Ives -- sorry to hear about this. Very worrying, I'm sure. If anything, I hope this can help you keep on track. It's a drag not to be able to get support from your family but also really common. So many here are doing TSM under the radar. Wishing you the best.

Ives,

I'm sorry to hear about that as well. I am also flying under the radar with TSM and come from a family with a long history of alcoholism. As far as my family is concerned I am sober. All of my drinking is done in secret and it is a real pain in the ass. I've even been reluctant to post here. On Wednesday nights both my wife and I go to separate recovery meetings at the same place. She goes to an Al-Anon meeting and I go to an AA meeting. I only go because she goes and my attendance keeps up a good appearance and lack of attendance would raise eyebrows. The truth of the matter is that I can't stand these meetings. All of the discussion of drinking does nothing for me. I hate living this double life and so want it to end (not end my life, just the obsession with alcohol to end), but here I am in the early afternoon and the demons are howling at me again. I wish your brother well. You can be a great example to him. I lost my oldest brother to addiction 3+ years ago.

I'm sorry about your brother. I wonder if he would be receptive to TSM. I hope so. He's lucky to have you to turn him on to it!

Week 0: 72 (before TSM)
Week 1-4: 63, 57, 69, 50
Week 5-8: 73, 43, 57, 56
Week 9-12: 47, 59, 55, 61.5
Week 13-16: 59, 65.5, 58, 57

No news, just posting numbers.

I have been on 62.5 mg for two weeks now. I am still apparently able to drink through the naltrexone at this dose. I should be feeling less motivation to drink because of the lack of reinforcement, but instead I am compulsively drinking a lot because I can still get some reinforcement if I drink enough. I'm finding myself looking forward to going home and drinking, and having an AF day is seeming more daunting than usual. I noticed a dip in my intake in the first week at the higher dose, but over the second week I've averaged 8.9/day. I was at 9.2/day for the last week I took 50 mg. I will probably give this dose another couple of weeks, then go ahead and bump up to 75 if things aren't starting to trend downward.

16 weeks in and still drinking 90% as much as before TSM. Sigh.

edit: Starting to consider giving DHM a try, as described in hovenal's thread. I am starting to get the impression that I might be one of the people who got addicted to alcohol mainly through the GABA system rather than the opiodergic system. I don't enjoy opiates, which seems to be really rare, so it would sort of make sense.

Ives,

I increased my dosage about a week ago (to 62.5 MG) based on your recommendation. It has only been a week but it appears to be having some effect. I went to dinner with my daughter this evening. Taco Tuesday. Before leaving for the restaurant I had a few drinks. Any other occasion I would have had every intention of having more at the restaurant. But for some reason I really didn't have much of a desire to partake. I certainly thought about it, but it was not overwhelming (like normal). In fact, I was completely engaged with my daughter and thoroughly enjoyed the conversation. Now I am back at home and although I am having some thoughts of having a cocktail, it is not overwhelming. I do hope that this is the sign of things to come. My intake is down this week, although I am still struggling with having AF days.

I am really glad it is working better for you. Tonight I had my dose a full 90 minutes in advance and it feels more powerful than usual. Too often over this last week, I've been taking 50 mg before I head home from work, and taking the last quarter-pill when I get home, and more often than not I have failed to wait out the full hour after taking that last bit of the dose. It's easy to pull out one individually-packaged pill at work and take it without anyone batting an eyelid, but pulling out chunks of pills from a special container and carefully trying to take them without losing or crushing them is a bit sketchy. I suppose I should start keeping pre-split pills and a water bottle in my car so I can take the dose in private and properly follow protocol. The full hour delay seems to be very important, as I've said many times...I have unfortunately failed to follow my own advice far too often.

Tonight after getting home from the gym (just 15 minutes ago), I really wanted to drink the soda in the fridge rather than the beer, but went for the beer instead, only because the caffeine would keep me up. Promising. (I should buy some caffeine free soda!)

It seems like you and I are very similar in our drinking habits and magnitude. It's impressive that you have managed to average about one AF day per week, so far, it looks like. I've only had one at all since I started 16 weeks ago. I really hope they will start happening more often for me soon.

Ives,
Given all that's been going on with your brother it's commendable that you've not only stuck with the protocol but are actively increasing your dose to improve your chances of success. Stress can often be a trigger for drinking, so I think it's a good sign that you haven't reacted to your brother's troubles by increasing your intake.
As for AF days...I'm on week 17 and it's only been in the last few weeks that I've started to have them. I started out with one per week for two weeks and then last week it seemed do-able to do 2. It was only once my overall weekly intake had come down for a while that I felt able to manage AF. Once the higher dose kicks in and your overall intake goes down I think you'll find that you'll be able to go for some AFs.It's still early days.
Ruth.

Ives, your determination is impressive and inspiring. I'm glad it's working a little better with an increased dose.

If you're still getting euphoric effects even on that, is it possible that you need 75mg? I've heard that some people do. I wouldn't be shocked if a handful of people need something like 100mg. I am not a doctor; I'm just spinning ideas. If I were you I'd probably want a liver function test before going much higher.

It's also possible that you're one of the 10%. You say you don't like opiates. Then again, it's starting to work for you, so let's hope for the best.

Ives,

Thanks for the response. I have been a serial violator of the 1 hour rule up until the last 7 days, and boy does it make a difference to observe that 1 hour rule. I have also learned that increasing the dosage to 62.5 MG almost completely masks the effect of the alcohol. I'm sitting here watching the World Serious after having my drinks and the effect is negligible at best. My normal inclination would be to keep drinking, but for some reason I don't have the overwhelming desire to do so and most likely won't. I want to get to the point where I don't WANT to have the drinks in the first place. Wishful thinking? I hope not and believe that I am heading on the right path.

I will say that the additional dosage of 12.5 MG has had some effects. I am really tired after taking it and the dreams are even more surreal than they have been. I have cut up all my dosages in advance so I don't need to worry about that when I am taking the medication. I take it all at once. It's one full pill and one quarter (based on a 50 MG pill). Even I can keep track of that!

The AF days are a struggle. They do not come easily and are usually the result of a really shitty hangover or being really busy. I am going to start voting for the really busy days so there are more AF days in my week. For me, activity is key and exercise is the best. I applaud your gym efforts. Keep those up! I surf, paddleboard, golf, and mountain bike. The time change is going to be a challenge for a lot of those activities during the week. So I'm going to have to make adjustments. Let's keep up the good work!