Strictly Sinclair Week 2

[Guest]

Strictly Sinclair Week 2

Hi Springer, here's the post:


DrRoyEskapa
Post subject: Re: 24/7 drinkerPosted: Thu Mar 26, 2009 4:02 pm


Joined: Fri Feb 06, 2009 5:39 pm
Posts: 68
The dose for naltrexone most commonly used in the clinical trials is 50 mg.

The maximum dose is 300 mg / 24 hours.

It is possible that 25 mg is enough to block the opioid receptors ... but I would err on the side of caution. If you are drinking throughout the day take 50 mg an hour (or as soon as possible) before you start at 9 am. If you are still drinking at 9 pm take another dose of 50 mg. It is possible that there are variations in metabolic clearance and individual differences among opioid systems. If you start at 9 am it is possible that by 9 pm - if you are still drinking - that the naltrexone may have washed out of your system to some extent therfore you might not be covered by opioid antagomism (blockade).

[SpringerRider]

Strictly Sinclair Week 2

I have read it and that and do not see a reference to 75 MG. I have been in direct contact with Roy and he is hesitant to go beyond 50mg. Way back someone asked what about the dosage protocol they should follow if they were to drink, say pass out and awaken several hours later. I had answered with a "rule of thumb" that if you take Nal on a particular day and drink than nap (or pass out) and reawaken (or come to) and decide to imbibe again, you should look at your watch. If it still is on the same calendar day, do not take Nal, if the day has advanced, take another 50mg. There was nothing scientific about my recommendation. It was simply to put the patient on a simple to follow protocol until they reached a more manageable level of drinking. In that particular case, Roy said that my recommend sounded good to him.

[Guest]

Strictly Sinclair Week 2

oceanaocean;760318 wrote: Hi Springer, here's the post:


DrRoyEskapa
Post subject: Re: 24/7 drinkerPosted: Thu Mar 26, 2009 4:02 pm


Joined: Fri Feb 06, 2009 5:39 pm
Posts: 68
The dose for naltrexone most commonly used in the clinical trials is 50 mg.

The maximum dose is 300 mg / 24 hours.

If you are drinking throughout the day take 50 mg an hour (or as soon as possible) before you start at 9 am. If you are still drinking at 9 pm take another dose of 50 mg.

SP What are you see here? This says take 50 mgs 9 am and then take another 50 mgs 9 pm. reading: QUOTE from Dr Eskapa

[thebigheads]

Strictly Sinclair Week 2

Hi everyone. As always, thanks for all the good info.
I have never seen anyone address the downside to all of this. I'm 3 months into TSM (initially just talking 150 mg Nal + Campral, but 2 wks later drinking again) I'm finding myself drinking less compulsively and the "obsession" has decreased tremendously. But I am still drinking daily. My marriage is falling apart, because I have nowhere to put all this "stuff" that drinking used to keep at bay. I'm sad, angry, and feel very alone. My husband, while a proponent of all this and well read on the subject, is having a hard time dealing with me when I'm "getting all emotional". We both knew this was gonna be tough, but it's just getting to be too much.
Nal is so effective in blocking the pleasure (if you can call it that) of drinking that I often forget how much i've had. I feel NOTHING when I drink. I'm completely compliant. I never don't take the Nal because I am desperate to get my life back. I am a 37 yo mom of 2 amazing girls, ages 3 and 5. Adore my husband, but we're getting closer to splitting up every day. Gotta get through this. I am really scared that i've put my faith in this and I'll fail. I've failed at sobriety too many times. Despite the compliance with Nal, I feel sick if I don't drink. The last few days I've been wretching and gagging for hours at a time. My kids are scared so I cave and drink.
I guess I just need some encouragement. My body cant take this much more. I'm so fatigued, don't sleep, and have almost constant chest pain which I imagine is mostly exhaustion. I put 100% of my energy into taking care of my kids, but am cracking. Help!

[SpringerRider]

Strictly Sinclair Week 2

oceanaocean;760409 wrote: [/COLOR]
SP What are you see here? This says take 50 mgs 9 am and then take another 50 mgs 9 pm. reading: QUOTE from Dr Eskapa

Let us not bicker but 50 mg 12 hours apart is quite different than 75mg at one time. The original question was whether 75 mg would be a benefit.

regardless - let it go.

[SpringerRider]

Strictly Sinclair Week 2

thebigheads;760852 wrote: Hi everyone. As always, thanks for all the good info.
I have never seen anyone address the downside to all of this. I'm 3 months into TSM (initially just talking 150 mg Nal + Campral, but 2 wks later drinking again) I'm finding myself drinking less compulsively and the "obsession" has decreased tremendously. But I am still drinking daily. My marriage is falling apart, because I have nowhere to put all this "stuff" that drinking used to keep at bay.
Nal is so effective in blocking the pleasure (if you can call it that) of drinking that I often forget how much i've had. I feel NOTHING when I drink. I'm completely compliant.

How much Naltrexone are you taking now and when do you take it?

[thebigheads]

Strictly Sinclair Week 2

50 now. I'm usually an all day drinker, slow and steady the last yr, but 2 bottles of wine a day at least. I take it in the am lately, cause I'm not very good at "planning" my drinking. I did have a good patch a few wks ago where I either didn't want to drink in the am, or knew could hold off for awhile and took it at around 12-1 pm.
I've never had any adverse effects on Nal, even on 150 a day. (I did, however, have an extremely bad reaction to the Vivitrol injection, but that's another story.) I am drinking a bit differently now. When I was hiding it, it was all day as in a sip here and there all day (obviously feeding a psychological and physical need.) Now that it's out in the open, I feel embarassed drinking early in front of my husband, so I try to push it as late as I can.
I am scared as hell. I don't know what has happened to me these last few days. My consumption hasn't changed, but god do I feel sick, and so weary. If I talk to husb about it he tries to be supportive, but inevitably we fight which makes me tremendously self destructive and depressed. I KNOW this will work. I've seen the "light at the end of the tunnel" just by the change in craving. But how to cope in the mean time?

[SpringerRider]

Strictly Sinclair Week 2

thebigheads;760919 wrote:
I am scared as hell. I don't know what has happened to me these last few days. My consumption hasn't changed, but god do I feel sick, and so weary. If I talk to husb about it he tries to be supportive, but inevitably we fight which makes me tremendously self destructive and depressed. I KNOW this will work. I've seen the "light at the end of the tunnel" just by the change in craving. But how to cope in the mean time?

All I can ask is that you stay the course. There is a misnomer where members think they are to succumb to the slightest desire to drink. Eskapa says it is perfectly fine to try to control your drinking. That does not mean crawling up the walls. But if you can delay a hour, that is fine. And a week later, try another hour.

Whatever you do, take your Nal 1 hr before you drink. If you can't wait, than 30 minutes. If you forget, take it as soon as you can.

[thebigheads]

Strictly Sinclair Week 2

Thanks. I do need to try to control it more than I do. At the very least I'm gonna make more of an effort to wait that whole hour. If I can do that consistently, I'll be better off. As it is now I usually take it and drink almost immediately.

[Guest]

Strictly Sinclair Week 2

thebigheads;762557 wrote: Thanks. I do need to try to control it more than I do. At the very least I'm gonna make more of an effort to wait that whole hour. If I can do that consistently, I'll be better off. As it is now I usually take it and drink almost immediately.

In all of this I get confused still, if a pill of 50 mg is to last 24 hours, and you take it at five pm you should be "good to go" till 5 pm next day. So if you start drinking at 4:00 and then take your pill, hypothetically you should be covered. I understand what you mean though, I do the same thing sometimes, and yes, Dr. Eskapa has said in a thread, if you forget, take it when you remember.
I think some control is very important, it gives us more self pride which then feeds our will power BUT lack of it is one of our MAJOR difficulties.
Best to you ART

[thebigheads]

Strictly Sinclair Week 2

My dilemma exactly ocean. If I could control it, then I would not need any of this. I obviously aim for that golden hour.....if only. But I never drink without. Even if it means washing it down with the first drink of the day.
While in treatment I was on 150 mg daily Nal. What I know about nal tells me there is no way 50mg a day is right for everyone. I'm gonna start doing a second dose cause I am an all day drinker. If this downward spiral continues, I'll be divorced single mom in a month. 3 months into tsm and I am incredibly depressed. I'm literally on the verge of losing everything I care about. I see big changes, but time is not on my side. Wish it was.

[SpringerRider]

Strictly Sinclair Week 2

I will try an make this clear as I can and then I am going to drop out of the conversation since I feel that I am being baited. I am not here to fight. Just to offer help where appreciated.

The Sinclair Method works best for a certain class of alcoholic. This is the binge and episodic drinker. The reason is that their triggers to drink are very distinct. The entire premise is targeted extinction. Members whose patterns were to drink around the clock are not the best candidates for the protocol.

If someone has patterned the addiction to alcohol in such a way that it is not conducive to The Sinclair Method, it is not the fault of Sinclair or Naltrexone. It is just what is. Those people are free to try Sinclair, and so be it. But if it is not working for them, it does not diminish the Sinclair Method in the least and they should look to other modalities.

There is a degree of a crap shoot in all of this. Accept it and move on if it is not working for you. But don't throw slime on something that has saved the lives for so many others.

[Lenore]

Strictly Sinclair Week 2

If a higher dose worked while in treatment I'd think about upping the dose too, thebigheads. Discuss it with your doctor first, of course. I did the same thing and upped to 75mg for awhile, and for me it was very helpful. I'm back down to 50mg (sometimes just 25mg) and now that amount works well for me. Good luck...don't give up.
Did you take 150mg once daily while in treatment, or split up?

[Lo0p]

Strictly Sinclair Week 2

SpringerRider;764474 wrote: I will try an make this clear as I can and then I am going to drop out of the conversation since I feel that I am being baited. I am not here to fight. Just to offer help where appreciated.

The Sinclair Method works best for a certain class of alcoholic. This is the binge and episodic drinker. The reason is that their triggers to drink are very distinct. The entire premise is targeted extinction. Members whose patterns were to drink around the clock are not the best candidates for the protocol.

If someone has patterned the addiction to alcohol in such a way that it is not conducive to The Sinclair Method, it is not the fault of Sinclair or Naltrexone. It is just what is. Those people are free to try Sinclair, and so be it. But if it is not working for them, it does not diminish the Sinclair Method in the least and they should look to other modalities.

There is a degree of a crap shoot in all of this. Accept it and move on if it is not working for you. But don't throw slime on something that has saved the lives for so many others.

SR, I have no idea where you got this idea but everything I have ever read seems to point to the contrary.

Here is Lena quoting and paraphrasing Drs. Eskapa and Sinclair. This sums it up quite nicely and is in complete contradiction to what you said above:

"Eskapa emphasized Sinclair's findings that the number of drinking sessions is more important to the cure than the volume of alcohol consumed per session. "De-addiction happens slowly but surely with the research showing that the more often you drink on naltrexone, the more you weaken your addiction." (p. 107; emphasis his). "Sinclair insists: 'We want to be clear that we are not encouraging patients to drink very large quantities at one time. Large volumes of alcohol do not help (do not hasten the de-addiction process) and can be dangerous. But drinking frequently while on naltrexone is beneficial since each time drinking is an extinction session.'" (p. 107 fn* [Eskapa's parentheses]).

That explains why our binge drinkers tend to take a bit longer to see results."

I think you are very wrong about this. Please support your statements.

[SpringerRider]

Strictly Sinclair Week 2

That explains why our binge drinkers tend to take a bit longer to see results."

Where is this quote?
Where is the contradiction?

What are you talking about?

All I am saying is that there is a degree of a crap shoot in every treatment.