Try not to be so hard on yourself Ives and if punching something (not someone ) helps then do it.

There is 20% failure rate with TSM. Of that 20% much of it can be attributed to improper use of medication, people who are not alcoholics using TSM, No family history, and then some unknowns. You may be an unknown but I still question your proper use of the med's. It's also possible, though this is conjecture on my part, that having started and stopped using Naltrexone both properly TSM and improperly, then going off of it, then back on again, may have built up some psychological road blocks that you need to come over. The fact that you stated that you, 'had planned to have no more than 7 drinks last night' in my humble opinion and understanding of TSM means that you are not in compliance. The only thing you need to plan is to take Naltrexone one hour before you drink then drink as much as you feel like. That's it.

I know what you mean by the concept of 'enough' too. I was the same way. If I had one drink then it was not enough till I either woke up on the floor or made it to bed and woke up wondering how I got there. That was most nights. Some nights were a bit more lucid. That feeling of not enough comes from the endorphin rush and then the chase. Do you still feel the rush when you take 50mg Naltrexone one hour prior to your first drink and then the chase after it? Do you still feel that sensation of not enough? If so then something else is going on which my initial thoughts on are that you do indeed need a higher dose or that perhaps you need to wait more then one hour prior to the first drink but I know?

I think you need to seek the advice of a doctor who really knows TSM and has experience in dealing with tough cases like yourself. We are just a support group who can offer advise based on our own experience and what works for us. I hope you keep trying and keep coming back to share your story as it will absolutely help not only you but anyone else who comes here in the future who shares your experience.

Dose hasn't been shown to improve things, the posts I've read on this topic say that 50mg is usually enough to cover all receptors and any more doesn't do anything.

It sounds as if you are drinking through the nal each and every time, so you aren't getting chance to feel the difference.

It's...interesting...to see the different takes people have on this. Eskapa is very clear in his book: all that is needed is to take the medication one hour before drinking, no "mindfulness," no willpower (he feels strongly enough about this to put it in the title and on the cover of his book), no deliberate attempts to change one's behavior. Naltrexone + drinking = cure, he says, over and over again. And yet, I post on this forum and I get replies telling me I need to change my behavior or that I need to be more mindful about my drinking.

Furthermore, Eskapa clearly states in his book (chapter 8, page 109 in my copy) that 50 mg covers 100% of receptors for MOST people, and that doses of 100 mg or more are occasionally prescribed. Well, I can tell you from my experience so far that 50 mg and 100 mg are very different. I can drink through 50 mg and get the "high." I can't on 100 mg.

If you couldn't tell, I re-read Eskapa's book the other night after I made my angry/frustrated hung-over post, which was helpful. I tried to drink each beer slowly and pace myself to no more than one per hour. I made it to bed having only had 6 drinks. And last night, I followed the same pattern, holding off the first drink until about 8 PM and reading a book while again pacing myself, having only 5 drinks.

So, today I feel pretty good. I have been busying myself with several projects, but I will say that I am definitely still thinking that I want a drink pretty frequently, starting about four or five hours after I got out of bed. I'm drinking flavored seltzer instead, but as the evening approaches -- and there's a soccer game on TV about to start in a couple of hours -- I definitely don't feel like today will be that first AF day. So 100 mg just went down the hatch.

Also -- I went back through my old logs from previous "TSM attempts" and found that I had some AF days in 2013 when I was averaging 8 units/day, and experienced no withdrawals. So I definitely feel at this point that I am free to try for an AF day any time I feel like I am ready with no risk of ending up in the hospital, as long as I can keep my daily intake under 8 units, preferably under 6 (more than 6 = significant hangover, 6 or less = feel pretty good the next day).

Yeah, but when I do that, I frequently have 10 drinks and I wake up with an absolutely horrendous hangover. I can't handle that anymore. Surely TSM should work just as well if I combine the "golden rule" with at least trying to keep my intake below the level where I am absolutely wrecked every single day with hangovers that make me feel like I'm dying.
Even off naltrexone, I don't feel an initial rush anymore just due to the high tolerance I've built up, and I have to get up to a pretty high BAC for the rush or high to kick in. What I do get is a pleasant, fuzzy feeling, kind of warm. It isn't a rush, it's not like a high, it's more of a calming, sedating effect. The naltrexone blocks the opiod euphoria but it doesn't block the sedative effect. I do still get the sensation of "not enough." I am glad I do not have any liquor in the house, because after a few beers I will start to feel the urge to supplement it with something stronger. The urge does not feel as strong, but it's still there.
Duly noted. My psychiatrist does not seem to be a TSM expert, although he is happy to prescribe naltrexone, order blood tests, and support me in what I am trying to do. For now I am going to stay the course and continue to follow the golden rule with 100 mg, and hope that I am able to swing some AF days in the near future.

Week 0 (09/23-09/29): 60 (8.3/day)
Week 1 (09/30-10/06): 56 (8.0/day)
Week 2 (10/07-10/13): 10, 6, 5 (7.0/day) - in progress

I have to wonder, if someone really wanted to use TSM to control or stop drinking, they would actually do what it takes to accomplish that. Reading this forum, makes it abundantly clear that just drinking as before and taking a pill one hour bedore has low success.

The problem is a love affair with alcohol, often to the exclusion of almost all else. We need to get away from the love affair with alcohol,to quit indulging it, and to discover there are many other constructive ways to spend your time, instead of drunk.

Continuing to drink eight, 10, 12 drinks at night or more, is just continuing the same old same old. You can take 1000 mg of naltrexone, and it will be meaningless in that scenario.

If the goal is to quit over drinking, then quit over drinking, and find ways to make that an effective proposition.

Find a counselor, work on urge therapy, find alternative activities, pause and take a timeout, and have days you don't drink yourself to oblivion, etc. etc. it is definitely a better way to live, but you can't know that, until you do it.

The Eskapa data of 80% "Cure" makes for a compelling title, but it is far from reality.

Where are all these cured people, and why aren't they coming back to post their success and their super new lives.

If there is truly an 80% success rate, why hasn't it become the go to therapy ?

TSM can work very well, but anyone doing it needs to know the reality.

Guapo, are you saying that it isn't a long term solution? I am confused by what you posted, for it sounds like you think that TSM is bogus. If you could explain, or pm me you thoughts, for now I am very concerned.



Ives, that was me, and I could not deal with those nal. overs; however, I felt like once I did decrease my intake a switch was flipped and I could feel the nal. doing its job. It doesn't mean that at times I don't have to stop myself (no more than 3 glasses of wine is my rule)for I do, but at least I can now stop myself, for before it was finish the bottle and look for more.

I think it is very important to find what works for you.

I do know that DR. E. is re-writing the book, for he has found a lot more out in the years that he has been practicing this, and one of the things that the "option saves lives" forum is stressing is mindful drinking (he is in contact with them and the C-three foundation). If you ever need guidance a few of people at "options saves lives" forum have become alcohol counsellors and are able to help you. You could email JoAnna and she will respond within 12 hours. She has been through the program successfully herself and helps a lot of people when in need (this is merely a suggestion and nothing more) (joanna@cthreeeurope.com)

I think there are only a lucky few that can take the pill, wait an hour, and drink like normal, and have their intake decrease without a thought. I have read (and feel) that the rest have to work at it and find what works for them, for it may be just more than an alcohol addiction (for me it was habit and emotional crutch which is where the work comes in).

I feel your frustration and anger, and remember we will be here to help the best we can,

Jaba

Jaba, it is absolutely a long-term solution and a great one.

I see the advice to drink as normal, and just take the pill to be ineffective and frustrating for many on this forum. Logic would tell you that you can't change your behavior by taking a medication.

You have to change the behavior!

If the new book does include some reference to mindfulness, that would be absolutely great.

TSM is a thinking persons solution, not blind herd mentality, such as AA.

I have watched the successes here, and almost all have found new activities to replace the drinking time. They also don't drink every day, and don't drink to excess. It's because they don't want to, because they realize it's a stupid way to live.

I don't know if that's mindfulness, or awareness, but it goes along way towards fixing this problem. You'll never be able to be aware, if you continue to guzzle excessive amounts of alcohol. Gaining clarity, and clearing your mind takes time, and that means not drinking every single day.

That's all

Sorry Jaba, I cannot PM you, because nothing shows up on your post.

PM me and I'll get back to you.

Thanks, G

Ives,

It was pointed out to me that JoAnna's email address is not "working" as a link. If you do need to reach out to her you will need to put that email address into your mail "to" and send her an email like any other email. I think it shows up like a like because it is a ".com" email address. I am sorry for the confusion.

Jaba

Well done making those changes Ives. I feel the book is too simplistic we are not rats acting on instinct, we are humans who can out think logic.

I fought with everything I had to get the cure I wanted, I needed it asap I'd already suffered serious cconsequences and was unfunctioning when I drank - with only myself to rely on it had to work.

A pill will not stop you putting hand to mouth.

Ps forums are only ever the tip of the iceberg.

I'm a success and I have a real life friend who is also a success, but who does not want to post. Our drinking was very different and so are our recoveries but we both wanted it and pushed hard.

Roger that