Strictly Sinclair Week 2

[Anna B]

Strictly Sinclair Week 2

Hi WaitingtoExhale--

I totally agree with you about the fact that there are many instances of patients doing TSM for years with impressive years of sobriety. Sinclair's examples from Finland go a long way to prove that point.

It's also great to hear about all of the examples from the TSM board who are now cured. That's fantastic. I don't know whether it varies based on people who were lighter drinkers (35 units) or not, although I do remember people talking about that on the Sinclair method board.

Thanks so much for sending along that link. I especially liked Jane Brody's column in the NYTimes about TSM. It blows my mind that it was buried and didn't end up a "most emailed article" given how many people need help w/ AL. I feel like all of us are pioneers of sorts. We are desperately trying to get better and are trying to gather and and all information in spite of how totally backward and uninformed the medical community (in general) seems to be about our problem.

Honestly, I wish I had the patience and fortitude to stick with TSM b/c I do sincerely believe that it can work. I also wish I didn't have the underlying anxiety disorder that needed treatment almost as much as my alcoholism. I know that, even if I was able to stay sober for an extended period of time, I'd still need to take medication for my anxiety. Sigh...

More importantly, I'm really happy for all of the people who are having success doing with TSM! That's very inspiring and, like I said, I'm not at all surprised that it's working.

Thanks for your response,

--Anna

[Zman]

Strictly Sinclair Week 2

Hi All,

Reading these posts with great interest. Did any of you happen to read this study - basically supports what most are saying about TSM: http://hamsnetwork.org/sinclair.pdf.

One interesting observation that is made is that for the 10% of people who are compliant with TSM but are not cured, it is observed that they have a gene which causes them to crave sweets. Is this something that others have heard before? I dont crave sweets, but are there any other "tip-offs" that may suggest that one would fall into that unfortunate 10% category? Are there any examples of people that you know of that have fallen into this category?

I have been on Baclofen for 6 weeks now, and while sometimes I think I am experiencing a reducution in cravings, other times I dont think I am. Also, the side effects at 150mg are pretty bad (serious somnolence) and not sure how much higher I can go. TSM is my back-up plan, but if I try that for 6 months and it doesnt work, I may be seriously suicidal.

Many thanks

Zman

[Zman]

Strictly Sinclair Week 2

Also, if you cant get a prescription, where do you guys get your Nal from? 4rx doesnt sell it.

[WaitingToExhale]

Strictly Sinclair Week 2

Hey Zman -

Yes - I had read that report, but thanks for putting it back up for others to read.

I sincerely hope Bac works for you as there seems to be some successes as well on that program. But I'm also happy to hear you are looking into TSM as well, as in MY heart this is a pretty proven solution for many.

As to the 10% that don't respond, you actually have it a bit backwards. They are suspected of including people who DON'T like "strong sweet solutions". It's reported in Dr. Eskapas book as well, The Cure for Alcoholism, Page 51.

Other "markers" that may be in play in the 10% are:

- People who do NOT have close relatives who are alcoholics.
- Who do NOT like strong sweet substances
- Who have a particular opioid receptor.

The many of us that are doing TSM are now over on another forum which only began in February. There are many of us that are at the 15-25 Week mark. Some claim a cure - and how fantastic is that!? Others of us are still plodding along, feeling our lives are very different (all in good ways) but that final "switch" has not yet hit.

Zman - if you ever consider TSM, you MUST think out further than 6 months. Not that you won't feel or notice changes before that, but it can be a very long process for some. For others it can be shorter. We just can't "re-train the brain" real fast after years of this habit. And that is exactly what you are doing on TSM.

Having no idea how much you drink nor your history - it's all so hard to say. But I can tell you it takes a lot of patience and at times it gets discouraging. But we're now seeing those same people that were discouraged turn the corner.

I really suggest reading a bit of the stories to get a better feel for what it's all about. You will see our struggles and our successes! =)

Oh, and I purchase my Nal from River, but I understand there is even a less expensive source. I believe it's posted here somewhere as I can never remember the name! I just stick with River because I feel comfortable with them and am often a creature of habit. (Ya think? HA!)

Best to you!

[Zman]

Strictly Sinclair Week 2

Waiting,

Thanks for the info. My parents both drink heavily and while i wouldnt say my father is addicted per se (because he never seems to drink to excess in a single sitting) i think my mother definitely has a problem. But I do not have a sweet tooth at all. Obviously I dont know if I have a special opiod receptor.

I'm a little surprised about the sweet tooth issue. Is there a strong correlation between alcoholism and having a strong sweet tooth? If not, then i would think there are lots of alcoholics who dont have sweet tooths, and as such, would fall into the 10% category.

I have trolled around the TSM forum, but am a bit confused as to where to post questions such as these. Could you suggest where? Can people email Dr. Eskapa or Sinclair?

Before I decide on going down the TSM route, I just want to make sure that there is no apparent reason that it would fail me.

Thanks

[Anna B]

Strictly Sinclair Week 2

Hi Zman--

Re: sweet tooth & alcoholism. You might find this article interesting:

Sweet tooth test 'may help prevent alcohol problems' - Telegraph

Personally, I had a serious sweet tooth as a kid but when I'm drinking I don't crave sweets at all. The times I've been sober, I crave sweets like crazy. N

--Anna

[Zman]

Strictly Sinclair Week 2

Thanks for the link Anna. Though what it says is depressing. Since there is a correlation, and I dont have a sweet tooth at all, I guess that is suggestive that I would fall within the 10% category...

[lenaleed]

Strictly Sinclair Week 2

Zman -- The sky is not falling. I'm sure you'll find many for whom TSM works who share your (our) lack of sweet tooth. Careful not to turn this into "if you have a sweet tooth it won't work." I'm sure a large percentage of the population are missing a sweet tooth. I don't have one and I'm doing just fine on TSM.

AnnaB -- Eskapa's book cites 102 published studies that either directly or inferentially support TSM. There are more cites on our bb. There is science in spades that TSM works.

For some it is taking longer than three months, and we see results in a bit less than that for some. Dr. Eskapa says repeatedly in the book that it takes at least three to four months, so you stopped at an unfortunate time. TSM results cannot be consciously felt until about that time; any reduced craving early on is sort of a side effect and not truly the extinction process. In the study for which WaitingtoExhale provided the link, three months was considered the induction phase, with the improvement measured after that.

Shortly before some of us started our own bb, a member who claimed to be an academic questioned the science ad nauseum. I went back and forth with her for days; she had not even read the book! She would post, "But there is no study that is a meta analysis." I would cite her one. She would say, "But the clinical trials were not double blind." I would cite her a published placebo-controlled, double blind study. Finally a few of us agreed that she was not trying to engage in healthy debate. I don't know what she was trying to do but it wasn't that. It's all in the thread by SpringerRider called something like "The Cure for Alholism book by Roy Eskapa, PhD." So I hope you understand if I am just a wee bit sensitive when the subject of the science pops up.

Given the anecdotal success reported here, and the early studies, I have no doubt that soon there will be clinical data in spades that baclofen works well for many. Meanwhile it is probably easier than TSM in many ways to pitch to doctors because the results come faster. Also, imagine walking in to your m.d. and saying, "Pleases prescribe me some medicine that requires my continuing to drink and then I will be cured of alcohol addiction. Oh, and I will not need counseling." Both methods stand to turn the rehab industry on it head.

I'm very grateful that we have these options as we each find Our Way Out and am so grateful to RJewell for providing this forum. Let's do our best, as we do our bit to share, that the information we make available is as accurate as possible.

Take care, lena

[Anna B]

Strictly Sinclair Week 2

Hi Lena,

I think you misunderstood the purpose of my posting. I wasn't trying to engage in a big debate about the science behind TSM because I believe in the science! (Also, I did read the book and I tracked down a bunch of the studies Sinclair cited.)

As I said in my post, I 100% believe in the principles of extinction. I also firmly believe that TSM works. All I was trying to say was that the COMBINE study--and many others--didn't follow TSM and that the effect sizes are small because of it. And saying an effect size is small doesn't mean that a particular treatment isn't working! (Incidentally, whoever that academic was that said that something wasn't credible b/c it was a meta-analysis needs to go back to graduate school. A meta-analysis oftentimes is the ultimate "study" because it statistically combines all of the other studies that have done into one large analysis, which I'm sure you already knew, but she clearly didn't).

Anyway, failing to follow TSM in the COMBINE study and others is a short-coming of the researchers who undertook those studies--if they had followed TSM, I'm certain they would have obtained much bigger effects.

So we are in agreement about the science. And, sorry if I'm being sensitive now, but the information I was sharing was entirely accurate and also consistent with the other postings about TSM on the board.

But I don't necessarily agree with you that I stopped TSM at an "unfortunate time." I fully understand that it likely takes longer than 3 months for TSM to work. But, as I said before, anxiety is a huge problem for me and a major reason why I drink. I cannot take SSRIs (so paxil & lexapro are out for me) and I didn't want to become addicted to benzos (which it seemed I was starting to). So baclofen was a good move for me because it has eliminated my anxiety while simultaneously helping with cravings. If I had stayed on TSM for a significantly longer period of time and it worked, I would still have to take something for my anxiety no matter what. And bac is the best thing thus far for that.

I too am VERY grateful for this board. I don't know what I would have done if I hadn't found it.

--Anna

[lenaleed]

Strictly Sinclair Week 2

I'm sorry. Both your points well taken. I'm probably a bit too sensitive because of past doings on the board and read your post too hastily.

[Zman]

Strictly Sinclair Week 2

Lena,

Thanks for your post, that makes me feel better that you dont have a sweet tooth either. Are you cured (or close to being cured) by TSM?

And I know that, obviously, lacking a sweet tooth does not mean that TSM will not work for you, period. After all, in the article Anne posted (good research by the way Anne, not sure how you found that) it stated that there was only a 65% correlation between Alcoholism and sweet tooths. but I'm just wondering whether, if you dont have a sweet tooth, your chances of success from TSM drop from, say, 90%, to 50% or so.

You say in the TSM forum that you visited Dr Eskapa about this issue. What did he say specifically?

Thanks

[lenaleed]

Strictly Sinclair Week 2

Zman -- Whoa there!! Please simmer down!!!! Please get past the sweet tooth thing!!! It's a canard, and I think you're making waaayyyy too big a deal of it. People easily misunderstand stuff (just look at how I mangled what Anna was trying to say in her post) and it is just "out there" for you to start guessing at the odds going down drastically due to a sweet tooth. Please get a perspective on this. Really! I pop in here to my old MWO home when I can, and from what I can recall your posts are calm and thoughtful.

People are already trying to reassure you in your posts about this at our TSM bb that many of us do have a sweet tooth and we are doing just fine on TSM.

Try to focus instead on this: Throwing out the few who, for reasons those of us doing this cannot comprehend, stop taking naltrexone, there is a phenomenal 90 % of people for whom TSM should work, and throwing the quitters back in, an 80% actual success rate!! And unlike other methods (except now baclofen maybe), studies show continued improvement as far out as three years, whereas other treatment method are measured by how many are left standing (i.e. not relapsed) after that time, even after abysmal initial success rates. Grab those odds and go. Be prepared, however, that a few of us, including the cured, have developed a penchant for Ben & Jerry's. I know Bob goes for Cherry Garcia but I get an occasional hankering for Stephen Colbert Americone Dream.

I started on January 13 but got critically ill from an intestinal infection and had to spend several weeks on opiate pain meds after two surgeries. But after about 18 weeks total time on TSM I'm doing great and well on my way -- down to about 3 a night with no effort from a high of up to 12+. You can see my story in detail on the TSM board. If you check over there, the non-sweet-tooth stories are piling up.

Seriously, I know it can seem like a scary proposition to commit to a treatment that does not produce meaningful measurable results for several weeks. It's very much like statin cholesterol meds: You can't feel them working day to day, but after a few weeks your numbers are way down and it's life saving.

What's the down side?

Best, Lena

[aurora borialis]

Strictly Sinclair Week 2

I like TSM. It has done alot for me but lately since I cut down on drinking so much, when I do take my Nal I get terrible side effects from it and I don't know why but it makes me feel aweful. So I have to admit that I missed taking it a few times just because I didn't want the side effects. It is strange because I did not have the problem at all for at least 7 months but now I seem to have developed it. I am trying to figure out what is different.

[Zman]

Strictly Sinclair Week 2

Lena,

Sorry if im sounding hysterical. I dont mean to. I'm just trying to figure out why the unfortunate 10% dont get relief. Eskapa says one possible indicator is not having a sweet tooth, and Anna's article states that the majority of alcoholics have a sweet tooth. So you see where im going here.

But in any case, I should stop with my unscientific pontifications. You said that you spoke to the good Doctor directly about this. What did he say?

[Zman]

Strictly Sinclair Week 2

Lena, I have been trying to post the below on the TSM thread, but there is something wrong over there and I keep getting logged out every time I hit "submit". Could you or WTE please post it for me? Here it is:

Q - you didnt mention whether you had a sweet tooth or not.

In answer to a question, Dr Eskapa states that:

"First off, the Sinclair Method - like so many treatments - is not 100 % effective. Sinclair tells us that there is a 12 % non-response rate. There is a possibility that the 12 % of those who do not respond are not addicted so much through the endorphin or 'opioid system' in the brain but that though other effects alcohol exerts on the brain and nervous system. For instance some non-responders are thought of as "GABA alcoholics" - which means they are motivated to drink not so much because of endorphin release but through a motivation to replace reduced GABA - a neurotransmitter that benzodiadepine drugs (like valium, librium, Baclofen) artificially raise in the brain".

Anyone who hasnt started TSM would immediately wonder whether they are a GABA alcoholic. I would imagine that the lack of sweet tooth is an indicator.

I think lots of people who havent started TSM, and many who have stared but who not seen any effects, would like to have Eskapa's thoughts on this subject. Does a lack of sweet tooth correlate to being a GABA alcoholic? Does TSM simply not work for GABA alcoholics?

I posted this question in the "Questions for Dr. Eskapa" forum but for some reason it was removed. Does anyone have access to the good doctor? If so, I think this would be a topic where the Doctor's thoughts/clarifications would be very helpful, and would hopefully put a lot of people's minds at ease.

Many thanks.