4 meds - which one?

[Merlot]

4 meds - which one?

_EndOfTheLine_;1017769 wrote: 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.

I understand. While TSM seems to be working for me more or less as described in Eskapa's book, it appears that the 78% success rate and 3 or 4 month time frame are too optimistic. At least that is my impression based on the posts of many people over at the TSM forum and here.

As I mentioned above in an earlier post, the 3 or 4 month 'cure' is not even really supported by the data found in Eskapa's book. If you look at one of the charts he presents a few times as evidence of the method it shows roughly the following:

115 successful patients with pre-TSM average drinking of only 37 units per week. These were heavy drinkers but not exactly all star alcoholics.

At 110 days on TSM (nearly 4 months), they were down to about 17.5 units per week, a 50% reduction in drinking.

It took these successful patients about 9 months to reach only 9 units per week, which is about a 75% reduction in weekly units.

[_EndOfTheLine_]

4 meds - which one?

I don't like the idea of working on averages- one patient could skew the whole result. I have been on TSM 124 days, not cured yet-hungover right now in fact. My intention is to see it out to the new year and then take a different angle- probably abstinence based on a CBT/REBT model. New Year is a good cut-off for me- its about 5 months, or 21 weeks. More than enough time in my view.

[37degrees]

4 meds - which one?

_EndOfTheLine_;1017989 wrote: I don't like the idea of working on averages- one patient could skew the whole result. I have been on TSM 124 days, not cured yet-hungover right now in fact. My intention is to see it out to the new year and then take a different angle- probably abstinence based on a CBT/REBT model. New Year is a good cut-off for me- its about 5 months, or 21 weeks. More than enough time in my view.

From your previous posts, I thought you had some improvement on TSM? Alcoholism is a tough, tough problem, and any improvement is good news.

Forums like these act as secular support groups, and are beneficial, so scientific discussions may not be appropriate here.

For example, the TSM "78% cure" rate was a self-report by a Finnish clinic which was not published in any peer-reviewed journal. More striking to me is that the same clinic - in current operation for profit - has not state their recent success rate! If they really have such success, wouldn't they blaring it from the rooftops? Remember, they are a *commercial* enterprise.

For what it's worth, 50% of placebos in various studies are clinically improved. In fact, 25% of placebos are abstinent at 6 months.

My personal opinion is that some of the AL treatments have modest effects, and worth trying. There is no magic bullet. I also think that "moderate drinking" is an unstable goal, and it is better to try abstinence.

[37degrees]

4 meds - which one?

Since I went off NAL/TSM 2 weeks ago, I have been averaging 2 1/2 drinks, from 0 to 6 drinks a day. There is no additional AL craving, nor endorphin rebound.

On some reflection, it seems clear to me that the whole idea behind TSM is so much bollocks. The endorphin system is involved in many pleasurable pathways, but it plays only a small role in alcohol. The clearest demonstration is that blocking opioid receptors (with naltrexone or naloxone) produces immediate agonizing withdrawal in narcotic addicts but has minimal effects on the alcoholic.

NAL/TSM probably has some small efficacy, but no one really know how it works.
Eskapa is just selling snake oil. (For those wondering about the medical ethics of "Dr." Eskapa, he is not a real doctor. He has a Ph.D from a therapist diploma-mill in California, and has zero peer-reviewed publications.

[Ne/Neva Eva]

4 meds - which one?

Lordy. I'm looking forward to hearing what you have to say when you set your sights on baclofen. Want to decipher the Science article in the meantime?
best

[37degrees]

4 meds - which one?

I don't have sights set on anything. I would be happy if everyone gets cured.

If it seems like I'm picking on TSM, it is because its adherents seem particularly self-deluded. For example, one of the MWO cross-posters was just admonished not to suggest (very weakly) that TSM may not work for a small percentage, because that is bad for morale. In fact, I suspect that it is the other way around - TSM works only for a small percentage.

It is strange, really. Even TSM'ers who have to move on to other treatments (Topa, BAC) keep on insisting that TSM works.

I guess another thing I find irritating about TSM is all the pseudo-science and catch-phrases tossed around - "extinction", "deprivation effect".

I think a lot of the benefit is from participation in secular group therapies (i.e. these forums).

Don't worry, I may never get around to BAC : ) . So far, off all meds, I find I've been moderating my AL intake adequately.

[Bruunhilde]

4 meds - which one?

Hey 37, how's 99?

Regarding God, I've been through every iteration of god analysis, and there is one very primary thought that you in fact ARE god, that god is in everyone and everyone is god.

I agree that criticizing a protocol or citing issues with it can draw fire, it's really a shame, because what is the forum for if we can't say anything and everything? We might as well be in an AA meeting talking about higher powers.

[Merlot]

4 meds - which one?

Just to counteract some recent posts and as a follow up to my earlier posts, since the New Year I have seen a massive change in my drinking as a result of TSM. I have just completed 5 months on TSM.

I am now drinking only once or twice a week and only about 2 to 6 units per week most weeks. I have been averaging less than a drink per day for weeks and weeks on end now. I no longer think about alcohol very much and my drinking, as rare as it is, is more to continue the TSM therapy once or twice a week. All cravings for alcohol are gone. When I do drink I feel no compulsion at all to drink more and more. In addition, I have gone out several times to bars, clubs and night clubs in the past several weeks (trigger situations) to test things out and find it easy to stop after a few drinks when on NAL. I actually keep wasting money due to pouring the last drink down the sink more often than not because I just don't feel like it!

I know TSM does not work for everyone, but it has for me. This is after years of struggles and trying a variety of different approaches.

Good luck to everyone in finding a solution for yourself. If you haven't tried TSM I highly recommend giving it a shot. No one is making any substantial money off this method and I am posting this here just in the hope that it may help someone like it has helped me. The cost to me was a $14.95 book purchased new and some $1.67 tablets I ordered online. Nothing else!

A very satisfied TSM 'customer' and initial skeptic.

[KisstheBull]

4 meds - which one?

Merlot, thanks for posting your experience. I have Nal sitting in my medicine cabinet. I took half a pill 2 weeks ago. I felt funky and kind of dizzed out. I drank and had a tremendous hangover the next day. Altough come to find out I was also coming down with strep throat unknowingly. I am afraid to try again. I really don't want to get that awful hangover ( much worse than just drinking w/o Nal) . Can I expect this to diminish with time? I noticed most people on this board are using Bac, so it is great for me to see someone using TSM. I have read the book and want to start but nervous to do so.:thanks:

[Merlot]

4 meds - which one?

Kissthebull, side effects are normal at the start. The most common is as you described -- a spaced out feeling. That almost always goes away after a few days. I'd cut a single tablet into 4 pieces and slowly increase the dose over time. Lots of helpful advice on the method can be found over at thesinclairmethod.com • Index page

A lot of breakthroughs seem to be occurring right now with people there and a lot of new people have joined. Good luck.

[KisstheBull]

4 meds - which one?

Merlot, thank you I will check out the link you suggested. I really appreciate it and I will try to do like you said...to split the tablet into four to start.
Thanks again!

[Bruunhilde]

4 meds - which one?

Merlot, this genome test, what kind of result details did they deliver to you?