Q, I have to agree with you 100%, unfortunately! Hope I can say and feel how you are right now!

Q -- I agree and disagree. I agree that the key is the number of extinction episodes BUT we are extinguishing specific triggers. You could argue that for we binge drinkers, for all of those times we have historically really tied one on, we need to duplicate similar occasions with similar numbers, only this time around with the nal blocking our opiate receptors. (Which is why Dr. Sinclair and Dr. Eskapa both say repeatedly, "drink as you usually drink," only on naltrexone.) For example, my best drinking buddy lives in Chicago and I usually only see him twice a year. And when we get together, we drink tons on those two bi-annual occasions. Now he just moved to MPLS this week and I spent last night with him and we drank a ton, just like we always do. And if I had just had a few drinks on the nal I doubt I would have the same level of extinction unless I drank comparably to what we usually drink. And no problem there -- after 4 double scotches, 8 beers and an uncomfortable night's sleep on his couch hearing him snore like Fred Flintstone -- we drank comparably. And yes, today I'm paying the price with yet another Sunday hangover. BUT, I'm on the board participating today and not lying prostrate on the couch, so that's improvement for me from pre-TSM.

Nick,

I quoted almost verbatium a statement made by Dr. Sinclair in "The Cure for Alcoholism." Look at the first footnote on page 107 of this book. Further, the question of binge drinking in nearly the same context as we are talking about it here was put to Dr. Eskapa on this board some time ago and he responded similar to Dr. Sinclairs statement. Do a search for details.

Yes, TSM tells us to drink as we normally would. However, drinking large amounts in one session (even if this is ones normal drinking pattern) doesn't gain you anymore than drinking moderate amounts in the same session.

As a previous binge drinker myself, I know that it is extremely difficult to stop drinking once you really get going. I rarely was able to moderate my drinking until very late in my treatment.

What I'm trying to say is that if you can moderate yourself some, it will make life much better and you'll still be getting the full benefits of extinction.

Q

Upon further review Q, I think you are right. That has to be my next step in TSM: using a little purposeful moderation to avoid hangovers. I didn't last night and I'm regretting it -- still am mildly hungover. Well, I'll have another chance next Saturday -- there is a big welcome home party for my buddy I boozed with last night and it will be a huge drinking affair. I'm going to go into that one with a new game plan of making Sunday hangover-free priority #1.

Q, I like this post and gives me a bit of hope with what you have said about binging before your cure. I need to try to moderate a bit as Nick also has stated here.

Week 5 update.

95 units ... mmm.
Not really a change considering I had mild nausea one night and only consumed 10 units.
If not for that, I would still be at Pre-TSM units.
I'm a bit depressed about the lack of progress and have been having panic attacks this week.
Last night I tried to exercise some control (i.e. I set a limit) but as usual my resolve dissolved in a sea of Red Wine and I consumed 16 units. To top it off, I broke my favorite wine glass that was exactly 2 units. Now I have to rummage around to find a replacement. Bugger.
I'm actually pretty scared right now. What if TSM doesn't work for me? Sooner or later the booze will catch up to me and then what?

Hi there
All i can say as others would is given your pre TSM level of drinking you are very early in this process; use the support here to see people's different patterns and try not to think too far ahead and become despairing. I know its hard but as someone else already said- you didnt get to be a drinker overnight and you wont extinuish this over night.
Hang in there!

I say "ditto" Tuttle. You shouldn't even be thinking about seeing any meaningful difference in your drinking pattern for several months. Three to four if you drink 35 per week and a whole lot more if you drink more than that. There is NO REASON to think this won't work for you! It works for at least 80 to 90% who use it right! It will work, just follow the formula and stick around here for support. We are rooting for you!

Just to clarify: I'm talking about those spikes that occur over several days, or weeks, with a binge drinker. Not only is that more time of drinking on nal, but it is, I believe, a sign that changes are taking place in the brain. Of course this does not mean a person should think, "Hey, I'm already loaded but I should have 10 more so I can really make some progress." Now that would be just plain silly =)

Week 6.
OK ... so my units are no better this week, but emotionally I am feeling much better.
No panic attacks and I have much more acceptance that TSM will take MONTHS to show significant results.
Some nights (I'm a nightly drinker) I have a slight feeling that I dont like or want to drink but I still consume my usual amount.
I hope this feeling will intensify and my units will start decreasing.
I would also like to say thanks for the words of encouragement that I have received.
They have helped