Joined: Fri Feb 06, 2009 5:39 pm
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I am in the US - New York right now - and TRYING to get coverage for the treatment. One great thing was meeting a reader aged 22..... she had been drinking "to black-out" .... lost friends and romantic relationships because her craving and drive for alcohol overpowered her life. She tried to hide the problem. She attended traditional treatments, AA, addiction specialists ... nothing helped. Until she found the Sinclair Method. She managed to get a prescription for naltrexone but did not exactly tell her doctors how she would use it.... Her life is entirely changed after four months. Craving is way down. I had dinner with her twice. The first time she ordered 2 glasses of wine and drank 1.5 glasses (small ones). A week later we met again for dinner and she had no urge to drink at all. She credits Naltrexone + Drinking (extinction) for saving her life. Literally. Her account of how nothing helped her until she started the treatment is moving. Makes all my work and Sinclair's so meaningful. I would like to express my appreciation to N101CS and all those who have joined this forum to help get the word out that we can help at least 80 percent of those in need. We have a long way to go. Less than 1 to 2 percent of those in need (in the US and most places outside Finland) have ever had access to naltrexone and those who have, have had intructions to take it with abstinence --- over 35 clinical trials prove naltrexone is worthless (even worse than placebo) when taken with instructions to abstain. Seventy plus clinical trials confirm that naltrexone is beneficial only according to pharmacological extinction - that is it only produces results when naltrexone (or nalmefene) blocks reinforcement (reward) to the opioid system (receptors and pathways wiring the addiction) in the brain coming from endorphins released each time we drink alcohol. The system remains intact for life and used to be incurable, irreversible, embedded for life - until now. This is practice for a telephone radio show tomorrow at 7-30 am. I will keep you all posted with links. There was one on WOR New York at 2 am recently and I had to compete with two others for some airtime. My person fear of public speaking - a common social phobia - is far less important than getting the message out there that there is an alternative to the "D Method" described by Sinclair in the Foreword to The Cure for Alcoholism which I post below. If any of you have any feedback for me from interviews that you may hear please let me know. Many thanks, Roy Eskapa, PhD http://www.TheCureForAlcoholism.comForeword by Dr David Sinclair: Dr. Eskapa has faced many obstacles in writing this book, though
few of them involving broken motorbikes, and his tenacity, energy,
and dedication (not only with the book, but also in promoting its
new and effective treatment for alcoholism) are the reason you’re
holding The Cure for Alcoholism: Drink Your Way Sober Without
Willpower, Abstinence, or Discomfort in your hands today.
Foreword xvii
I have been most fortunate in that I’ve been involved in the
development of this new treatment method since the beginning.
It is very rare that a scientist gets to see his work go all the way
from theory to laboratory experimentation to clinical trial, and
then on to a safe and approved application. But there is one more
step I hope to see, and it is this step that I hope this book will
help accomplish. If this method for treating alcoholism is going to
fulfill its potential, doctors and patients must know about it and
understand it.
The Cure for Alcoholism should also reduce the problem that
currently only a small fraction of those people who need help ever
seek treatment. This is understandable with the traditional treatment
method, which I call the “D Method.” Consider the steps
involved in most current treatments and imagine if you would
want to sign up:
Detect. Before you are allowed to start treatment, you have to
admit that you are an alcoholic, with all the stigma that unfortunately
(and incorrectly) is associated with that label.
Delay. Once you have finally agreed to say, “I am an alcoholic,”
and developed enough courage and motivation to go into treatment,
you may be told that the earliest opening in the program
is three months or more away. This is more of a problem in some
countries than in others, but where it does exist, it takes the heart
out of seeking help.
Detox. You start with the horrible experience of alcohol withdrawal.
If no medications are used, detoxification is painful and
disturbing; it may even be fatal. It also destroys brain cells. If medications
are used, they’re usually addictive drugs: benzodiazepines
such as diazepam (Valium) or chlordiazepoxide (Librium) or
barbiturates such as phenobarbital (Luminal) and pentobarbital
(Nembutal); these drugs will help you through the alcohol withdrawal,
but you may end up—as many do—with two addictions
rather than one.
Detain. Next you are put away for weeks in a place—rehab—
where it is supposed to be impossible to drink. You have to put
your life on hold to do so, forcing you to choose whether to lie to
friends and coworkers or else tell them you’re an alcoholic and
xviii The Cure for Alcoholism
risk their reactions. If you’re lucky, your job will be waiting for
you when you return. But only if you’re lucky.
Don’t Drink. All this time, the main thing you want to do is to
drink. Nothing has weakened the craving and now, after weeks of
alcohol deprivation, it is even greater. Yet, the main thing everyone
tells you is, “Don’t Drink!”
Denigrate. Some treatment facilities will attempt to break your
spirit and resistance, for example, by insulting you, waking you
up at odd hours, making you perform demeaning jobs, and forcing
you to confess all your past sins in public.
Disulfiram. You are in treatment because you cannot resist
drinking. Now, without doing anything to improve your ability to
resist drinking or to reduce your craving, the facility’s doctors may
put you on a prescription of disulfiram (Antabuse®), where if you
do what every fiber of your body insists you must do—drink alcohol—
you will suffer agonizing torture and may even die. You must
face this ordeal every day for the rest of your life. The disulfiram
will do nothing to abate your craving, and if you ever stop taking
the disulfiram, your craving will probably be greater than it was
before you started taking it.*
Dollars. The treatment, especially because of the inpatient detoxification
and detention steps, is very expensive. You have to be
able to afford this even though, during your detention, you won’t
be collecting your regular paycheck and may even lose your job.
And finally: Do it all over again. The odds are very high that
within a year or two you will be back where you started, deciding
whether to go through the treatment again, and then again. . . .
The new method detailed by The Cure for Alcoholism changes
all of the D steps. There’s no Detection. Our method is for anyone
who wants to control their drinking. No Delay. The treatment is
* Soon after I first wrote this, an old friend, Pat, asked me about Antabuse capsules because the
alcoholic husband of a friend of hers had been given one. I told her that I thought its use was
similar to the treatment of the Abu Ghraib prisoner told he must keep his arms raised or else
suffer agonizing torture and even die. I met Pat again recently and she said, “You remember the
alcoholic who was given the Antabuse capsule and told that if he drank, he would die? Well, I
just heard that he drank, and he died.” She went on to explain that he had abstained for about
a month, but eventually could take it no longer and started sipping alcohol. Personal problems
arose. Finally, he bought and drank a large amount of alcohol. And died. I suspect his action
was similar to that of a prisoner who finally chooses death over further torture.
Foreword xix
completely outpatient and can start immediately. No Detox. You
drink as you normally do, but because of this method, your craving
slowly decreases, so your drinking also decreases gradually
and safely. No Detention. No Disulfiram. No addictive or dangerous
drugs. No Denigration. Your dignity is emphasized. Costs are
reduced. And there is no revolving Door: the method works the
first time around and instead of relapsing, patients get progressively
better the longer they have been undergoing treatment.
We should not blame doctors and clinicians for this D Method.
Until now, it was the best they had to offer.
Let me give an example. I had just given a lecture to the staff
of a hospital in Massachusetts explaining pharmacological extinction,
the key concept in this new method, and how to use
it to help their patients. The head physician, Dr. Michael Pearlman,
liked our results and was excited about using the extinction
method. On the way out, he introduced me to one of the patients,
Kathy, and told her I had developed a new medicine for treating
alcoholism.
Kathy looked at me suspiciously. “Is that one of those medicines
where you can’t drink anything?”
I replied that ours was almost the opposite. You had to drink for
our medicine to work. She thought that was an interesting idea.
I described how drinking was learned. She agreed: she’d been
there and done that.
Then I explained how learned behaviors could be removed by
extinction. She had heard about Pavlov and how he used extinction
with his dogs to eliminate their conditioned responses.
The new treatment made sense to her. “I think I might like to
try that . . . but I don’t want my usual doctor here giving it to me.
He steps on me for my being a mother and all.”
I assured her that degrading patients was not part of the procedure.
“Indeed, one of the rules I insist upon is that patients must
be treated with dignity.”
She looked up at me with a surprised glow. The idea of being
treated with dignity had not occurred to her in a long time.
More important, however, was what Dr. Pearlman told her: “You
xx The Cure for Alcoholism
see, Kathy, before we did not have naltrexone and extinction. So
we used any hammer we had to try to make you stop drinking,
including telling you that you are a bad mother if you drink. But
now we have a better way.”
The goal of this book, at least initially, was to inform folks in
America about this new method. Developed countries, like the
United States and Finland, would certainly benefit from it. For
most patients, it does—as the book’s title says—provide the cure
for alcoholism. It is safer, cheaper, more humane, and more effective
than other treatments.
Where the method has the greatest potential benefit, however,
is in developing countries.
The situation is similar to that with mobile phones. They provide
benefits in countries like America and Finland where there is
already an existing infrastructure of landlines, although to some
extent landlines are in competition with mobile phones and can
hinder their development. Mobile phones really shine, however,
in places where there is no infrastructure, as in much of Africa.
Mobile phones in these places provide the capacity for “leapfrog
technology,” connecting people to one another and to the world
without first having to spend a fortune stringing cables across the
land. They allow developing countries to skip that intermediary
step entirely.
The same is true for our treatment. It does not require prior detoxification
or detention. The first clinical trial in the world treating
alcoholics without prior detoxification was the one we conducted
here in Finland: patients who were drinking yesterday are simply
told to take naltrexone or nalmefene before drinking today.
I once gave a presentation at an alcoholism treatment hospital
in Virginia. The staff understood how pharmacological extinction
worked and accepted the results I showed them, but mentioned
one problem: “What are we supposed to do for a living?” The
hospital received a certain amount of money for each alcoholic it
detoxified. Where would the money come from with a treatment
that skipped inpatient detoxification?
This may have been an obstacle to the spread of the treatment
Foreword xxi
in America and other developed countries, but it is a major advantage
in developing countries. They have not invested millions
building facilities for detoxifying and detaining alcoholics. They
do not have large numbers of people already trained to work in
such facilities. Our method, therefore, could provide developing
countries with another form of “leapfrog technology,” allowing
them to help their people with alcohol problems without first having
to spend a fortune building a treatment infrastructure.
Using the new method where traditional treatments have not
been established sounds good on paper, but would it work in
practice? Dr. Eskapa has shown it probably will. He introduced
the treatment to the clinicians working with CORD in northern
India. CORD’s national director, Dr. Kshama Metre, recently sent
me the results from their first twenty-eight patients. They had a 75
percent success rate. This is virtually the same as the success rate
we found in our clinics in Finland and close to the rate reported
by clinics using the method in Florida. Of course, the sample from
India is still small, but there is no reason to suspect the method
will work differently in different countries. Unlike many alcoholism
treatments, extinction with naltrexone or nalmefene should
be relatively independent of cultural factors.
Recently, I was describing the science behind the new method to
a young visiting scientist in our lab in Helsinki. It was gratifying
to find that he accepted without hesitation each of the major discoveries
and conclusions leading to pharmacological extinction,
but I was not really surprised. Today, these points are generally accepted
by most of the leaders in the field. After my talks, I am often
told that the top clinicians in alcoholism treatment knew all of
this all along. The consensus for decades has been that alcoholism
is a learned behavioral disorder and that the endorphin or opioid
system at least played a role in the reinforcement of drinking. Extinction
has been known for over a century to be the mechanism
for removing learned behaviors. The obvious conclusion to anyone
putting these points together is that naltrexone and nalmefene
could be used to extinguish alcohol drinking. I am not sure why
others, with the notable exception of Abram Wikler in the field of
xxii The Cure for Alcoholism
heroin addiction, did not previously speak out more about the use
of extinction in de-addiction treatment, but it is more important
that most of the alcoholism experts agree with the conclusions
today. Such approval within the field may mean that the time has
come for this method’s general acceptance among doctors and
patients. The Cure for Alcoholism may well play a critical role in
establishing this acceptance. And hopefully, with this acceptance
will come a more enlightened era—of truly curing addictions.
David Sinclair, PhD
National Public Health Institute
Helsinki, Finland
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