I'm sorry if this has been asked before or if I have missed something obvious but I have been wondering about something: Why is pharmacological extinction confined to drugs and alcohol?, could the same principal not be applied to eating problems like Bulimia, for example, or even activities like gambling or shop lifting?

Curi

The quick answer is "Yes". Any behavior mediated by the release of endorphins will, in theory, be extinguished through the blocking of opiate receptors. I remember reading about eating disorders and about chocolate. See p. 178-180

Compulsive gambling can also be treated with nal and has a pretty good success rate.

So theoretically any compulsive behaviour is susceptible to pharmacological extinction? it need not necessarily be an opaite or dependance creating compound like alcohol, tobacco or heroin? it can work for psychological addictions/compulsions too ?

I'm not sure if it can treat any compulsion/addiction -- just those that involve endorphin release. There's a chapter in the book about other uses of Naltrexone. All studies are in the very early stages. But I'm pretty sure Dr. Sinclair has moved on from alcohol research -- in his mind, its efficacy for alcoholism has been proven already. I think he's testing it for eating disorders. I think I saw sexual compulsions also listed in the book.

I've looked into this alot as like TSM I see thaa future of addiction management must be pharmaceutical
I joined site to ask question whether naltrexone treatment is effective for cocaine and benxodiazipine addiction. Have seen it has been asked but not answered with any conviction. I hope the guys behind tsm will consider it i due course.
It is taking a long time for treatment of abuse to move away from 12 step, group and cbt therapy as an effective cure. The aa and na lobby is quite frightening in their attacks on other ideas even though they have ben told that their success rate is less than 10%. Their high is now the groups and reliving life with drugs rather than the drugs themselves. Anyway, given the difficulties pharmas have even coming up with an effective anti-depressant then you can understnd the difficulties involved in simultaneously flatteniing and lifting various neuro-traansmitters. Combinations of modafinil, naltrexone, buspirone and pregabalin have shown some benefits plus anti-convulsants (I happen to take these for epilepsy). I am seeing my psychiatrist on Monday and he is mr meds expert - I have done some research and hve lots of questions for him - I will report back.

Bizarrely he sees cocaaine use as much less harmful than either alcohol or benzos but he doesn't realise how much i take and the toll it takes on my body - no sleep then handfuls of pills to sleep then a strip of pro plus to go to work and so on and so on. I will let you know if i hear of nything helpfu and i'd be really grateful if you'd same for me.

I do all the non-pharma stuff like counsellors , non 12 step group and accupuncture. oh and hypnotherapy. These things are so often advised as treatments and they are totally worthless for addiction. Still do em though! Mr gullible!!
cheers

Thanks Nick and Jezz.

I suspect TSM has to be useful for problems other than alcohol, I mean, how can a pill recognise the difference in endorphins released from alcohol or heroine or even chocolate?

For example: I need to reduce my alcohol and chocolate consumption (for someone else it might be benzos or whatever), if I consume both alcohol and chocolate on the days I take Naltrexone, I wonder if the effect would be the same on both? ...

Curi

I was under the impression Naltrexone is used as a treatment for drug addicts, including Cocaine and Heroine for the very reason it blocks opiods.

Regards food I have a binge eating habit, having suffered from Bulimia in my early to mid 20s. I have found my desire for chocolate and junk food to be much lowered whilst on naltrexone, and if I do stray (which is usually when I'm drinking) then it's a lot less than it used to be. My conclusions are that I'm an endorphin junkie (I've also exercised to a high level at various times too).

Thanks for that UKBlond, your experience sounds logical to my uneducated ears.

Naltrexone is used to treat addicts of various substances and comportments as well as alcoholics and people suffering from motor neurone diseases, but I think The Sinclair Method has only been really tested for alcoholism, but I believe Dr. Sinclair is looking into using the same method for other addictions.

Hey Curi,
Its my understanding that the Sinclair Method was developed from the results of a naltrexone study on heroin users. All of the users were told that they shouldn't use heroin during the study as a small dose would cause no effect and a large dose would be lethal. It turns out a small portion of the placebo & nal subjects used heroin during the trial. The nal subjects that sneaked heroin or methadone showed signs of pharmacological extinction, i.e. they showed a reduction in the compulsive heroin use.

Naltrexone does not make a distinction for what you are trying to treat with it. In this logic you could theoretically treat anything that causes an endorphin rush; bulimia, meth, cocaine, self-mutilation, gambling, sexual mania, etc.

Your question :

really got me thinking...

Has anyone on the board adapted their nal sessions with booze to include other compulsive behaviors? Kinda like a dual selective extinction treatment??

Thanks for the food for thought