Hey MLB, I'm wishing you the best.

I have to admit, I've never seen a graph like yours in the forum. Most people seem to have a spike somewhere between their 2nd and 8th weeks, but yours did not spike until much later than that. Also your units seem to follow pretty regular patterns most of the time and seem to lack the erratic quality that a lot of other graphs have. I have no idea what it means, but it is interesting. Good luck to you.

mlb, I'm glad you posted. I've been thinking about your situation and trying to come up with something useful. I've searched the board to try and find a similar spike in numbers after 7 months and I haven't found anything yet. Clearly you were responding to nal very well. Maybe it's time to change things up a bit. I'm just throwing out ideas here. Ditch your drink of choice bourbon for something else; beer, red wine etc. things that are hard to drink quickly. Get out of that TV chair where you do most of your drinking, walk, workout, read. Replace the habit you want to get rid of with something else that is more positive. You can do it. We are all rooting for you.

mlb -- I've been hoping that you would come back and I'm glad you did. I think we go through this wondering if TSM will work for us or not (and the jury is still out on me) and we wonder what we will do if it doesn't work. Your posts are important for all of us because we do need to have ideas and models for how to achieve our goals if it turns out that TSM isn't the way. I think about what I will do if TSM doesn't work for me -- probably an abstinence program in downtown DC called Straight Thinking, and I know if will be hard. TSM would be easier and more pleasant, but if the easier way doesn't work for me, and I still determined to be successful through a more difficult route. Perhaps just setting your mind to the fact that one way or another you will beat this will help you find a path.
The one thing I have noticed for myself is now much more I drink when I am at home in my regular set pattern (husband goes and buys wine even if I don't want him to; I drink it with him in front of the tube). When I was on vacation I drank less and felt more in control. I think that St. V has a point about you getting out of the chair and out from in front of the tube -- the power of habit is incredible.
Best of luck and keep us posted,
Amy

mlb, I did a search for "spike after months" and found similar experiences by weird-oh, beentheredonethat, jerry, zero_nine, DOMD and Joe12pack so it's not unheard of. One question I had is what is your subjective experience of drinking like? Your graph gives the objective numbers but do you feel different now when you drink? Is there less urgency? Are you watching the clock waiting for happy hour? Do you leave drinks unfinished? Can you get distracted and forget you have a drink? I think these are all signs that extinction is happening and positive changes. Worse case scenario you are still down 26% from your pre-TSM numbers. That's got to be better for your body in the long run and you're no worse off than you were when you started except now you've had a taste of AF days and 22 drink weeks. Hang in there.

I think the two things that hurt me the most over the past 10 weeks were not participating in this forum and not setting a goal at the start of each week. Previously, I had been doing those things.

Well, I'm back now, even if I won't be the most active participant, and I set a goal for my units for this week. It's a modest goal, just less than last week so I get the graph moving down again.

Thanks for the support from all who've replied to this thread.

--mike

I haven't been the best at keeping up with the forum either, mostly because for once I actually have a lot of writing jobs coming in. But as noted, I've been experiencing a spike as well, which is very disheartening after nine months of progress. I had gotten to the point where I was hardly thinking about alcohol any more, but now those urges have returned. I hope it's a momentary blip, but if not, I'm willing to try something else - perhaps nalmefeme, which doesn't have the potential for liver damage that naltrexone does. For now I'm stickin' it out, though. My graph is still trending downward, although not at the precipitous rate it was a month ago. Best of luck to you as well. This certainly is one unpredictable ride, isn't it?

I just re-read The Cure and the concerns about liver damage and Nalrexone are overblown, according to Eskapa. "Increased liver enzymes were noted at doses greater than 300 mg -- six times the recommend safe dose of 50mg!... The prescribing dose is well within safety limits." Page 62.

The disadvantage of Nalmefene is that you have the nal in your system 24/7 and cannot reinforce alternative, positive behaviors. Also, who knows what effect continuously having your endorphins blocked will have on your mood.

Just an FYI as you consider other options but hopefully TSM will work for you.

Is nalmefene available already? I thought it was still in trials.

It will be interesting to see how nalmefene changes TSM. Since the patent hasn't expired, the pharmaceutical company will most likely promote it and that will be good for all alcoholics. But that also means it will be more expensive than naltrexone.

It will also be interesting to see how the subtle differences between naltrexone and nalmefene change the user's experience of TSM.

I met my goal for last week, which was just to get the graph headed back down again. The goal for this week is to just keep it going down. I feel like I've got some control again.

Hey MLB.

Just want to add that the above-advice is spot on, IMO. If you want to reduce numbers, get away from your favorite drink. And if you can, switch to beer or wine. It's almost impossible to drink as many units with beer because you get filled up. Also, it's so very easy to knock down ten units with booze in no time so I highly recommend you make the switch, if possible. Also, changing your routine at home is a great idea too. And is your drinking experience any different on nal, as asked by St. V?

Hang in there.

My best,

Nick