! maybe only 2 glasses of wine tonight!), and I always come back to drinking a bottle of wine or more almost every night night (or about 6 or 7 shots when I drink vodka.) So I guess that puts me at 35 - 50 units per week.

I am fortunate that this level of drinking has not caused any major life problems for me. I have never lost a job, I have never gotten a DUI, I have a happy marriage, I am a 42 yr-old at-home mother of two small children (I left my road warrior tech consulting career a few years ago to raise kids), I live an otherwise healthy lifestyle, and so on.

BUT, when I start drinking, I don't stop till I hit that magical point of intoxication ... and I keep going well beyond that. I have had many blackouts, many regrettable, cringe-worthy experiences, many embarrassing times when I was slurring my words in front of friends and neighbors, too many walks-of-shame (back in the day) and have woken up countless times with a hellish hangover, self loathing, regret, despair and promises that THIS would be the last time. I have lost so many days feeling sick. My husband is often frustrated and disappointed that I can't stop drinking once I start (he is one of those lucky "normal" drinkers.) I say keeping up with little kids, laundry, house work, etc. is too overwhelming ("that's why you don't have any clean underwear, honey!"), but the truth is, it wouldn't be so hard if didn't have a constant hangover.

My drinking makes NO SENSE in my otherwise healthy lifestyle. I am really careful about the food I eat and I used to exercise regularly. But I am finding that I am slowly gaining weight and I am not exercising because my motivation is very low with a hangover. It is hard to look in the mirror in a yoga class when I feel terrible and toxic inside. It feels like such a lie. Yet drinking is a compulsion I can't seem to control. I keep setting goals and failing, and the root cause is always alcohol. I am afraid I am damaging my liver (my last blood test showed elevated bilirubin levels) and slowly killing myself. And still, I don't stop.

In my most recent search for a solution, I ran across a reference to Naltrexone (as an anti-craving medication) in a book about addiction. I Googled it and found TSM. Could this be true? The solution has been out there all along? I am beyond excited .... this method makes so much sense to me! I have read Dr. Eskapa's book and have spent time on this site and can't wait to get started. I feel like there is finally a chance to break free from this obsession!

I have avoided AA all this time because the idea of surrendering to a "higher power" (especially as a borderline atheist!), calling myself an "alcoholic" for the rest of my life, feeling like my problem is a moral failing, etc. all did not feel right to me. Understanding the neurological basis for my addiction makes so much more sense to me. I come from a family of very heavy, problem drinkers and daily drinking was normal in my home. Adding to that genetic and social predisposition, I started drinking in early high school, increased my drinking in college and moved on from there to daily heavy drinking. The neural pathways were set long ago, I haven't had a chance .... until now.

I am looking foward to being involved in what looks like a great, supportive community!
YG


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I went to a very kind, understanding and knowledgeable doctor today, who has experience treating people with TSM. I am elated! She said she has had mixed results, but that she has had the most success with people who are

1) highly motivated to make a change
2) have tried many things and ruled them out, and are educated about TSM
3) follow the instructions always - one hour before drinking, take Nal
4) understand that it will take a long time, and that some people never get to healthy levels, but still drastically reduce their drinking and increase their control and quality of life (e.g., two drinks a day for a woman is not considered "healthy", but is way better than 7 or 8 a day!)

After a blood test she put me on 25mg for two weeks, then up to 50mg after that. She said her patients have done well increasing dosage on that schedule. She wants to see me again in a month to see how I am doing, and will review the dosage at that point. She said she normally sees a reduction in units to about 3/4 the pre-TSM units in the first month or so. Then she sees a 50% reduction in 4-6 months, and usually about a year to reduce more from there.

I told her I was worried about extinguishing other endorphin releasing activities (like yoga, exercise, sex, listening to great music, etc.) and asked when I should start the "selective extinction" process when my opiate receptors are super sensitive due to upregulation. She said we would not start "selective extinction" till at least four months in, and not to worry about extinquishing other behaviors. She said by all means, keep doing all the things you love.

So I took my first dose last night, 25mg before dinner. I felt dizzy, spacey and extremely irritable. I couldn't finish my dinner, because I completely lost my appetite. The first glass of wine went down unusally slowly, but after the second glass I drank the same amount and speed as usual, about 6 units total. I considered more, but decided to go to bed. I did notice that I did not get that warm glow I usually get in the first two drinks, but I kept drinking anyway. Perhaps out of habit? I don't know what else to do when I finish a glass, besides pour another one.

I took 25mg at 5:50pm tonight, and started my first glass of wine at 6:50pm. I felt a bit dizzy, but not as bad as last night. I was not irritable and my appetite was fine. I drank pretty quickly, not slowly like last night. We watched a movie with the kids, and I was sure to measure out extra wine to be sure I would not run out and have to run upstairs for a refill. All pretty typical so far.

But then ... I poured glass #5 prior to reading stories at bedtime, again just in case. Always pre-emptive! I fell asleep in bed with my son. I woke up at 10:45pm ready to go to sleep for the night. Glass #5 was still on the kitchen counter. I forced myself to drink a few sips, then poured the rest back into the bottle. Now THIS is unusual. Placebo? Maybe. Just tired? Maybe. Naltrexone? Maybe.

I had minimal side effects today and the book says to take 50mg after two days, so I am torn. My doctor said to take 25mg for two weeks. I should follow instructions, but I feel impatient. Whew ... take a deep breath, this will be up to a year, I need to be patient. Okay, I am off to bed. I had a total of 4.5 units in three hours and more sounds icky ... seems like a good sign so far. I may be starting the honeymoon. It will be nice to wake up with little to no hangover tomorrow.

'Night everyone!

Wow YG, your first experience is remarkably similar to mine, minus the kids portion . As I'm sure you have, you can read many posts on this board detailing a similar first experience, followed by a lot of ups and down. Not saying this to be negative, I'm just commenting on the fact that the first couple of days can really embolden your belief in this, as it has with me. I'm in for the long haul.

Tonight is my 4th night using Nal/TSM. I did 25mg, after an absolutely horrid night at work, the disheartening loss of my favorite sports team, and being invited out to drink by some gals I know. It seems unreal I am home, by myself, at 1:30am, with only a 6 pack in me. Sorry for hijacking your thread with my story, but I guess what I am saying is enjoy the "honeymoon" period and "weak effect", but look forward to the same feelings once this treatment runs its course.

Hi Yogagirl!
I'm on week 9...and STILL play mental ping-pong with placebo? trigger? naltrexone? fatigue? stress? It can make a lady crazy I keep trying to remember to remain patient and not overthink it. I liked that your MD gave you a longer (and probably more realistic) timeline for a cure. PHEW. That helped me take a deep breath...I am doing this on my own and only have the book to go on (which states a much shorter time until extinction). Anyway, welcome! I'm looking forward to reading about another momma's adventures with Nal!

Welcom YG. As I said to you ina pm, we are so alike. I can identify with every last detail of your story. My kids are older - which means they are taking more notice of what Mum is drinking Lucky you, that you have found a great Doc. I am on nal since mid March - 90% great - the last 2 weeks or so have been the yucky 10%!!!! All part of the jouney

I was speaking to my local Doc this week and I asked her for her opinion on nal - she dismissed it completely. She doesnt know I am buying it on line. I am just about to write the tale in my journal. I dont want to be hogging your journal. Be kind to yourself and I wish you lots of luck. Remember -we are all here to help each other. I think we should start a Mum's 'nal' league here!!!!!!

Hi Yogagirl,

Your first couple of nights are pretty much what I experienced ie not being able to finish last glass. Enjoy your honeymoon and remember things will be up and down a bit in the coming months, so get ready for the ride.

Thanks for the warm welcome, and for sharing your thoughts, everyone! And please never worry about hijacking my journal, I am always happy to get comments.

Day 3 - 25mg of Naltrexone again. No side effects, drank 5.5 units of wine (a bottle + 3 oz) pretty quickly, but possibly with more clarity. I fell asleep reading my daughter stories this time. I woke up at 4am again, and didn't sleep well after that.

I am already playing some interesting mental games. I can't figure out if I am drinking faster than normal because I can (since I am not hiding and I am measuring like a scientist!), because the Nal isn't working, because I am trying to override the Nal, or what.

I am also getting nervous that, although I had side effects the first day, they are mostly gone now. And I am drinking roughly the same amount as usual (although I am not sneaking a few more, because I fall asleep too early.) Does this mean it won't work for me?!? God I am such a perfectionist and so impatient ... this process is going to be hard!

Also, for all of you out there doing this on your own, I promise to post all the feedback I get from my doctor. Mario, I think you had asked if she knew how hard it is for people to get Naltrexone in other places. She knows she is only of a few in my area that will prescribe using TSM. I told her about Andrea's experience in Ireland and she had no idea ... she was shocked.

One thing I am wondering about now is why she has me waiting for 2 weeks to go up to 50mg. I am petite, so maybe she wants to make sure I have time to really get used to 25mg before increasing. But the side effects are already gone, so I am tempted to move up to 50mg now. Again with the impatience!

It's like Nick says.....Nal+Al+patience=cure I'm having to learn that myself. I'm 12 weeks in and wondering if it will work. the book says 3 months is when most people experience a great drop off, but I have been up and down without ever going under 38 units in a week. I've seen it take longer for a lot of people here so I'm hanging on. and why not? If I'm drinking anyway I might as well take my Nal. until I find conclusive evidence that it won't work for me I'll stay the course

Yogagirl - regarding the two weeks at 25mg - no idea what your doctor is thinking (not being psychic and all) but personally I'm thinking it's a pretty smart way to reduce the potential for strong side effects to derail people early. It's pretty discouraging to go from so hopeful before starting to GACK, I'D RATHER BE DRUNK type side-effects. Perhaps in her experience some folks just quit at that point?

I cut myself back to 25 mg for about the first week after trying to apply the standard protocol. The protocol described in the book starts with 25 for one day, then up to 50. Given that the whole process is going to take months and months at a minimum, I'd say any possible minor stretching out of that overall time-line is a "who cares" compared to the total loss if someone bails on the program because they ramped up too quickly.

Just a random thought.