I logged into this forum today for the first time in a long while, and checked my old posts to find that my first post was in May 2011, where I talked about starting TSM for the first time. That was the first time in my life I had attempted to do anything about my drinking problem.

Well, now, over four years later, I'm 30 years old and the alcoholism is the same as ever. I've attempted TSM three or four times, usually for about six months at a time, and up until recently, without a doctor's supervision. I also briefly experimented with baclofen and had a ton of awful side effects, but no improvement in my condition. Once again, I am taking naltrexone, this time working with an actual psychiatrist. We are trying higher doses and adding other medications into the mix. I decided it may be helpful for me to start another thread here to help keep me motivated to keep taking the pills and keep better track of my intake.

I have been taking 75 mg of naltrexone daily for the last couple of months, and as is common, saw some improvement (~20% reduction) for the first week or two, then back to the usual ~10 units per day within a short time. I'm also taking about 1200 to 1500 mg of gabapentin each day, usually 300 mg every 6 hours, which is a brilliant medication, as it (1) reduces the effects of hangovers, (2) helps with anxiety, (3) helps me get better sleep and stay asleep longer, and (4) combats restless leg syndrome, which affects me from time to time. My doctor showed me some studies that have shown that these medications combined have a greater success rate than either of them taken alone.

My goal right now is to reduce my intake to the point where I can have alcohol-free days without worrying about severe withdrawal. I haven't had a sober 24 hour period in over a year. I have never had DT's, seizures, or anything requiring hospitalization, but on really bad hangover days, I feel dizzy, confused, very ill, and it sure seems like worse symptoms will manifest if I don't drink. My brother was recently hospitalized for seizures related to alcohol withdrawal and now I'm really scared that it might happen to me, too -- although his intake on a units-per-pound-of-body-weight basis was around double what I'm drinking now.

My doctor is recommending that I attend an inpatient detox as I have not thus far been successful at tapering on my own. However, he has also increased my naltrexone dose to 100 mg in the meantime, which I am working on ramping up towards. Blood tests show that my liver, kidneys, and everything else they tested are remarkably healthy, even after a few weeks at 75 mg (not to mention 10 drinks/day for almost ten years straight).

I am finding that taking part of my dose in the morning and part in the afternoon is more effective than the standard 1-hour-before-drinking rule, especially as far as keeping me on track with actually taking the medication. I am typically hung over in the morning, and the motivation to take the pill is much stronger than when I have just gotten off work and I know that the pill will put a damper on the enjoyment of the drinking I'm about to do. When I take a dose in the morning, I feel less motivated to drink after work, however, I get some nausea after the morning dose. I also definitely notice that the naltrexone is active in my system for more than 24 hours after the last dose, as evidenced by the fact that I have skipped taking it altogether a few times and drinking felt the same as if I was on my normal dose. It takes a couple of days to really clear out of my system, at a 50 to 75 mg daily dose.

So, as a starting point for this new thread: Yesterday, I was severely hung over all day, even after taking gabapentin. I drank starting at about 4 PM to get rid of the symptoms. By bedtime, I would estimate I had about 12 drinks. I woke today with about the same level of hangover, and called in sick to work. Now, at 3 PM, I am sipping on my first beer of the day, as I just can't put up with it anymore.

The goal for the next week is to get my naltrexone dose up to 100 mg and get my alcohol intake down to ~6 units. If I can hold that level for a few days, I will then try to have a couple of ~3 drink days, and finally attempt a couple days of sobriety. Tonight I hope to keep my intake at 8 or less.

Average over the last several years: 10 units/day
09-22: 12
09-23: 12
09-24: 7
09-25: 8
09-26: 7
09-27: 8
09-28: 9
09-29: 9
09-30: 6

Welcome back Ives,

I am so sorry for your plight, and this is a rocky road that you are on. I am happy to hear that you have decided to go to counseling and they are actually letting you drink with the nal. (almost unheard of).

Can you give us the doctors name and location for future references?

I have done some research on the different meds. for alcoholism, and I do hope this combo works for you.

It does sound like you are having a good start, and that you are learning about yourself (i.e.taking your pill in the morning) and that is going to help you in the long run.

I am also sorry to hear about your brother, and I do hope that he is doing better. What a scary grip alcohol can have on us.

Please don't stay away too long and let us know how your med. combo is working for you,

Jaba

It sounds as if you have what I call 'the fear' and it is horrendous to break through.

UKB - what do you mean by 'the fear' ? Just curious....

Ives - sorry to hear what you are going through - but every time you stop taking the Naltrexone you strengthen those pathways in the brain - you must keep taking it EVERY time - not for 6 months on and off ..... I am glad that you are working with someone who is hopefully helping you though - but I doubt that he will be using TSM ......even though he is using Naltrexone.

I wish you all the best with this - it sounds awful for you,

Hugs, Maggie

Has your doctor read the book and the peer reviewed journals and research papers? I ask because it sounds to me that you are doing TSM wrong. I don’t mean to sound like a jerk but there is a reason why there is a 20 percent failure rate for TSM and improper use of the medication is a well documented one. In fact the studies show that taking a daily dose of Naltrexone show no benifit what so ever and in fact can make matters worse.

I'd seriously consider reading the material again and talking to your doctor about it. Stay strong, follow the golden rule and good luck.

I've not read any papers BUT the anecdotal stuff I've read says that whilst higher dose can be the answer for some, higher dose generally doesn't do anything much more because you simply cannot cover any more than 100% of the receptors.

This is going to be controversial so time for a disclaimer. Everything that follows is based on my own experience, feelings and observations, at no time do I recommend doing anything against medical advice.

So the fear.

These are my words to describe how it feels to be detoxing from alcohol and afraid to detox. I experienced this a few times, I can remember being in the shower with 'jelly legs' knowing I had to have a drink later that day or I'd, well I couldn't face the consequences.

The fear can be real and based on serious withdrawls, it can be a fear of facing the world without the warm blanket of alcohol. It's so scary that it's easier to go get another drink and put it off. The unpredictability of physical withdrawls are also interwoven.

I think that's all I want to say for now!

UK I know exactly what you mean. For me the fear was more about the fear of the inevitable physical suffering that my addicted brain would inflict on me if it didn't get it's fix. That of course would come with a side of mental anguish to boot.

I wish that I had the fear!!! It might mean it would be easier for me to do this whole thing !!! I have no physical suffering wither with or without AL - I did have a couple of Nal Overs but have not had one for ages - neither have I had an AF day for ages - grumble grumble grumble ....

HUGS, Maggie x

Yea Maggie good point. Once I would punch through the suffering and get sobered up the fear could be used as a tool to stay dry. But it only ever lasted so long before the justification to drink wins again.