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Barbara A.

Hello to All! I was on this forum last Fall asking about Baclofen for my adult daughter. Now I have a few more questions. For context, my daughter got on Baclofen last October after my research discovered it's benefit's for alcoholism. She was an occasionally binger. She was on low doses (about 30mg a day). After she got drunk for the first time since being on Bac (in November), she ask for Naltrexone (from the addiction specialist, who complied) which she has taken about 4 times when she has wanted to drink socially. The Nal worked great!  Her goal moved from trying to be totally abstinent to using Nal for social occasions. Fortunately, she can get the scripts easily and reasonably priced.  However, the addiction specialist prescribes the Nal for daily use and did not seem to be familiar with TSM, much less condone it! We are reading "The Cure for Alcoholism" and my daughter is interested in doing it. But, first of all she doesn't exactly know how to go about it because she has been abstinent except for two relapes (1 day each) about a month apart, in Nov. and Jan, except for the 4 times with Nal mentioned above. Would she step up her drinking to before Bac even though she doesn't have cravings? Should she get off the Bac so that more cravings would be there to stimulate more drinking? Does being on Bac slow down the opportunity to go for the "cure." Sorry, we didn't know about this before! 

Also, we would be very interested in knowing what the results have been for those who have done TSM. In fact, it sounds so good (78% success) that I'm wondering why everyone on this forum wouldn't try this first, and then if it didn't work go on to something else! Is it costs, no access to Nal, or some other reason? Is a little scarry for her to deliberately increase her intake on the assumption that the "cure" is forthcoming, so we'd want to be sure it's worth the risk before she tries this. I say "try this" because even though she has taken the Nal several times, I don't think it is enough to be achieving pharmacological extinction.

I have not been able to identify any local physician that actually works with and gives support for those using TSM in her area....Dallas/Ft Worth, Tx, USA.  I have found an online resource "MDProactive" that identifies that they use the Sinclair Method but I don't know if they just prescribe the Nal or really give any valuable support...i.e. answer questions, etc. I know my daughter has liked meeting with the addiction specialist monthly to review what's happening with alcohol (and her life) but it's pricey ($150 an appt.) and the MDProactive is only $49! I think she will have a consultation with MDProactive and get a feel for this. If anyone knows of someone is her area that really works with patients TSM way please let me know!

Any wisdom, insight, experience, or advice you have regarding this topic would be greatly appreciated!

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Barbara A.

I did go on the cthreefoundation but did not find anyone that actually supports TSM.

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StuckinLA

No one would suggest drinking more to try TSM. Nal is usually prescribed as an anti-relapse medication, but no one is going to watch over her to make sure she takes it every day :D. It won't interfere with bac, so no worries there.

I hate to speak for anyone else, but most of us went the bac route in an attempt to deal with underlying anxiety that caused the drinking. There have been varying degrees of success.

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Initia Nova

Bummer you couldn't find anyone helpful. For sporadic or binge drinkers I have not seen daily nal be useful. TSM is the way to go, but probably not effective enough alone. I like to combine with baclofen. Or campral or gabapentin or topamax. Each pt is different. 

Many Drs probably prescribe daily nal because that is how it is FDA approved to be used in the US. Bac is not FDA approved for AUD in the US and the needed dose is different for everyone. Plus varied side effects, some can be severe. I feel bac should only be used under close supervision of an experienced physician. 

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Barbara A.

Thanks so much for your helpful comments, Initia Nova. In your opinion, will pharmacologic extinction take place Using Nal if there are long periods between drinking sessions? As long as someone is consistently taking the Nal will the extinction eventually take place? What if the person takes the Nal when drinking most of the time, but occasionally chooses not to? How does this alter the outcome?

I want you to know how appreciative I am for having an experienced physician in this area to answer a few questions. It is frustrating to not be able to identify any doctor who is willing to walk through TSM with patients. It is additionally disappointing to not be able to talk to a doctor who can answer  questions like I am asking you! Just wanted you to know how valuable and rare you are! And be assured I will not take advantage of your kindness by asking a lot of questions! BTW, where do you practice?

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Initia Nova

My pleasure Barbara. I have pts that drive for many hours to come to my office, so I know how desperate people are for information and help. I am in NJ. Send me an email and we can try to talk on the phone later today if you'd like. Would be easier to answer your questions 

Dr Patrick Sullivan 

info@MyInitiaNova.com

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Barbara A.

How extraordinarily kind of you to offer to talk with me! I have emailed you my number and outlined my questions. Thank you so much!

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phoenix
On 06/02/2018 at 8:52 PM, Barbara A. said:

Hello to All! I was on this forum last Fall asking about Baclofen for my adult daughter. Now I have a few more questions. For context, my daughter got on Baclofen last October after my research discovered it's benefit's for alcoholism. She was an occasionally binger. She was on low doses (about 30mg a day). After she got drunk for the first time since being on Bac (in November), she ask for Naltrexone (from the addiction specialist, who complied) which she has taken about 4 times when she has wanted to drink socially. The Nal worked great!  Her goal moved from trying to be totally abstinent to using Nal for social occasions. Fortunately, she can get the scripts easily and reasonably priced.  However, the addiction specialist prescribes the Nal for daily use and did not seem to be familiar with TSM, much less condone it! We are reading "The Cure for Alcoholism" and my daughter is interested in doing it. But, first of all she doesn't exactly know how to go about it because she has been abstinent except for two relapes (1 day each) about a month apart, in Nov. and Jan, except for the 4 times with Nal mentioned above. Would she step up her drinking to before Bac even though she doesn't have cravings? Should she get off the Bac so that more cravings would be there to stimulate more drinking? Does being on Bac slow down the opportunity to go for the "cure." Sorry, we didn't know about this before! 

Also, we would be very interested in knowing what the results have been for those who have done TSM. In fact, it sounds so good (78% success) that I'm wondering why everyone on this forum wouldn't try this first, and then if it didn't work go on to something else! Is it costs, no access to Nal, or some other reason? Is a little scarry for her to deliberately increase her intake on the assumption that the "cure" is forthcoming, so we'd want to be sure it's worth the risk before she tries this. I say "try this" because even though she has taken the Nal several times, I don't think it is enough to be achieving pharmacological extinction.

I have not been able to identify any local physician that actually works with and gives support for those using TSM in her area....Dallas/Ft Worth, Tx, USA.  I have found an online resource "MDProactive" that identifies that they use the Sinclair Method but I don't know if they just prescribe the Nal or really give any valuable support...i.e. answer questions, etc. I know my daughter has liked meeting with the addiction specialist monthly to review what's happening with alcohol (and her life) but it's pricey ($150 an appt.) and the MDProactive is only $49! I think she will have a consultation with MDProactive and get a feel for this. If anyone knows of someone is her area that really works with patients TSM way please let me know!

Any wisdom, insight, experience, or advice you have regarding this topic would be greatly appreciated!

I have had incredible success with TSM/Nal, I was a binging type alcoholic although did have periods of daily drinking.

 

I wouldn't recommend drinking more 'just' to do TSM, what I do recommend is that she uses TSM whenever she drinks. You say her drinking reduced on the occasions she tried Nal + Alcohol which is a very good sign that TSM would work for her.

 

At first I knew if I drank I wouldn't wait the hour, so I took a nal early in the day every day for the first few weeks. Also I didn't actually drink for the first week, simply because I was fed up of drinking and baclofen which I'd tried without success (I tried just about everything before TSM), I felt ill and not in the mood.

 

Sure this isn't pure TSM but it worked, and it saved my life - saving lives is important.

 

With TSM you drink when you want, whatever you want but my experience is you don't need to force yourself to drink.

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Barbara A.

Thanks, Phoenix. My daughter is doing TSM when she drinks as far as I know. She doesn't share much with me, so can't be sure how it's working. But the fact that it has worked for you as a binge drinker is a real encouragement to me!

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phoenix
On 31/05/2018 at 4:47 PM, Barbara A. said:

Thanks, Phoenix. My daughter is doing TSM when she drinks as far as I know. She doesn't share much with me, so can't be sure how it's working. But the fact that it has worked for you as a binge drinker is a real encouragement to me!

Barbara glad I've been able to help, for the record I know a whole range of drinkers who've had good results from TSM - every day, lower intake, higher intake, binge drinkers all sorts. Another observation I've made is that it tends to work best for those who keep it simple, and don't try to out think it.

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