Selincro - sucking the joy out of life next couple of days - stop taking or reduce dose

General health and lifestyle
21

The NICE guidelines appear to make no sense at first.

Firstly, they talk about it being for women who drink 5 units a day and men who drink 7.5. The first reaction to that is 'THEY don't need it!!'

The guidelines are sketchy. My colleague and I, who use The Sinclair Method with our clients believe that there are a number of reasons for this, the most important one being that if a person was drinking say a bottle of vodka a day, and they took Selincro and found they didn't want to drink at all, there is a very high risk that they would go into withdrawal from alcohol which could be extremely dangerous and even fatal in some cases.

NICE qualify this by saying that this level of drinking (5 or 7.5 units) is TWO WEEKS AFTER the initial assessment. That suggests that they believe that a person should reduce to this level before starting on the drug. This would minimise the risk of withdrawal symptoms.

The way we work is that we offer a detox first to those who are drinking way in excess of the 5 or 7.5 units per day and then start Selincro after that, when they are drinking 0 units. We then tell them to take a pill IF they are going to have a drink and NOT if they are not going to drink that day.

The important thing to know is that Selincro blocks the opioid receptors in the brain. These receptors are stimulated by endorphins that are released by the body when people drink alcohol. Some people get a far greater reward when these receptors are stimulated and these are the people who get into difficulty with alcohol. By blocking the receptors before drinking, a person who has difficulty controlling their alcohol intake will no longer get that additional reward. They will simply react in the same way as healthy drinkers do. They will still enjoy the taste, they will still get drunk if they drink too much and they will enjoy the atmosphere and less inhibited conversation associated with social situations where alcohol is available. Over 2-3 months, if they take a pill and block those receptors every time they drink, their body will learn not to expect that additional reward and they will be able to have 1 or 2 drinks and not get that urge to carry on drinking. They will also wake up the next day without the desperate need for a drink. Throughout that 2-3 month period, some people will find that they reduce their drinking after the first pill and others will find it gradually reduces.

Once this period has passed and they reach the point of 'pharmacological extinction' - the point when they have unlearned their addiction, they would be at risk of re-learning it if they drank unprotected. For that reason, they must ALWAYS take a pill 90 minutes to 2 hours before drinking (until somebody comes up with an even better treatment option).

It is also important to know that there are many healthy activities which release endorphins which stimulate the same opioid receptors. These are things such as eating certain sweet and spicy foods, riding rollercoasters, extreme sports, exercise, having sex, cuddling babies and stroking animals. For this reason, the pleasure of these activities would be diminished on days that they took a pill. It is therefore necessary to avoid drinking and Selincro on the days they do these other activities if they want to gain maximum pleasure from them.

Some people report a feeling where they get no pleasure from anything in life when they first start taking Selincro. It is an effect which WILL wear off over the first few times they take it, along with the other side effects of nausea, sleepless nights etc.

The 78% success rates in Finland refer to 78% of those using The Sinclair Method EITHER cutting down their drinking to much lower levels OR stopping drinking altogether because they simply don't get the same reward from it (and some were addicted but never actually liked the taste that much anyway.)

The Sinclair Method is the most effective treatment method available in the world today. The 78% success rate in Finland compares with less than 10% success rate for rehab.

22

Hello Paul, thank you for joining the discussion it is very helpful. I knew nothing of TSM until a couple of days ago after it was mentioned here. Yet I followed the progress of Nalmefene introduction into England and jumped at the opportunity. Obviously not fully informed. I am i guess a typical target for the NICE Guidlines. I don,t consider myself an alcoholic ( or didn,t ) Over the years my wife and i just crept into this habit of drinking every evening. Both of us successfully continuing to work in senior posts in health until retirement. The drinking continued of course and got earlier in the evening. My main reason for wanting to cut down my intake was for health reasons and not the way i was functioning. I want to try and inprove my fitness. Where in the past i could cut down my drinking for long periods of time and have days off i now found this difficult to do and wanted to enjoy my evening drinks. Never a hangover but saying to myself the next morning why did i drink again.

So my expectations were that i take a tablet each day that would help me not to feel like a drink or restrict the amount. On the two days a week i wanted to drink, i.e. in company with friends, i would not take the tablet. I now discover that this is not the way it should be.

The information i have read over the past couple of days on the Scottish Trials and UK licence indicates no reasearch evidence for continuing to take the drug for more than a year. In fact on prescribing in the UK it advises caution. I recall also reading that the granting of the UK licence was not based on The Sinclair Method. Am i correct on that or have i misread ?

23

I hadn,t quite finished my response when i sent it so can i add this.

My understanding at the time of the two weeks after assessment in the NICE guidlines was that this was people like me drinking at that level before and after assessment. My whole interpretation of the introduction of Nalmephene in the UK was that it was aimed at those individuals such as myself. Not those heavier level drinkers requiring detox.

So how do i proceed giving the longer term implications that i was not aware of when starting out on this journey. I guess i don,t really have an option. My plan that i would be on these tablets a few months and stop does not seem realistic hearing what i am hearing here.

Paul, is there someone in the UK involved in the licence / Nice whome i could correspond with to discuss further ?

24

You won't get much joy from NICE because they are a government body who are not easily accessibly by phone for the public.

Nalmefene is aimed at anybody who is drinking too much and the guidelines of what they should be drinking immediately before starting on it are for safety. In order to make it accessible to people drinking a lot more, we give people detoxes to get them to a point where we can do it without breaching guidelines but that doesn't mean that everybody who can benefit from Nalmefene needs a detox.

You will not find many experts in the UK. You can talk to me via private message. I know you said you had trouble sending me one before, I will send you one, see if you can reply to that.

 

25

You will not hear The Sinclair Method mentioned by the NHS or by NICE or by many health care professionals. People are stuck in old ways of thinking and there are many GPs that still have very little knowledge of alcohol detox even decades after it was first used. There simply is no motivation from the NHS to deal with addiction adequately. This has resulted in private clinics springing up everywhere, some which are not bad and some which rely on people failing time and time again for their repeat business. It's absolutely scandalous in my view.

I can't talk too much about what I do in this public forum as it would be seen as me promoting my business.