TSM has been around for 40 years, only 15 of which humans have been involved (sorry little rats!). Anyway, the trials were all done at 50mg. This seems to do the trick for most, but titration is a tricky business and even Eskapa and Sinclair don't have all the answers. The TSM naltrexone range seems to be between 25mg and 200mg.

One of the most important reasons higher doses may work is that naltrexone metabolizes out of the system more quickly in some people. I'm sure there are other factors that play a role, too, from genetics to weight. This is true for other drugs, as well: depression to autoimmune diseases to schizophrenia are treated with considerable tweaking of meds until the magic combination arises. It isn't a "one size fits all" process with other diseases, so it makes sense that alcoholism not be treated any differently.

I take issue with only one thing—time—sticking with 50mg for the first 4 months (low end of the cure curve) before embarking on higher doses makes the most sense to me.

Hey YG, thx for yr comments on my weekly progress thread ! I've just read yours... We are experiencing very similar results thus far. It's great to have someone at the same weekly stage. Have a great week 5. All the best. Kiwi.

Hope you have a great week, too Kiwi! Every day brings us closer to being cured !!!

Great to have you along for the ride, Kiwi! We'll have to continue comparing notes since we started so close the the same time. And you got to see Train? I'm so jealous, I'll bet that was fun!! I just saw Sting with the Royal Philharmonic Orchestra, and plan to see several other concerts this summer. Interestingly, my biggest worry is always who will drive, because I think concerts are way more fun with many drinks.

And I have to say ughhhh .... I am officially on the TSM rollercoaster. I think my honeymoon, if I even had one, is over. I have been drinking so much, so fast the last few nights it is like I never started TSM. Interestingly this coincided with increasing my dosage to 75mg (still not sure why my doctor recommended this?) and also a monthly event that nature has bestowed only upon us ladies. I am keeping track of that too, to see if there is any relationship (my sister swears there is!)

I am also wondering if certain triggers cause increased drinking, and have to be "drunk through" in order to rewire? I hung out with some drinking buddies that I had not seen since starting TSM, went out to dinner with some new friends, and went to a family party ... that's where all the heavy drinking occurred. At least none of it was home alone, like before. I consoled myself by recalling a comment (from ToxicGirl, I think?) that even non-alcoholics overdo it sometimes, and certain situations just turn out that way.

Okay, I am off to join the neighborhood in celebrating Independence Day by drinking wine and exploding illegal fireworks (the big ones are banned here in Colorado, but we can get them in Wyoming, only a few hours away!)

Hey Yogagirl,
Yes, it was me that said "even non-alcoholics overdo it sometimes" and if there is ever a time to overdo it, it would be a long, holiday weekend! I think the bulk of the population drank too much yesterday. So forgive yourself, focus on happy thoughts, and move on. Who was it that said, “Feelings are like chemicals, the more you analyze them the worse they smell" (I cannot remember who said this, but it is an astute analogy). We TSMers seem to enjoy burning the candle at both ends, analyzing all this inconsistent behavior, unruly drinking etc. and all for naught. Where does it get us?

Here is another good line (I'm full of 'em today!): The mighty oak will break a branch, but the willow bends in the wind...something like that. Anyway, be the willow—bend in the wind, go with the flow because the more you push, the more you fret, the more you analyze, and worry, the worse you will make this TSM journey.

I'm not an expert, but I believe our triggers can make us drink and often drink more (that is why they are triggers). So yes, since TSM is all about extinguishing, drinking through triggers makes a lot of sense.

You are only a few weeks into a very long journey. It took you a while to develop your drinking habits and it makes sense that it will take your brain a while to undo them. So given the choice, make this TSM journey fun!

Hi girls, yoga and toxic,

It has been my experience that the brain, when confronted with denial of the endorphin reinforcement can go into hyperdrive trying to find a way to catch that old buzz we so desire. Each trigger that worked in the past to get us high is tried, sometimes repeatedly, until the mind finally comes to grips with the idea that that old buzz simply no longer exists for us. This realization can come with a great deal of sadness for some of us. It has been described as losing on old friend, although I view it more like escaping an abusive relationship.

As always, that's just been my experience. Some people seem to just get cured and not have to go through all the psychological crap.

Thanks for the insight, Firebird ... I think you are right. It is like escaping an abusive relationship!

So, I have not updated over a week. We had a holiday weekend in the US, and I ended that week with 39 units after several long days at the pool and playing with other heavy drinking friends. I tried not to worry about it when I got to 10 units in one day, and told myself I was extinguishing those triggers. Still, hangovers suck, so I can't wait to be further along on this journey!

This past week, I felt like I drank a lot because I had a few nights that seemed heavy, and felt terrible the next day. My dad was in town, which is always a big trigger for me. But, when I looked at my total units for the week, I was way down! Only 23 units total, which is a big drop for me. Yippeee!!

I am noticing now that where I used to have 5 glasses of wine and want more, now I seem to get to 4 glasses and feel done. No blackouts, no sneaking shots of anything when no one is looking. Something is changing ... I am not there yet, but I do believe this is working!

Great News Yoga! Keep it up. I like the analogy about the abusive relationship. I got trashed the other night. smoked a lot of pot and pot makes me drink more. so I remembered why I quit smoking (really buying ) ups and downs are the thing here!

Thanks, Joe! I like to watch your progress because I was reading your early posts with great interest when I was just learning about TSM and waiting to get a prescription for Nal. Its so great to see you steadily reducing your units and sounding happier. Sounds like those overdoing it days are much further apart than they once were.

I had an AF night the other night and decided to smoke a little pot, which never has been my drug of choice. I proved to myself once again that I don't like it. I had a really weird reaction, like images in my head were in a kaleidoscope, and turned into scary, demonic faces and other disturbing imagery. Not cool! I spent the whole night tossing and turning, jumping out of my skin with every strange house noise, and kicking myself for trying again to like pot. I guess I am so used to being altered in some way in the evening, I wanted to replace the alcohol with something. Maybe someday I will figure out that whole "I'm just high on life!" thing ... not there yet!

Hey YG,
23 units!!!! Wow!!! Thats fantastic !!!
While I'm sure our units will go up and down for a while we need to celebrate the wins along the way. That's a damn good week !

Have a great week 7.

Kiwi.