I too don't think you can speed up the process, however I don't believe that drinking the same amounts as you did pre-TSM is a goal.

I interpreted 'drink as usual' to mean 'drink as you want' and I certainly didn't force down the units I used to drink. For a start I didn't want to drink that much, it was only my cravings driving that. TSM took the edge off and allowed me to choose to drink less, if I really wanted to which I really did want to.

If a person drank 20 drinks pre-TSM how is carrying on to aim at 20 drinks with the nal going to change anything?Surely the result will be a person drinking 20 drinks and taking nal?

So.

I was a binge drinker mostly.

I drank for 1-3 days and could white knuckle abstain for 2-10 days in between benders.

I started TSM my units dropped immediately (see above post on me not wanting to drink the usual 30 units), drinking became less harmful from that first session, so I drank whenever I wanted to - which became daily (I'd always wanted to drink every day but resisted most of the time because I knew it was so harmful for me, I didn't function when I drank, all life was off during a bender). So my pattern changed almost immediately due to TSM.

So I wasn't drinking as I usually did. Ok several times during my 15-20 year alcohol problem I did drink 5 days per week for 5-6 weeks at a time, remainder of the time though I drank mostly in binges.

So TSM was a different pattern for me, and then past cure point I did find it easy in combination with a lifestyle incompatible with alcohol, to then drink perhaps once a week, or fortnight or month, or several months.

I do get the context stuff and completely agree with it, I had spikes with new triggers and new situations.

Thanks UK Blonde,

I still think this is pretty confusing, for I have control now, and I can finally stop. Where before I would have to drink until all the al. was gone in the house, or pass out and I was never able to have an af day even after a heavy night of drinking (the benefit of not having a hangover ). I have seen that my desire is stronger in different situations, but I am still able to control my intake, although it is little more than I prefer; however, I am still able to stop.

I am unsure if it really matters about the amount you drink as long as you are drinking in situations that triggers your drinking, or am I wrong? And if you have control, shouldn't stop if you can? For isn't that considered mindful drinking? I surely do not want to keep drinking just because my brain is screaming "FEED ME" and I know I have had enough, or I will regret it in the morning with a hangover or a nal. over. I am putting myself in situations that caused me to drink in the past, but I also have avoided certain situations in fear of not being able to control my drinking (being around my mother-in-law is one of them). I understand if I do not put myself in those situations I am avoiding I always have that strong desire (and maybe problems) and most likely have an issue unless I take the nal. and drink...BUT do I really need to drink like I did before, or could I just have 2 glasses of wine like a normal person and move on in hopes that the extinction process will happen in time?

I also thought that af days were a good thing as long as you are not white knuckling it all the time? Just because I have a moment of weakness and get the urge should I pop that pill and drink? Or should I stay with my commitment of being af? I thought that we had to figure out how to live with al. in our life like a normal person, not turning to al. because it is habit. Like me drinking to help me sleep...I know that drinking doesn't do anything to help sleep, but I still had it in my mind I should drink to help me relax. I had stopped that mind frame a couple of weeks ago, but the tension I felt and that was/is my habit. Should I not let logic in and tell my booze brain NO!

I find it that the response that Dr. Eskapa gave Cheeto was not a yes or no answer. I would have like to have seen an answer that was more "no, you must keep on drinking" or "yes, as long as you are in situations that trigger your drinking, one glass is enough". Instead he goes back to what the book says and drink like you normally would...which doesn't answer the question does it really matter about the amount! Or am I missing something?

Jaba

Hiker girl

Sounds like you are making amazing progress! And the fact that you can string so many AF days together so consistently is something to be proud of.

As far as NAL overs go - I guess I have had them after a heavy night of drinking since taking NAL. But I also used to get hangovers pre NAL - and if they were really bad I would head straight for the hair of the dog and get rid of it. I always just chalked it up to a couple of more lost days in my life because of AL. But I have noticed that nal overs have reinforced the fact that I have to get off this crazy train of drinking so much. So after getting out of the stupor of the nal over - I usually manage a AF day or two. And then go back to my normal pattern of taking the pill and drinking as I want. And the results are starting to show. As someone said a little earlier this journey has a lot of ups and downs. But it is a lot smoother than pre NAL days.

I guess my opinion would be this: I would not mess with the dosage just to make you feel better physically or mentally in the morning about drinking .

Rereading the book could be very helpful. But my understanding of it is indeed that you should drink normally while on Naltrexone to get the maximum benefit of TSM. Sounds kinda crazy but when you read into it and really understand how extinction works it makes sense.

Before TSM us binge style drinkers probably all had very similiar behaviors. We would have to make plans for our drinking. Even daily drinkers have to do this right? You get up and go to work and maybe you get a call from your significant other that friends are getting together for dinner tonight. Immediately your thoughts are, I need to get enough booze to survive this. You start the plan. You will stop off at the store on your way home and get a couple bottles of wine for the dinner party, a tall boy for the ride home, and another bottle to hide in the laundry so you can sneak away and get your levels up for the party.

You know what I'm talking about.

Those are addictive style habits that make TSM difficult for us all. But now that you are on TSM you should continue to do what it is you do till it just fades away into the oblivion and you pretty much almost forget what it was like to be that way. I'm already half way there at only 3 months. Last night for example I come home from work and I sit down to take my shoes off. Earlier that day I thought I might go alcohol free but at that moment I thought, gee a beer would be nice right now. So instead of fighting it like I used to do in the old days... ((No no no I promised myself I wouldn't drink please please leave me alone!!!)) I just take my pill and enjoy a beer which just so happens to be another valuable lesson in extinction.

I had 3 drinks last night. I can live with that right now.

So the point is don't plan for AF days. If your inner demon wants to drink then feed it but only on Naltrexone. You need to trick that inner demon. He want's it so you pretend to give it to him. The inner demon is the reflexive neural pathways that you built in your brain that reinforce the opioidergic system response. You spent many many years building this super highway in the brain so it's going to take some time to tear it down.

Having said all this there is also the concept of Harm Reduction. If you are drinking 13 drinks a night on 50mg's of Naltrexone then it may be wise to consider using your will power to try and reduce the harm that will cause. But in everyday situations you should not avoid your triggers, just treat them. Think of it as treatment. Sort of like if you have a headache then you take some aspirin, well, if you want to drink then you take your Naltrexone. If you have a favorite bar you go to every Thursday night or something like that then by all means go, just take your Naltrexone one hour before and go enjoy yourself. In this way you are not only having one more experience in the process of extinction but you are also reinforcing positive empowering behaviors of being able to control your drinking, live a normal life, and carry on day to day.

The old school AA abstinence method would teach you to do just the opposite, avoid your triggers, avoid your friends and even family who drink, change your life style and so on. All the while this defective treatment has been shown to cause more harm then good due to the alcohol deprivation syndrome which I think most of us binge drinkers can very much relate too. The only thing that strengthens the inner demon is planned white knuckle alcohol free days. Furthermore if you plan an alcohol free day then become weak and submit to your desires not only have you reinforced the deprivation syndrome but you have also suffered another psychological blow of failure, weakness, and submission to your addiction. Don't give into it.

I can only speak for myself and what I've read but since I started TSM I don't think the same way anymore. When I decided to drink last night I only had 4 beers in the refrigerator. 3 months ago that would have been a very serious problem. In fact I used to joke about it as a 'beer emergency' but it really was.

So I think the gist of the point is that we should not be trying to plan like we used to. We should not abstain to sort of 'earn' the right to drink again. We should not take Antibuse to help us stop for at least one day. We shouldn't even pray. none of that will work. The only thing that will lead us down the path of extinction is to drink while on Naltrexone. Sounds crazy but it's true.

I think we will all get to a point where that planning desire just sort of fades into a natural occurrence to be alcohol free. When it does that planning becomes a bit more natural and easy. If at that point you plan to have an alcohol free day then it's not quite as serious as it is now and when you begin that alcohol free day you won't be chronically thinking about it as an alcohol free day. It will just be a day like any other day. It won't be ever present in your mind. You won't feel proud of yourself for being 'AF' that day. You shouldn't be proud to have an alcohol free day. 'Normal' people aren't proud to have alcohol free days and your goal is to be normal. It should just come like any other day and when it does you won't even really know that it is there.

Ocean, what you say is so hopeful to me where I am right now. Also you are a terrific writer. Please do not stop posting!! I need your encouragement right now. Thanks so much. xoxo Newlife

Ocean,

Interesting thought, and I agree with some; however, I am finding more out on the options saves lives forum that there does come a point that we should be "controlling our intake". Granted, they do say "when the time comes, or when you are ready" and even the book says to take an af day, but if the patient is "white knuckling" it they should continue drinking the next day.

There is no black and white in the process, and I am having a hard time with that fact. Do I think someone should be af if they are not ready...NO! Do I think you need to exercise restraint after a while being on TSM, I am not sure, and I do not think anyone else is either. I have read that you need to slowly drink and listen to you brain and feel the drug working. Well, sometimes I can feel it and sometimes I cannot. I still drink slowly and I will still stop at my limit.

This is from the forum that is a prime example:

Moyra Moderator posted:

If you can manage the odd AF day, that's brilliant! And the fact that you say you can usually control your drinking when you're out with friends now definitely means you're making progress, given that you say that used to be difficult. Yay you
On the drinking at home thing, I don't know if you have a wine cellar or equivalent large stocks of your favourite drink, but if not, and you're buying it in regularly, how about setting yourself a limit and saying, OK, this is how much I am going to allow myself to drink today or over so many days, so this is how much I am going to have in the house and only buying that amount in. Then if you manage to stick to that limit, give yourself a reward by doing something you enjoy, buying yourself a small treat, whatever. Positive reinforcement, basically, in the same way as you do the good endorphins thing on your AF days.

Good luck with your AF potluck dinner and yes, you can do this

So once again, I say there is no black and white...only grey.


Jaba

Ocean, ditto what Newlife said.

I want a string of af days so I can see if I feel like myself again. This flat feeling is really starting to get on my nerves. I do realize, though, that forcing an af day is harmful on many levels. I was beside myself last week on my way to book club, knowing I was going to be af. I am not doing that tonight while out because I realize that, even if I don't drink, I still feel like a failure if it is difficult. So, for now, I am just going to let it go and hope that soon the drinking will change. It already has, as I have no alcohol hidden and I am not nervous that I will need that one more drink and not be able to surreptitiously get it. I need to focus on what has changed, not what has not. Thanks, again, Ocean.

For those who are on the other forum, I would take what Moyra says with a grain of salt because if you read her bio you will see that she has never had a drinking problem and never used TSM. Joanna, on the other hand, has been there and used TSM with success so I would put a lot more faith in her advice. Just my $.02. Newlife

Yeah I think I'm trying to more or less say the same thing. Especially for new comers though. They tend to struggle with the idea of alcohol free days at first. They should never be forced however they should be accepted or even marginally willed. And you are right the book does suggest that they are a good thing. In fact it goes on to elaborate that if you are blessed with alcohol free days then that is a good opportunity to get those endorphin running while doing something good for yourself like exercise, food, or anything that reinforces that positive behavior.

Grey is definitely the color.