4 meds - which one?

[ignominous]

4 meds - which one?

Try the Bac man. Might even help you climb down off the high horse.

[Merlot]

4 meds - which one?

37degrees;1013085 wrote: Well, I am finishing 3 months on NAL/TSM. I can't honestly say it makes a difference. I drank very little the past week, but AL intake goes up and down.

Here is an interesting personal experience. Due to work-related reasons I was AF and NAL-free for the 4-day weekend. Today, I had a couple of beers without NAL. According to TSM doctrine, I should have gotten such an endorphin rush that I wouldn't be able to stop drinking. In fact, I didn't finish the 2nd beer because the bar/restaurant was so cold that I left. The buzz (mild from just 1 1/2 beers) was about the same as on NAL or pre-TSM.

I am going to conclude that NAL /TSM does nothing for me. I am sure that it works for a few people, just like any other treatment. There are some who insists that it works yet has deviated from the Method by adding other meds, or imposing self-control, or persisting for a year. I read comments like "I had 10 drinks today, but I feel in control, and besides without TSM I would have drunk 20, so this really works", or "I am down to 50 drinks/week thanks to NAL", or "I still drink daily from habit, but I have zero craving for 2 weeks now, so I am cured". I wonder how many people are really benefiting from this remedy.

I may try BAC next, but I am very leery of its cognitive side-effects. Maybe I will just try self-control for a few weeks. It didn't work before, but I am older now, and have some AL-related legal problems as an impetus.

It's too bad if it is not working for you. However, I'd give it more time. I took a look at one of the studies by Sinclair and it actually took about 9 months for the average person to cut their drinking down by 75%, from a modest average 37 units pre-TSM per week to 9 units.

I must say I was quite skeptical of TSM at first but as the weeks go by I am more and more a believer. Pre-TSM I was drinking everyday for years and averaging around 60 units per week or more. I am now on about week 12 and drinking around 20 or less units per week with very little effort besides taking the pill -- once I start drinking I simply don't want to drink as much as I used to any more. It used to be hard for me to do a single AF day, but it's much easier to do so now. I can only hope that this keeps up as it is something of a miracle, almost too easy. The only question now for me is whether it is sustainable long-term: only time will tell.

TSM is not a cult. It is simply a method. Eskapa's book might have been too optimistic on some of the time-lines and numbers. Obviously people posting over at TSM forum are going to be 'into' the method when they are doing it. Most people when they commit to something and are hoping for positive change, put aside some of their doubt and skepticism and just give it a shot. If you have a drinking problem, what could you have to lose simply taking a inexpensive tablet before drinking. If it works for you great. If not, by all means try something else and there are some other good ideas here.

Anecdotal evidence from many forum posters suggest TSM works for most people to at least some extent: at the very least it tends to cut some people's drinking down very substantially (50% or more). Others (most?) do far better. You need to give it a good 9 months I would say to be sure if it will benefit you. However, it appears that it does not work well for a sizable minority. Certain studies are now being conducted to determine if certain genetic markers can provide insight into whether the method will be successful for various individuals.

Message to others reading this. Give TSM a try if you are thinking of doing so. What do you have to lose? It seems to work for a lot of people.

Good luck.

[Dabhar]

4 meds - which one?

37....what price would you pay to be free of your alcohol dependancy? Probably a LOT if you didn't have to sacrifice time off work etc. However...there are a lot of people here who swear by Baclofen as being their total deliverance from Alcohol. I am suggesting that if you are able, take a few weeks off work...and give Bac a try....push past the side-effects....give yourself the gift of a few weeks off in order to free yourself from the rest of your life!

Think about it. We are here to help you.

Take care
Dab

[Sunnyvalenting]

4 meds - which one?

IMO, if you start at a low dose on a weekend you may not even need to take time off. I found that at day 3 with any increase, my side effects were more tolerable. One could then take 5 mg 3/day from saturday through thursday. bump it up the following week to ?10 (or a bit more if tolerating it). As long as you went slowly you could likely not take time off.
I took time off because I was at a clinic and they had an intensive psychotherapy part as well which was full time. IMO it was the bac and I didn't need all or ?any? of the other stuff. I don't begrudge it tho as it was part of finding bac. If I had titrated slowly, in my experience, there would have been no need to miss work generally.
Sunny
Sunny

[37degrees]

4 meds - which one?

Thanks for the info. I will prob. take a couple of weeks off in Jan. anyways, so it will be good timing if I do start BAC.

I am now off NAL and will just stay med-free for December. I have been AF for the past couple of days following several days of drinking. If I don't hit and maintain my AL goals by January, I will go with BAC. (Just looked up the price on Costco - I've never seen a prescription pill for 11 cents before!)

[Merlot]

4 meds - which one?

I just wanted to provide some further info on my above post re Naltrexone and TSM. It appears certain people respond better than others and that will depend on their genetics.

Here's a link to a study which may be of interest:

An evaluation of mu-opioid receptor (OPRM1) as a p... [Arch Gen Psychiatry. 2008] - PubMed result

Here is a company where you can obtain your genome array and suitability for NAL treatment:

https://www.23andme.com/health/naltrexone-treatment-response/

Good luck to all in finding your solution whatever it may be.

[_EndOfTheLine_]

4 meds - which one?

Merlot;1017316 wrote:

Here is a company where you can obtain your genome array and suitability for NAL treatment:

https://www.23andme.com/health/naltrexone-treatment-response/

Good luck to all in finding your solution whatever it may be.

Would not like to have my genome sequenced. What if I've muscular dystrophy heading my way....

There's also a health insurance concern

[37degrees]

4 meds - which one?

Merlot;1017316 wrote:
Here is a company where you can obtain your genome array and suitability for NAL treatment:

https://www.23andme.com/health/naltrexone-treatment-response/

Good luck to all in finding your solution whatever it may be.

Interesting. I've heard about the company in the news before, but I didn't know the service was so cheap. I just went and ordered the kit. I won't get the results for a couple of months, but I will post my result for that particular marker for NAL-responsiveness.

I looked at the abstract that you posted. The publication is a sub-analysis from the COMBINE study and so of course reflect the larger results. Of note is that half of the study participants had "good clinical outcomes" on placebo, and that NAL was not statistically different from combined behavioral intervention even in the genetically-favorable group. (That's from me eyeballing the graphs.)

The NAL group was not following TSM, of course, but the >50% response rate to placebo shows how difficult it is to estimate true efficacy from anecdotal reports.

Thanks.

[_EndOfTheLine_]

4 meds - which one?

Its insane that only 25% of alcoholics have the Asp40 allele

[37degrees]

4 meds - which one?

_EndOfTheLine_;1017351 wrote: Would not like to have my genome sequenced. What if I've muscular dystrophy heading my way....

There's also a health insurance concern

You would have muscular dystrophy by now, but I get what you mean. The disease with the clearest ethical considerations - Huntington's, where a easily confirmed genetic abnormality leads to an inexorable early neurological decline and death - is not tested. However, they do test for many carrier states and disease propensities.

[_EndOfTheLine_]

4 meds - which one?

I'd def love to get it done to see if I have the allele, but I reckon I do anyway by my response to Naltrexone. Either that or I'm one of the 50% placebo....

[37degrees]

4 meds - which one?

_EndOfTheLine_;1017602 wrote: I'd def love to get it done to see if I have the allele, but I reckon I do anyway by my response to Naltrexone. Either that or I'm one of the 50% placebo....

Actually, since TSM claims to work in a different paradigm, traditional-use NAL studies wouldn't apply to it anyways - something Sinclair and Eskapa specifically state.

[Merlot]

4 meds - which one?

I'm having the test done myself.

One thing I have to mention is that in my case I had a profound initial reaction to drinking on NAL, where I literally could not drink more than 25% of what I normally would per day. Example, 2 or 3 drinks vs. 8 or 9 drinks. Also, I immediately noticed that I was not having the same response to alcohol and was missing a lot of the buzz or ephoria I would normally experience. There is no way that reaction could have been placebo in my view. I am a very skeptical, or rather scientic minded, person and have always been suspicious of the efficacy of non-traditional medicines, vitamins, supplements, etc. However, my reaction was very immediate, strong and real. The initial reaction was not like taking some vitamin or supplement which is supposed to have this or that claimed effect and you are hoping it subtly works its magic. It was more like being hit over the head with a sledge hammer -- i.e., nothing subtle about it at all. After a couple of weeks I found I could drink more on NAL and that worried me, but the spike was short lived and my weekly units have been in free fall ever since.

I am just trying to give another perspective on TSM for readers here.

Again, I wish everyone the best in finding a solution for themselves. There are a wide variety of drinkers and drinking problems. It is reasonable to think that methods will work better or worse for people depending on a lot of factors including genetics.

Good luck.

[_EndOfTheLine_]

4 meds - which one?

37degrees;1017679 wrote: Actually, since TSM claims to work in a different paradigm, traditional-use NAL studies wouldn't apply to it anyways - something Sinclair and Eskapa specifically state.

In this case I think the methodology is largely the same; It doesn't seem that the alcoholics (drunks :P joking) were disqualified for drinking. I don't think that abstinence was specifically stated as an aim in this study, although clearly ethically favourable.

[_EndOfTheLine_]

4 meds - which one?

Merlot;1017749 wrote: I'm having the test done myself.

One thing I have to mention is that in my case I had a profound initial reaction to drinking on NAL, where I literally could not drink more than 25% of what I normally would per day. Example, 2 or 3 drinks vs. 8 or 9 drinks. Also, I immediately noticed that I was not having the same response to alcohol and was missing a lot of the buzz or ephoria I would normally experience. There is no way that reaction could have been placebo in my view. I am a very skeptical, or rather scientic minded, person and have always been suspicious of the efficacy of non-traditional medicines, vitamins, supplements, etc. However, my reaction was very immediate, strong and real. The initial reaction was not like taking some vitamin or supplement which is supposed to have this or that claimed effect and you are hoping it subtly works its magic. It was more like being hit over the head with a sledge hammer -- i.e., nothing subtle about it at all. After a couple of weeks I found I could drink more on NAL and that worried me, but the spike was short lived and my weekly units have been in free fall ever since.

I am just trying to give another perspective on TSM for readers here.

Again, I wish everyone the best in finding a solution for themselves. There are a wide variety of drinkers and drinking problems. It is reasonable to think that methods will work better or worse for people depending on a lot of factors including genetics.

Good luck.

I'm glad for your success and I don't want to discourage people from invstigating this option. However, I am annoyed at how misrepresented this method is by Dr Eskapa. Its not medically ethical to give cite stats that indicate a 78% successful outcome where other studies contradict this. Its implied that this figure is unanimous amongst all the researchers- in fact its way more complex. I don't like it, and my personal anger is that I suggested this to other people based on his representation, and now I have to retract it, after:
a) Acknowledging I have a drink problem to people I don't want to know that.
b) Embarrassing a family and having them face another false hope.