Eskapa's Book, The Cure for Alcoholism

[lenaleed]

Eskapa's Book, The Cure for Alcoholism

I don't read reviews by someone who hasn't read the book

Good morning all -- Through posts and pm's, some of us have got the clear message that many of you are not comfortable with a way that is not Your Way Out. We don't want to cause controversy. So we will instead post here:

thesinclairmethod.com; Index page

R Jewell has put together an amazing program and an amazing web site. Her outside-the-box approach to dealing with alcohol issues has given so many (including me) their lives back. I learned a great deal here and encountered many wonderful, supportive members.

Take care all -- Lena

[rv9]

Eskapa's Book, The Cure for Alcoholism

AWIP - I am sending your question directly to Drs. Eskapa and Sinclair. I will let you know when I have a reply.

[A Work in Progress]

Eskapa's Book, The Cure for Alcoholism

Well, that's too bad, Lena. As you can tell, I'm not nearly as interested in "the book" as I am in the "method" and the ideas behind it, and any research that supports it. The book is of no importance to me, for reasons I have given; but the method might turn out to be a major contributor to the array of interventions that can help people who are suffering terribly. I suspect that RJ herself would want you to stick around! And so would I! There is no reason I can see that you cannot be as much a part of this community as anybody else who is using medication to help with an alcohol problem.

[A Work in Progress]

Eskapa's Book, The Cure for Alcoholism

rv9;539889 wrote: AWIP - I am sending your question directly to Drs. Eskapa and Sinclair. I will let you know when I have a reply.

Thanks RV! I will look forward to any responses!

[SpringerRider]

Eskapa's Book, The Cure for Alcoholism

A Work in Progress;539897 wrote: I'm not nearly as interested in "the book" as I am in the "method" and the ideas behind it, and any research that supports it.

But the Book exposes the "Method"! Except for personal experience, which you said yourself is subject to bias, the book is all we have to offer you.

I had also suggested we move to our own site but for somewhat different reasons. The Sinclair Method is very unique in that it REQUIRES that the patient DRINK in order to be treated. It is not that he/she is permitted to drink but that they must drink! This is a huge paradigm shift. The Sinclair method is not compatible with abstinance. I know of no other treatment that resembles this.

Having said that, no one should resume drinking just to try the Sinclair method. That would be destructive and plain stupid. This program is not for those people. And for that reason, I think it best that we do not flaunt this treatment in front of people that are already sober. We are not recruiters. We are his patients.

I am with Lena and am moving on. You are welcome to vist our site and continue a mature and intelligent discussion.

[cyclefan]

Eskapa's Book, The Cure for Alcoholism

SpringerRider;540035 wrote:
Having said that, no one should resume drinking just to try the Sinclair method. That would be destructive and plain stupid. This program is not for those people. And for that reason, I think it best that we do not flaunt this treatment in front of people that are already sober. We are not recruiters. We are his patients..

That was clear all along to anyone who TOOK THE TIME to read through your threads. Those who did not, and only found fault, well I am sorry for their narrow minded viewpoint.

I find it difficult enough to keep up with this site but will try to make an effort to stop by when I am able to keep up with your progress. I wish you great success and hope you find relief from your cravings. xo Beth

[rv9]

Eskapa's Book, The Cure for Alcoholism

one2many;540057 wrote: I always thought there was enough room for all methods on these boards......after all, MWO is not an AF site. I feel bad that you felt you have to move because people are objecting......it does not seem fair.

one2many - In my mind the "moving on" is more so we can organize things a little better. Since none of us are moderators here, we can't post some of the things we'd like to - the video of Dr. sinclair, for example. Further, "our" threads get mixed in with everything else and it's hard to follow.

I'm sure most of us will continue to drop by here from time to time.

[bloggy]

Eskapa's Book, The Cure for Alcoholism

I am an older member here- I will be using the Sinclair Forum as although I did dabble with it a few months ago for a short time I did not have the information and there were no other members doing the method for support.

However I will continue to post also here as I think at the end of the day we all have a common goal- to be free of the nightmare and bad experiences that our abuse of alcohol has bought.

I do think it beneficial for all if Sinclair followers have our own forum- if successes become common the method will become important in it's own right and probably many forums will spring up- as SR said this method is very different from any other as we have to drink for it to work. I for one will feel more confortable knowing I am not upsetting anyone else, but hope to still come here as I usually do.

[rv9]

Eskapa's Book, The Cure for Alcoholism

An answer for AWIP from Dr. Sinclair

AWIP - Here is Dr. Sinclair's answer to your question:

Certainly.

The Finnish trial was specifically designed to test the method (32. Hein?l?, P., Alho, H., Kiianmaa, K., L?nnqvist, J., Kuoppasalmi, K., and Sinclair, J.D. (2001). Targeted use of Naltrexone without prior detoxification in the treatment of alcohol dependence: A factorial double-blind placebo-controlled trial. Journal of Clinical Psychopharmacology, 21(3): 287-292. ). It had one group given naltrexone with instructions to use the medication while drinking in a controlled manner - and then in the latter parts to take the medication only when intending to drink. They were told not to drink more than they normally drank, so as to avoid alcohol poisoning. They also had strong instructions to avoid drinking and driving or using other mechanical equipment. There was a double-blind placebo-controlled group that had the same instructions but received placebo rather than naltrexone. The naltrexone + drinking group did significantly better than the placebo + drinking group. This was a huge difference, partly because the placebo + drinking group did so poorly. This supports not only the conclusion that naltrexone + drinking is safe and effective, but also confirms the conclusion from AA and elsewhere that controlled drinking is not a good solution for alcoholics who are not taking naltrexone.

At the same time, the trial had two other groups. One had naltrexone plus instructions to abstain, and the other one had placebo plus instructions to abstain. Again the groups were randomly assigned and double-blind. The results showed clearly that naltrexone was no effective when used with support of abstinence. Indeed, there was a strong tendency for the naltrexone with support of abstinence to do worse than the placebo plus support of abstinence. Our later work indicates that is because these patients often stop taking naltrexone at the same time start drinking again, thus getting no extinction (since drinking is never paired with naltrexone) but instead supersensitivity-enhanced reinforcement of alcohol drinking.

The naltrexone + drinking group also did significantly better than the naltrexone plus support of abstinence. Thus the conclusion is supported that if you are going to administer naltrexone, it should be done along with instructions to drink normally.

The original Yale study used a similar design although it was not intended to test extinction.(3.O’Malley, S.S., Jaffe, A.J., Chang, G., Schottenfeld, R.S., Meyer, R.E., and Rounsaville, B. (1992). Naltrexone and coping skills therapy for alcohol dependence. Archives of General Psychiatry 49: 881‑887 ). It had the two groups with support of abstinence, and like Hein?l? et al found no significant benefits of naltrexone over placebo when abstinence was demanded. It was, however, accidental that they had patients drinking while on naltrexone. Their other two groups were called "Coping" with drinking. They were told that we know you probably will not abstain, but when you do drink, don't lose your confidence and drop out - instead you should cope with drinking. It was admitted by the authors that these instructions did in fact encourage sampling of alcohol. Like Hein?l? at al, the naltrexone + coping with drinking did very well, and significantly better than either the placebo + coping with drinking or the naltrexone + support of abstinence.

The Swedish clinical trial used almost the same design and also found the same results. (25. Balldin, J., Berglund, M., Borg, S., M?nsson, M., Berndtsen, P., Franck, J., Gustafsson, L., Halldin, J., Hollstedt, C., Nilsson, L-H., and Stolt, G.. (1997) A randomized 6 month double-blind placebo-controlled study of Naltrexone and coping skills education programme. Alcohol and Alcoholism 32: 325 )
br />The Texas study on naltrexone for cocaine addiction used the same design and found the same results. (59. Schmitz, J. M., Stotts, A. L., Rhoades, H. M., and Grabowski, J. (2001) Naltrexone and relapse prevention treatment for cocaine-dependent patients. Addictive Behavior 26(2):167-180. )

The very first trial found that naltrexone was more effective than placebo in treating heroin addiction in those patients who self-administered heroin while on the medication but not in addicts who abstained from opiates while on the medication (Renault, P. F. (1978) Treatment of heroin-dependent persons with antagonists: Current status. Bulletin on Narcotics 30: 21-29 ). It concluded that extinction was the cause for the benefits.

In addition, we did several dozen experiments with rats demonstrating that naltrexone and other opioid antagonists extinguish alcohol drinking.

David Sinclair



I'd like to add one more thing: Dr. Sinclair is a researcher for the government of Finland. Unlike virtually every other treatment provider, he doesn't "have a dog in the hunt" with respect to commercialization of this method of treatment. Eskapa has books to sell, but Sinclair is in it for the science.

[momof3]

Eskapa's Book, The Cure for Alcoholism

Spring Rider,

I think the use of Naltrexone sounds promising. I am looking forward to hearing about your experiences and results.

[A Work in Progress]

Eskapa's Book, The Cure for Alcoholism

RV, thanks, fantastic! OK, so there is basically one study ("the Finnish trial," published in the J. of Clinical Psychopharmacology) that actually tests the "Sinclair Method," and of course (as previously discussed) there are several other published studies that did not test the method, but which had findings that are suggestive that the Sinclair approach might be successful and should be tested further. I can't tell, of course, without reading the full text, how many subjects were in that Finnish trial, but it looks like a really good design, and with very good results.

I think it's fair to say that so far the peer-reviewed research is looks promising. It's WAY premature to say that "the research has already been done," of course. Here's what I am wondering about: first, how serious is the potential problem with liver toxicity (and other side effects)? I have read the literature on this, and there are no settled conclusions, as yet. Second, is this going to end up being a lot like Antabuse? I.e., will people do quite nicely as long as they keep taking their Naltrexone... but then crash and burn when/if they decide they'd like to really start drinking again? That, I suppose, will be the "real test" of the "extinction" theory. Time will tell.

Anyhow, I do hope all of you do very well with this method, and, again, I am sad that some of you felt that you did not fit in, here at MWO.

[SpringerRider]

Eskapa's Book, The Cure for Alcoholism

one2many;540106 wrote: Thanks for clearing that up for me guys, I got a fright and thought someone was being mean to you.

I will be visiting the new forum to see how you are getting on!

You are welcome. There was nothing personal.

I noticed your tag line - Day 5 nicotine free.(but like an antichrist)
I quit nicotine July 6th, 1980. I went cold turkey, sort of...

All I can say it don't quit quitting. If you stumble and smoke, throw away the pack and get back to quiting with sincerity. I slipped three or four times but only for a few minutes. You will either be nicotine free or bankrupt.

Also, that avatar makes me look forward to becoming a dirty old man. Thanks!

[rv9]

Eskapa's Book, The Cure for Alcoholism

Here's what I am wondering about: first, how serious is the potential problem with liver toxicity (and other side effects)? I have read the literature on this, and there are no settled conclusions, as yet. Second, is this going to end up being a lot like Antabuse? I.e., will people do quite nicely as long as they keep taking their Naltrexone... but then crash and burn when/if they decide they'd like to really start drinking again? That, I suppose, will be the "real test" of the "extinction" theory.
Everything i've seen is that Naltrexone is very safe at the doses we're talking about (50mg/day). AFAIK, they haven't seen toxicity at doses below 300mg/day. They (I'm not sure who 'they' are) are even working on making it OTC in Europe.

Taking Naltrexone before drinking is a 'requirement' of the method. Eskapa indicated that if I drink without naltrexone I likely won't slip into alcoholic drinking immediately, but will do so faster than if I'd never had the problem to begin with. He ballparked a couple or three months. Of course, this would be amplified in the week or two after stopping naltrexone because of upregulation.

Spontaneous recovery is always possible, too, which is why it's important that naltrexone always be carried or readily available.

Honestly, taking the naltrexone is easy, easy, easy. I've never had the inclination to not take it. The perceived difference in the effects of alcohol isn't large enough that compliance is an issue (for me, anyway).


Anyhow, I do hope all of you do very well with this method,

My drinking is already down to a level that I'd consider a success (< 15 drinks per week). My only concern at this point is that a week ago I had two instances where I drank something like 6 drinks in a short timeframe. These were after my buddy's son died and I was hanging out with his family. I hadn't been in a "family gathering" (a strong trigger situation for me) since I started naltrexone and thus that wasn't a trigger I'd extinguished.

[SpringerRider]

Eskapa&#39;s Book, The Cure for Alcoholism

A Work in Progress;540184 wrote: how serious is the potential problem with liver toxicity (and other side effects)? I have read the literature on this, and there are no settled conclusions, as yet. Second, is this going to end up being a lot like Antabuse? I.e., will people do quite nicely as long as they keep taking their Naltrexone... but then crash and burn when/if they decide they'd like to really start drinking again?

Let me chime in here.
First - As my MD said, the toxicity effects of Naltrexone should be insignificant to the damage done to the liver alcohol. The circular provided with the prescription had only mild caveats, along with the normal run of the mill list of reported side effects, mainly mild nausea for the first couple of days.

Second – Here I will address a gross conceptual error. Naltrexone does not truncate the effects of alcohol in any way. It is not working on the alcohol. You are still fully capable of drinking until you pass out, if that be your desire as long as you do so while taking Naltrexone. The difference is that the next day, after you sober up, you will not have that indefatigable craving to start drinking again. Like the normal drinker that you have become, you will probably feel a degree of natural aversion for a day or so; especially if you indulged enough to puke your guts out and got naked in front on your kids.

I have yet to meet the masochist who finds crawling-up-the-wall cravings a desirable experience. You mileage may differ.

[A Work in Progress]

Eskapa&#39;s Book, The Cure for Alcoholism

SpringerRider;540223 wrote: Let me chime in here.
First - As my MD said, the toxicity effects of Naltrexone should be insignificant to the damage done to the liver alcohol. The circular provided with the prescription had only mild caveats, along with the normal run of the mill list of reported side effects, mainly mild nausea for the first couple of days.

Second ? Here I will address a gross conceptual error. Naltrexone does not truncate the effects of alcohol in any way. It is not working on the alcohol. You are still fully capable of drinking until you pass out, if that be your desire. The difference is that the next day, after you sober up, you will not have that indefatigable craving to start drinking again. Like the normal drinker that you have become, you will probably feel a degree of natural aversion for a day or so; especially if you indulged enough to puke your guts out and got naked in front on your kids.

I have yet to meet the masochist who finds crawling-up-the-wall cravings a desirable experience. You mileage may differ.

SR, perhaps I am overly concerned after hearing anecdotal reports from a few people here at MWO who have reported problems adjusting to the stuff, including one who said her "eyes turned yellow" (scary!). But, from what I have seen, the latest stuff in the journals seems to be reassuring with regard to liver toxicity...

Also, as to the other question: I understand what you are saying about the "gross conceptual error." What occurs to me is a bit different, I think. Since the experience of drinking is no longer pleasurable when one is using Naltrexone (although it is certainly intoxicating), I am wondering about people who decide they want to drink AND enjoy it again? That is what reminds me of the compliance problem with Antabuse, i.e., just the plain old desire for the (probably very distorted) memories of enjoyable experiences, drinking alcohol with friends, or whatever. Of course, the effects and methods of action of the two drugs (Antabuse and Naltrexone) are totally different. But the underlying potential problem MIGHT be similar, over the long haul.