Hi,

I'm posting this for my boyfriend who is using the TSM to gain control over his alcoholism. He is a heavy drinker, consuming up to a liter of whiskey a day on the weekend. He has been using TSM for a little over a week and has noticed a distinct difference in the amount consumed each day. However the problem....

His weekend pattern is the problem. Typically before Sinclair he would get up, drink anything left over from the night before and then visit the liquor store at 9 am and start in heavy, be passed out by noon, sleep, and then wake up and drink more. He often would taper or abstain and have shaky Sunday and feel much better by Monday. During the week he never drinks until after work, typically 1-2 pints, rapidly consumed and then sleep early.

Since starting TSM, he takes the med at 3 and gets to drink at 4, he has noticed a significant decrease in desire to consume as much, cravings are still there during the day, but volume is down significantly, as well as the "drunk behavior" he remains much more in control of himself, checked into the world as it were. He still gets a little out of it if he consumes more than a pint and a half.

He doesn't know what to do on the weekends. Last weekend he took the med at 4 drank most but not all of a liter, woke up and choose to take the med in the morning and felt like crap all day. He drank his pint an hour later, but still felt like crap all the rest of that day, and the next, but waited to take the med on Sunday until 3 and felt better after that.

So he doesn't think at this point, he can wait until 4 to drink on weekends, but feels awful when he takes the med early. So take the med late after already having some drinks? Take half a dose at a time, starting early? Take it early and suffer (he won't do this by the way...)? Looking for some input from those who have been through this.

J

J - I will let some of the more seasoned TSMers respond to your question, but the golden rule is Nal one hour before any Al. That becomes a significant problem when you are drinking pretty much all day so I don't know the answer, but you surely will get it from someone here.

Welcome, and hope TSM works for you BF.

50 mg should cover him for a 24 hour period. Side effects resolve within a few days to a week, typically.(Eat something with the Nal) There should be no problem in taking half dose twice a day. The half dose reportedly blocks 100% of opiate receptors for more than five hours. All efforts should be made not to drink without Nal on board. But even if one drinks without waiting an hour, Nal will kick in within 30 to 60 minutes. Still, the best bet is to take half doses (hour before alc) until side effects go away.

Thanks for the replies so far.

I wanted to add for anyone reading that may be wondering what another person is experiencing early on. He has noticed a definite slow down in rate of consumption. He used to pretty much slam what he was drinking and now he drinks it much slower and feels less desire to drink that amount.

He is still early, just the second week, but feels very positive about the results so far. He knows there will be back slides. Today is a great example, he didn't take any med this morning, has been drinking, felt buzzed early but has been much slower in all day consumption.

J

Theoretically, one pill will cover you for 24 hours, but I always take one every 12 hours just to be safe if I drink for that long.

There are very few rules in TSM, but taking that pill EVERY TIME one hour before you drink is the most important one and in my opinion, crucial to success. If he is like most people, his side effects will go away soon so it shouldn't be a big deal to do that. Many studies have shown that intermittent rewards are more addictive than predictable rewards so I definitely feel that not taking your nal and drinking (either on purpose or accident) can set you back a great deal.

Hi J,

I admire anyone who stays in a relationship with an alcoholic. And your man certainly fits the description, it sounds like.

Question: How long has he been drinking? And more importantly-- how long has he been drinking like how you described: Constantly, with only sleeping in between?

How old is he?

And might he consider switching from the hard stuff to beer? Minneapolis Nick did that and it worked really well for him.

Brace yourself, kitten.

By all accounts this is a long process with initial side effects, severe hangovers, and a slow extinction of craving. I am in my 7th week and I know that I have many moons to go.

You are in the right place! Hang in there!

He is lucky to have you,

Ketchikan1

Some answers to the questions...

He restarted drinking about 18 months ago, prior to that he was sober 8 years. He did the AA thing before, but isn't comfortable with that format.

He restarted because he missed it, truth be told. That is part of the appeal of TSM, he wants to regain control but still retain the ability to have a drink now and then.

He is in his mid 40s. His drinking has generally increased over this 18 month time period. I blame tolerance for part of it, also the memories of how he used to drink. He knows this is really unhealthy and that is a motivator for decreasing his drinking as well.

He doesn't like beer at this time, he feels the calories are worse for you from beer, not sure I agree, but whatever.

To be honest I put up with it because he is a nice guy, he isn't a mean drunk at all, he just goes to sleep when he gets super drunk. He is a stable person, holds down a job without any problems there. I personally don't struggle with alcohol, but do drink occasionally. The way I look at it, we all struggle with something on some level, this is just a more visible struggle.

Oh and I wanted to add I appreciate the input.

Okay, J.

Thanks for your candid report.

What I have found interesting is that a lot of us partaking and contributing to this forum have a distaste for AA. Here's why: Alcoholics Anonymous teaches that we are weak, powerless and immoral. I mean, there is even a step (one of TWELVE) that demand the alcoholic write a list of all the immoral and trecherous acts we have committed. Yeah...... I'll get right on that............... not....

We have come to realize that we have a genetic predisposition and we have continued our drinking through the days, the nights, the celebrations and the funerals. We'll drink, as my dad said, "Whether the Tigers won or lost." Doesn't matter....

It's a brain held hostage.

You and your man are in for a ride.

Advice: Read the threads of those who have gone before you both and who have succeeded.

There are many. And their stories and testimonies are life changing.

Sounds to me that you are committed to TSM enough for the both of you! Good...

We alcholics need all the help and support we can get.

You obviously attended the Enabler 101 class.. and aced it!

Welcome again,

Ketchikan1

I thought I would register with my own name,

B has been on for a month now. There has overall been much improvement. We ventured out to bars last weekend and he was happy to be coherent the entire night, and to have enjoyed himself and not felt anxious about being there, one of his reasons for drinking to excess is social anxiety.

He has some trouble on weekends still, habits are hard to break. He still feels the drive to get up and drink right away, but has had 2 weekends where he waited until 4, took pill at 3 like his normal week day pattern. He reports feeling much much better overall. His followup liver tests and labs are improving already so that is a good thing.

Generally he is down to a pint an evening, with an occasional extra half in there if things are going on. He is drinking the amount much much more slowly and reports days when he feels like he doesn't really even want to drink.

He has had one AF day and felt good all that day and really good the next day.

I feel that we are on the right track, progress is slowly creeping along. It is good to remember that this won't work overnight. I personally believe that there are habits that need to be changed, I think that at this point there is still a feeling of needing to drink because that is what he does, not necesssarily what he wants to do.

I am encouraging him to embrace those feelings of success and to encourage him to go with it. I will try and encourage introduction of more healthy habits like walking and hope that some of those will begin to give him mental rewards as well.

J

Amazing! You two are a wonderful team. Your guy is so lucky to have an attentive and loving coach. Best of luck to both of you, but the progress you report is GREAT! You have to expect some ups AND DOWNS, and that is perfectly normal. It's the overall downward trend that makes this work. And, it does. This forum is full of CURED success stories.

Hang in there and take care!