Hi, I'm sorry I haven't posted here for so long. I hope everyone has been doing well and finding progress.

I have had some personal issues that have continued to dominate my life and interrupt my committment to recovery. I haven't dealt with some of those issues and I've started both TSM and baclofen (not at the same time) and have given up before giving either method a real chance of success. I can be a coward when things get tough, and I'm also a loner who retreats into my shell sometimes instead of sharing with others.

I have found a clinic that offers a naltrexone implant for about $1,600 (Australian dollars) but they also try to include oral Antabuse as part of their treatment. Obviously the Antabuse would make the Sinclair Method impossible, but if I could get out of that, would a naltrexone implant allow TSM to work if I drank "normally"? My drinking level is about 180 to 190 units per week, which I know is at the upper end of the scale even for alcoholics. Being a daily drinker, the implant would be the same as taking Nal every day, and it would take away my bullsh*t excuses to stop taking oral Nal. At least that is the theory.

Does anyone else here have any experience with naltrexone implants? Since the Nal would be in my bloodstream and brain all the time, drinking as I usually do each night would be the same as taking oral Nal one hour before drinking, wouldn't it?? It would have to cause pharmacological extinction.

Best wishes to you all, and any opinions or advice would be appreciated.

Greg

You may want to post this question in Dr. Eskapa's forum.

IMO, you shouldn't use the implant. Remember, NAL totally locks down the opiate system in your brain, so you won't experience the effects of endorpines in any situation. Early in TSM, you'll be taking NAL just about everyday to make sure you don't accidentally get a urge to drink out of no where an drink AL without NAL. However, as you get further along in TSM, you will get more and more control over your drinking. As you gain control, you'll want to start taking planned AL free days and not take NAL on those days. This way you can enjoy activities that release endorpines.

Why do you feel that you need to have NAL in your body at all times? Most of us carry a NAL pill with us at all times, just in case.

Q

Greg -- I posted two replies in your thread at MyWayOut. The short answer is yes, but only if the effect is only for a month or two. Then oral nal is best.

Thanks Q and Lena. My question is now basically irrelevant, as the clinic offering the implant is not a place I would trust. They think Nal is an anti-craving med to be used together with Antabuse, and the implants are their money spinner. However, I thank you both for your replies, and thanks Lena for your replies over at MWO.

Q, I can understand why you wonder why I'd want Nal in my body all the time. The simple fact is that I'd choose any other treatment that could stop alcohol addiction if such a treatment existed, because I DON'T want to have my endorphin system constantly blocked. I have experienced shyness, loneliness, and dysphoria/depression all my adult life. That's why I turned to alcohol in the first place, when I was in my early 20's. It "worked" to temporarily give me an emotional escape from life every night...I knew I could put up with the worst of days as long as I had the alcoholic escape at the end of each day to retreat into. I dread any treatment that may block pleasure and cause even more depression, and I fear naltrexone for that reason. My reason for wanting Nal in my system all the time is that I'm worried I will just give up taking oral Nal again, especially when I feel depressed and want to get high on alcohol. I know I have just lined myself up for severe criticism by saying that, but are there any alcoholics here who have not felt in two minds about quitting? I can see that I'm not in the same category as many here, who have made the decision to save their lives no matter what it takes, but I haven't given up totally.

Lena, I know you have done so much to help everyone. I know you will feel annoyed by what I've said here. All I can say is thank you, and if we don't see eye to eye, we each have our own path to follow I suppose. I just don't have anyone to talk to in real life. I have built up such a tolerance that I can concentrate and write even after 18 standard drinks. In fact I can't sleep even after huge amounts of alcohol. It hits me most the day after, when I sleep in until after midday, and spend the afternoon recovering. I was going to PM you but I probably wouldn't make much sense so I'll leave it till another time.

Greg

Hey Greg -- As a fellow alcohol addict, you will never get criticism here for expressing a frank opinion. We all have issues to deal with in the best way we know how. The important thing is you continue to educate yourself, through all your suffering. I left you another post on MWO about the depression issue.

I'm glad you saw the naltrexone implant clinic for what it was. You are a part of this community here and we hope you keep coming back as long as we can be of support.

As I said over there, best wishes in whatever you decide.

Greg,

Taking NAL is not going to prevent you from getting drunk (high), trust me. There has been the occasional person on here who has reported they don't feel the effects of AL when taking NAL. IMO, these people are in a very very small minority. Most people seem to feel increased effects of AL after taking NAL.

I think most of us here, especially earlier on in our treatment, looked forward to taking NAL prior to drinking as it gave us a kind of green light to just drink what every we felt like drinking. As you move further into the treatment, you start to feel a great deal of security in taking NAL as you know it is helping you to get better. Bottom line: I think the risk is fairly small that you'll just stop taking NAL unless you have bad side effects or something from it.

However, if you honestly feel that you will not take NAL because of depression or the like, then perhaps the implant is the way to go until you get some of your craving under control.

As far as the depression issue goes, I don't think NAL is going to cause more depression. The way NAL suppresses endorphines is a sensation that is difficult to put to words, but it is just barely noticeable. The best way I can put it is it is like eating a favorite dish and noticing that a spice or something is missing, but you really can't put your finger on exactly what is missing. You just know it tastes a little different.

Q

Thanks again Lena and Q, I value your opinions and support greatly.

Lena, I just posted a fairly long reply over at MWO since several people responded. Thank you very much for your message there. I was only worried about criticism here because I posted once before here and was told by one member that my post was "bullshit", but that is an old disagreement now.

Thanks Q for your advice too. I have been scared that something that blocks the opioid receptors would be certain to worsen depression, but I realise that my fairly brief experiences with Nal so far are not enough for me to conclude that it actually increases or causes depression. So much of alcoholism already involves depression, so it is too easy to blame a medication for something it may not be responsible for.

You have both been around since this site/forum first started, and the fact you are both still here is an inspiration in itself. I don't check every post and I don't even check in every day, but I wish you and everyone else all the best.

Kind regards,
Greg

Hey Greg.

As someone who deals with depression on a relatively mild level (no meds) I can tell you that my experience has been that my drinking clearly and directly impacts my mood. You can pretty much chart how good I'll be feeling each week by the number of drinks I've consumed. Although the issue is not medically proven, there is no doubt in my mind that my depression is tremendously exacerbated by booze. Moreover, every physician I've ever discussed this topic with has uniformly told me that booze is terribly destructive to moods and makes moderate depression far worse. All of that said, once you take the nal orally (if you go this route) you may have the "honeymoon period" where your drinking sharply drops for a week or two after you initially take the naltrexone. This has happened to the majority of us on this board. And if you have this period, I believe you may be pleasantly surprised to discover that your depression will be greatly reduced with your reduced consumption. It is certainly possible. And if it does happen, the chances of you not taking the nal because of depression/apathy would be substantially reduced.

I also agree with Q about the buzz factor on naltrexone, with a qualification. I definitely get a different buzz when drinking on naltrexone that is hard to describe. There is more control, less sloppiness and more clarity. I also get less of the euphoric feeling from drinking BUT as Q accurately describes it, it's not like I'm still not eating my favorite dish: I am eating my favorite dish with a little less spice. It's not like I'll think, "This dish is no good without that spice" and consider quitting the nal. And, unfortunately, as I proved to myself this past weekend, I can absolutely get obliterated on naltrexone if I drink too much.

I also agree that the patch is not ideal -- that you should try to carry a nal with you at all times and pop it one hour before you drink. If you try this and fail, then go the patch route (if that is even still an option for you). I personally would not want my endorphins blocked 24/7 as it will disrupt pleasurable, positive activities.

On a side note, I know that when I first came to this board I casually threw out the term "bullshit" on one occasion. I don't even remember the context or who it was directed to, but if it was you I apologize for my insensitivity. I would feel very bad if I was stifling any honest discussion on this board, especially from someone who is as sincere as you.

I wish you the best.

Nick

Hi Nick,

I began drinking many years ago because I already experienced severe depression, which was caused by shyness and an inability to establish relationships. I have been very shy all my life but have also wished to establish a relationship with someone of the opposite sex. No matter how much I drink, I'm always the shy guy standing in the quietest part of a pub or club. I look at all the other people having fun and wonder why I'm not like them, but I have accepted that I'm different, and not getting any younger either.

You weren't the person who used the term "bullshit" so don't worry about that. The person who did say that is a genuine and committed person, and we sorted out our differences a long time ago. It was largely a misunderstanding due to the way I had written one of my posts.

At the moment I have decided NOT to persue the Sinclair Method, for my own personal reasons.

Best wishes,

Greg