Feel like I'm relapsing on Naltrexone

General health and lifestyle
1

Hi All,

Been doing really well for the last 5 months on Nal, a slow but progressive cutting down of the alcohol. 

However the last 3 weeks it has been going up again :-( not sure why. 

Naltrexone has killed my urges and ability to drink wine, I actually dislike the taste and struggle to drink it, however I have now switched to vodka to avoid this issue -.- 

I find Naltrexone doesn't work as well with spirits and I can still easily drink half a bottle of vodka in one night while on Nal. I really want to get this down. I'm also back up to drinking four nights a week instead of two. 

Don't get me wrong this is still an improvement but after 6 months almost on Nal i was hoping to be doing better and  be more stable with drinking less nights. 

I can still easily drink 10-15 units per night and suffer a blackout. 

Do you think upping the amount of Naltrexone will help me? I'm struggling and feel like I'm going backwards 

2

'Naltrexone has killed my urges and ability to drink wine, I actually dislike the taste and struggle to drink it, however I have now switched to vodka to avoid this issue'

Do you not see a gaping hole in the problem? You are deliberately trying to circumnavigate the success of naltrexone to give you the buzz.

You have to work with medications not try and beat them. You either want to give up or continue having the buzz, you can't have both. What if naltrexone beats the vodka, where will you go next to 'avoid this issue'?

3

Hi Natalie,

It isn't that drinking vodka makes the naltrexone less effective, it's just that drinking spirits of any kind tend to go down to quickly and when it floods the pre-frontal cortex part of your brain, the decision making process goes to pot and so you are less able to make rational decisions about when to stop.  Indeed, in the clinics that use The Sinclair Method as a treatment, patients are discouraged from drinking spirits at all for this reason.

Increasing your dosage is unlikely to have much long term effect on this.  The dosage was most probably correct for you because for 5 months, it was working well.  This wouldn't have occurred if the dosage wasn't right.

I would encourage you to go back to what you was drinking until you reach the inevitable extinction of your cravings, and then re-evaluate what/if you still want to drink spirits (or drink at all for that matter).

As long as you have remained compliant throughout the vodka drinking then it will not have affected your ultimate progress towards extinction. 

(My above also makes the assumption that you haven't changed brands of naltrexone or added any additional factors, such as another medication, into the equation).

4

Hi, thanks!

I don't get the buzz from vodka or any alcohol anymore but I can still drink a lot of vodka compared to wine say. 

I wish I could change how I'm viewing this and instead of switching to spirits to go back to wine  

I'm actively avoiding wine so I can still get drunk even though I don't get a buzz from it, which seems ridculous. I'm getting nothing from it at all now apart from ill. 

The brand of Nal might be different as it comes in a different box everytime as they always have to order it in specially. But I am sticking to at least an hour before every drink to take it and more time if I can as that seems to help also. 

I think I will go back to wine! and avoid spirits now if i can. I can't see any other way around it! 

I wish i could motivate myself back into some kind of routine because i feel like that would help, but life has been up in the air the last few years lol. 

5

'I'm actively avoiding wine so I can still get drunk'

The problem is, if naltrexone works for spirits, will you move onto something else?

'The brand of Nal might be different as it comes in a different box everytime'

I think what Joanna is worried about, is have you switched (been switched) from Naltima to Nodict. What is your current brand?

6

What you are saying here confirms that it absolutely isn't anything to do with the dosage - which, incidently, it rarely is.  Though there will always be the exception to the rule when it comes to maybe needing a little more naltrexone, it usually has more to do with action than dosage.   And the fact that you are not getting the buzz means that the brand of naltrexone is fine too.

Here is the thing with these (any) medications.  They do not stop you if you are insisted on pouring the drink down your neck.  With naltrexone, all it does it block the endorphin rush that means you are compulsively being driven to continue drinking.

With that blockage in place, there becomes the question of putting some action in to learn NEW habits in place of the old drinking habits.  This takes time and patience, because most all of us have ever really known is drinking.

Here is a good question for you:  why do you feel the need to get drunk?  Is it a way that you cope with stresses of daily life?  Are you looking to escape something?

The answer to this, whatever it is, will tell you that in place of alcohol you need to be looking to change your lifestyle in other ways.  For example, if it is a coping technique, then you will need to learn new and more healthy/appropriate ways of coping.

If you do nothing but remain compliant, then the good news is that eventually your brain will realise that getting drunk without the buzz is a pointless thing to do, but how long would that be?  The longer it goes on, the more likely you are to eventually convince yourself to not take the tablet and you will be back to where you started pre-naltrexone.  This treatment is a marathon, not a sprint.  It took me 8 months to complete become indifferent to alcohol.

And when it does happen, you will still be left with having to find something to fill the void.  For nearly all of us, alcohol has filled some kind of void - whether that was pain or boredom.  Take the alcohol away, and there is a huge big void that you can fill with lots and lots of GOOD things.

Take this as an opportunity which is both exciting and exiting in equal measure.  It's like an etch-a-sketch?  (Remember that, ha ha!).  You have the opportunity to shake away the old remnants of something you were happy with - drinking - and redraw a new future for yourself that is far, far, far more rewarding that your old one!

7

Sorry, I meant 'exciting and enthralling in equal measure'.

Wish we could edit posts!

8

And of course 'something you were UNhappy with'.

Gosh, can you tell I haven't had a coffee yet this morning???  I am going to get one right now!!!!

9

Hi Joanna,

Do you really think it's true that if you remain compliant eventually your brain will adjust and you will just give up trying to drink? That's what I've been advised and told that regardless of mindful drinking or not that eventually it will work.

Do you think that's true (trying to remain hopeful)

Thanks

10

You have hit the nail on the head. 

If i had to question why i drink...in the past it was because i was unhappy with my relationship and life and bored. I have changed the relationship and my life somewhat....

But i still feel kind of empty? I keep trying to find hobbies or make friends or take up something to fill my time and I have not succeeded yet. I only work part time and almost desperately want to up[ my hours to try and stop the week day drinking, but I'm in a job I don't particulary love so not sure it would help. 

I do suffer with depression but i always assumed that was the drinking too. 

I feel like i might need more help, but i tried councelling more than once, and have been to the ARC clinics etc. 

Now looking into hypnosis maybe? I dunno....I know i have mental issues as well as drinking ones, which lead to which i dont know anymore? 

Sometimes i feel without drinking there would be no excitement in my life, not that i find drinking exciting anymore? It's odd and hard to explain. 

But your right the drinking is not my only issue, it's maybe a mainifestation or underlaying things. Councelling is meant to drag this stuff out but it never really did to be honest. 

I think that sometimes i think that life is pointless, stuck in this stupid rut of having to work until you die with limited freedom. Sometimes all i wanna do is pack a bag and fly off somewhere but responsibilies tie you down. 

 

11

The science has shown that it is true, and that is also confirmed by my own experience of counselling people on this method.

The issue is that the longer someone perceives an issue with TSM working, the more chance there is that they will get impatient or dissillusioned and start not waiting the hour, or skipping/stopping the tablets altogether.

From my experience, it is certainly a smoother process if someone works with the tablets to start learning new habits etc - simply because they start to see results and they don't fall into that high-risk area of non-compliance.

The stats show this method is effective for around 78% of those who remain compliant.  Interestingly enough, it worked for 100% of the rats prior to human clinical testing.

Of the remaining 22% of humans, around half of those cause themselves not to be in the success group because they stop taking the tablets for whatever reason.  It is thought that this method is not clinically effective for 10% or less of humans.

When I counsel people through this, I focus a lot of this element of mindfulness when drinking and habit-changing.  Just because it seems to give people a noticable change and that change, no matter how small in the first few months, helps spur them forwards. 

12

The more you write here, Natalie, the more I hope you can begin to see that these things take time and will not be eradicated in just a few short months.  I know, for me, the patience aspect of this treatment was one of the difficult things to get used to, but it's worth it.

All I can urge you to do is stop the vodka and start to visualise where you want to be at in the future.  If you can see it, then you can start to realise that you are not stuck and are, in fact, moving towards that future.

If you do feel that the depression is an issue, then please see a doctor to see if you are depressed as opposed to just feeling down.  Depression is a chemical imbalance in the brain that, if you suffer from it, will not go away on its own.  I am not saying about immediately asking for anti-depressents, but rather just talk to someone qualified in treating those with depression to see if you are, indeed, a sufferer.

You had a great 5 months, and now the reality of not being able to rely on drinking any longer is kicking in.  This is not unique to TSM and you will find that any type of treatment involves some sort of lifestyle change in order to live comfortably without relying on alcohol.  I can't remember if you have ever attended AA, but one thing that they advocate (and I agree with) is that just removing the alcohol makes someone what they call a 'dry drunk'.  This means that they are no longer drinking, but everything about their mindset has not moved forward and they exhibit all the traits of a problem drinker, but just without the alcohol.  That's not a nice way to live, and once you find them, you will see that things are so much better without the reliance on alcohol.

13

Thanks Joanna that's really helpful. You are right it's hard to believe it will work so I can see why you would want to help people have quicker success. I am being compliant but not mindful. And am hoping it will still work as you say.

I can still drink 2 bottles of wine - but usually it's less and it used to be often 4- so I know it is a reduction over all. But it's hard to keep faith- and i was beginning to worry that actually you have to do the mindful drinking to make it work- and that then felt hard and was making me despondent. But I'm glad you're also say you think eventually it will work even without.

14

Oh my those words could've come out of my mouth! I feel exactly the same way. I have been a binge drinker my whole adult life, worsening as the years went on. I have anxiety and depression. I drink to excess almost every time I drink, having black outs many times; forgetting what I said or antics I did. Thank God nothing major, never drive drinking or hurt myself. My hangover lasts 4 days of depression then a cloud lifts. I need off this roller coaster. This happens about 1-2 times a month. I exercise every day. I have almost quit smoking for over a year; meaning I smoke when I drink.

I am praying mightily that Naltexone works for me. I just started following this group today… I just began counseling also for my unhappy private life as well as the drinking. I am going to switch back to drinking wine… I had actually stopped drinking wine because it makes me feel so terrible the next day… Have been drinking spirits. But based on these threads I think I will switch back to wine and be more mindful of it and the use of naltrexone.

I am 57 and feel like I've wasted a lot of my life with this binge drinking… My tendency to beat myself up and blame myself and the drinking for everything that is happened to me in my life and I've had plenty of negative things happen. I am single I don't have a boyfriend though… no children. I drink to forget my unhappiness my unsettledness my feeling that I always belong somewhere other than where I am… I have one brother both of my parents are gone. I have a few good friends. But I feel very alone and I know that is part of the reason it's not much of the reason that I'm a binge drinker.

This is my first post. I am grateful that I have found you all and send a prayer up for myself and everyone in here for supporting each other. I will be here for the long run it will post my progress with Naltexone, and in general.

15

I meant I do have a BF....phone can't hear lol

16

Please do let us know how you're doing, Dee! 

17

HI there. you seem to be in a spiral going down and few friends a family to help you. Perhaps you have hit rock bottom like I did and thought enough is enough...time for a change!! Try it.....think of how much better you will feel then next day and also how much less guilty....Robin

18

As I mentioned secondslong, not being mindful only increases the chance that sooner or later (before the treatment has achieved it's goal) you will give in to that 'hard to keep the faith' bit and stop the treatment.

It's a risk you need to weigh up, because it is a very, very real risk of non-compliance. 

I admit that I can never understand why people don't try to help make things a smoother process by being more aware and mindful when they are drinking.

19

I think because it takes a little more magic out of the bullet. I agree that mindfulness is very important.....it's like instead of taking the medicine with a full glass of water or food, you're taking it with mindfulness.

20

It wasn't something I was told about as necessary when starting the treatment so I suppose it wasn't on my radar as being necessary. So I suppose that makes a significant difference. Plus all kinds of other very longstanding psychological reasons which I won't go into here. For me the deprivation effect of giving up is absolutely huge which was one of the reasons tsm was suggested and I imagine why mindful drinking wasn't sold as part of it. But I can understand you not understanding. And maybe if I'd been working with you it may have been different. Maybe it still will be. The panic of not doing it right- another failure and self blame has been taken away (if it's true- well it hasn't but I like it as an idea) with the idea that this is a medical problem with a medical solution and that with compliance it will work even if it takes time - is what I have been told and then reading here about mindfulness worried me because it made me doubt that.

I know that for others I don't believe in blame and judgement whatever the cause of difficulty (not just with addiction ) be it medical or mental health wise- I'm absolutely passionate about and committed to that in my working life. I believe that also about people who cause harm to others - not just themselves. I don't expect others to agree- but this (nothing to do with tsm and my own alcohol) is a long term way of understanding others for me. And not something I can really go into online. But I don't expect others to agree. I understand you have been helping many people and giving people hope. I've heard about the amazing support you have offered. I think if I had understood this was needed for this approach it may have been different but it wasn't. Im really not knocking the support I have had from the person who has helped me - prescribed me this. It's been amazing. Just a different message from here.