Smiley,

Welcome to the boards.

I really appreciated your story, as it clearly shows how ineffective abstinence is for some people. Dr. Eskapa explains in his book why cravings actually increases over time as a person uses abstinence to control drinking. It is a real vicious cycle.

As others have pointed out, the "Pros" can't ethically recommend TSM to a person who is abstinent. However, that doesn't mean we can't . Seriously, I'm of the opinion that if a person is using abstinence and it isn't working for them or they are unhappy with it, then by all means switch to TSM. The sooner you start, the sooner you will be cured. It is no different than any other medical treatment in this sense -- if a Dr. prescribes a treatment for an ailment and doesn't work, you go back and try something else.

I agree with Kris and Nick about drinking prior to starting TSM. It will not set you back at all. As Nick points out, the only thing that would set you back is drinking without Nal after you start. I would suggest that you try to moderate your drinking until the Nal arrives so that you don't feel like hell on a regular basis. This is basically what I did.

Once again welcome!

Q

Actually, the advice a wise M.D. would give you is no different than the advice Eskapa suggests they give patients who currently are drinking: If you are going to drink, always take naltrexone one hour before. p. 107. This resolves the perception that physicians are advising patients to drink. They are not. They simply are telling patients to take nal if they do drink (which of course they will).

Of abstinence, Eskapa says this: " . . . [S]tay with your current treatment if it is working for you."p. 88.

It hardly sounds like your current treatment is working for you at all, does it? So, if you are going to drink (and you are), take nal every time.

Best wishes as you begin the journey with us.

Thanks ever so much everyone for your support.

I was really feeling like a loser (partly because that seems to be the opinion in AA if you drink), until I started to read the book and then received your replies. Now I realise I'm fighting an impossible battle with my head. Wish those pills would hurry up and arrive! I feel so optimistic now.

Thanks everyone.

Good luck Smiley! You will do well!! There is a ton of support here and you will totally benefit from it!

Hi everyone,

My pills arrived this morning. I'm trying to have alcohol free days today through Thursday due to work commitments and I don't want to stink of booze! I plan to drink next on Friday and over the weekend, so will start the pills then. But if I can't keep to the AF days, I will make sure I take the pill and hour before I drink.

I read the book and feel really hopeful this will work for me.

Hi Smiley, really nice to meet you here

I started TSM just 11 days ago, so our progress will be interesting to compare. I also started shortly after resuming drinking following some months of abstinence. I think we're a little unusual in that respect, perhaps, among the members here.

So glad to hear you got your Nal! I was very sensitive to the side effects for the first few days, especially, but after a week they are still noticable but much less. It seems to affect everyone differently, and I am very sensitive to medicines, but in my case I wasn't really prepared for the SE and just glad I didn't have anything important on for the first few days.

I would definitely start on 25mg as suggested, and if you do decide to drink in the next few days you could always wait till the weekend to start the method proper if you get SE, I'm sure a couple of days extra drinking without Nal will hardly make a difference.

Anyway, best of luck to you as you start on this exciting journey!

That's great Smiley. And 8 is entirely correct! Almost all of us have SIGNIFICANT side effects when we start the nal. They go away almost immediately (within a week or so) but can initially be very unsettling. Severe nausea and feeling "spacey" is quite common, as is disrupted sleep. You should try 25 mg the first time in order to minimize side effects and take it on a full stomach. Only progress to 50 mg once you test out the severity of the side effects. When I first took 25 mg I came back to this board very ticked off that the book basically said most people have no side effects and if so, they are minor. That is not the general experience for us on this board -- most of us have them, they are severe initially, but they usually go away almost immediately (after three or four nal sessions). So, let us know what happens. Good luck! This is the start of something big for you.

Hello Smiley!

Just wanted to say welcome - glad you joined us! I hope you'll be one of the lucky ones who have no or minimal side effects, but no matter what, TSM is worth it. Let us know how you're doing. Everyone here is very supportive, so you'll never be alone. Best wishes!

Hi all,

Thanks for the advice regarding dosage to start off. I didn't have to work today, so last night I decided to try my first dose of Nal and drink. I took 25mg with some food and after about 20 mins started feeling really spacey. After the hour, I had a glass of wine, but felt really sick so I went to bed. Slept for an hour and then felt ok so carried on drinking. Drank less than I usually do, maybe because I felt so spacey on the Nal.

This morning woke up without the usual hangover which was great, but still feel a bit sick. Not too bad, so will persevere.

Thanks again for saying about the dose, I think 50mg would definately be too much at the moment!

Congratulations on beginning your journey Smiley! It may be a long road we are travelling on, and we will need patience for sure, but that doesn't make starting out any less exciting eh?!

I personally found the strong SE quite reassuring - they certainly showed me the power of Nal! I was also surprised though, that for something that affected me so much, they mostly disappeared very quickly. After a few days on 25mg I stepped up to 50, which again hit he hard, but as many people have said after a few more days of that I was fine again. Now two weeks in I still feel a bit spacey but nothing major. Drinking feels 'different' which again is a welcome sign for me.

Good luck and please keep us updated on your progress