Naltrexone is working for me!!

[Brummy]

Naltrexone is working for me!!

Thanks Pompey, your story about the Villa made me laugh! My husband's a Blues fan by the way! We live in Canada now so don't know if the drug is available here - will find out. Have made a Dr's appt for this Thursday and will hopefully get something to help. Books and Psychologist isn't helping. What worked for you? Are you still on the Merry-go-Round?

[Sunnyvalenting]

Naltrexone is working for me!!

In TSM does anyone have an ultimate goal of abstinence?

[Brummy]

Naltrexone is working for me!!

Hi Pompey. Did you see my post yesterday? If so, I'd be interested in your reply. Thanks

[Caroline Elizabeth]

Naltrexone is working for me!!

Hey Sodonewithit,
What book are you referring to? Is it Roberta Jewel's "My Way Out" or another. I have done Topamax and the first and second time I used (first and second order from River Pharmacy) it seemed to work great and I was amazed, but now it doesn't seem to be doing the job so I just weened myself off. I would love to learn more about Nal and try it. I am back up to at least a bottle of wine a day and I know that is not good for my body not to mention I hate that wanting of it. I too am a "functioning alcoholic and have been for about 4-5 years. I have 2 boys 10 and 13 and feel like I am not always giving my best because I am intoxicated. I really want something that works. Thank you for any info.
Caroline Elizabeth

[Caroline Elizabeth]

Naltrexone is working for me!!

Need info about Nal

Hey Sodonewithit,
What book are you referring to? Is it Roberta Jewel's "My Way Out" or another. I have done Topamax and the first and second time I used (first and second order from River Pharmacy) it seemed to work great and I was amazed, but now it doesn't seem to be doing the job so I just weened myself off. I would love to learn more about Nal and try it. I am back up to at least a bottle of wine a day and I know that is not good for my body not to mention I hate that wanting of it. I too am a "functioning alcoholic and have been for about 4-5 years. I have 2 boys 10 and 13 and feel like I am not always giving my best because I am intoxicated. I really want something that works. Thank you for any info.
Caroline Elizabeth

[37degrees]

Naltrexone is working for me!!

Hi, new poster here.

I've been on the Sinclair Method for a few weeks, and here's my perspective.

Since I drink every day, I take NAL daily, which is no different from the traditional non-TSM use. I find my AL intake is down slightly, mostly because I now feel drunk on lesser amounts of AL. The craving and buzz are about the same. For me, it is acting like a mild, non-dangerous form of Antabuse rather the "pharmacological extinction" as advertised.

I have read Eskapa's book, and lurked on the TSM forum, and I think the much-touted 78% "cure" rate is highly dubious. That number is from an unpublished series from one clinic which chooses not to update its results.

NAL is pretty benign, and easy to just take before drinking. I think it is worthwhile to give it a try, as I am. But, if I don't see clear objective results in 3 months (average number of drinks, maximum drinks/day, AF days), I am not going to delude myself and insist that it will work if only I give it another month, or 2, or 6.

Just my take.

[Illuminae]

Naltrexone is working for me!!

TSM

Caroline, the book is by Dr. Roy Eskapa and called the Cure for Alcoholism and describes The Sinclair Method. Kind of a bold title, but it has worked for many. Just like My Way Out, some on TSM have the ultimate goal of abstinence while others just seek controlled drinking. Some on TSM originally just sought controlled drinking and ended up with abstinence or near abstinence, just really not caring about alcohol at all anymore.

37 degrees, the TSM book claims it works in 3-4 months and most find that isn't the case, but many have found success in 6-9 months.

People's experiences also vary with taking the naltrexone faithfully as the book advises and that's it, while others need to take it and also apply some effort at reducing AL intake or having AF days.

I myself have been on it for 10 months. I definitely reduced my AL intake and attitude for the better, but was still a daily drinker. Started applying some effort over the last couple of months and saw even more improvement. Wanted to take it to the next level so have been learning about the MWO method and just started on Topamax this week.

I think each of us needs to find what works best for us. I've seen folks with success on both methods, or combinations thereof. Bottom line, we're all trying for help, motivated, and there is proof that this stuff works for a lot of people if you read the boards.

Good luck to everyone!

[37degrees]

Naltrexone is working for me!!

Illum,

I am glad that you are doing well on TSM, but your reply really shows the problem with these treatments in general, and TSM in particular.

If TSM doesn't work in 3-4 months, and people find success in 6-9 months, why not take it to 12 months, or 36 months? It seems that the book is wrong in at least one aspect. Then why believe any of its claims?

I would bet that after 36 months, or even better -10 years- many alcoholics will be cured. The natural history of alcoholism is that some will get better, some will get worse, and some will stay the same. The thing is, I want to handle my alcoholism now, or at least in the next year. I don't want to be cured at age 85.

Alcoholism is a tough disease. I will try all the proven treatments, recognizing that the success rates are not great. But I can't delude myself if some modality doesn't work. Keep in mind that just doing your best (i.e., no meds, no therapy, no AA) also results in cures.

My gratuitous opinion is that if you have been on TSM for 10 months and you are still drinking daily against your wishes, then TSM doesn't work work for you. The "78% cure rate", the "pharmacological extinction", the "extinction bursts" I see blurped on the TSM forum are so much BS.

If alcoholism is a medical disease, as I believe it is, then I also accept that it may be incurable for some. If so, then the remedy should be palliation - trying to make life better for us and our families in the face of drunkenness.

[Illuminae]

Naltrexone is working for me!!

Let me be a little more clear. I saw definite and quick improvement with Naltrexone. I stopped creating opportunities to drink like making excuses to leave work early, drinking at lunch, the desire to do stuff like that is completely gone so I'm really happy about that.

also, I wouldn't say I'm still a daily drinker against my wishes exactly, I have a lot of other circumstances I'm working through like overcoming habit vs. craving, and a husband that also drinks a lot that makes it hard to get out of those habits.

the book is based on some pretty sound science. Just because TSM as described in the book doesn't work the same for everyone is no reason to believe that NALTREXONE treatment isn't working.

37, my wish for you is that you do continue to give it a chance, read some of the positive experiences, and be a bit more optimistic. Believe me, I'm much happier now than I was, I'm just trying to bump it up a notch and a big part of that might just be me overcoming my dynamic with my husband and my habits, which would mean the nal and TSM really have been working and I just need to get out of my own way.

[37degrees]

Naltrexone is working for me!!

As someone who has served on an IRB (gateway for clinical studies) in a previous life, I have to call out TSM as "scientific".

Eskapa's book has no scientific justification, and the author himself has no academic credentials. The multiple references offer no support for the claims.

This is like trying to refute perpetual motion - it is obviously wrong, but it takes so much trouble to address it point by point.

In brief:

Extinction in both classical and operant conditioning is a given.

Pharmacological extinction occurs in animal models. It is proven nicely for alcohol in rats *bred specifically* for alcohol studies.

"Pharmacological extinction" has never been shown in humans, and in fact has never been invoked in any human studies.

Opioid receptors are involved in alcohol, but are prob. secondary to dopaminergic reward systems. There is no reason to expect that opioid blockade would curb alcoholism.

The 78% cure rate comes from a non-peer-reviewed report of patients in one Finnish clinic. The same clinic - still in operation and with a website - has not updated its results in the 20 years since.

(Since Finland still has one of the highest alcoholism rates in the world, I would suggest donating heavily to this clinic so that it can help its fellow citizens.)

No peer-reviewed study has shown more than a mild effect of targeted NAL. Yes it works, but not that well.

The studies have mostly look at 12 weeks, and TSM posters have insisted that effects may not be seen for another month, or year. There is no physiological basis for these claims. In fact, if TSM works on the basis of "extinction" (highly unlikely), then there should evidence of an exponential decay early on in any measured parameter. There is none.

There is evidence that NAL works. There is no evidence that TSM is much better as a treatment modality.

Look, if TSM has cured you, great. Doing nothing (spontaneous remission) can also cure you. It just bugs me that TSMers drag out "scientific" support where there is none.

[Lo0p]

Naltrexone is working for me!!

37degrees;988036 wrote: But, if I don't see clear objective results in 3 months (average number of drinks, maximum drinks/day, AF days), I am not going to delude myself and insist that it will work if only I give it another month, or 2, or 6.
37degrees;988254 wrote: The studies have mostly look at 12 weeks, and TSM posters have insisted that effects may not be seen for another month, or year. There is no physiological basis for these claims. In fact, if TSM works on the basis of "extinction" (highly unlikely), then there should evidence of an exponential decay early on in any measured parameter. There is none.

https://www.mywayout.org/community/f2...tml#post979676

[37degrees]

Naltrexone is working for me!!

1) One case.

2) AL use was steady from week 0 to 15, then dropped suddenly. Exponential curve-fitting seems forced. More like a step-off.

3) Chart is inconsistent with "extinction" theory. What is the presumed physiological basis behind the sudden improvement at Week 15?

4) Inconsistent with all currently known drug effects. Should we just continue on for months and years hoping that we too will get a sudden step-off?

[Lo0p]

Naltrexone is working for me!!

There are actually 2 cases there. I had third one with charts handy that I'd already made over a year ago, but I can see this is going to be a waste of time.

The exponential fit is MS Excel's, in all instances. You could take the issue up with Microsoft, but I'm quite confident you'd get the same trend line if you plugged those numbers into any graphing software. As a matter of fact, you'd get the same result if you did it on construction paper with crayon. Maybe you could blame the crayon's then, or the downward slope of the table you drew it on.

I was going to write this earlier but I thought it'd be rude and kind of putting words in your mouth:

"I'd take issue with almost everything you posted about every drug and all of your options, but it sounds as though you've already made up your mind. You've made a lot of assumptions about all of these drugs that, in my mind, are jumping the gun quite a bit. You don't seem to be open-minded to any ideas. In fact, I'm sure you'll have some kind of inane issue with these graphs.

You've got your plan and you are sticking to it. It sounds like no one is going to convince you otherwise, regardless of how brilliant or boneheaded it may turn out to be. I certainly am not going to spend any time trying to elucidate anything else for you."

I could also respond specifically, point by point to the rest of your 4 points but I fear I'd be talking to myself and it'd be an exercise without reward. Why are you posting here? Are you looking for validation? The only person you need to convince here is yourself. You've done a damn good job of that already, before you even started talking.

I think I need to stop responding here because I don't want to start a fruitless dialog with someone who complains about the dogmatism of all of the different approaches while following his own like a single lemming in a cult of one.

Uggh yeah. I'm tired. You could respond I suppose for your own benefit, even though it very well may not be.

[Lo0p]

Naltrexone is working for me!!

I think it's healthy to approach all of these treatments with a good dose of skepticism. I certainly did. I now consider myself cured. I drink whenever I want to as much as I want. Hell, I even look for opportunities to drink to take advantage of another 'extinction session.' The truth is, they come by rarely these days and when they do I more often than not pass them up because I don't feel like drinking. And when I actually do drink, I struggle to knock back a unit or two at most like 3 times a month. I can still get drunk if I want to, I did recently. I just don't ever want to anymore.

Even given my own personal experience I still harbor skepticism about these treatments and how many people (or what percentage) they can actually help. I even share some of the same concerns as you. But your skepticism seems to me like it crosses the line into more of an 'attitude' type thing.

I'd ask you to explain your claims of "BS" or "contradictions" but I wouldn't read them, because I'm already tired of the attitude.

We're all here together to help, offer support and advice based on experience. But we can't help you answer questions like "4 meds, which one?" when it's something you've already decided and aren't interested in other people's opinions. I know you feel like your own opinion is correct and it isn't your own opinion but is a matter of fact. I for one, when I hear you speak, hear: "Blah, blah, blah. I'm right, this is why: Blah, blah, blah..." Where the blah's are leaps in logic and interpretation's of facts colored by your own beliefs, something which you espouse to hate.

[37degrees]

Naltrexone is working for me!!

Actually, my original post is on why *I* chose to go on NAL.

I disagreed that I am the one with the attitude. I think that all 4 meds have mild effects on AL consumption, while many users think they have found the holy grail. If read with a dispassionate eye, some of the posts in this and other AL forums clearly reflect irrational grasping at straws. And, it seems that both BAC and NAL cures have suffered relapses. Not surprising, since the natural history of alcoholics successfully treated by traditional methods is that they relapse, often after years.

If I seemed to be picking on TSM , it is because of the particular shoddiness of the theory and empirical evidence behind it. And no, I am not going to refute each of the 100+ papers quoted in Eskapa's book one by one. Suffice to say that most of them dealt with rats or are totally irrelevant to TSM claims.

At the moment I am on a 3 month trial of NAL (corresponding to the Sinclair Method). I really don't see major changes so far, and I am not going to continue it for another 6 or 24 months. At the end of 3 months, I will try BAC. In any event, I am not going to delude myself about my alcohol use or problems.

In a medical model, some meds just don't work, or some conditions are just not treatable. It may be that some people have incurable alcoholism.