Strictly Sinclair Week 4

[A Work in Progress]

Strictly Sinclair Week 4

Hey Lena! Welcome back!

[lenaleed]

Strictly Sinclair Week 4

Thanks WIP! The article's free!

[A Work in Progress]

Strictly Sinclair Week 4

lenaleed;544135 wrote: Thanks WIP! The article's free!

hahaha! OK! By golly, I'll READ the thing!

[aurora borialis]

Strictly Sinclair Week 4

I just read the Times article and enjoyed it very much. Thanks for the link. Still doing quite well on Sinclair method. Life is improving day after day!

[Q_]

Strictly Sinclair Week 4

nancy;541721 wrote: Just want to point out, what these people are doing with the Sinclair Method is somewhat similar to how topamax is used. Roberta had a drinking problem and found a drug that allowed her to still drink but not to excess. It's the cornerstone of this program. But of course the the program also includes hypno and supplements, and support on this site. Regardless of those few scathing PMs, her website to me shows openness to all kinds of medications that come along, including baclofen and naltrexone.

You mis-understand The Sinclair Method. Taking Naltrexone isn't simply a way to not drink in excess.

What Dr. Sinclair determined through his research is that alcohol addiction is a learned behavior driven heavily by the brain's endorphin/opiate system. This endorphin/opiate system is a very powerful mechanism that drives the alcohol addict to drink well beyond what is reasonable (or what is even giving them pleasure). Note, this is my own very simplistic understanding of what Dr. Sinclair determined in his research.

Naltrexone is an endorphin analgesic, meaning it neutralizes the effects of endorphins on the brain. In other words, while taking Naltrexone endorphine releases have no effect on you what so ever.

With the Sinclair Method, one takes Naltrexone at lease one hour prior to drinking, but only when and always before drinking. This is done over time (4 months or so), resulting in the brain unleaning that drinking will result in an endorphine reward. This is known as pharmacological extinction.

You see the difference? We are drinking while taking Naltrexone so that our brains unlearn that it means to be addicted to alcohol.

Q

[A Work in Progress]

Strictly Sinclair Week 4

lenaleed;544135 wrote: Thanks WIP! The article's free!

OK, Lena, as promised, I read the article! Here are my impressions. Below I have copied excerpts of the article, then put my own responses (in brackets) to the various segments that I think bear some comment:

If, each time you engage in a behaviour that releases endorphins, you strengthen that behaviour, it follows that if you engage in the behaviour and don't get the endorphin release, you weaken the urge to use it. Thus, unburdened by a craving for alcohol, a former heavy drinker can use alcohol with control.

[WIP: The neurochemistry of alcohol dependence is very complex. The “endorphin” explanation provides part of the picture, but not all of it; there are other processes (mental, emotional, and biochemical) involved that have a major impact on our dependence (craving, lack of control) on alcohol.]

That is the theory and this treatment for alcoholism is called the Sinclair Method, after David Sinclair, the scientist who discovered it and who claims a 78 per cent success rate over three to four months. The measure of success is controlled drinking within normal safety limits, or abstinence.

[WIP: 78% is fantastic! I will be very interested to see whether that number will be replicated, or repeated, in other studies, done by other researchers.]

Sinclair's work could change the way in which society perceives addiction, making it a treatable condition rather than incurable, Eskapa maintains.

[WIP: “Treatable” is not the same as “curable.” Chronic conditions that must be controlled by medication are NOT “curable.”]

Perhaps the most remarkable aspect of this story, which began some 40 years ago, is that while Sinclair can name 76 clinical trials that prove the efficacy and safety of his method, most alcohol addiction professionals don't know about it, or reject it. “I cannot help remarking that anyone who claims to have found a ‘cure for alcoholism' cannot be taken seriously,” says one of the UK Government's eminent advisers on alcoholism.

[WIP: It just is NOT true that there are “76 clinical trials that prove the efficacy and safety of” this method. We just had this long discussion about that on another thread. There are a lot of studies that use naltrexone; only one published (peer reviewed) study that directly tests the “Sinclair” model. Accordingly, all responsible scientists, treatment providers, should be interested in this method, but not necessarily to the point of adopting it, until there are genuine, published research results that DIRECTLY (not indirectly) support the method.]

Balancing the numerous trials that prove that it leads to controlled drinking, loss of craving and sometimes voluntary abstinence for alcoholics and heavy drinkers, there are also 36 trials that indicate that naltrexone does not work if you are abstinent when you start using it. The Sinclair Method is specific: naltrexone plus alcohol equals cure. For it to work, you have to continue to drink. You take naltrexone only on the days you drink and, as your craving for alcohol reduces, you will drink less. If eventually you choose not to drink, you will not take naltrexone.

[WIP: Again, all these published studies do nothing but create a very intriguing suggestion as to what might be the best approach to using naltrexone for alcohol dependence. And the phrase “naltrexone plus alcohol equals cure” is hugely misleading, because the word “cure” is being mis-used.]

The need to continue to drink initially is the main reason why the Sinclair Method has been rejected by so many alcohol addiction professionals. Most are wedded to the idea promulgated by Alcoholics Anonymous's 12-step programme that treatment must involve abstinence. Naltrexone was endorsed for use in alcoholism by the World Health Organisation in 1994 and by the US Food and Drug Administration in 1995. In 2006 the American Medical Association recommended it for treating alcoholism in generalised medical settings. Yet many doctors appear to be uncomfortable advising patients that they must take a drug and also drink - so, when they prescribe it, they insist on abstinence.

[WIP: I Believe that another reason that the method is not yet being enthusiastically embraced is because the relevant scientific literature has only one peer-reviewed study that directly tests the model.]

Sinclair [says that] one clinical trial shows a 50 per cent success rate for the Sinclair Method after three years; three-year figures for the 12-step programme are more commonly about 5 per cent. …

[WIP: 50% success after 3 years is very good! I would love to see some published research that backs up that figure!]

“Naltrexone does indeed reduce some of the brain-stimulation effects of alcohol,” says [one treatment provider]. “I don't think it's right to claim that this is a universal solution for all people who have problems with excessive drinking but it does help some. We prescribe it to people who continue to drink in the hope that it will reduce the frequency of the sessions where they drink to excess and put themselves at risk. If they take naltrexone before they drink, they can have some satisfaction from the taste and some mental effect from the alcohol but report that they don't want to carry on and ‘lose control' of the amount they drink. Unfortunately, quite a lot of our patients don't take it as prescribed.”

[WIP: I tend to agree with this person quoted just above. And this whole problem, or question, about compliance (both short-term and long-term) is, I believe, going to be the make-or-break question about this “Sinclair Method.]


Bottom line: as I have said before, I think this method has some VERY intriguing early results and great potential for alleviating the suffering of alcohol dependence, for some people. It is not, in its current form, anything that approaches a "cure." And the long-term compliance question is the thing that I think will be the biggest test.

[BecomingMeAtLast]

Strictly Sinclair Week 4

Springer,

Thanks for keeping this going. I'm fascinated by this and have been following the threads. I'm sorry I haven't posted more. I will also be following thesinclairmethod.com board thread. You all are in unchartered territory as far as I'm concerned and I'm grateful for all you are doing.

Be