I just learned about the Sinclair method after attending a month of rehab. I'm sober but still white-knuckling and the whole AA higher power thing is just not working for me. I know it is ethically not possible for Dr. Eskapa to recommend that someone who is recently sober begin drinking, but the idea of being free of cravings once and for all really appeals to me, especially with the low success rate of the abstinence + meetings method. Should I happen to feel a slip coming on, could I take natrexone and still not become re-addicted? In other words, would the naltrexone still be effective in re-wiring my pathways if I were to use it as a going-forward medication every time I plan to drink, or would I have to return to my previous drinking levels for it to really work? (As I was at 8-10 units a day a month ago, and I'd rather not return to that level if I could just have a drink or two after taking naltrexone).

P.S. My father has a history of drinking problems and I am of northern European descent, so I'm pretty sure I come from the right gene pool for the Sinclair method to work, but I'm thinking of getting a genetic test just to be safe. Does anyone know what they should be looking for?

Hi Rhoda, welcome and congratulations on one month sober!

First off, it's perfectly normal to have cravings after a month of abstinence, your (or anyone's) body and mind haven't had enough time to adapt to a life without alcohol yet. The good news is that the longer you go without alcohol, the less you crave it.

But of course, I get what you are thinking: If I (we) don't have to abolish alcohol from my life to lose an addiction, why should I put myself through that? So to answer your question, yes, if you're going to drink, it's better to drink with Naltrexone. The primary reason for this is to avoid Alcohol Deprivation Effect (ADE). But having said that, there are no guarantees, unfortunately. The truth is that there is no way of knowing how you will react to Naltrexone until you can try it, yes there are some genetic tests that can be done which can give you a probability percentage of responsiveness, but no guarantees.

You sound like you know TSM already, so you know the theory. Dr. Sinclair recommends that we drink as we normally would to allow Extinction to occur. There is a certain logic that dictates that the more often you drink the faster extinction happens, but again, there are no guarantees. The bottom line is that if you decide to drink again with Naltrexone as per TSM, you will possibly go through a period of pre TSM/abstinence drinking levels before you see improvement, if you see improvement. Sadly there is that 22% of people who do not respond to Naltrexone.

I'd suggest that you take your time, think things over carefully, read as much as you can about TSM and Naltrexone. Read about addictive behaviors and Cognitive Behavioral Theory. Contrary to popular belief, most people go through one or several periods of abusing substances or behaviors in their life, most of those people get over their addictions on their own. Ironically, the ones who find it the hardest are the ones who go into "treatment" as they are taught powerlessness, helplessness, that they're incapable of managing their lives and all manner of negative, self-confidence destroying messages.

Take your time to decide and remember that the longer you are abstinent, the easier it gets and the better it is if you decide to follow TSM.

Good luck.

Curi

Thanks, Curi. I appreciate your helpful response. And yes, I am concerned about the one in five people who don't respond to TSM, so I'm doing a lot of homework before I dare even think about testing the waters!

I did have a real problem with the helplessness/shaming doctrine of the 12-step treatment I was in, and I really don't want to attend AA meetings the rest of my life. At the treatment center, they told us repeatedly that we would likely fail we didn't go to meetings regularly, get a sponsor, etc. I'm just not down with the cult-like mentality of AA at all. And yes, I do miss wine with dinner and when going out with friends, I'll fully admit Even if I don't get the euphoric high, the idea of being able to drink occasionally like a normal person is really appealing to me--despite the fact that it involves taking a pill first (I used to always take aspirin before going out, it can't be more of a bother than that!)

You mentioned that cravings get better with time, but the counselors my treatment center said that the opposite is true; as one of them told me, "when you are in an AA meeting, your disease is outside in the parking lot doing push-ups." There were patients in the treatment center who had been sober for 20+ years, and when they relapsed immediately began drinking more than they had decades ago! This is what scared me the most, and why I'm so interested in TSM. I'd be happy to hear if you've had a different experience with cravings improving.

I'm also wondering if I'm reading your last sentence correctly: "Take your time to decide and remember that the longer you are abstinent, the easier it gets and the better it is if you decide to follow TSM." So the longer I'm abstinent the easier it would be if I do decide to try TSM?

Finally, you mentioned that people have going through periods of substance abuse and recovered without AA--I've wondered about this as I know a few people who seem to have done so. My period of chemical dependency was technically only 6 months long--before that I was a regular but non-addicted drinker (never had shakes or even the mildest withdrawal symptoms). Yet I still have cravings now...I guess it only takes a few months of hardcore use to flip that physical dependency switch on. Yikes.

Thanks again for weighing in.

Rhonda

P.S. I am in cognitive behaviorial therapy as well--good call!

There has this very week been a documentary on TV re addiction. In it abstenance based recovery is recommended but only because the addict who is sober knows if he takes any drug again his addiction is still there. With TSM the actual addiction is addressed, it's removed. A TSMer is no longer addicted to alcohol. I personally also avoid all mind altering drugs bar caffeine and even that I keep a firm reign on because I just don't want to risk other problems.

Hi Rhonda,

The reason people who relapse often drink excessively and sometimes worse than before they quit is because of a well documented phenomenon called Alcohol Deprivation Effect (ADE). Because people have been deprived of alcohol for a period of time, their "need" to drink is akin to someone who has been in a desert for 24 hours without water and is finally given access to some, imagine how that person would gulp the water. But this only happens once a person has started drinking alcohol again. It's not the same thing as craving.

Cravings do decrease with time, not just for alcohol, but everything, think of something you tried to reduce or quit; smoking, chocolate, sugar in your coffee, soda, carbs, internet, whatever. In the beginning it's really hard, we are obsessed with the substance (or activity) we are trying to reduce/stop, but over time, we think less and less about the substance until it becomes a non issue, especially if we learn how to manage cravings, like knowing to eat or drink water as hunger and thirst spark alcohol cravings, as do being tired or various emotions, especially the unpleasant ones, this is where CBT comes in. Physical dependency and therefore physical cravings disappear very quickly, it's the psychological/cognitive part of addiction that is trickier.

There are some people on this forum who tried TSM after a period of abstinence, myself included. We found it easier and quicker to gain control than most others who did TSM the traditional way. I think this is because our addiction had already been extinguished by abstinence (as long as we didn't drink, of course) Then when we did resume drinking again with TSM, we were spared ADE and therefore did not plummet like most people who relapse. This is just guesswork on my part but I do think that the skills you have learned in rehab and the fact that you are no longer physically addicted should make it easier for you to gain control, than if you tried TSM while actively drinking.

Yes, it's not unusual for people to abuse substances or behaviors for a period or maybe several periods in their lives, and then reduce or stop the abuse, in fact, it's the norm. Look at all the ex-smokers, or people who have lost a lot of weight or young drug experimenters who stop using addictive substances because they just grow out of it. A good example are Vietnam vets who were heroin addicts in active service, yet most of them stopped using when they returned home to normal living. All of these people reduced or quit unaided. You can read more about this here:

viewtopic.php?f=20&t=2930&hilit=stanton+peele

Hi Rhonda,

Welcome to the forum.

I'd suggest you get a copy of Dr. Eskapa's book and read it. There is hordes of great information in it.

Specific to your question, Eskapa/Sinclair state that one just needs to take Naltrexone before drinking and then to drink like you normally would. They also suggest that one should try not to drink to excess. The problem with many people is that once they get going, then really can't stop until intoxicated. If you can stop at 2-3 drinks, then more power to you. I read Dr. Eskapa's book to say that TSM will work for you.

Q

Hi Rhonda,
It seems as though you and I have a similar history. My father also was an alcoholic. While I have been drinking wine for several years now (a couple glasses at dinner) it's only been the last year when it took on a life of its own with black outs and such and I morphed into the next-generation alcoholic. I have reported my story in a couple places.

Wish I could provide some inspiration. Just that I'm another one experimenting with Naltrexone and have found this forum to be very helpful during my battle.

Thanks everyone for the helpful responses. I'm reading the Eskapa book and looking into having genetic testing as soon as I can figure out which genes they need to look for...still sober and feeling good now, but weekends are hard when everyone else is enjoying their cocktails. I miss red wine the most

Gotthegene,

I'd love to see your online progress--where did you post?

Thanks all,

Rhonda

Rhonda,
My progress is in Gotthegene's Progress....but I have not updated my "units consumed" for the last couple months...I'm back on the board now trying to renew my battle with drinking so you can find me usually under "active topics". Will try to update my consumption stats soon.

I think I posted as "I've become my Father" when I first introduced myself to the forum.

i dont know about it, but there is a genetic test you can get to see if naltrexone will work for you. ive seen it somewhere on this board. i would not recommend drinking if you have stopped. i envy people that have stopped. drinking is a nightmare when you are an alcoholic. at least for me. waiting to try naltrexone.