Naltrexone

[nicnak68]

So having stopped Baclofen for many reasons I'm now starting naltrexone tommorow and will keep you posted on how I get on

[Ne/Neva Eva]

I just added naltrexone to my arsenal of pills, Nic. I have heard both things--some people swear by and are amazed at it's efficacy and some think it doesn't do anything. Whatever. I'm voting on it doing something.

The nal has made my stomach really upset which is a common side effect, so don't forget to eat something with it. Are you starting on 25mg? That's where I started (3 days ago) and will take the full 50mg after 6 days, or when my stomach calms down. Whichever comes first.

Sorry I didn't respond yesterday. Ran out of words...Spent the day in my own little space. I had TWO social functions on Wednesday and I think they wiped me out! lol

Keep us posted and good luck!

[Ne/Neva Eva]

Also, are you doing TSM or trying to remain abstinent? I'm torn about which avenue to take, but am still drinking at the moment, so it doesn't really matter. Are you still drinking?

[nicnak68]

Hi Ne
I took my first 25mg today and am doing TSM
Took the pill one hour before drinking and its definetly having an effect,drinking much slower

[nicnak68]

Also,as far as I know it doesn't work unless you drink.Reinfircing things in your brain ect

[Ne/Neva Eva]

Also,as far as I know it doesn't work unless you drink.Reinfircing things in your brain ect

That's the theory behind TSM, and probably how I'll use it, too.

But I have also heard from people who use it the traditional way, the way it's generally prescribed is that you take it everyday and try to maintain abstinence, and it has worked for them in that way, too.

I decided that the bottom line is that it was worth a try to see if I could speed up reaching indifference, instead of slowly titrating up on baclofen alone. But I'm eager to see how it works for you.

And I agree, it did something the very first time I took it. Even at just 25mg.

[YouKayBee]

Yes there are two ways to take it, if you are drinking you might as well take it.

Do be aware of the honeymoon effect which is a period at the beginning of TSM where you may notice an effect, followed by quite a long time when your drinking may go back to normal or evening worse. Many people give up at this point thinking it's not working - but it usually is and can take anything from 6 months to over 12 months to actually make a difference.

On the other hand I was lucky enough to see my intake half right from the first session drinking doing TSM, and it never went back to pre-TSM levels.

[aihfl]

The nal has made my stomach really upset which is a common side effect, so don't forget to eat something with it.

Several times when I took nal (I took 50mg straight away), I experienced what I can only characterize as mild opiate withdrawal with nausea, profuse sweating and chills (I have the dubious honor of having been addicted to prescription opiates as well). I had to take nal my entire stay in rehab and I kept with it afterwards, even when I relapsed post rehab. It didn't diminish the effect of the buzz in any way, so I eventually stopped. I hope you all have different results.

[Otter]

Has anyone seen Father Jack on Father Ted. The actor died a few days ago.

My problem here and I think this is why I come across as so pro-baclofen is that my experience with alcoholism is in cases which make Father Jack look stone cold sober. He could sit in a chair and by comparison, behaved sensibly. My experience is with a much worse case so I just can't get to grips with people who say they have an alcohol "problem" but can come here, post, type, google, work, drive cars, see straight, use the toilet and not their own bed...

I think we are all talking about different things. I don't now think that a lot of people here meet the DSM V criteria for being diagnosed with AUD as an illness and if that is the case, Naltrexone may help them use their own wits to stop drinking.

Take it from someone who has seen alcoholism at its very worst. Naltrexone is not the answer. Where there is a real and very serious "illness" and you drink because you get a buzz, enjoy it, you are nowhere near the state of someone who drinks alcohol because it has become a physical requirement to stay so drunk they have no appreciation of being alive.

[nicnak68]

Hi otter
I'm not sure I really know what you are trying to say.

[Otter]

I am interested in whether anyone has any experience of either the long term effects of Nal or if anyone who uses it has as extreme a condition as that which I have mentioned. It seems to me to be a treatment to reduce drinking in those who drink heavily but probably would not be diagnosed with AUD or at least serious AUD.

[guapo]

Long-term effects of NAL , after about three years, Are unnoticeable. What is noticeable, is no more problems with excessive and life ruining alcohol abuse.

Some take the medication every day, and continue to drink every day, as that is what they want to do. Others use it as a path to sobriety.

Others find it can lead to an indifference to alcohol, and seeing that getting drunk serves no purpose

I suppose it depends how much medication you consume,

For me, taking small doses five or six times a month is plenty, and I see no issue with that.

You can debate the AUD definitions, until the cows come home. Definitely not a black or white definition.

Having a bit of experience dealing with alcohol abusers, the only certainty, is that controlling the problem requires two things.

Committing yourself to doing it.

Decreasing or stopping drinking

[Baclofenman]

My experience is with a much worse case so I just can't get to grips with people who say they have an alcohol "problem" but can come here, post, type, google, work, drive cars, see straight, use the toilet and not their own bed...

I think this group is what is known as a "Functioning Alcoholic" - Just because they are in control of their facilties does not mean they do not have an "Alcohol Problem"

However I expect the point you are trying to make is that Functioning Alcoholics are not Alcohol dependent? - In which case I disagree

[Edit] Otter, I get the distinct impression you think their are a lot of "*Plastic" Alcoholics out there which is slightly patronising on those who recognise they have a dependency problem without becoming a total emabarassment to themselves (possibly a bad turn of phrase but all I could come up with) [/Edit]


Regards


Bacman

* Plastic may be a British phrase but it means false-consensus bias

[Otter]

The problem is with terminology. If one takes Ameisen's discovery that there is a Gaba b involvement and an organic illness and which is treatbable by treating Gaba b dysphoria, then this illness is one which can only be treated with baclofen or some other Gaba B agonist. By definition, this disease, is not being treated with Nal. What is being done is more like a substitution of one eurphoria creating drug for another.

What this may be doing is lessening the impact of alcohol on the brain and allowing it to recover thereby giving a person greater control, but then you are back to 12 Step approaches, will power and you are not treating or curing an illness directly with the drug itself. That is my point.

I have some other concerns or reservations about Nal. Since it is being hyped by TSM people for profit I wonder if the stats on its success are reliable. I also wonder if it works for anyone who is truly suffering from alcohol addiction which has reached a point where it can properly be defined as an "illness".

Another concern I have is that I have a horrible feeling that doctors are going to be faced with huge problems when they start trying to justify presxribing it when there are risks associated with continuing to drink and the drug itself may make people unable to properly weigh their situations and they end up drink driving or similar and blame the doctor. Why would a doctor bother if baclofen becomes avaiailable and there is no need to actively encourage a patient to drink. I see a real legal/ethical/ liability time bomb.

[neophyte]

I was what you defined as a functional alcoholic, I had a job, hobbies, friends and a partner. I never "lost it all" and was drinking 24/7. I was functional on the outside but mentally I was not at all.

I had high anxiety all day until I drank at night, when I was drunk I had like 30 mins of euphoria then followed by paranoid and suicidal thoughts. I
contemplated suicide constantly. So you can't label that as not having a real alcohol problem. I think you can't really understand unless you have been through it. The mental side of things breaks some people before the physical.

I knew I had to stop but I couldn't because of the cravings. Everyday I would say not tonight, then on auto pilot I would head to the liquor store to buy bottom shelf whiskey.

I was also alcohol dependent, each morning at 4am I would wake up because of glutamate rebound in a panic. The rest of the day I was basically in alcohol withdrawal and towards the end of dependency I realised having 1 or 2 drinks in the morning smoothed things over. I found baclofen shortly after this phase and i think I narrowly avoided heading towards the 24/7 drinking phase.