I ask this because after, say, 3-6 months of using naltrexone and then stopping, what happens if you need opioid pain relief for something like, say, surgery? With the gradually upregulated opioid receptors, would pain management with morphine or fentanyl in normal doses actually cause a life-threatening overdose? Or do the opioid receptors return to their normal states after a few days of stopping the naltrexone? This is potentially a scary scenario that would be helpful to have an answer for.

I'm at the end of my third week on the Method and so far have noticed no progress (yes, I realize it's much too soon). I had a tough time convincing my doc to prescribe the stuff and he finally agreed to 30 days, providing I come in for liver function tests before the Rx runs out, which I will do. I hope that if my liver enzymes are in the normal range as in the past, and that he will understand that the process takes months and continue to prescribe. He can't seem to grasp the paradoxical mechanisms underlying the theory which was new to him. "If it is so successful, why hasn't it become common practice given the alcohol problems in this country?" he said. I don't want to overwhelm him with material since that would be off-putting, but next time I see him, I might bring a brief synopsis of Dr. Eskada's book, or perhaps a printout from an NIAA publication or perhaps the recent NYT article by Jane Brody. Any other suggestions?

Finally, the matter of using naltrexone when taking benzos. I happen to have essential tremor of the head and neck, together with some cervical dystonia. The pulling on the muscles and neck tension can be painful at times while the bobbing and shaking of my head is embarrassing in social situation. The only things that help this condition in my case (and I've tried the gamut of choices suggested by neurologists, short of having electrodes implanted in my brain) are GABAergic substances. Propanolol, mysoline, baclofen have zoned me out in the past. Currently, 5-10 mg. diazepam (prescribed by my doctor) with occasional "holidays", plus 300-600 mg of gabapentin, as needed are partially helpful. I've been on that regimen since the 1990s. However, the most effective though temporary "cure" for the tremor, unfortunately, is alcohol. Two or three glasses of wine in the evening, and the neurological condition vanishes like magic--only to reappear next day. (A well documented effect of alcohol upon essential tremor). But I've been drinking much more than three units at night, escalating alarmingly over the past several years to over 100 units a week. (I gather one unit is 5 oz. of wine?) Thus it appears to me that I'm both a GABA AND an Opioid type drinker--GABA for a real palliative issue and the Opioid for subsequent pleasure--the latter of which most likely causes me to lose control of my intake. Despite the provso that the method won't work for people on benzos, since my drinking is for two entirely different purposes, medical plus pleasure, I do wonder if removing the pleasure part via the method would help me control my intake to normal levels just needed to control the essential tremor despite also drinking for GABAergic effects. Or am I barking up the wrong tree?

Mike

that could be deadly and no the receptors wouldnt 'return to normal' without opiod related behavior in high doses (lotsa excersize) this is why you must wear a medical alert bracelet informing any emergency medical staff of your medicine

they have all sorts of other pain killers they could give you in place of morphine

and tell your doc it isnt common practice because a generic medicine that costs 7 bucks for a months worth isnt worth advertising, capitalism at its most shameful

this is very scary, and my biggest worry about sinclair method. i dont think it is made apparent how life threatening a dose of morphine can be to someone on nal, in fact i am still not sure of the facts and have just asked a question for confirmation. i am also unsure as to what happens when/if you come of the nal, i was under the impression that if you hadnt taken nal for a few days you were ok to take opoids with no problem, but here it states diffferently.

Dr Eskapa, please could we have an answer to a very, very important question. (sorry if it has been answered before, i just cant find it)

From what I read it goes like this. If you take opiods while on nal they won't effect you the way they are supposed to, the receptors are blocked. When off the nal, because of enhanced/ more receptors you are more sensitive to the stimulus, whether it be opiods or alcohol, thus possibly making your addiction worse than before you started TSM. I didn't gather anything about normal doses of meds causing an overdose.
I believe the idea is, if you have to do something requiring an opiod, you go off the nal, then resume taking it for drinking after that time has passed.

The issue isn't about overdosing on morphine its about the fact that if in an emergency you need pain medication they need to know about the nal so as to give you one that will not be blocked. There are at least two if not three people on the site who had accidents or ops and simply stopped taking their nal for the duration and resumed TSM afterwards. Hope this is helpful.

Listen,I don't know if I am on the right topic--but I need help!!I am on week 16-Naltrexone 50mg one hour before drinking...There is no difference what so ever!!
I don't have cravings--just love coming home from work and de-stressing with wine!!
Is there anyone out there that can help me????

Thanks

Your experience is common and absolutely nothing to worry about. Check this out:
http://www.thesinclairmethod.net/community/viewtopic.php?f=7&t=690&sid=07630ce67a197886d7940ec1f70af249