Naltrexone is working for me!!

[Lo0p]

Naltrexone is working for me!!

37degrees;991292 wrote: 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.

The contradictions are actually a crucial part of the argument. There are no rats in these papers: Annotated Bibliography Sinclair Method Naltrexone Alcohol - Naltrexone Cures

You didn't even bother to read them. :thumbs:

[37degrees]

Naltrexone is working for me!!

Thanks for the link.

It will take me a few days (I am drinking, you know) to go thru them. I don't live near a medical school library and don't want to pay $30 for online access to each article. I will probably pay for 2 at most - which 2 would you recommend?

The first reference on the link is "Treatment of heroin-dependent persons with antagonists....". Nothing to do with alcohol.

I have actually looked at many studies of AL and NAL, including targeted therapy (approximating TSM), and the preponderance of evidence is that NAL has a moderate effect in suppressing AL consumption, and targeted NAL is not much better. Eskapa (a non-scientist) can gather as many irrelevant and non-supportive citations as he wants, but the fact remains that there is not a lot of science behind TSM. They may bamboozle laymen, esp. those with some college psych courses behind them and pretensions to scientific literacy.

There are good reasons why main-stream medicine has not adopted TSM despite a reported 78% cure rate, and it is not because of conspiracies and money-grubbing; it is because the evidence is weak.

I pick on TSM because its followers seem especially vulnerable to self-delusion and propensity to toss around pseudo-science. Just take a pill, drink all you want, wait a year or more. Really?

Look, I admire the personal stories here and other forums, and the rah-rah-rah support offered by most posters. Even if a particular treatment makes no objective difference, if someone feels better for a day, or less desperate because of an online comment, it is a very good thing. Keep it up.

[37degrees]

Naltrexone is working for me!!

I just very quickly ran thru the list of references - many of them dealt with narcotic addiction, not AL. Since NAL is a pure narcotic-antagonist, and AL's opioid-agonist effects are minor, these references are disingenuous.

One thing hit me: Dr. Anton, a major figure in AL research, was in the list of references several times. In his only clinical article (that I know of) - published in the New England Journal of Medicine - he actually advocated abstinence in conjunction with NAL. No mention of TSM.

Of course, he was probably silenced by the main-stream medical/pharmacological/therapy establishments.

[Lo0p]

Naltrexone is working for me!!

I have full access to most of them. But you're right it's not exciting. I haven't even come across other studies of targeted nal.

The touted cure rate is false. I think you might be selling yourself a little short by quitting so early, which is what I was trying to show you with those graphs.

What I did was TSM and then ADDED high dose baclofen. And well, you can see the results in the link in my signature.

[Lo0p]

Naltrexone is working for me!!

37degrees;991335 wrote: One thing hit me: Dr. Anton, a major figure in AL research, was in the list of references several times. In his only clinical article (that I know of) - published in the New England Journal of Medicine - he actually advocated abstinence in conjunction with NAL. No mention of TSM.

You are reading it wrong. :H

The contradictions are a part of the argument! You have to read the first section about the bold and the underlining.

[Lo0p]

Naltrexone is working for me!!

37degrees;991335 wrote: I just very quickly ran thru the list of references - many of them dealt with narcotic addiction, not AL. Since NAL is a pure narcotic-antagonist, and AL's opioid-agonist effects are minor, these references are disingenuous.

Renault, P. F. (1978) Treatment of heroin-dependent persons with antagonists: Current status. Bulletin on Narcotics 30: 21?29. ? Renault, P. F. (1980) Treatment of heroin-dependent persons with antagonists: Cur rent status. In: Willett, R. E., and Barnett, G., (eds.) Naltrexone: Research Monograph 28, Washington, DC: National Institute of Drug Abuse, 11?22. First clinical trial of naltrexone and only controlled trial for opiate addic tion. Large double-blind placebo-controlled (DBPC) trial (n=197) plus 1005 open-label patients. Naltrexone was effective but only in patients who dis obeyed instructions not to use opiates while on medication. Not effective with abstinence. It was concluded that naltrexone works by extinction. Basis for FDA acceptance of naltrexone for opiate addiction.

That's showing extinction in action in the first clinical trial with naltrexone. It's not about alcohol...Were you drunk when you read the book?

[Lo0p]

Naltrexone is working for me!!

Dude you haven't even read this stuff, did you read the book? :H

[37degrees]

Naltrexone is working for me!!

Lo0p;991346 wrote: Renault, P. F. (1978) Treatment of heroin-dependent persons with antagonists: Current status. Bulletin on Narcotics 30: 21–29. ? Renault, P. F. (1980) Treatment of heroin-dependent persons with antagonists: Cur rent status. In: Willett, R. E., and Barnett, G., (eds.) Naltrexone: Research Monograph 28, Washington, DC: National Institute of Drug Abuse, 11–22. First clinical trial of naltrexone and only controlled trial for opiate addic tion. Large double-blind placebo-controlled (DBPC) trial (n=197) plus 1005 open-label patients. Naltrexone was effective but only in patients who dis obeyed instructions not to use opiates while on medication. Not effective with abstinence. It was concluded that naltrexone works by extinction. Basis for FDA acceptance of naltrexone for opiate addiction.


That's showing extinction in action in the first clinical trial with naltrexone. It's not about alcohol...Were you drunk when you read the book?

So why are you quoting it as support for treatment for alcoholism?

I looked up "Naltrexone: Research Monograph 28". Of the large number of study participants, only 17 of NAL and 18 of placebo users "cheated" and thus inadvertantly tested the TSM hypothesis. That is 17 and 18, not 1005. Plus, post-hoc subgroup analysis may lead to new hypotheses to be tested,but can't be used to form firm conclusions itself.

Neither the authors nor the reviewer concluded that "that naltrexone works by extinction". That's Eskapa's slant! I don't know what the heck he is talking about "Basis for FDA acceptance of naltrexone for opiate addiction". I thought you have access to the original articles. Why don't you go read a few before mindlessly parroting the Book?

Effects of NAL on narcotic addiction can't be directly transferable to its use for alcoholism. As already stated, AL hits many neural pathways and not just the opioid receptors, of which it is only a weak agonist anyways.

[37degrees]

Naltrexone is working for me!!

Lo0p;991350 wrote: Dude you haven't even read this stuff, did you read the book? :H

Yes I did, and I still have it on my Kindle.

I thought you went on to other therapies because TSM didn't work for you?

[37degrees]

Naltrexone is working for me!!

Lo0p;991341 wrote: You are reading it wrong. :H

The contradictions are a part of the argument! You have to read the first section about the bold and the underlining.

I love it: "The contradictions are a part of the argument".

Standard cult reasoning.

[Lo0p]

Naltrexone is working for me!!

I share your skepticism, on week 12 of TSM I was going bonkers. But I'm sorry I just can't read this stuff anymore.

:goodluck:

[37degrees]

Naltrexone is working for me!!

Oh boy, I read a few more of the annotated references given on the official Sinclair site, and some of the one-line comments are just flat-out misrepresentations of the actual articles. I don't know if the commentator (?Eskapa) is deliberately confabulating or is just scientifically ignorant. What a pile of crock. TSM may or may not work, but most of the references quoted don't support it and the annotations are laughable.

Don't take my word for it. Give a few of these articles along with the annotations to some of your friends who handle clinical studies. Watch them roll their eyes.

This kind of deception hurts real people. I looked at the TSM forum and there are folks there who are down to "just" 50 drinks/week or more after many months of TSM but insist that they are being cured because of Science. "Extinction." "78% cure rate." "Hundreds of studies." "Waited half-an-hour instead of one hour before drinking." "Rewiring the brain." "You gotta believe." Basically the classic alcoholic denials given cover by the pseudoscience of TSM. All the while posting their daily experiences consistent with severe alcoholism.

Ironically, Eskapa doesn't treat any patients with TSM, since he is not a doctor.

[37degrees]

Naltrexone is working for me!!

Lo0p;992805 wrote: I share your skepticism, on week 12 of TSM I was going bonkers. But I'm sorry I just can't read this stuff anymore.

:goodluck:

Lo0p, I wish you the best, and I congratulate you in successfully managing your alcohol intake.

But, Sinclair or Eskapa in this annotation is flat out lying. The study and review does not support TSM in any way. Either you haven't read the original sources or you are scientifically illiterate. Most of the other references are likewise non-supportive or irrelevant. The fact is, people like you with pretensions to scientific or medical literacy have been so bamboozled and bedazzled by ScientificLiteratureReferences that you fervently believe that TSM is SCIENTIFIC. In actuality, there is some support, but it is weak.

Medical literature isn't exactly quantum mechanics, but it does have nuances and sophistication that you and many others are missing. Why do you all buy into a book written by a non-scientist, non-academic, non-doctor whose only other published work is "Bizarre Sex"?





Renault, P. F. (1978) Treatment of heroin-dependent persons with antagonists: Current status. Bulletin on Narcotics 30: 21?29. ? Renault, P. F. (1980) Treatment of heroin-dependent persons with antagonists: Cur rent status. In: Willett, R. E., and Barnett, G., (eds.) Naltrexone: Research Monograph 28, Washington, DC: National Institute of Drug Abuse, 11?22. First clinical trial of naltrexone and only controlled trial for opiate addic tion. Large double-blind placebo-controlled (DBPC) trial (n=197) plus 1005 open-label patients. Naltrexone was effective but only in patients who dis obeyed instructions not to use opiates while on medication. Not effective with abstinence. It was concluded that naltrexone works by extinction. Basis for FDA acceptance of naltrexone for opiate addiction.

[Lo0p]

Naltrexone is working for me!!

NIDA Research Monograph 28, Page 17 wrote:
Since the theory behind narcotic antagonist treatment involves
extinction and the concept of extinction implies some use of narcotic
drugs, a subsample of those individuals who had at least one
urine sample positive for morphine and/or methadone was studied.
Only 17 of the naltrexone and 18 of the placebo subjects actually
tested the blockade by using an opiate agonist (heroin or methadone).
But, in this subsample, the naltrexone patients had significantly
fewer subsequent urines positive for methadone or morphine
and this difference was statistically significant. Also, the pattern
between the two groups was different. The pattern in the naltrexone
group was to test once or twice with heroin or methadone and
then to stop. The use of these drugs in the placebo group was sporadic
during the entire course of treatment. Thus, it seems clear
that naltrexone can prevent impulsive heroin use in motivated patients
from becoming a full-fledged relapse to chronic heroin dependence.

http://archives.drugabuse.gov/pdf/monographs/28.pdf

Sure it's not the actual trial but this is what the reference refers to (The NIDA report). Here's an interview with Dr. Sinclair where (at 36 minutes in) he explains why he referenced that particular trial: http://m.podshow.com/media/77/episod...12-03-2006.mp3 I'm done chasing your ghosts buddy. :bedtime:

edit: It was never cited by Eskapa or Sinclair (or me for that matter) as a reference to a study that shows naltrexone is effective against alcohol. It was referenced to single out those 17 patients specifically. I haven't read the book in over a year, I don't even own a copy (can I still be in the cult?) but you've got it on your Kindle and you should be able to sort through all of this yourself without complaining about it until someone shows you.

You can't just call people out for not doing the legwork when you haven't done it yourself. You're looking at this list of references, and that's all it is (references in a book), and calling it bullshit. All the while you are calling out anybody who just looks at it and calls it good and saying they're stupid.

I actually have read every single one that I could get my hands on (which is most of them). Lucky you, I think I'm the only one that drank the kool-aid that actually did! It's been over a year so the details are a little foggy but I did do it. If you'd like a copy of one of them just ask.

There are two off the top of my head that I'd like to throw you're way. But they're in PDF format so I'd have to email them to you. I've got to go watch the Rally to Restore Sanity right now (8:30 am here, I just edited my post from last night) and then I gotta work later.

[Lo0p]

Naltrexone is working for me!!

If we could sit down together, face to face and I could show you everything that I have. I'd have to meet you halfway and call a a lot of it BS. But we'd have to do it over beers (that is if I could choke down a couple), for several hours, and we could follow all the paper trails the whole way. I've got most of those printed out gathering dust in my closet, and I've been through them a hundred times.

The book is crap, half of the cult will tell you that. If I were Sinclair I wouldn't have supported it. There is substantially less actual support for it than it would make you think. But there's also lot more there than you're thinking right now. And there's the home runs too.