Hi All - Had to pop in on this one. Thanks to Spacious for being honest. We do need to support any method for getting sober. We also need to be honest about TSM. I agree that this is a supportive forum for those of us trying to control our drinking with TSM, but I also believe that we can be open to alternatives and the fact that Eskapa himself says that this doesn't work for everyone. So, we must be open to those it doesn't work for and not lambast them for saying so.

I don't know if I'm one of those that it doesn't work for. I can still see that it has given me some relief from out of control drinking, but that is about all I've gotten from TSM thus far. I still drink way too much (about a bottle a day of wine) and can't even believe I'm still taking Nal after 74 weeks on TSM. I don't dare stop though because before Nal I drank many nights to oblivion and now on Nal, I don't. I have a feeling that Nal cures some, controls some, and then for those like me, it just stops me where I was at when I started TSM. On December 1, 2010 when I started TSM I was drinking a bottle of wine or a bit more a day and getting blasted drunk. Now, I drink a bottle a day and stay relatively lucid.

Anyway, I'm rambling, but wanted to thank Spacious for taking the time to pop in here and give us an update. Many of the members of this forum have had to find other methods for finding control or cure for their drinking. God bless us all and you too Spacious.

Half Glass

Spacious - Just one more thing. Perhaps TSM did help you afterall. Maybe it was the thing that allowed you to move on the Campral and then abstinence. I'm sure you don't believe that, but so far my experience has been that it does lessen my desire for wine slowly (very, very slowly for me) day by day. So, again, we all need to be open to whatever works! Although I agree with you that it works for some and doesn't work for others, let's celebrate those it does work for.

Half Glass.

Hi Half Glass, in a way you are right, I knew that I HAD to try everything before quitting. I have tried every intervention that I know of: I'll list some of them somewhat chronologically and add my experience with them:

- Various moderation techniques, including MM. Found it useful in the short term but ultimately I ended up pissed eventually.
- Disulfiram orally. Convinced my doctor many years ago to prescribe this. Helps some people, but I succumbed to the temptation and either stopped taking it or drank on top of it.
- AA. Usual experience with AA, if you buy into the program it probably works but its too high a cost. I still go to the odd meeting when I'm bored though, however it contributes 0% to me being abstinent and would have a negative impact if I let it.
- Rational recovery: First time round it hit me hard and quit immediately for several months. A moment of temptation at Xmas sent me tumbling back into the world of addiction.
- TSM. Useful in curtailing the extent of binges, but I ultimately found that it was not as described. It also had several negative psychological effects- (i) I began to see drinking as acceptable because it was part of the cure (ii) I began to see myself as powerless over my addiction; that the endorphins and brain chemistry were in the driver's seat rather myself- a fact I now believe to be bogus.
- Started taking Campral around October last year; didn't really notice any effect on my drinking frequency or intensity. Still unsure as to its benefit, but I am happy to take it for the time being.
- Baclofen. Read Dr Ameison's book on this drug. Very interesting book and well worth a read. Baclofen may well work, but the book understates the side effects and while they may be "benevolent" they were for me intolerable (extreme sadness and altered global cognition). I gladly stopped taking baclofen after about a fortnight or so.
- Disulfiram implanted: had to travel far at great expense to have this done and it didn't make a bit of difference. I drank on top of it and it had no effect- makes sense though because they implant a relatively small amount of the drug. The wound site got infected too, and the implant eventually begun to extrude.
-After Disulfiram implant failed I was determined to quit, because in my mind I tried everything and had realised that there was no help for me anywhere, and that it was simply up to me. I could no longer make the excuse for drinking that goes like "its ok for me to drink today, because I'm going to get help for it on Monday, or I'm going to try this book or that technique" or whatever.
-I announced this to my alcohol doctor, who does nothing except support me while I figure out what the best path for me is and make sure that I'm not going to die. He also prescribed Campral, which again I'm not sure if it does anything or not, but I take because I was taking it when I quit and I don't want to change anything. I still get cravings for alcohol, but they're pretty pathetic compared with what I got when I first quit. The first month was pretty tentative but that feeling has faded. That's another excuse I had used: "I have to drink because of the abstinence deprivation effect", complete bullshit, it gets much easier with time, not harder.

So in summary I suppose I had to try all these things in order to finally quit. I'm not a person who can learn from other people's experience easily; I'd prefer to see for myself. Maybe that's the glaring contradiction I've missed here: I've been critical of other's people's attempt to have their own experience with TSM etc. I'm torn though, because it is distressing to know that people could lose a lot through drinking, and for the greatest beneficence its best for me to give my honest appraisal without suppression of detail. This is only a medical treatment if all the available information is disclosed because only then can informed consent exist.

Anyway, enough blethering from me,

Cheers for your replies,

AAA

Can't resist adding my 2c any longer...

It's probably a bad idea that we use the overly general term "cure" here far too often. I found nal via an internet search for drugs that could reduce drinking, not eliminate it, and as such it has absolutely been what I would call a miracle so far.

To me the ideal result of taking nal would be that my hard binges would be cut off far far earlier, but that I could still enjoy the first couple (~four) drinks. That's exactly what it's done for me. People who want effortless abstinence are likely more prone for disappointment. I haven't read Eskarpa's book, and I don't plan to. I dug into the primary literature on naltrexone and have found that my response has been fairly similar to what is seen in rats: I still drink more than your average field-rat, but much less than before.

I also feel the need to point out that a lot of us talk about moderate alcohol consumption as if it is an unhealthy thing, when there is really not any good medical evidence to support that notion.... quite the opposite in fact. Drinkers live longer than teetotalers, and that has been shown time and time again in well-controlled studies that infuriate AA and MADD. Until recently I had viewed moderate consumption as a scary thing because it always led to heavy consumption. Now it doesn't. Yahtzee.

Maybe I'm just lucky or maybe my standards are lower. I don't really care.

Anyway, Spacious I applaud your new mindset and the realization that it's up to you to do the work if you want to be abstinent. I wonder if it would also help to go back to taking oral antabuse. You stated that in the past you would stop taking it. Maybe now with your new attitude it could be more of a second line of defense rather than a magic pill. I know for a lot of people it helps maintain abstinence.

Again, for me I think that it would be psychologically damaging for me to take a pill that prevents me from drinking. It sub-communicates that I am powerless over my desire to get **** faced drunk and if I believe that I know I'm fucked. I know at times I will want to drink and will expect to enjoy it but I will not drink simply because I know it's the wrong thing for me to do. I won't roll over for that desire for pleasure any more and I'm really glad about that fact.

RE: moderate drinking- if in all honestly its OK for you then there's no problem with it. My aim was always abstinence though. Also, minor point but I'm skeptical about the studies that suggest moderate drinking lowers mortality. There were concerns as to whether there was a selection bias in that the teetotallers included ex-alcoholics. Maybe they accounted for that though? Not a big deal anyway, you have to die of something and if this is the biggest concern wrt to drinking then its not too bad.

Fair enough. The positive effects of antabuse are entirely psychological, so if you are getting a negative effect from it, stay the hell away from it! I wish you the best of luck going after it the old-fashioned way. People will tell you you can't do it, but it's not true. My dad did it for 30 years. For some people, it's the only thing that works.



There was a major study that came out in 2010 that *did* indeed control for ex-alcoholics. Even with this confounding factor removed mortality rates were lowest for modest drinkers. Here is the study:
http://onlinelibrary.wiley.com/doi/10.1 ... x/abstract
Anyway, more importantly is what you have written in bold. Sure, I guess I'd like more years here on this earth given the choice, but what matters more is quality of life. With moderate drinking on nal, my quality of life is easily higher than what it was during some of my abstinent periods. If that's not how it was working for you, that sucks, and you are doing the right thing by getting off the bottle altogether. I wish you all the best.

Spacious --

Thanks for your detailed and honest reporting on your experience.

My best wishes--

Hi Spacious - I want to be where you are. Not quite there yet, but so agree with everything you say and have said. One day....maybe today I will put the booze down for good. Congrats to you.

Half Glass