Originally, the test members were to remain abstinate and take Naltrexone daily. 17 members were cheating and were continuing to use while taking the drug. Because they were providing daily urine samples, the cheating was immediately known but allow to continue so as not to compromise the overall sampling group. Strangely, they reported the most significant decrease in craving at the cessation of the test period. It was then that they began to ponder the idea of extinction.
Pavlov postulated the Stimulus, Response, Reward paradigm. We all know the story of the ringing bell and feeding the dog. If you train a dog that he will be fed after ringing a bell, the dog at some point, will salivate at the ringing of a bell, even when no food is offered. He is now condition. But if you continue to ring the bell and not feed the dog, he will eventually dissociate the bell with food and no longer respond. That is the process of extinction.
Old theories of alcoholism were based on the pleasure-pain relationship. That presupposes that alcoholics perceive drinking in a rational manner. But we continue to drink far beyond the point of pleasure so Sinclair concluded that another mechanism must be in place. Aversion therapy has always been short lived. I have met alcoholics who have drank on Antabuse.
I have a little background in the field. I have an undergraduate degree in psych from the Univ. of the State of NY, Albany. I attended the Navy?s IAAS (Inst. Of Alcohol Abuse Studies), did a practicum at the Betty Ford clinic and became a counselor for three years at an Alcohol Recovery Center. All this time I was in recovery. I have been in and out of recovery with runs exceeding 12 yrs. This is not a pompous litany of, ?I know more than everyone else?. Indeed, I am impressed with the intellectual acumen I have encountered in this community. I just want to emphasize that I am not entering this protocol as a blind lemming.
One of the points that Eskapa makes, as does Sinclair by proxy, is that this is not a program for those who are happily abstinent. Why bother if you are where you want to be?
Many users have Naltrexone have not given it a fair shake. I have read all too many say I took Naltrexone for three weeks and it helped me stay sober. Naltrexone used in that manner has failed completely in double-blind tests and did no better than placebo. The protocol is Alcohol + Naltrexone = Cure. To take Naltrexone without drinking is the same as not feeding the dog above without ringing the bell. You may starve the dog but so nothing as far as unlearning the conditioning.
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