Virgil, this is perfect, all fixed!!!

Hi Folks,

I've just completed week 21 on TSM. Once again, it's not been a particularly good week in terms of number of units consumed. I know we keep quoting Dr Eskapa as saying that TSM takes 3 - 4 months minimum and I can live with that; it's (sort of) consistent with Figure 3 in The Cure for Alcoholism. But here is where I have a problem. When I first started out on TSM having just read Dr Eskapa's book, I was expecting my alcohol intake to reduce roughly in accordance with Figure 3.

Figure 3 shows a steady reduction in alcohol intake right from the outset and this reduction continues as time progresses finally settling at around the 300 days mark (10 months). Now, some of this community's members have displayed a similar pattern. I suspect that Figure 3 applies to light to moderate drinkers. However, for heavy drinkers (like myself) with many years of drinking, the reduction in alcohol consumption shown in Figure 3 does not appear to be applicable. For this reason, it would also be interesting to know the average age of the participants in this clinical trial (I'll ask Dr Eskapa the question). BTW, I use the terms 'light', 'moderate' and 'heavy' purely to convey the general idea of what I'm trying to say without the need to define each regarding quantity of units consumed. One other thing - I realize that Figure 3 is based on the average of 115 successful patients.

So, in short, I am disappointed with my progress. Just recently, there have been a few glimmers of hope and I will keep going as I have no viable alternatives.

V.

Hey V --

I think you hit on the biggest flaw with the TSM studies to date -- unless I missed it, there is no reference to HOW LONG the subjects were drinking alcohol as of the time they started TSM. The other major flaw is that 35 drinks per week is NOTHING compared to what many of us consume. Both of these factors -- the amount consumed on average and the length of time of heavy drinking -- would seem to be -- in fact, I will say ARE -- CRITICAL variables in how long it will take TSM to work.

Think about Pavlov's dog, with the pairing of the bell and the salivation response. The dog may have started salivating to the bell only after say, ten pairings. When you then remove the food and ring the bell, the dog will stop salivating in short order (extinction). But if you paired the bell with the food, say, 1,000 times, TRUST ME, it will take the dog FAR LONGER to stop salivating when he hears the bell only than if the bell was only rung ten times. This is a fact under conditioning theory -- there are varying degrees to the strength of the conditioned response. And the same principle is directly at play here with us as far as length of time we've been drinking: the longer we've been drinking, the higher degree of our conditioned response and consequently, the longer it will take for extinction to occur.

So it looks like we on this board are going to have to set the new standard for how long extinction takes to occur when we have been boozing for 25+ years and have been consuming two or three times the 35 per week that the subjects in the studies consumed.

I'm glad you are at least seeing a "glimmer" -- I really want to see something positive happen for you soon -- you deserve it!

Nick

Thanks, Nick.

V.

Hi Folks,

I've just completed Week 22 on TSM and I'm running out of steam. So much so that I can't be bothered with recording my alcohol intake at the moment. I've never felt like this before. I fear that I'm going to be the first to announce that TSM has not worked for me. Although I've been successful academically, I have failed on numerous personal matters. And it looks as though I'll soon be able to add TSM to that list.

Who knows - perhaps things will get better. I certainly hope so.

V.

Hi Virgil,

I can understand your frustration after being so patient after all this time, and am still amazed at your positive attitude through it all. I've looked back through your progress thread, and I see you had some minor side effects when first taking the Nal, so it seems that you had some sort of response to it. But I wonder if it just hasn't been strong enough. Have you considered increasing your dose, and would your doctor be open to this? Dr. Eskapa mentioned that some might need more than 50mg, and pointed to the example that treating compulsive gambling required a much higher dosage (can't remember how much). If I remember correctly, I believe G4M started to see more pronounced results after increasing her dose to 75mg. I've often wondered if things would have happended more quickly for me at a higher dose, but my psych wouldn't prescribe more than 50mg. He still thinks I'm abstinent, said that 50mg is the standard effective dose, and I can't afford to buy more Nal on my own.

I finally found the link to an article I saw earlier that explains people metabolize Nal differently. Given my psych's dismissive attitude about uping the dose, I didn't pursue it any further, even though I mentioned it to him. I don't know how valid/accurate the article is, but it might be worth a shot. Here is the link:

http://www.scienceblog.com/community/older/2000/A/200000159.html

Hi Kris,

Many thanks for your reply, which I value highly. Also, thanks for the link; I haven't seen that article before.

Regarding a higher dose of naltrexone, I seem to recall that my doctor suggested it a couple of months ago. I didn't follow it up at the time as I put my (lack of) progress down to the fact that I take a benzo. However, in view of your attached article, I'll re-visit this topic with my doctor.

Thanks again.

V.

Virgil -- Please also try to remember that at Week 16, you are not yet at four months. It may take longer. Please stay with us, because you are a valued member of this community.

Hi Lena,

Many thanks for the feedback and the kind words. I'm not sure why you thought I was at Week 16 - I'm at Week 23.

All the best.

V.

Hi Virgil - I would hate for you to give up after being patient for so long. Perhaps up the dose as Kris suggested.

I was ironically thinking about you last night - (hopefully that's not too creepy, I was thinking about several members here - I was just thinking about whose success stories I would love to read and how much patience you in particular have and how, even though you are still drinking at high levels, you never express any anger or much (if any) frustration on this board. One of the few well-spoken, even-tempered individuals here .)

I sent a silent prayer that this would work for you soon. We all deserve this cure and while I can't comment on whatever failures you see in your personal life, on this board you are still viewed as a success for your incredible spirit and thoughtful responses.

I really, really believe that it just takes additional time for those whose addictions are more firmly rooted in their brains. If you do decide to stop or seek another treatment plan, I hope that you still stay with us. I would miss your posts. I'm hoping, like WTE said, that you stick with it (very good list of reasons, WTE). I can tell you from the other side that if I had had to do this for a year and ended up where I am now, it would still be worth it. It's totally unbelievable, Virgil - I just have zero zero zero connection with alcohol at this point. And I am very confident that the feeling is permanent.

I sincerely believe you (& WTE & LaBear & elf & Kris & houtx & Lena & everyone else) will be here eventually - it will just take more time for you because your addiction is more pronounced. But once you are here, it's done. Cured. For good.

Easy for me to say - but hang in there, give it a bit more time. And thanks for sticking with this for so long!