Hi there,

I guess I'd fall into the concerned spouse camp. I'm here because of my fiance (I'll call him Mr. ND). He has been using TSM since May 15 or so. I want to preface my story by explaining that he has cognitive impairments due to a childhood brain injury and 3 month coma after being hit by a drunk driver. So a lot of the stuff I say is going to sound wildly codependent if he were in possession of full faculties, but I'm being very careful working with a counselor to make sure that I don't cross the line.

Mr. ND has a family history of drug and alcohol abuse, and has been drinking for close to 20 years. It intensified 5 years ago after his grandmother, who raised him until he was 10, passed away. He has a lot of other stuff that he drinks to forget too.

We met in the hospital, when he was there for rehab last summer. I'm pretty sure he went back to drinking the day he got out, and the next 6 months are ugly with lies and betrayal. At some point during that time, I threw up my hands and stopped trying to control any aspects of his drinking behavior, including not to drink in the house. He continued to have numerous health problems that were obviously alcohol related, and when I came across an article about TSM, I knew I wanted to ask his doctors to try it. Of course, his whole treatment team is on team AA, but he has problems with being in groups, so rather than letting a barrier to treatment stop us, I convinced them that any treatment he was willing to try was orders of magnitude more effective than the "perfect" treatment he wasn't willing to try.

So he's been taking naltrexone for about 4.5 months now, and a couple of months ago I got fed up with the fallout from the high levels of drinking (I needed to borrow my mom's steam cleaner after he managed to pee the couch and the bed within a week). Plus, he was running out of money before the end of the month (he's permanently disabled and can't work) and borrowing money from his mother, who isn't the healthiest individual emotionally, and I didn't want him beholden to her. So together we agreed that each month, I'd be moving his money into his savings account where he wouldn't be able to use his debit card to buy beer anymore, and if he needed access to his money he'd need to arrange for me to take him to the bank. And I would buy beer for him and keep it in my safe, doling it out like medicine in little bits so he couldn't drink so much at once anymore. At that time, he was probably buying 4 to 8 24 oz. cans of Busch Signature, which is almost 6% alcohol. This'd be an improvement over the Mickey's and Steel Reserve High Gravity he often bought-- sometimes just to spite me, despite knowing that they make him have dissociative seizures and make him sicker than the increase in alcohol consumption would really account for.

I started off letting him have 5 16 oz. cans of Busch Sig per day. Then I switched him to regular Busch and Busch Light, then down to 4 cans a day. Then I switched him to a local light beer with only 4% alcohol, and then we went down to 12 oz. cans. At some point, we discovered that he likes non-alcoholic beer, so I started buying that for him too. The cruddy part is that those NA beers are more expensive than any of his full alcohol beers. Ugh. But the good news is, we've decreased his consumption from 90 or more US unit drinks per week to under 30 (taking into account that he probably gets the equivalent of 1 unit drink per day from the NA beers combined).

That is still double where we need to be, of course, but after some very good discussion this weekend, going lower than this right now would be too uncomfortable. He just stopped smoking herbal remedies a couple of months ago, which I didn't even ask him to do. He wanted to prove to himself that he could, and that he could eat without it. I'm so proud of him for that! I hope that was a big boost to his confidence, to accomplish something he'd set his mind to (and I didn't even know he was doing it). So as he jokingly put it, "Dammit, woman, I just stopped smoking [herbal remedies] so get off my case about the beer!" I get that he's feeling the loss of that, and trying to change too much at once is a recipe for failure. So we're going to be holding for a while at 4. I know it's still damaging, but from a harm reduction standpoint, I'll take it. It'll give him time to work with his counselor to find other coping strategies to take the place of poisoning himself to forget.

And my gosh, the change in him has been tremendous! He is not having seizures (that result in paralysis and me having to hoist him around for a couple hours; good thing I lift weights!) and he is cogent and lucid all the time now. It is a joy to have conversations with him again. Bonus-- he's spending more time taking care of the house and it's looking and feeling like a home, which I never had before!

After watching me do it for him for a while, he's now doing a good job of tracking his drinks and his daily naltrexone himself (he's yet to have a planned AF day since starting the nal). Where we're struggling is getting in touch with rating his cravings. He has a hard time recognizing and articulating feelings anyway, so I'm sure this is related. Also, I would like him to start moving his nal dose a bit closer to his first drink. He is a huge night owl, so he might be up until 3 or 4 am drinking his beer, having taken his pill probably between 10:30 am and 1 pm and starting to drink at ? o'clock (probably 3 or 4). Do you think it's a good idea to give him half to take during the day while I'm at work and then half when I get home at 6 or 7? Or since he drinks every day, do we just trust that the once a day dose has him covered?

Wow, sorry this has turned into War and Peace. I hope it's ok for me to use this as a progress thread too, since reading and writing can be a big chore for him and it'll be me doing the updates.

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Welcome to Club Concerned. :>

I'm very glad to hear how well Mr. DB is doing, and that he's taken over his own tracking seems very promising.

Tracking anything, from food to activities, seems to become a conditioner reinforcer in itself. I track my daily step count with a pedometer app, and every time I stand up now I pat my pocket to make sure I have my phone so I get my steps.

Thanks for the welcomes, y'all!

I'm currently not tracking my food, but I usually do, so I know what you mean.

So, I stayed up waaaay too late last night and am very tired. We got into a heavy discussion that lasted until almost 3 a.m. and I have to get up at 6 for work. It wasn't an argument, because we rarely have those, and I'm still left kind of puzzled.

I'd discovered some cash in his pocket Saturday while gathering clothes to wash (enough ruined clothes from stuff left in pockets will learn ya to go through them before they go in the wash!), and I woke him up from a dead sleep to talk about that. He says his mom gave him some cash last Thursday. Normally he tells me about minutiae like that in excruciating detail. I hate being so controlling, and if it wasn't the solution we'd worked up together, I would absolutely not do it. He says he didn't go to the store with the cash Friday, and I do believe him based on his behavior Friday night. I am not sure if he went Thursday afternoon and is lying about it. So, when I found a tray full of change last night, I (apparently) said, "Oh my god, where did you get all this change?!" He told me it was part of some money she gave him Saturday to pay me back for buying him some presents on her behalf, and to be fair, he did give me that amount. But there seemed to be several more dollars in coin, probably enough to buy 2-3 high al. tallboys.

I was trying to lead him to the conclusion that having that cash to hand was risky and that he would give it to me. I have my own stash of coins in my safe that I put there to keep him from getting into it to go to the store with. Turns out, he'd been dropping coins in there too, and then I just locked it up from him! I don't know whether he's upset that he didn't have the opportunity to share his money with me or that I'd sent a rude message that that was mine and I was keeping it away from him. I'm not sure if this is his addicted brain trying to manipulate me, but I surely did feel ashamed that I had unwittingly deprived him of access to money he'd put there and treated it as if it was all mine.

I think he is mad how careful I am to avoid even the appearance of exploiting a disabled person. I understand his mom would throw his expenses in his face and scream at him about them, but my only intention was just to sanity check for myself that I wasn't taking more from him than he was using (share of expenses, clothes, games, care costs for his cat, plus beer and cigarettes). I think contributing all his income to the family war chest makes him feel like a family man, something he's wanted probably more than anything his whole life (momentary overpowering cravings for substances aside). And when I'm reluctant to take everything from him that he can give, I think he balks because it diminishes that feeling of being the family man. On the other hand, if I don't keep an accurate accounting, I'm afraid I'm vulnerable to his nickel-and-diming that adds up to me not being able to achieve the financial goals I have for myself.

Then he brought up how several months ago I said I'd pay him to do chores around the house (there's a limit to how much he can earn on his disability benefit). Now that I'm paying for his beer and cigarettes and making sure his cat gets an exorbitant standard of care (I'm a bit of a nutter about cats), that's a wash.

I offered to involve him in the budgeting process so that he can see that, no, we cannot in fact afford unlimited non-alcoholic beer and we can't be buying video games all the time. He declined.

He also let me know that he knows perfectly well how to get access to his money from his savings account with the ATM at the convenience store. Well, I hadn't thought about that until a few days ago, to be honest. I'm not surprised, though, because even though some people might try to apply the "r" word to him, he is a smart person in a lot of ways. It's just that executive function is among the things that got damaged in his brain when he was a child. He knows he has poor impulse control. Am I wrong in thinking that I'm not trying to "outwit" him at every step and control all conceivable ways of him getting alcohol (I know he can find neighbors to visit too!), but just trying to add in a little inconvenience that will give him just enough of a pause to reconsider?

I did end up putting the change into the safe, but at this point, if he's known all along and hasn't been accessing the money, maybe the physical addiction has abated to the point that he won't go back to the old way. It's just that any time I point out to him that if he doesn't limit himself, he's going to run out (of beer, money, whatever), he seems to become constitutionally incapable of limiting himself. And he said himself that he needed that little push that I gave him a couple of months ago by taking on the bursar role. He also said the day before that he feels good and he's happy about having slowed down on his drinking.

This is just so frustrating. Am I really being a stingy bitch, or is this just a lot of smoke and mirrors from his addicted brain having a little extinction burst tantrum over not getting that reinforcement anymore? Or is that a false dichotomy and there's something else going on here I'm missing?

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Oh, my, no! I would not tolerate my mate verbally abusing me, and he knows that. No, like I said, it was a respectful discussion that was just confusing as to whether there was a clear resolution. I talked to him on my way home and we think it's just that he had a bunch of accumulated thoughts that he'd kept forgetting to tell me and needed to clear the air, not that he disagreed on any particular point. We need to keep in mind that he can't necessarily formulate reactions in real time during a discussion, as he needs more time than other people to process. We're going to try to be proactive about everything in general so that we have time to talk about an issue, process, revisit, repeat as needed, before making decisions. And to be patient with our imperfection in that process. We'll also bring this up with his counselor Thursday, and I'm sure I'll discuss it with mine tomorrow.

I forgot to give him any beers today and he was able to rate his cravings at 5/10 at 7 p.m. I think he's working on this without obsessing, which is better than I could do. So I think we're on the right track!

I'm gonna go check out the OSL forum and ask what they think.

Hi, ND! (I just realized that for some unknown reason I referred to Mr. ND as Mr. DB in my earlier post. I blame autocorrect. )

You might be interested in the book Beyond Addiction: How Science and Kindness Help People Change by Carrie Wilkens, Jeffrey Foote, and Nicole Kosanke. It has a lot of specific ways to reinforce and influence others (in a good way!) plus some very good info on reinforcing and helping yourself feel happier and less chaotic.

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Well, jeez, it's been almost 6 months since I posted! I've been thinking of you guys though.

I wanted to update very quickly because I don't want to take out too much time from our evening together... Mr. ND just informed me that when the beers in the safe are gone, no more. He's ready to take the plunge!

His plan is to have a beer or two sometimes when we go out to eat (after taking his Nal and waiting his hour, of course!) and that's it. I'll update historical data at some point, but for now, suffice it to say that his average intake over the last 3+ weeks has been 1.6 units/day, and 35% of days are AF!

I am soooo proud of him! I knew he could do it, and I knew Nal was the boost he needed to do it!

Fantastic news, Mrs. ND!

Sounds like "Extinction Accomplished"!