I have posted this on the My Way Out forum, but thought I'd put it here too in case anyone here may be able to offer an answer.

There are still a few medical sources that are trying to say that naltrexone helps reduce alcohol cravings markedly when it is taken by itself, that is, without also drinking at the same time. This of course is contrary to what everyone who supports The Sinclair Method has stated over the past few years. These are not just doctors who have been told to prescribe naltrexone for abstinent alcoholics, but now include researchers and company leaders with a financial interest in promoting naltrexone as an implant or injection (Vivitrol being one brand name of this).

I was about to dismiss this as marketing propaganda, but then I remembered one or two individual reports here and there over the years, in which alcohol dependent people said that naltrexone when used during abstinence DID actually reduce or eliminate their desire to drink alcohol. Placebo effect or real effect?? If it really does help this way, then it must be able to do something via blocking opioid receptors without alcohol having to be present, which goes against the usual explanation of how it works (i.e that it blocks alcohol-induced endorphin release and reward).

If anyone knows anything about this, I'd be interested to hear about it, since I cannot recall exactly who stated that naltrexone had helped them while sober.

P.S. The medical sources I refer to include an Australian addiction clinic that administers 6-month naltrexone implants, and one of the managers of the company that makes Vivitrol. Both still claim they firmly believe in the use of naltrexone during abstinence from alcohol.

Well, anecdotally I can say that once I take the nal, I don't want to drink, or don't want to drink as much. But I think that's partially at least because I have really bad nausea from it (still!), so it triggers a negative association. I wouldn't be surprised if it had some anti-craving effect on its own, though probably not enough to stop a determined drinker.

That's a really good question and it's something I have often wondered about myself. According to wiki:



In fact everywhere you read about Naltrexone it says that it is an opioid antagonist which works by blocking the opioid receptors in the brain and therefore blocking the effects of opioids or alcohol. So as I understand it, one would need to "use" so that the opioid receptors can be blocked, if you're not drinking/using, what is Naltrexone blocking? I can't find anything which explains that, which might be why I often see things like "the mechanism is not fully understood"

I think there are two possible explanations, 1 is placebo, and the other is what EL says about how we feel when we take Nal, we are less interested in alcohol when we drink with it, but if it is taken without drinking/using, there must be a feeling of general disinterest in everything, or it's blocking the effects of other endorphin releasing activities, which I find worrying, would daily use of Nal with abstinence not lead to depression??

Curi

The info on this is kind of murky.

Some people on this board have found an early and marked reduction in cravings.

Others -- me included -- not so much. This is what leads some to use baclofen. Rev9 is one of the folks here who eventually went that route. There are others, too. Check the "Am I a Problem Drinker?" thread.

I have been experimenting with L-glutamine, which some people on the My Way Out board have used to success. So far, not much diff for me.

Nal was approved by the FDA for use with an abstinence protocol. But the TSM authorities say Nal + abstinence has been proven not to work.

Many people, myself included, find themselves drinking less with Nal -- but still more than they'd like to as they slog through the long process of extinguishing the reward circuit that's been hardened in our brains from years of drinking.

i guess i could be clearer - for me, naltrexone makes me feel nauseous and specifically, disgusted by alcohol (the taste, flavor, strength, etc) a lot of time. It is very much tied in with smell and taste for me - certain things will also taste wierd when on nal. I don't know if I'm the exception here or just extremely sensitive. But yeah, nal doesn't mean I don't want to get drunk - but it does often mean that I don't want to DRINK. However, if I drink fast enough to get past that, then it tastes ok again.

Thanks for the replies, and sorry it has taken me so long to say that. I am very seldom here these days.

I have long felt a craving not just for alcohol but for a high/buzz/hit in general at night. While off alcohol, I turned to cannabis. My interest in naltrexone when used without drinking was in the hope that it may help me overcome my cravings for an altered state of mind in general, as I have heard suggestions of its usefulness with other addictions (including non-drug ones like gambling).

If I try it again and have any success, I'll post about it here.

Greg

Good to see you here. I've only used TSM, but in saying that I don't force myself to drink, carrying on drinking problematically wasn't an option so I used TSM with some mental and dietary tools to acheive abstenance most days.

I no longer have to fight urges or cravings as a result of TSM, most of the time getting drunk, alcohol and the taste or smell of it is simply not attractive. Only reason I do drink is because I can, and it's there if I want to.

Now I have been a 'high' chaser, drinking just fired me up and I tried other drugs over the years to get this effect too. I also have been a binge eater and bulimic. I have noticed my desires for junk food, and binge eating have reduced massively since using Naltrexone. I know my drinking and eating often were intertwined so taking Nal 1 hour before drinking, which will have probably also included eating junk, could possibly have retrained my thought-reward process regards food too.

I can say that life can feel a bit 'dull' at times with Naltrexone however my life with alcohol, and even food was horrible, dangerous at times and just not becoming to me. I was much more depressed in my old habits, than I am on Naltrexone. I can reason and live life properly now.

I also do experience the extreme highs which come about during receptor upregulation, 48 hours after a dose. This is pretty exciting when it does happen and it usually coincides with a healthy behaviour for me. I did however decide at the start of TSM that I was going to go on a health and fitness drive, and have driven at it all the way through. I am not sure it would be the same for someone who hadn't decided to 'train' themselves in that manner.

I do think TSM could work for other 'highs', such as gambling etc if taken 1 hour before the activity is commenced.

Hi Uk, glad to see you too. I actually started on this forum before joining MWO from memory.

Thanks very much for your input about this. I remain interested in naltrexone, and the fact that you don't need massive amounts (as you do with baclofen) also makes it appealing.

Some things being said on MWO at the moment also make me wonder what effect baclofen can have on the minds of some people, or even whether they are taking something else being falsely sold as baclofen. Pure gibberish posts really.

Anyway I'm glad you're still posting here and doing so well!

Hey! Interesting posts, I don't completely understand the science behind this. I'm following TSM and it's working! Haven't put much more thought into it than that, which is not my usual style, I have a way of overthinking too much in my life. My boyfriend has been sober for 11 years, after he got out of treatment he was prescribed Naltrexone, he claims it did reduce the cravings and helped him to stay sober.

Cheers, Zippy