That's the willpower aspect I'm struggling with now. Before TSM I couldn't stop myself from drinking and more than 2 AF days in row was impossible. Now I think I am readdicted, but not quite to the same point. I struggle with the willpower to take the pill first before drinking. Having AF days is not terribly difficult.

As a result, it's those situations where booze REALLY contributes to the atmosphere that is difficult for me. Like dinners out and social settings.

I have a degree of social anxiety so the alcohol+euphoria helps me to feel better in a social setting. I actually don't have much fun without alcohol around people I don't know very, very well like colleagues. I know I can get drunk on naltrexone but that's not what's missing...it's the happy party-like feeling.

Naturally, I want this to work (I actually envision myself becoming AF in the long term), but it's these particular triggers that I am struggling with. I read a post here that suggested taking a naltrexone at the first thought of NOT taking one, and that stuck with me.

I can't speak for using it to combat not taking one. But it's advised not to take it until the alcohol craving hits so that the craving is connected with unrewarded drinking.

Also, as aforementioned you're covered for twelve hours and then should readminister if drinking is continued.

That sounds like a workable plan, Seafowl. Maybe use a booster dose if it's getting towards the 12 hour mark?

Do you take any other meds?

Hi Seafowl.

Let me put a thought in your mind.....

What if, following 20+ years of research, and over 120 clinical tests, Dr Sinclair discovered that taking naltrexone ONE HOUR prior to a particular event not only reversed a cancer diagnosis, but meant that you had a future of not falling back into problems?

Would you mess with it? Or would you take that pill, no matter what adjustments you had to make in your life to do so?

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Let's get real here. The optimum way to take the tablet is, [i]as perscribed[i], by Dr Sinclair - that is either as soon as a real craving hits and then drink one hour later OR if you know you are going to drink at a social function, one hour prior to when you expect to be having the first drink. To get the best results, this really isn't negotiable.

Do this and the need for a second tablet is virtually eliminated as the chances of you still drinking 12 hours after taking the pill are reduced.

Take the tablet in the morning 'in case you change your mind' is not a good idea because firstly and most importantly, that isn't how TSM works, and secondly you will find that endorphins are being blocked from all the activites you do that day. The idea of TSM is to 'target' the drinking endorphins first and foremost so that you brain has a lightbulb realisation that drinking doesn't do what it once did.

Part of the process is learning to trust in yourself and trust that, as a commitment to your desire to get well, you will make changes to ensure that you get into the 'new' habit of taking the tablet one hour prior to a drink. That is important because the new habit needs to become a learning pathway in your brain, and that immediate connection between 'drink=must take a tablet' is something that you need to have for the remainder of your drinking life.

Please ensure that your compliance is as it should be, and then you will maximise your chances of never having to go through this ever again.

Right. I know compliance will be an issue. Hence why I created an account and started posting for feedback.

I'm fully intend to follow the golden rule regularly and have no problems sticking to it. I am particularly concerned about a couple occasions a year which is when I will insure myself with taking it as soon as I get out of bed before I have all day to talk myself out of skipping "just this once".

Booster dose is a good idea for these days!

I read the reviews and the book sounds very interesting, thanks! Just practicing mindfulness of my mental state is helping me not automatically react to stress in old ways. It will be great to read the science behind it.

I hope you find the book useful!

Yeah, I think if you're only taking the Nal early a couple of times a year, not a big deal. I can see where missing the euphoria could be a tripping point, so good to make a plan about it now.

Stick with us and keep on posting, Seafowl! Somebody else is going to read about how you dealt with this and maybe it will help them get a handle on it.

I am happy that my first hurdle of a conference in DC went seamlessly. I was not tempted to skip the nal before the team night out; I knew it had to be done, and to start on the path of on-off nal is too risky. I'm glad I have it in me to just follow the rule even during tempting times.

I have also dropped my dosage due to SEs. My frequency and units are dropping precipitously on 12.5mg. Compliance is much easier knowing I won't be facing a headache/stomach upset for a few days after dosing.

I am 88 lbs and I tend to need much smaller doses of drugs to avoid SE's so I am pretty comfortable at this dose as long as I don't see a spike. I can definitely tell the lack of the "warmth" at this dose.

Sounds good, Seafowl. I had to back off to 12.5 till some really odd SE's mostly abated, now I'm back at 25 and they're manageable. You can also try taking some anti-nausea meds (Dramamine) prior to taking the Nal, that's worked well for some. Good job on overcoming the temptation!