Sinclair Method Journey with Naltrexone

[EraserHead]

Reasons to stop (or reduce) drinking:

* I am pretty much a functioning sort of alcoholic, and don't have any major "problems" because of it. Hence the difficulty in convincing myself to quit or cut down. At worst, drinking often causes me to stay up too late and then wakes me up too early (thanks, cortisol). Then I am in a tired haze all day, and not on my game. I could be so much more effective and on my game, if this weren't the case. A few times I've shown up to work with a hangover that must have been rather obvious, which is embarrassing.

* I am in my 40s and the weight keeps creeping up. Drinking doesn't help.

* I have a 5-year-old child. Right now "drunk daddy" = "fun daddy." However, growing up I had several friends with an alcoholic for a parent, and they most certainly did not consider that parent to be fun in any way.

* I drink around a bottle and a half of wine a night, on average. Not sure how many units that is, but it amounts to a pretty good chunk of money. Right now that money is literally going down the toilet (by way of my kidneys). It could be going to lots of other, more useful things.

* I am constantly clearing my throat and have a swollen throat almost all of the time. Doc says this is due to acid reflux at night, and that the remedy is to not drink wine in the evenings. Easy enough, unless you're someone who feels compelled to drink wine every evening. I worry this might eventually cause throat cancer, and that would be a real bummer, wouldn't it?

* When I drink too much sitting by myself watching TV, and stay up too late, and then I'm hungover and tired the next day for absolutely no good reason, it really makes me want to kick myself.

* I am getting tired of being "that guy" who can always be expected to get drunk. (No one has ever said this to me, but I feel that is the perception people probably have.) In my 20s and 30s it was kind of cool or cute, but now it isn't cute anymore.

* Back to the weight thing again, trying to cut carbs or whatever else is totally useless when you drink alcohol, as it totally screws with your blood sugar and makes you compelled to wolf down a bagel in the morning.

[YouKayBee]

Sinclair Method Journey with Naltrexone

Hi Eraserhead

Have you got your Naltrexone and when do you plan on starting it?

You give lots of reasons for quitting, alcohol is supposed to cause cancers from lips to stomach and liver - basically anything it touches so a good reason to lower consumption(if you use mouthwash using an alcohol free brand might also help with that risk too). Initially you might find your sleep pattern worsen BUT Naltrexone can also have the side effect of drowsiness although nothing like as strong as traditional tranquilizers, benzos, baclofen etc.

I think, and this is only my opinion is that many people become dependent on alcohol in their lives, so well done on facing the issue. Naltrexone can also bring with it horrible hangovers BUT if you are already feeling tired, ill from your drinking levels, then you might find this improves.

On your final point, regardless of compulsion to eat bagels, alcohol contains LOTS of kcalories. 1 litre can contain 1000kcals. 1lb is roughly equivalent to 3500kcals over and above the body's requirements so doesn't take many days drinking to reach that figure - assuming you are eating well remainder of the day.

When following TSM one suggestion is to measure your drinks, that way you'll see progress much more easily. Another ket to success is never drinking without nal once you start, and several months in trying some enforced AF time seems to speed things along. It does take time - approximately 6-12 months but some people do really like it, and see massive benefits from it.

[EraserHead]

Sinclair Method Journey with Naltrexone

I decided to go the Sinclair Method approach after not having much success with kudzu. It seems to have helped a lot of people here. I was also inspired by some recent news articles, and was impressed by the research I read.

As a scientific side note, research shows that "among subjects of European descent, individuals with one or two copies of the Asp40 allele treated with naltrexone had significantly lower rates of relapse (p=0.044) and a longer time to return to heavy drinking (p=0.040) than those homozygous for the Asn40 allele." I'm unclear on what exactly constitutes the Asp40 allele. The best description I could find is here, which seems to indicate a C or T at rs7511984. But then some other sources seem to associate Asp40 with rs1799971. My values here are rs7511984:CT and rs1799971:AA. So I'm not sure if that counts as Asp40 or not... If anyone out there understands more about this genetics stuff, please clue me in about it!

Anyhow, I ordered 50 tabs from AllDayChemist. It took a while (maybe a month?) for the package to arrive. Then a shipping envelope showed up on my doorstep with stamps from India on it, with 5 packs of Naltima-branded Naltrexone-HCl, with 10 50mg tabs per package. The outer packages were crushed and in pretty bad shape, but the pills inside were still sealed and intact.

I can confirm that they taste pretty horrendous. You want to have a big glass of water ready and get one down fast. I have been taking them for 10 days now. I usually take one just as things are winding down at work, a half-hour or so before I leave, since I customarily have a first glass of wine not too long after I get home. So that gives it about an hour or hour-and-a-half to kick in. I have the feeling that it's actually more like 2 hours before it starts to take effect.

I have not experienced any side-effects as listed on Wikipedia. In fact, the effects are VERY subtle, and I must say I don't notice much of anything while drinking, other than:

(1) I start to feel very tired after a few drinks. This is the opposite of what I usually expect, as AL tends to have a stimulatory effect on me. (In fact, I often just down a couple martinis when I'm out but feeling tired, just to pick me up!) So it has certainly reduced my drinking in that I often just go home or go to bed when I would otherwise continue drinking. So I guess that is something.

(2) I seem to get drunk faster. I've had a very high tolerance for a long time, and don't usually get to the swaying and slurring phase without a lot of effort. Now it seems to come pretty quickly.

(3) Much worse hangovers. Along with the high tolerance, I haven't had bad hangovers for quite a long time (unless I really try hard). Now, it doesn't take much to make me miserable the next morning. Last Sunday morning I had a prolonged perspective of the bathroom that I hadn't seen for quite a while!

Other than those three things, I don't have much else to report. But I will continue to post here as things come up, on the off-chance that it might someday be useful to somebody....

[YouKayBee]

Sinclair Method Journey with Naltrexone

I've never looked into the genetics stuff, all I know is that it worked for me and I was happy with that.

Yes pre-TSM I initially would get a buzz from alcohol, I was energised from it, "where's the party" type effect. Like you once I started TSM I noticed feeling tired, rather than raring to go and would go to bed/stop drinking because I couldn't be bothered!

[EraserHead]

Sinclair Method Journey with Naltrexone

Hi YouKayBee,

Thanks for your reply! I never thought of it in those terms (ignorance is bliss!), but yes, 3500kcals is a lot!

Anyhow, I think you posted just as I was writing my follow-up, and you can see that I've indeed experienced the drowsiness and horrible hangovers you mention.

I've actually been sleeping pretty well, though I've also started taking 5000mg of Vitamin D in the mornings, which is supposed to help with that. (And no, this is not a perfectly controlled experiment what with starting the VitD at the same time as the Naltrexone... Oh well.)

Thanks very much for the advice. Do you mean measure your drinks as in pouring them in a measuring cup first? Then what would be the goal? Just to keep a record of how much I drink, to track progress? And yes, I'm with you on never drinking without the nal; that seems like a good idea, considering you're trying to slowly short-circuit that reinforcement link. And I would look forward to some AF time, though I must admit it doesn't happen for me very often these days.

[EraserHead]

Sinclair Method Journey with Naltrexone

We crossed posts again! But I'm glad to hear that I'm having a similar experience to yours, and that it seems to have worked for you! I'll continue to post here as things come up.

[YouKayBee]

Sinclair Method Journey with Naltrexone

What I mean about the drinks is that some people don't keep an accurate track and can't always see they are making progress, but seems that you have already noticed a difference, which is a good sign.

[EraserHead]

Sinclair Method Journey with Naltrexone

Weird thing happened...

Went out with my buddy to catch up and have a couple beers. We only had a couple, but I'd been drinking wine at home earlier, before we went out for the beers.

We stepped outside for a smoke. I only smoke when I drink, and haven't smoked much lately. Anyhow, got a real head-rush from the nicotine, and when we went back inside I was feeling dizzy and nauseated. So I didn't finish the beer I had there for awhile, just sat and listened to my buddy talk about some girl. Then things started to level off for me, and I gulped down the rest of the beer I had there and we left. (Normally I would probably try to talk the person with me into going somewhere else for another drink, but not this time.)

When I got home, I wanted to watch Jools Holland which I'd recorded earlier, and went to the fridge for the wine. Normally, I would sit there and drink several glasses in front of the TV. I had bottle that was already open. No work the next day. There was no reason not to drink. It was a situation that normally I would not think twice about.

But this time, I just looked at the wine and realized I had no desire to drink it at all. Just no desire. Instead I grabbed a can of seltzer and drank that while I watched TV. Then went to bed.

It's interesting, because this was not in any way an act of willpower. I simply did not have the desire to drink. And that is a pretty foreign feeling to me, especially when I've already had a few....

It's only been about 2 weeks now on the nal. Has anyone else experienced something like this? I have to say I am kind of amazed.

[YouKayBee]

Sinclair Method Journey with Naltrexone

EraserHead;1665008 wrote: Weird thing happened...

Went out with my buddy to catch up and have a couple beers. We only had a couple, but I'd been drinking wine at home earlier, before we went out for the beers.

We stepped outside for a smoke. I only smoke when I drink, and haven't smoked much lately. Anyhow, got a real head-rush from the nicotine, and when we went back inside I was feeling dizzy and nauseated. So I didn't finish the beer I had there for awhile, just sat and listened to my buddy talk about some girl. Then things started to level off for me, and I gulped down the rest of the beer I had there and we left. (Normally I would probably try to talk the person with me into going somewhere else for another drink, but not this time.)

When I got home, I wanted to watch Jools Holland which I'd recorded earlier, and went to the fridge for the wine. Normally, I would sit there and drink several glasses in front of the TV. I had bottle that was already open. No work the next day. There was no reason not to drink. It was a situation that normally I would not think twice about.

But this time, I just looked at the wine and realized I had no desire to drink it at all. Just no desire. Instead I grabbed a can of seltzer and drank that while I watched TV. Then went to bed.

It's interesting, because this was not in any way an act of willpower. I simply did not have the desire to drink. And that is a pretty foreign feeling to me, especially when I've already had a few....

It's only been about 2 weeks now on the nal. Has anyone else experienced something like this? I have to say I am kind of amazed.

My units halved from the first session with nal, no continuing the next day and no doing really stupid things. I just couldn't be bothered to shovel the old amounts down my neck.

[gracieb]

Sinclair Method Journey with Naltrexone

Hi Earaserhead, it looks like we started taking the nal at the same time. At first I started drinking more-I think because I felt like I could without getting plumb wasted. I haven't had a blackout since I started which is nice.

But I think I'm starting to level out now and definitely having some aversions but I'm not sure if that's a "switch" or just the fact that the nal makes me kind of queasy. I don't want to get my hopes up too soon. I've heard some respond very quickly and some take a very long time. Like over a year. Ugh. I do hope I'm not one of those!

I've also read that for some there's a honeymoon period where the drug seems to be working, but then there can be a resuming later until the real cure happens.

But no matter what, I am going to keep the Golden Rule. :P

I don't know if you know, but there is a forum for the Sinclair Method here:
thesinclairmethod.com • Login

Very slow, but there are people who respond if you ask a question.

Good luck to you.

[EraserHead]

Sinclair Method Journey with Naltrexone

Despite my experience the other night, I can definitely say I haven't hit any "switch" to speak of. Yesterday it was a nice evening and some friends were at a rooftop spot, so I had a few mojitos and then went home and drank some wine while watching TV til midnight or so. Then woke up too early this morning and feel tired and blah today.

Yesterday's nal came from a new package, and I almost wondered if it was a dud.... Checked the expiration, which was fine. (Incidentally, I noticed the box says it isn't to be sold for more than 543 rupees, which is only about 10 bucks. So they are making a good deal more by mail order than they would selling it locally!)

Other than my experience the other night, I can't say I feel particularly averse to anything yet. But I have slowed down a little. Last night after I got home I just made tea, rather than going straight for the wine. And glasses are lasting a bit longer. I am making it a point not to "try" to do anything.... Just drinking as I normally would, or however I feel.

YouKayBee, when you say your units halved after the first session, do you mean you experienced that much of a change after just one pill?

gracieb, I notice you have talked about Kudzu and L-Glutamine as well. Are you still taking these with the nal? I actually still have some in my little pill case that I keep the nal in, but haven't been taking it. What's your experience with that?

[gracieb]

Sinclair Method Journey with Naltrexone

I find the kudzu, especially, to be helpful in helping in controlling binges. I can't drink as much when I take it and last week I was out and drank and it turned into a bender and then I realized it was probably because I didn't take the kudzu. It doesn't fix it for me, I can still drink too much, but it does make it so I drink slower, have this kind of full feeling and don't go for broke. The L-Glutamine seems to help this way too, and it helps with cravings somewhat. So I'm using these to help moderate until the switch kicks in.

You might check on the brand of your nal. Is it nodict? Some folks on the other board felt that one was inconsistent in it's quality. Also, it might be your body adjusting to the drug. I think patience is key with this treatment. I'm really not looking for a cure for at least three months. Some have taken a year and then bam, switch all at once. And the length of the cure seem to correlate with how long you've been drinking. Which makes sense, if your brain has been being trained to find it's pleasure with alcohol for twenty years it's going to take a little while to retrain it. It's subconscious, so you won't necessarily feel any thing working.

Not to come off as a know it all, this is just what I've been reading on the Sinclair sight.

[YouKayBee]

Sinclair Method Journey with Naltrexone

EraserHead;1665759 wrote: Despite my experience the other night, I can definitely say I haven't hit any "switch" to speak of. Yesterday it was a nice evening and some friends were at a rooftop spot, so I had a few mojitos and then went home and drank some wine while watching TV til midnight or so. Then woke up too early this morning and feel tired and blah today.

Yesterday's nal came from a new package, and I almost wondered if it was a dud.... Checked the expiration, which was fine. (Incidentally, I noticed the box says it isn't to be sold for more than 543 rupees, which is only about 10 bucks. So they are making a good deal more by mail order than they would selling it locally!)

Other than my experience the other night, I can't say I feel particularly averse to anything yet. But I have slowed down a little. Last night after I got home I just made tea, rather than going straight for the wine. And glasses are lasting a bit longer. I am making it a point not to "try" to do anything.... Just drinking as I normally would, or however I feel.

YouKayBee, when you say your units halved after the first session, do you mean you experienced that much of a change after just one pill?

gracieb, I notice you have talked about Kudzu and L-Glutamine as well. Are you still taking these with the nal? I actually still have some in my little pill case that I keep the nal in, but haven't been taking it. What's your experience with that?

Pre-nal/TSM I would drink 30 units in most sessions, which could be a few hours, or all day. I often would drink the following morning and write the next day off, that's if I wasn't vomitting. Sometimes, very occasionally I might have only 20 units in a session (ie on one day). I might drink for 1 day or 3 days, then manage 2-10 days of abstenance. I did have spells where I drank 5 days a week, for up to 6 weeks, 30 units a day so have sort of done daily drinking too but would get so bored and low I'd give that up and do something like a detox. Drinking this amount each time meant I couldn't function if I was drinking, nor the day afterwards.

I didn't actually initially take nal strictly TSM, I was advised to take it earlier in the day because I couldn't trust myself to wait once the urge came on, so I took mine late morning, if it got really late before I wanted a drink I'd then take another 50 or 25mg dose. The first time I drank on Nal I didn't go above 15 units and never had done since then. I was soon down to 10 units BUT because it was now safe for me to drink, I had gotten into daily drinking - by which I mean in the evening. Waking up after drinking I never drank in the morning again. I did once or twice for social reasons have lunchtime drinks, but never because I'd woken and wanted to drink.

So my session units came down but overall weekly didn't drop that much, but over time I was able to put AF days in, until I was only drinking perhaps twice or even once a week, I also had occasions where I only drank 1 or 2 drinks and left it there.

Took me 6 months to get to a point where I could say the drive to drink had been removed, but the changes started from day 1.

I will say there were times when I didn't notice much of a difference, times even after cure when I did have some 'racy' evenings and I was scared it had stopped working. I did however know when I awoke the next day that I was able to not want a drink - which I told myself was the sign it was still working in some way.

What I'm trying to say is that my experience was that you don't feel it all the time AND I have a theory which was backed up by others, that as you come across new triggers, you sort of have to extinguish them. For instance 2 months into TSM I had my first holiday for years, and flirted with someone I fancied - I had what I call a spike, there were other things that cropped up, bits of stress, celebrations, different drinks I tried to see what they tasted like that sort of thing. I thoroughly believe you have to drink through these triggers, and remove the association with relief from whatever it is, as part of the journey to retraining your brain. I also did a lot of work on myself, something that is still on going - I thought I'd finished that, then something recently came up and affected me more than expected. For me there was definitely a cognitive aspect, firstly recognising that you don't have to get blasted, that you might prefer to go to bed instead of those extra drinks. Dealing with things I've listed as triggers, getting through situations on less alcohol or none at all. Learning how to deal with yourself and others.

I've gone on a bit, so sorry if I've monopolised your thread. It's so difficult to describe in a few sentences.

To sum it up, we are not lab rats who can take a pill and not drink or drink less, we are human beings with the ability to argue the toss with ourselves - which means any fix for alcoholism has to involve body and mind.

[EraserHead]

Sinclair Method Journey with Naltrexone

Happy Saturday! I have two things to report, so I'm going to make two separate posts here about each.

First, I want to follow up on my last post and on gracieb's and YouKayBee's responses. I had switched to a new package of nal, and suddenly wasn't feeling the effects that I had felt before. No more tiredness after a few glasses. In fact, I quite effectively sat and drank a bottle of wine by myself and stayed up late getting drunk and watching a dumb movie, and then kicked myself all the next day at work for being hungover and tired for no reason. And despite continuing to take the nal, I now did not experience any tiredness, any reduction of desire to drink, or any unusually bad hangover. So what gives?

gracieb suggested to check the brand of the nal, as people have noticed inconsistencies with some brands. I'm using Naltima-50, manufactured by INTAS Pharm in Dehradun, India, and purchased from ADC. The expiration on them is Aug 2016, so they should be OK by that measure.

Another possibility is that my body is adjusting to the drug, and/or, as YouKayBee suggests, coming across "new triggers." YouKayBee, I think this is a fascinating theory, and it makes total sense to me about "drinking through the triggers." You're very right that there is a complex psychological mechanism going on here, and we all need to work through it in our own way. The interesting thing about TSM, for me, is how it attempts to work *with* your psychology instead of against it, as so many other methods do. It's kind of like when they tell you not to try to swim against a current that is carrying you away, as you'll just tire yourself out faster. I always felt the same about other treatment methods. The great thing about TSM is that it is much easier psychologically, and, presuming that it will in fact work effectively over time, helps you to re-adjust your attitude towards alcohol without relying on willpower and self-denial. (I have a strong philosophical opinion that "willpower" is one of the most damaging constructs of our society -- people often presume they lack it when in fact they are hampered by too much of it.)

Anyhow, back to the story: These are good theories. A few nights ago, I decided to test the "inconsistent nal quality" theory by just opening a new box and using pills from a different batch for a few days, to see if it was related to the batch. If I still didn't feel anything, then maybe it was just my body acclimating to the medication.

The result? It was like night and day. First night on the new batch, all the old symptoms came back: Got tired and no longer felt like drinking. When I did drink a lot, had a horrible headache the next morning. It was like Day One on the nal all over again.

So I think the nal inconsistency is indeed to blame in this case. I threw out the "bad" batch and continued on the new one. I'm just worried that 7 days of drinking on the ineffective nal reversed whatever changes might have happened previously!

gracieb, would you mind sharing how much kudzu & glutamine you take, and at what times of day? I think I will start adding that to the nal as well, and see how it goes.

[EraserHead]

Sinclair Method Journey with Naltrexone

Now on to the second thing:

I mentioned in an earlier post that I chose nal partly because of the supporting science that I'd read behind it (I'm a science geek.) There was one thing I read but didn't quite understand, regarding the genetics discussed in many of the science studies. Well, I've done a bunch more reading and now understand it much better, so I'd like to share that here.

Let me first summarize the scientific theory, as I understand it (please correct me if you see anything wrong): Certain people who show alcohol dependency may do so because their brains produce more happy juice (dopamine) when they drink alcohol. This juice is due to opioid receptors that become more active in some people than in others when they drink alcohol. The increase in activity for some people can be traced to a single genetic polymorphism (i.e., the letters on a single gene) that will cause production of a protein called Asp40, rather than a different protein called Asn40.

The gene location in question is OPRM1, or SNP rs1799971, or position 154360797 on Chromosome 6. It's also referred to as A118G. It can take one of two different nucleobases: A (adenine) or G (guanine). Every SNP has two nucleobases on it. So in this case, either you are homozygous (both letters are the same) with AA (Asn40/Asn40) or GG (Asp40/Asp40), or you are heterozygous (one of each letter) with AG (Asp40/Asn40).

You can find this info here:
Rs1799971 - SNPedia

The standing theory is people who are GG or AG at this location produce Asp40 (while AAs only produce Asn40), and the Asp40 protein causes the greater opioid response to alcohol. The naltrexone interferes with that greater response, so these people are better candidates for nal treatment. Indeed, a number of studies have shown that Asp40 carriers show better outcomes with naltrexone, while homozygous AA people don't seem to do any better taking nal than they would just taking a sugar pill placebo. (Though a sugar pill must taste better than the nal!)

There have been some criticisms of the findings of these studies, which should be taken into account.

TL;DR: If you do not have a "G" at location rs1799971, studies imply that naltrexone treatment probably won't help you much.

That said, I had my own genome sequenced by 23andMe last year (they'll do it for $99), and my own value at this location is AA. So in theory, the naltrexone would be wasted on me. However, as I've said above, I definitely have noticed some effect. So I'm going to continue to take it and see what happens.

I think I will also cross-post this into a new thread, just to see if anyone else cares to geek out with me....