Very interesting points guys. It does make sense to me to start drinking as soon after the craving as possible, but I don't think I'll worry about it too much as long as I am always taking Nal one hour before drinking.

Marvellous Q - I dream of being in that same state myself one day.

Well, my mini-honeymoon didn't last long! Lol, the side effects weren't as bad last night, though still nauseous today. But I plowed through 13 UK units as quick as I ever did, and when it was all gone I wanted more, more, more - just like the old days. Gonna try to stick to 10 tonight, 12 absolute max, as that seems to be the point at which the beer-devouring monster in me loses all control.

My last dose at 25mg today, assuming the daily reduction in side-effects continues.

This appears to be a textbook case of the honeymoon followed by the "extinction burst", recently identified by Hapful. There is typically an immediate loss of interest in alcohol when starting TSM, primarily because while your body adapts to naltrexone, you feel nauseous, spacey, and downright uncomfortable drinking on the nal. This is brief and only lasts as long as it takes for your body to adapt to the naltrexone. Then there is a resumption of drinking, often to pre-TSM levels or even HIGHER. This is explained under conditioning theory as the "extinction burst" and has occurred with lab animals. If you give a bird a food pellet each time he presses a lever, when you stop giving the food pellet, the bird, desperate for the positive reinforcement it is used to getting from pushing the lever, pushes the lever more and more, waiting for the positive reinforcement that does not arrive. That is probably what's going on after the "honeymoon": the endorphins are blocked when we are drinking on the nal so we instinctively reach for the bottle, more and more, in order to get that old endorphin rush we are so fond of, hence the sharp rise in our drinking after the honeymoon. Eventually (after several months), when we realize (subconsciously) that no matter what situation we are presented with (i.e., no matter what the trigger) that the endorphin rush is not coming, we lose interest in alcohol and are cured.

The beautiful thing is that the honeymoon followed by an increase in drinking is absolute proof that TSM is working for you! Great news!

Thank you so much for that Nick, an extremely clear explanation.

I must say I am feeling so positive about the way things have gone in such a short rate of time, even though I know it is a very long road ahead. I've taken all the extreme side effects as a good sign that Nal is working on me, but it's lovely to hear it from someone who knows so much more than me.

It sounds a bit like quicksand (I think, or is it a type of mud??) where the alcoholic urge is struggling to escape, but the harder it struggles, the faster and deeper it sinks..?

Kind of, sort of. But it's more complex than that because progress under TSM is a roller coaster ride and not just a downward plunge. There will be periods where things are great, rotten, great, rotten with not much rhyme or reason to them. The bottom line: naltrexone + drinking = cure and it works with or without our knowing it, whether we want it to or not.

Hi 8,

Just wanted to let you know incase your concerned about the side affects, that my initial side affects yesterday were basically non existant I actually forgot to start drinking.

My lingering side affects seem to be tired in the mornings after drinking...my energy level seems to shoot up after I get myself going for the day and in a surprisingly good mood. Just an FYI.

hapful

Thanks hapful, all the feedback from you guys is giving me so much food for thought and encouragement right now. To be honest, the hangover was pretty rough today, and feeling 'spacey' and not quite myself for the third day in a row, I was having doubts about continuing - or rather being able to continue - but I forced myself to take the Nal tonight and then tuck into the lagers hehe.

Well, on my sixth beer tonight now (each one 2 UK units). Two or three beers ago I was counting how many I had left, in my old 'glass half empty = glass is already smashed to pieces on the floor, the end of the world is nigh' thinking. Now, part of me is still loving necking the lager, as if it's going to take me off to happy oblivion. But a surprisingly large part of me doesn't even want to finish this one, and there's certainly zero chance I'll be raiding the stash for the last two cans I had in reserve.

Perhaps (I'd go so far as to say 'almost certainly') the honeymoon persists, but on a less obvious level.

Either way, I feel I'm on the right path, bring on the future!

So, 12 units last night, and I'm aiming for a similar total tonight as anything more in one evening and I'm cheese on toast the next day.

My first full 50mg tablet tonight and it's hit me as hard as my first half-tablet did. Very VERY heady, with a slightly unpleasant edge or atmosphere to things. Very odd.

Anyway, I have absolute faith that it's just another brief little spot of side-effects to get through. A necessary, and completely acceptable part of the whole package.

12 UK units again last night.

I felt absolutely exhausted last night, but woke up at a very early (for me) seven am this morning, still exhausted. I tried to stay up but had to go back to bed at ten and dozed lightly until 1 pm.

Been feeling really spacey all day, am shattered even though I haven't done anything much. I'm pretty nauseous, with retching this morning, which I've had before just from the drink. If it continues beyond the other side effects I'll start taking Zantac, and/or may switch to wine from gassy lager.

I really don't like this heady feeling, and am in two minds whether to go back to 25mg tonight for one night. I have a sense of dread again about taking a full 50mg.

I'm also wondering why we take 50mg when 25mg covers us for 12 hours? My drinking sessions are only five or six hours long.

Hi 8,

seems like you are going through what I went through during my first few sessions. I asked the same exact question too!

I started with .25 for my first session. Next day I felt just like you, only I didnt retch. The next session I jumped right on into .5 because I just wanted to get through any side affects as fast as possible. I felt exactly as you do, only no retching. But it took me all day to get out of the spacey feeling, where I could concentrate on anything I read and I felt very tired all day. Even though, I didnt drink close to as much as I normally do.

Anyway, the next day side affects for me, still persist, only not as bad, and it seems that each time it gets a little better.

Also, someone replied to my question, and I apologize I cant remember right now who it was, they said that the .5 covers us BETTER than .25 and .5 is what TSM calls for. So we must follow the method to a T.

I know we have different drinking patterns, but so far your side affects and concerns are mimicing mine, so I thought I would just FYI you about me.

Keep on keeping on!

Thanks so much my friend, I am not that far behind you so it's invaluable to have your thoughts and advice I read here as much as I can too and gain so much from what others have already been through, but I've just been so far spaced out since I started on my cure it's hard to keep up most of the time...

I know I've read on here about why we should take 50mg, I just can't find it when it really strikes me as important, typical! I serached the book too, but no joy.

Oh well, I swallowed the whole 50mg without thinking about it too much, and so glad I did just get on with it. It's great to hear that it gets better, and I knew really that that's the case, it's just been hard.