Not trying to change your mind, but just as general info -- if there are liver issues to consider, nalmefene is a similar drug which is processed by the kidneys.

I can see why you're discouraged and wish you'd made more progress. Five months isn't that long; some take up to a year. If a faster recovery is needed, have you thought about Schick Shadel? It sounds pretty grueling, but it's hard to deny that it works.

AA isn't very successful, statistically. I'm skeptical of any "specialist" or "expert" who pushes AA, because anyone who actually knows the field can't avoid learning that AA doesn't work. Some addiction specialists/experts/counselors are basically just shills for AA and ignore all the contrary evidence.

Whatever you decide to do, be careful and good luck.

I'm sorry and disappointed, too. I had high hopes for you. Still, TSM is not the last possible treatment, as some characterize it.

I would throw my .02 on the whole doctor thing. I know lots of doctors, and what they say is not necessarily true (I know, shocking). The whole liver thing is, IMO, besides the point if TSM reduces consumption in the mid-term. Naltrexone would be a very small drop in the bucket at the levels you're drinking at, so...meh to that.

I think Vivitrol injections would definitely be worth a try, especially as you've already revealed your disease to your doctor / insurance company. Might as well make the best of it, right? If even those don't work, then you know that, chemically speaking, you're just not a Naltrexone kind of guy.

Be sure to try to supplement the medicine with good ol' fashioned inner strength. Remember the 13th step -- stop drinking!

Hey, and even if you don't do TSM, still post here. I don't really do it either, but this is a very good forum for alternative therapies to AA.

AF day 63 in a row for me!

Barry and Lisa

Congratulations. I had hoped to be posting success and helping others like you are by now. It's frustrating I'm not able to. I'm impressed you and others continue to post and offer encouragement after declaring cured status. I'm not ready to submit to AA or the brutal Schick treatment. I'll keep taking the nal but have to admit I'm losing hope in this method. Will take some time to think about next moves. Thanks again,

The dogs are restless

If it helps any, you're still within the normal time frame.

Does drinking feel different on nal than it did without?

Honestly it does not feel different. The craving is there. The feeling is the same. I feel better immediately after the first. And don't feel like stopping until sleepily tired sets in. Can function all day normal until 6-7 pm then it's on till bed time 10-11pm. Weekdays I keep one foot one the gas one foot on the brake. But weekends it's all gas pedal. The brakes don't exist. Definition of a functional alcoholic?

5dogs,

I'm sorry to hear your frustration. I can understand your discouragement having been there not that long ago. I just passed the one year mark and it has been a long slog. But I can say that in my case it has been worth sticking with it. AA didn't provide any lasting relief for me. Regardless of how hard I worked the program that little devil was on my shoulder telling me to drink. TSM hasn't completely solved that for me, but it has diminished it a great deal. I've also discovered that you have to exercise some level of self control and decide not to drink. As time has gone by those AF days have increased little by little. To Barry's point, try that 13th step every now and then.

Looking at your totals it doesn't seem like you would need a detox program. I'm wondering why the doctor is insisting on that. I have been surprised about how little the medical profession knows about addiction and the treatment of it. My GP has been useless in helping me with my addiction. Where did you get your original prescription for NAL? Perhaps you could go there to get the scrip for Vivitrol? Don't give up, success might be just around the corner!

Noobie here. To the med, that is. My intake is, without having done the math, regularly well over 100 units a week.

2 questions:

First, it is not my understanding that the medication should (or rather, must) be dosed up until the feeling of drunkenness or euphoria (?) is absent in a session in order for extinction to work. Am I mistaken about this? If this relatively long half-life chemical blocks my endorphin receptors, am I to then understand that I can flood away that blocking effect with enough of the proverbial juice? I recall nothing regarding this matter in the book concerning this treatment.

Second, what is an SE?

Thanks and now on to the rest of your thread. Please forgive if one or both queries are answered in it and no need to reply. I will find them along the way.

Best outcomes to you good sir.

If you're speaking of "drinking past" naltrexone, that's something else. That's not applying enough alcohol to wash away the blockage -- alcohol doesn't disintegrate the blockage or otherwise use it up. "Drinking past" refers to drinking for a long period of time, so that the naltrexone begins to wear off (which has nothing to do with whether or not alcohol was actually consumed; it always wears off).

5dogs is speaking of something other than "drinking past" -- he's speaking of having a higher than average number of opioid receptors in the brain, so that a higher than usual dose of naltrexone is needed to achieve 100% blockage of them.

Neither of these things is something you should be worried about right now. Just get started, and troubleshoot if and when there is trouble, okay?

Now THERE is the sigfile I have been hoping to see.

Amazing progress

And, FWIW, Thank You for the inspiration I have been looking for as an equally heavy drinker at the outset.

Thanks.

That was just exactly the sort of 'data' I was looking for. And, no, I won't be troubling myself with these more intricate matters.

One must learn to walk straight occasionally before endeavoring to run, no?

On edit, and having now read enough to get to your link
http://2.bp.blogspot.com/-r_gn_fCXskQ/U ... wchart.gif

I am taking my dose (still 25mg NOOB style) powdered. And even still, making it the full hour all but once which was the better part of an hour. I understand how this works, and a bit more with all I read. It is not my plan to condition myself to a state that is even worse than the one I am in which is Already among the Worst of the Worst.

Anyway, thanks so much for your earlier reply and especially this chart. I am not going to overthink this in these early days, but I do appreciate the information so very much. I already have a lot of tools. And now, finally dusting off that toolkit, unlocking it and throwing some more in, I am evermore inspired with what Will Be.

Maybe a "good thing" about my heaviest intake is that I almost never drink more than four hours.

When I do start to give this sort of thing some thought, I will have to consider whether to updose when switching over to gin. As things stand, my current goals are to ADD some AF even if they require again taking some antabuse instead of the naltrexone to force the matter and to stick, at least for this opening phase, to malt liquor as much as I can.

The context for this thinking has to do with my gin and food habits over several years now. In order to insure both maximum drunkenness and as much functionality the following morning as possible, my routine has been to preplan a meal routine in advance of the first nightly pour so that, even in a blackout, I have LOTS AND LOTS ready to eat at the end of the session. That way, I can sauced to an extent many here seem never to have experienced (let alone nightly...) and then eat myself out of being so drunk/hungover the next day to be able to get up and do a days work before repeating the murderous cycle.

A bit of a "foodie" when not too pitifully "planning" by means of laying out all manner of fast, frozen, or simply easy pantry junk, I can already see one good way forward is to actually COOK as I have wont to do when my head is on straight.

Now at the top of my second and last 40oz malt liquor of the night - I call these my moderate nights, would you believe - I have waiting on me homemade Spanish rice and more freshly done spinach (*way lots of that as greens and berries are I think the only thing that have saved my life up to this point) and smoked chicken enchiladas than I could eat in four nights of screwing my life up with gin.

Of course, the next trick is to enjoy a healthy homemade dinner at actual dinner time instead of at ten o'clock after drinking a third (*big) bottle of booze in the prior three hours. And then, after dinner, STOPPING the drinking.

It's amazing and shameful to reflect on how many nights I have been HUNGRY and made dinner, and then settled in to drink to huge excess instead of eating. And woe to me on those infrequent occasions when I drank so much I failed to then eat before stumbling a few feet to bed. That could mean a lost tomorrow and, many times, has.

To think I once used to be freshly showered after a good run and enjoying a bit of wine while cooking a good dinner and only a very bit more while having it before settling in for an evening I could actually and fully remember the next morning.

Hermit enough not to have hundreds of nights of regrets for what I did with and to others drunk over the years, I am still saddened to think of the literally thousands of very tasty meals I scarfed down with nothing to remind me of them but a ruined, grease stained shirt the next day.

Tonight, that won't be the case. Even if my so-called moderation extends to the bottom of this second 40 oz.

And that is not solely because it has warmed up now down in these parts and I am a shirtless old drunk.

Again, thanks for the chart. Now, to forget about it other than that I can find it later after chalking up a parcel of days where 80 ounces of more-than-mere-beer is somehow supposed to be "progress."

On edit

If one takes your chart as two columns, I would say at this very early point that both bottom line apply. Perhaps we should visit this matter of dosage relatively sooner than later. I definitely still feel the enjoyment of drinking. Case in point, this evening where I am perhaps only around an empty-stomached near four strong beers.

Of course I am also only on 25mg and for the fourth time. Even more, I am drinking after a 42 hour cessation. That generally rare interval of not drinking is not enough to make me feel like a "million dollars," but is enough to equate to a third or more of a million. And, as a drunk with marginal employment effects, a 1/3 is cause for "celebration," dontcha know.

Anyway, I post this solely because I want to offer you this as raw, early information Melissa. I am NOT so inebriated nor so uninformed that I cannot realize there must be more accumulated information to work with. To wit, the aforementioned plan I *WILL* be sticking to in these coming first weeks.

Again, thank you so much.

Edit on "On edit" - Egregious typo on sticky old keyboard: Re your chart = "and having now"