I'm reading about other people's progress and there seems to be a lot of focus on the amount of alcohol consumed, as if that's the measure of success. I'm a little confused by that since that doesn't seem to line up with the clinical measurement of success. Maybe I'm missing something.

We all know that nal + drinking = extinction, it's a pretty simple equation, but it isn't drinking that is undergoing extinction, it's craving. In the clinical studies don't they use a 1 to 5 measurement to estimate craving, and isn't that the data used to plot the published extinction curves? You might think that if you crave it less you will automatically drink less but that is not always the case right? It's simply not that linear.

It seems to me that alcoholics might continue to drink for reasons other than craving, and that being mindful of other behaviors is very important to long term success. Doesn't there come a point where after the extinction process has had time to work, you have to consciously decide that you're going to take advantage of the reduced craving to drink less? Factors like "how much you hate your addiction" or if it's "love/hate" will ultimately play a big role in what you make of the craving reduction provided by the Nal.

Anyway, I'm just in week one, but I'm thinking about how to measure success. So far a drop in consumption but I was kinda overboard waiting for my nal to arrive from the far side of the world. My craving though was clearly affected from day one, and there's nothing wrong with pouring out unfinished alcohol the morning after. I'm pretty convinced that I'm one of the 4 in 5.

Thoughts? How do you measure success?

Good question. Everybody would think success is improving their Bad drinking behavior, but is the goal to stop drinking completely, or make it not a worry anymore ?

Another post here mentioned the holy Grail of indifference, and that is the best result of all. It doesn't matter whether you don't drink, or just drink sometimes, because it has ceased being the focal point of your life. Amount of drinking doesn't matter at that point, because you're likely drinking next to nothing.

My guess is a lot of people don't really know what they're trying to accomplish exactly, but from what I see, most end up drinking very little, and are quite happy about that.


It creeps up on you over time without you realizing it, that's the beauty of TSM. That is success.

Good question all41,

IMHO guapo is correct, indifference should be the goal or another way I've seen it put "is giving back control"

Nal 1 hour before and drink as normal = extinction. This is working at a subconscious level we cannot reach. What's happening up there in the old grey matter is real, pathways are being weakened and extinguished.

Of course since we have all been trying to kill the beast for so long in many different ways. We continue to add bells and whistles in the hope that we can accelerate the extinction process. Changing behaviours alongside TMS may work for some but depending on circumstances no one suit fits all unfortunately.

I have learnt that there are as many different alcoholics as there are individuals and the great news is wether a binger, habitual, daily, happy, anxious, sad alcoholic etc etc etc TMS will work. Nal 1 hour before and drink as normal for as long as it takes = extinction = indifference = control.

It's hard to keep faith with such a simple concept as nal + drinking = success when we cannot see the daily or weekly improvements in the millions of pathways.

My guess is that given enough time, most folk who follow TMS and never again drink without haven taken Naltrexone/Nalmefene one hour before will regain control and can then look at the future in order to decide wether social drinking or complete abstinence is for them.

Hi all41 - and everyone else.

I think you can only measure 'success' based on what it is you hoped to achieve in the first place. We can all measure our consumption, craving and results compared with everyone else, but I personally believe that 'success' is when you achieve your own goal.

For example, someone who has been drinking 100 units a week and has managed to cut down to 50 and is no longer having blackouts, no longer losing control and arguing with family etc - may not feel successful because they are still drinking 50 units. But surely if they have already achieved a better quality of life, even if they haven't yet got to the 'cure' point then surely that is 'success'.

I am two weeks in now and I feel successful - even though I know I am not yet 'cured' and have a way to go. I'm still drinking too much - but I have gone from 60 drinks a week (every week for several years with no break) to 16 in the first week and 30 in the second. But the success for me is my attitude. I no longer crave uncontrollably. Before TSM by midday, all I would think about was my first drink of the day, planning to buy several bottles of wine. I would choose to not go out and rather stay at home so I could drink. For the first time in my life, I feel a 'stop' button. I can drink several glasses of wine and then think 'I've had enough now'. I have had a couple of occasions when I've still drunk too much - but that 'too much' has been just a small percentage of what I would normally have drunk in that same situation (ie: at a party).

So in the scheme of things - I can't really be counted as a success to other people yet. But for me this is a huge success. My life is already so much better - no arguments with husband, not horrific hangovers, no shame. Even if I am never 'cured' I am very happy with what I have achieved so far.

Amen Snapdragon, I couldn't of said it better! Isn't it amazing that a little pill can do so much? Congrats.

It's like the flip side of that classic tip to identify drinking problems: "If it causes problems, then it is a problem." Similarly, if drinking causes no problems any longer, then it's not a problem any longer.

Thanks snapdragon, this is something along the lines that I am thinking too.
It's like I was a sneaky kid with the forbidden fruit that all I wanted and could think about was drinking with no one looking so I obsesses about it. I would think before drinking, "should I drink, No I can't drink today, I have to quit, oh maybe just one, OK let's drink, etc etc and that would play in my mind until I drank every evening. Then the next morning I would go over and over of what an idiot I was to drink again, of how I drank too much, I will never be able to stop, etc. I was going mad with over consuming thoughts of alcohol.
Anyway TSM (and hey thistime we are doing TSM not TMS, haha!) has now given me permission so I am not sneaking around, this tells me it's OK to drink cause that is what you have to do for extinction to take place.
So not sure you guys know what I am talking about but now I am more of the responsible adult and alcohol, the forbidden fruit has lost it's huge importance. Yes I do still look forward to having my drinks at 5PM and actually do still enjoy the taste but I feel a little more relaxed about the obsessing. Maybe that could be cravings being curbed, not sure?

You know in one respect I have had success from day 1

Naltrexone pretty much stomped on my euphoria induced way of thinking, and I am very aware of how it has put me on a more "even mental keel" when I'm under the influence.

I experienced it again last night, home with the kids, with my wife still at work, trying to get the kids to do homework, feed the dogs, stop fighting, put away the chickens, water the pigs, cook dinner yadaya. It's usually a situation that can set me off when they don't cooperate, and I was as calm as could be, thinking to myself, now that's weird., but weird in a good way. Didn't feel quite so much the Shakespearean idiot, full of sound and fury, signifying nothing.



Tomorrow, and tomorrow, and tomorrow,

Creeps in this petty pace from day to day

To the last syllable of recorded time,

And all our yesterdays have lighted fools

The way to dusty death. Out, out, brief candle!

Life’s [for the alcoholic] but a walking shadow, a poor player

That struts and frets his hour upon the stage

And then is heard no more. It is a tale

Told by an idiot, full of sound and fury,

Signifying nothing.

Sure sounds like it.

I really enjoyed this thread as the question had me stop and think about where I'm at in regards to my craving(compulsion really) to binge.
It has been 25 days on Nal for me and I haven't felt the sudden compulsion to drop everything and drink until I blackout. Knowing my pattern of drinking and the quickening frequency of my binges prior to starting Nal I would have had 2 binges by now. Maybe to early to say, but I'm impressed with my results so far after just under 4 weeks! Naturally time will tell.
The idea of "forbidden fruit" i.e. sneaking & hiding my drinking, no longer applies as I am now having 2 drinks 3-4 nights a week with my wife where before I was all about hiding my drinking. I don't particularly crave having a couple of drinks on these days with my wife - kind of nice actually without all the baggage - but mainly to give the Nal some alcohol to work with. I usually never drank in between my binges, as mentioned in an earlier post, so I see light drinking now as a form of inoculation against a future binge. Also, I don't have that feeling of Euphoria anymore (Yea!) with the first drink or two, plus the time or two that I drank too much on Nal the hangover -"Nalover" was brutal and I do not want to experience that again!