Hey there, fellow TSM'ers. I have been taking naltrexone, and practicing this method for about 2 and half, maybe, three years now. I kind of go up and down with my drinking habits, some nights having a few glasses of wine, other nights drinking half a box I want to get control of all aspects of my life, especially my diet, and that extends beyond drinking (I'm a 5'10 male, that weighs 125lbs, with no appetite...but there are several things that seem to come up as road blocks, very often, such as anxiety, depression, and sleep disorders.
I take Wellbutrin for social anxiety, ADD, and depression, I have been on and off Vyvanse and Modifinol for ADD, lately have not been taking it, because I have had tons of chest/gastro pressure for the last couple of years, and have underwent several procedures, with no avail to my conditions. I also take Xanax, as needed, which is rare for anxiety, and I usually end up breaking it out, only when I absolutely cannot get my body tired enough to try to lay down. With that being said, I feel generally tired, most of the time. I have recently started taking Seroquil, but it makes me have nightmares, like chain, 7-8, nightmares in a row, throughout the night, waking me and my girlfriend almost daily, since I have started taking it(last night, I audibly shouted "Call 9-1-1!, before my girlfriend woke me, and told me I was having a bad dream). I smoke cannabis frequently, and have since I was 18-20y/o, with occasional breaks, but with much more regularity. I don't think I've gone much more than a day or two without, in a few years now, though.
I'd just like someone else's perspective on my lifestyle, and I don't mind if some of the truth hurts. And I don't mind being brutally honest about my lifestyle and habits.

Finally, I do have my first question for the forum: I understand that you should take Naltrexone even after drinking, but what about taking it, even before you know your going to? For example, I take my Naltrexone every day, drink almost every night, but I often take the medicine 2-3 hours before I start drinking, instead of 1-2. Has anyone else had an experience like this and gotten stricter on their routine, and noticed a significant difference?

Thanks for allowing me to be a part of the community and thank you to anyone that may be able to lend a hand.

hhmmm - you have been on nal for 2-3 YEARS? But you 'understand that one should take naltrexone even after drinking'. Where did you hear that? TSM and Nal - well, TSM is taking the naltrexone at least an hour before drinking ..... and if you have been taking it for that long, I am wondering why you are not 'cured'. Do you take it EVERY time at least an hour before drinking? What are you hoping to get from the Nal? What is your drinking style and where are you at with the intake?

Re the other stuff - I am the wrong person to ask about pot - I do not smoke it and only ever tried it once - a LONG time ago - didn't like it. I am not sure what you are asking really when you ask about us giving you our perspective on your lifestyle. If you have to ask us that, then in my mind, you know that something is wrong - or you wouldn't ask. Just my opinion mind ....

Just a thought - have you ever tracked your intake? How has it gone over the past 2-3 years?

All the best, Maggie

Hi Maggie,
Thanks for replying. I have been talking naltrexone for about 2 and a half years, yes. My consumption at that time was approximately a fifth, if not more of vodka. Since then, my max out is probably about a bottle and a half of wine. This is rare, but occasional, so I wanted to be honest.

As far as reading about taking naltrexone after drinking, I read that from a topic in this forum... I actually was doing Google searches on the subject, when I came across that post, which generated organically in a Google search. I proceeded to make an account from there, and wanted to introduce myself, and my personal habits, through this "New Here" sub. I am currently typing from my phone, because I am in an office video conference, but if you would like me to CC that post, that I got that from, I'd be happy to, once I'm off work.

I'm definitely not looking for any judgmental, subjective analysis, just an objective, unbiased one, if it's even needed. The point of my post, was to introduce myself, and identify why exactly I am here, as I thought this was what the whole sub, here, is for?

No need to talk about cannabis, if you don't have experience. And really I'm not looking for anybody to denigrate that, as I am a strong advocate of the plant, but I am all ears for objective opinions.

Finally, as I said in my post, I was looking for the answer to "Is there any issue with taking naltrexone 2-3 hours before drinking, instead of 1? My guess is the inhibitors would start to wear off, but I'm seeking more experimental based opinions. So, to answer you, no, I don't always take it an hour before drinking but 99% of the time, I take it AT LEAST an hour, sometimes two or three hours, before having my first drink.

Thanks for commenting. I appreciate the feedback. Let me know if I am still being unclear.

No sorry - I guess I just didn't understand - as to taking the Nal 2-3 hours before drinking, my answer to that, is that it is fine. I think that the nal is supposed to be good for 24 hours but I am also led to believe that after 12 hours, if one is still drinking, it is wise to take a booster. For some it is better to take it 2-3 hours before drinking - sometimes they find that the urge to drink has passed ....

It really doesn't matter where you found the thing about taking the Nal after one drinks - except to say that it will not work on the extinction process if taken after drinking, so I am not sure why anyone would want to do that. Maybe whomever it was, was confused?

SO, yes, this forum is to talk about Nal - I am wondering what dose you are on, for if you are still having a problem after this long, I am wondering what you are hoping to get from Nal. My goal was to drink like a normal person (whatever that is). I thought it had taken a long time for me - it took 11 months to the day but I am finally there. I am sorry that you are still having issues - I am hoping that someone else will come along and maybe be of more help than I have been!

Hang in there......

hugs, Maggie

Doc -

Welcome to the board and thanks for the post! Yours is an interesting situation, but it sounds like you've made some gains with TSM.

The peak concentration of Naltrexone happens about an hour after taking it, so you would may well be better off sticking to the 1-2 hour range. I recall one reporting that they waited 4 hours and seemed to be treading water. Do you tend to metabolize drugs quickly? It could have an impact on the optimal time for you.

Protection lasts about 12 hours, so if it looks like you're going to be drinking after that, you should take another and wait an hour before resuming.

Do you have a particular start time? Do you drink every day?

Some people report that SSRI's increase their alcohol cravings, but for any given AD, some say they drink more, some less and for some there's no change. It seems to be peculiar to the individual, just like finding the right AD to begin with. Benzo's tend to thwart TSM, but it doesn't sound like you take them often enough to make a difference.

How are you getting your Naltrexone, via a regular doc, TSM doc or online? How much are you taking?

Maggie, I think the book says to take the Nal ASAP if you find yourself drinking without. Far less than optimal, but better than nothing.

Welcome DrG0nz0,

Could it be that you are talking about Barry4? He did something that wasn't TSM. He would get completely wasted and then take the nal. He had an experience that was similar to my nal overs, and that experience would cause him to abstain from alcohol. I wouldn't suggest for anyone to do it, for you will feel like you are dying and need emergency care. Even though my nal-overs were that severe, they would only stop me from drinking for two days after, but they did cause me to cut my intake down after the third one.

Taking the nal after you realized that you haven't, or you started to drink looking for that buzz, is always better and was mentioned in the book; however, again I would warn that side effects could happen if you are already drunk, or had more than one drink.

I would have to say for me no, but everyone is different. I found that if I pushed my drinking time back from 1 hour to 2-3 hours after I take nal I would forget to drink; however, I was one that would be watching that clock, and I was really having a hard time with that hour, so working up to that point was progress.

It maybe depending on the rate your body metabolizes the nal. Have you tried upping your dose if you feel that you are not getting the full benefits of TSM?

Do you take the pill everyday knowing that you will drink? Or are you taking the pill as an actual craving hits? Can you put a number on your desire/cravings? Is it a 10 (where you are climbing the walls, having withdrawals, etc.) or a 1 (wanting a drink is a flitting thought)?

How are your AF days? Do you struggle with them? Are you able to have more than one day at a time? What was your longest stretch of AF days? How do you feel during/after your AF days? Do you find your intake increases after a stretch of AF days?

Do you think you maybe drinking more out of habit? Or could it be subconsciouly because of a trauma?


*MJ does help with cravings and I have seen posts where people were using TSM and MJ and still have gotten "cured". I do not believe it will hamper your progress; however, I am not a AUD doctor or counselor. If it works for you that is all that matters (I do wish it was illegal in my state).

*I am on Wellbutrin and Adrenal and I do not think that it hinder my progress in TSM; however, everyone is different.

*Benzos will hinder your progress (which I am sure you know).

*Seroquil is a drug I have not taken, but I have had friends that went on it. I do not know how it would effect TSM, but it is a drug I would use as a last resort for sleep. I would have very vivid nightmares with the nal, so my heart goes out to you.

There are other meds out there that are used off label for sleep, and Seroquil is one that (IMO) messes with your brain as well as your body. It sounds like you are not having a good experience with it, maybe ask your doctor for something else. Some have had a great experience with Gabapentin and it is, for what I have read, used in AUD therapy (just a suggestion). Here is a website with a list of off label use drugs for sleep http://cnsdiseases.com/current-therapies-for-insomnia (I hope it works). We need to be advocates in our on health, and we need to find what works for us.

Remember everyone is different and this is a very personal experience.

Jaba

P.S. Sorry for rambling, for I do that when I am tired.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3853523/

This is a study that I found interesting. One of the things that was pointed out was "higher serum 6b-naltrexol was strongly associated with lower ratings of alcohol liking and effect" (from another study http://www.ncbi.nlm.nih.gov/pubmed/11003204). The second study that came to that conclusion was a very small study and it was done on heavy drinkers. If this is true about 6b-naltrexol and the plasma half-life of naltrexone is about 4 hours and 13 hours for 6β-naltrexol, I believe you would be covered waiting longer; however, I am not a scientist or a doctor/pharmacist.

This is a study that was done on Naltrexone and metabolism, and even though it was for opioid dependences, it is interesting that a patients did metabolize nal faster. http://jat.oxfordjournals.org/content/38/4/212.full

SO, maybe waiting only one hour maybe helpful (I am just trying to give you the facts, so you can come to your own conclusion).

Like I say, we are all different, and what works for one may not work for another.

I hope the links work, and you find them helpful,

Jaba

Hey, Gonzo. Welcome.

Have you read the book, "The Cure to Alcoholism" by Dr. Roy Espaka? If not you should. Besides your question I'm a little unclear on where you stand with TSM at this point. It sounds like it has reduced your consumption, but also that you're still daily drinking a sizable amount which most here would be still trying to significantly reduce. In any event I would encourage strict adherence to the one hour before drinking rule and taking it afterwards would be rather ineffectual simply for the fact the endorphins have already reached your brain. The whole point of this is for the endorphins never to reach the brain again, ever. Only then can we expect real progress never mind a 'cure'. Similarly we can never have a drinking session and skip Naltrexone as again we would be shooting ourselves in the foot. As another here mentioned you really should be taking Naltrexone only when you have a craving and then waiting the hour. This ensures the brain associates the craving with an unrewarded drinking session thus deaddicting the brain. Through this you should ideally be working towards 'alcohol free' days. I mean unless you are comfortable with drinking daily in which case 'each to their own' applies.

Regarding your use of Xanax (benzodiazepine) I'm of the mind that it should be discontinued with resect to TSM. Dr. Espaksa specifically addressed that here and echoed the same sentiment if at all possible because of course it is received by similar opiate receptors leading to more brain confusion. I stopped (tapered) after taking it for a number of years and feel fine. As for the Seroquil while I do not know definitively if it is subject to complications with TSM, being a anti-psychotic class drug it is rather severe. Really the sedating effects are only secondary to its true use. I would highly recommend switching to Trazedone (I take 150mg night, 6'2'', 220lbs) which has no side effects to the point of not even feeling groggy in the morning. I am on Wellbutrin 300mg daily and have had no complications whatsoever with TSM. I only drank 4 units one night the entire month of February. Lastly, as a heavy cannabis user I saw no complications with TSM or found any with research, but anecdotally simply stopped using it 7 weeks ago for the first time in many, many years. I can't help but think that has had something to do with TSM if for no other reason that I have been able to restructure so much of my life thanks to it.

Hth.

wow

Wow, thank you all so much for all the feedback, everyone. I greatly appreciate the detailed analysis of my situation. This seems like a great, caring, articulate community. I'm sorry it took me so long to respond. I have just been very busy with work, and home renovations (I haven't been on a bender or anything lol).

To detail my case, my alcohol consumption has drastically reduced since I first began TSM, not as much I would like, though. I can't really explain why my urges are so infrequent; I do drink almost every night, but usually it's not very much. Last night, for example, I had three glasses of red wine, over a 5 hour period. On Friday, however, I went out by myself to a local show, and eventually ended up pretty drunk when I got home.
When I first started TSM, it was like I just didn't even think about having a drink. I had no cravings, and when I went to pour a shot, I would just think, "Well, I'm just doing this because it's a habit," but I wouldn't really ever crave it. After that I switched to beer, primarily heavy beers, like IPA's, and I could hardly make it through one of those. Since then, though, things have been up and down at times. I will confess that I have not been the strictest about taking it an hour before drinking EVERY time, and I have gone a few times without taking it at all, before a drink. Lately, since 2016 began, I have really tried to be stricter with this, and getting into better shape in general, but I admit, that, from hearing all of the feedback, some of my efforts have fallen short of what I really need to be doing for this method.

A little off topic, but in association with my up and down consumption, I also think it's kind of important to mention that, in the past two years, I have developed some type of minor physical aliment; it feels like I have a ton of pressure in the left side of my chest, and upper regions of my abdomen. I have rare, infrequent, random pains, and I get short of breath. This isn't every day, but it's most and the day's that I do have it, it really really lowers the quality of my life. I can't eat, breathe, enjoy things as simple as watching tv, because I pace around, fixated on the pressure, when it is present. For some reason I keep thinking "If I could just have a couple of drinks and relax, this sensation will go away," which does happen, almost every time, after a drink or two. ...But sometimes that drink or two, does not stop there. I have underwent CT scans, endoscopy's, barium swallows, in just the past few months, to try to figure out what the pressure is from; one radiologist suggested that I had lost too much weight, in too short of a period of time, causing the layer of fat between my small intestines and aorta to disappear, which, he suggested, may be what I am feeling. (I know it goes away from drinking, more than likely, because I'm just numbing it, but spending thousands on procedures, and having these different specialist come to me without a diagnosis, has become frustrating, so I will confess that some of this, this specifically, and drinking to sleep, is self-medicating). ...As I just mentioned, I also drink, sometimes, to help me fall asleep, as I have a very active mind, and Seroquil just doesn't do the trick. This is a major proponent to my actual active day, in addition to the sensation that seems to be present more than it's not. I never get good sleep. I wake up on average 5-6 times a night, and it's restless sleep, when I am out, that are filled with chain-nightmares. I think Trazodone is a good recommendation for me, and I am going to ask my doctor to put me on it, very soon. However, when I was very young (from about age 9-15,16) I was taking Zoloft and Adderall during the day, and Traz at night and it made me really dysfunctional. Every morning was an absolute struggle for my parents to wake me, or for me to get myself up. I would be so groggy that I would fall asleep in the shower, sitting down, fall asleep half way throughout the day, in classes, or whatever, so I have been turned off from it for that reason. Maybe my body has adjusted, and Traz might be a much better solution for me, at this point, though.

I have not read Dr. Eskepa's book yet, although I have downloaded it onto my computer. I will begin reading it tonight, with due diligence. An interesting bit; my psychologist was actually very close friends with Dr. Sinclair, until his fairly recent death; they developed several patents together, including a CO2 inhaler for agoraphobia. I was actually extremely lucky, and honored, to speak with Dr. Sinclair, in my psychologists office, while he was in Finland, where he was residing, and where he passed, from my understanding. I was able to go over my prescription regiment, where he approved everything I was prescribed, including Xanax, for the skeptic on that (I do appreciate that insight, but I take it very rarely), although we breezed by that topic, and moved onto others, where he was extremely interesting and encouraging. A truly remarkable fellow; my Dr., who was such good friends with him, said Dr. Sinclair once went AWOL for a month, only to bring back a 100+ page dissertation on ending the wars in the middle east! May he R.I.P., and may his legacy live on in the many people struggling with alcoholism, and traditional treatment programs.

I am currently taking 50mg of Nal, for those interested. In addition, I take 300mg Wellbutrin daily, and was on the 50 mg of Seroquil for about two weeks now. I read this thread yesterday, and got encouraged with the talk of Trazadone, so I called my Dr yesterday, and he called in a script for me today. I have switched on and off of Vyvanse and Modifinol for ADD related symptoms, but as of late, I have not been taking it, because of the ailment that I mentioned before; my physician and specialists have assured me that it is not heart related, yet we have not done any heart tests, no EKG, no stress test, so I am not entirely convinced. I have an ultrasound on my gallbladder, and a gastro-emptying test? Like where I swallow a camera pill, or something?... coming up, and I'm going to ask the radiologist to take a look at my heart too, with the ultrasound. And if I get a gastro diagnosis from it, I'll know for sure, and will resume taking a medication for my ADD.

Thanks again for the open arms welcome. I hope to be able to get some counseling from this community, and would love to give some back, once I'm on a very clear path, myself! Best Wishes. -Gonzo