I'm 5 weeks in now. Doing remarkably well. These are my conclusions so far:

1 TSM is not a TOTAL miracle but a PARTIAL miracle. NAL addresses only one aspect of the drinking problem and that is the initial rush of opoid receiver satisfaction. The body still feels alcohol and its effects in all other physical ways. A lot of alcohol abusers (myself) and drug abusers LIVE for the rush. In training the body that the rush from imbibing is no longer there, it becomes possible to control alcohol. That has been my case. HOWEVER...the other effects of alcohol on the body must be managed by will power. If you continue to drink yourself blind while on NAL, I think the chance for success is nil.

2 IN MY CASE (not recommending) I have found dropping from initial dose of 50mg NAL to 12mg to be just as effective. I assumed that since ULTRA low dose NAL has now been used with morphine to supply pain relief without addiction, the 24hr coverage is NOT needed unless one is drinking for 24 hours. This seems to be the case with me. I religiously take my low dose 1hr before my 2 evening beers (down from 6-8) and manage easily to stop there. I feel like a normal human being in control.

3 Where am I now? Never better in the last 20 years. In control. Lost about 15 lbs. Feeling quite proud. I have had a couple of AF days but I feel that is low priority. I am grateful and happy to be in control and allow myself to indulge in my favorite brews. I now sleep well, don't snore as much and am becoming more active. NO down side!

4 My advice. DO NOT look on this as a MIRACLE. This (TSM), (NAL) is a fantastic TOOL. It makes it possible to do what you need to do but YOU have to DO IT. No religion, no steps, no meetings, no creeps, no hitting bottom, no BS. BUT, you must USE the TOOL! If you don't use the tool to lower your drinking level and take control then what is the point? Then TSM just becomes another excuse to drink.

Good Luck...
Steve.

Point #2 is interesting. I took 12.5 and didn't get much in the form of side effects, but when I doubled it to 25 - holy crap. I still feel messed up 3 days later, not going to try that again until 12.5 is ok. Maybe just super sensitive, but I did drink less than normal even on 12.5.

I personally feel no need to up my 12mg dose and will probably lower it eventually to reap the benefits of Low Dose Nal application. YMMV. Again, this is my personal, unguided experiment and I take responsibility for my own actions. I recommend my actions to NO ONE.
Steve.

I'm nearly the same number in, and I couldn't agree more with point number one. I almost wish they'd come out with a updated edition of the book that touts the science the same, but doesn't frame it as such a one-stop shop.

Yes, the alcoholic rats quit 100% of the time, but the rats don't have an drop of the emotional baggage that we do. It's not like the rat is going, "geeze, i always thought I'd be in management by this point in my career. And I've gained another ten pounds. I'm such a loser. Screw it, I'm getting hammered." They're not drinking the alcohol for anything other than the rush. No rush? Why bother?

I did read about studies they've done just about addictions in general and what a large part environment played. The rats (yes, again testing on junkie rats in the boring cage with nothing to play with or look at turned to the drugs a LOT more than the rats who had a lot of places to play with other rats and run around and do whatever else happy rats do. They were happy to the point that they never even took to the drug at all.

I'm really interested to hear your POV on the lower dose. Typically my drinking has only been from roughly 5-9 pm or so, and I've wondered if I could just target that window by timing a lower dose around 4 pm. I haven't had severe side effects of the gastro sort but I've definitely felt more flat/down in general since starting Nal about 6 weeks ago. I tried adding Lexapro after talking to my doc but it just made me exhausted, so I stopped it. I just started a new role at work and it's the worst timing for me to just be apathetic and listless about things.

Stephen, I've gone back to 25 from 50, and find it works just as well, and I don't feel so crappy for the next several days. By crappy, I mean a general listlessness, and the loss of enthusiasm in general.

That feeling is the reason I only drink about once a week only in general. I'm not seeing where drinking is leading to any real benefits, except that sometimes the taste is pretty good

I may go down to one quarter of a 50 mg tablet and see how it goes, I suspect it's going to work just as well, without the sleepiness and the general malaise the 50 mg seems to cause.

You are absolutely right though, NAL is a tool, not an answer. Taking 50 mg , and drinking daily, is a double whammy, as both are depressants !!!

I might add that the real secret is behavioral changes, not drinking daily, and developing a mature and responsible attitude towards drinking. That means never drinking to the point of inebriation, understanding what moderation means, and taking control of your actions.

Amen, Brother. I found a handy little pill cutter/ crusher/ container at Rite aid for about $5. Red cylinder about size of film canister. For you youngsters..that's a plastic container that photo film used to come in. Photo film?....never mind.

I too have found 12.5mg to be just as effective. Once I quit drinking via NAL, when I then would have occasion to drink, taking 50mg was no fun at all, especially after not taking it for awhile. So I wouldn't take any. Bad idea. Now I take 12.5mg, and it works great with no side effects. Maybe one needs 50mg for the 1st go around, but for on-going maintenance, 12.5mg is great.

Very interesting stuff. One part that kind of makes me feel uneasy being on week 1 is hearing you guys still having unpleasant feelings on taking Nal so many weeks in. I think drinking can still be fun and relaxing when done in moderation and social setting and I don't want the thought of being down the next couple of days from Nal to make me be the guy who orders club soda instead.

I haven't encountered this discussion before, but it makes perfect sense. There is no doubt that Full dose naltrexone does leave a lingering sense of apathy and listlessness for a few days, at least for me

Even worse if there's a holiday situation, and you might take 50 mg of naltrexone and drink several days in a row, even if it's just a few drinks

I've drank a few times with no naltrexone at all, generally just one drink or possibly two, and I found I didn't enjoy that either. I'm guessing the 12.5 will work just fine.

I think I just stretched my supply of naltrexone out by four !!