What is TSM?
The Sinclair Method is an approach to treat alcohol use disorder by "retraining your brain" to not desire alcohol. It uses an opiate blocking medication. Typically, managing alcohol consumption to lesser amounts is the goal versus complete abstinence. However complete abstinence is often achieved naturally and without struggle.
What is Naltrexone?
Naltrexone is in a class of medications known as opiate antagonists, also known as blockers. It attaches to the mu-receptor in the brain, blocking alcohol or opiates from binding and producing euphoric feelings. Naltrexone is non-addictive and does not produce physical dependency. The medication can reduce a patient’s urge or desire to drink and can help patients drink less or remain abstinent. It may also interfere with the patient’s desire to continue drinking more if he or she slips and has a drink.
Do I have to stop drinking?
No! In fact, TSM only works when you continue to drink. The medication blocks the euphoric feeling that alcohol provides, so when you continue drinking while utilizing medication it retains your brain to not enjoy alcohol. thus TSM reduces the urge to binge or drink altogether.
Do I have to detox from alcohol prior to starting Naltrexone?
No, not necessarily. However due to the potentially life-threatening side effects sometimes associated with alcohol withdrawal, you should always consult with a physician prior to reducing or stopping alcohol intake.
Can I use TSM for moderation?
Absolutely! About 88% of people using TSM have a goal of moderate drinking. Some of those will be complete abstinent with alcohol, even when that wasn't necessarily the goal.
How much will I reduce my drinking?
Researchers have published reports that show TSM has an overall 78% success rate in reducing alcohol use. Everyone is different, but on average TSM users who strictly adhere to the protocol experience the following reductions:
First 30 days: 10 – 20% reduction
30 days – 6 months: 10 – 50% reduction
6 – 12 months: 50 – 90% reduction
1 – 2 years: 70 – 100% reduction
2+ years: 80 – 100% reduction
Can anyone use TSM?
No. If you are taking an opioid medication, if you are currently pregnant, or if you have severe liver damage, TSM is not recommended.
What are the side-effects of Naltrexone?
Side effects are a potential with every medication, and naltrexone is no different. Most common symptoms include mild nausea, abdominal cramps, restlessness, bone or joint pain, myalgia, and difficulty sleeping. These usually subside within the first two week of treatment. Though very rare, naltrexone can elevate liver enzymes, necessitating periodic blood testing for liver enzyme elevation.
Do I have to do counseling?
As with any medication assisted treatment program, counseling is always recommended for long term recovery. However it's not mandatory to successfully reduce drinking, as long as compliance with the medication is met 100% of the time for the rest of your life.
Why won't my primary care doctor prescribe this medication?
While we cannot speak for any specific reasons why a doctor will not prescribe a specific medication, typically most primary care practitioners are not comfortable managing addiction. Treating addiction is a specialty type of medicine, and your PCP may not have the proper training and/or resources to assist you with recovery.