Hi im from New Zealand had a detox a few years back went on a nal program lasted 6 months until it finished, went to a work conference & fell off the wagon. I have again got on a program again 6mths started yesterday & got really sick, lack of alcohol I guess. Started researching & came accross the TSM method thinking about giving it a try as a long term solution. My wife is concerned that you can get worse before getting better & what that will do to our already fragile relationship. Can anyone suggest an article or post for her to read.
Lloydkim

This is my favorite post for concerned spouses:

http://www.thesinclairmethod.net/community/viewtopic.php?f=4&t=360&start=0&sid=7e1bdd8fbcbe9468db1dbac437880135

I hope you decide to go ahead with the Sinclair Method. It's almost shockingly effective. Getting worse before getting better isn't all that common, really. Most of us just start getting better right away.

I'm confused about whether you take the drug everyday or only prior to drinking

Only prior to drinking. Naltrexone one hour before drinking, on days when you drink. No naltrexone on other days.

Reportedly, one doctor who works with Eskapa advises new patients to 'dose' with alcohol daily for the first two weeks. The reasons are to get any issues with nausea behind one, and to launch the pharma extinction process. After that, as Melissa notes, he simply requires 50 mg one hour before any drinking, according to any drinking schedule the user practices without nal. Reportedly, again, Eskapa does not utilize the two-week kick-starting process, as the clinical trials merely require drinking according to the user's normal patterns. (I'm referencing private correspondence here; the correspondent has had direct contact with the subject doctor, and with Eskapa.)

What is extremely clear from the clinical studies is that naltrexone is only effective if taken with alcohol. All of the clinical studies that paired naltrexone with abstinence show failure. Eskapa is extremely plain on this point. (In the USA, abstinence-based alcohol treatment is so embedded with the medical profession that this is the practical barrier to its broader adoption.)

I'm on my second go-round with naltrexone and in both instances it immediately suppressed any real desire to drink. However, as I did the first time, I do currently consume alcohol essentially as a complement to the naltrexone dose, as the above doctor recommends. (IOW, I immediately lose the compulsion to get buzzed, once on nal. And I was not, when in full alcoholic flower, a light or moderate consumer of alcohol.) In my prior case, the relearning/extinction process seemed to function per the studies, and within a month I'd still lost any cravings for alcohol consumption, whether or not I took the nal. (Why I failed, previously: I fell into the 'wishful thinking' trap and slowly ramped up my alcohol consumption again, with no pre-drinking nal dose, as though I were somehow different than the tens of thousands of people who have been helped by nal. I will not do that again.)

The other thing people do, on Eskapa's recommendation, is keep a nal pill on their person (much like a heart attack survivor carries nitro in a key fob case or the like) once they are 'trained' and largely or completely abstinent. Then, the only requirement to maintain compliance is to take nal an hour before any possible alcohol consumption. This is my life plan now. I'm confident that only my own decisions can subvert this solution to lifelong consumption.

For me, this is the truly liberating feature of TSM. For me, this is like seeing a door open to a better life, a door I didn't know existed. In direct contrast to AA and other abstinence-based programs, which have success rates below 10 percent, this aspect of TSM does not make every day of the rest of our lives some sort of existential trial. Of course, YMMV, and I'm merely describing my own reflections on the practical and emotional conditions of the TSM process. But as Eskapa has stated dozens of times, the only proven approach is to maintain compliance in this fashion. I will be outspoken and suggest that any deviation from his protocol is 'wishful thinking' (or active self-sabotage, which is certainly active in my case). Good luck to you.

Thanks. I have started the one hour before on 25mg to start as was pretty sick on 50mg. I'm taking Naltraccord brand not sure if this is time release or not

Just my opinion, but I bet you weren't as sick as you are after a pint or two of hooch. In my case, the wooziness only lasts a day or two. I'd go 50 or go home.

Again, in the book most people use as their primary source, Eskapa says to use 25mg the first few times in order to check for bad reactions to the drug. After that, 50mg is the standard for most people (although some will turn out to need more).

Eskapa may have changed his mind on this point, but it's not crazy for someone who just read the book to do what it says.

For me, the nausea lasted about a week. I had to drop down to 12.5 and take an anti-emetic before it went away, and then increased my dose back up to the full 50mgs.