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Naltrexone


Alcofree
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Hello All!

Where do you buy Naltrexone? Delivered to the UK? Is it true that you take Naltrexone only if you want to have a drink, rather than every day like Baclofen? 

Edited by Alcofree
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2 hours ago, Alcofree said:

Hello All!

Where do you buy Naltrexone? Delivered to the UK? Is it true that you take Naltrexone only if you want to have a drink, rather than every day like Baclofen? 

Usually 1 hour before consumption. It works if the drinking is planned but not if it is ad hoc. It therefore need some user input, which I like (It shows the user is serious about the deal) but it can be abused if the user "wants to go and get bolloxed" by missing it. Of course this is purely a personal opinion maybe slightly tinged by the fact that I am a hardened abstainer :)

Have you approached your GP with a view to them prescribing? AFAIK, they can prescribe this but it is generally to the (already) abstinent and with CBT thrown in but things may have changed since I last looked into it!

 

May need an update?

Regards

 

Bacman

 

 

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4 hours ago, Baclofenman said:

Have you approached your GP with a view to them prescribing? AFAIK, they can prescribe this but it is generally to the (already) abstinent and with CBT thrown in but things may have changed since I last looked into it!

Most GPs in the UK prescribe naltrexone only if it is initiated by a psychiatrist/addiction specialist.  Getting to see one of these can be a struggle.  I guess that's why most people buy online and treat themselves. 

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1 hour ago, Molly78 said:

Most GPs in the UK prescribe naltrexone only if it is initiated by a psychiatrist/addiction specialist.  Getting to see one of these can be a struggle.  I guess that's why most people buy online and treat themselves. 

Hi Molls - I am aware of this but not wishing to harp on like @Otter there is a duty of care and there IS a directive for GP's to offer this with CBT, should the subject meet the criteria. The OP could speak to the GP, tell them of their intention (to buy off the net) and in the event of this proving a success, expect the duty of care aspect to be fulfilled

And again, not wishing to sound like Otter, if the GP aint listening - Find one that will!

However, yes Molly, you are correct, the best way in is via a specialist but unless you want to go to Scotland (Chick), chances are the GP is your best route

Regards

 

Bacman

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@Alcofree mainly I will tell you my journey to abstinence.  @Baclofenman @Otter and @Molly78 you might find this interesting info as a personal experience dealing with getting meds prescribed in Canada (likely similar).

Edit, to answer before I get started. Health Canada only approves every day. So that is not true. It may be more effective with the Dr. Sinclair Method, "the elimination but the gov't here says every morning. I didn't give myself the chance to try it that way. Ordering out of country has its risks. One reason I steer away from ordering from out of country is that fake drugs do exist. You may work fine with APOTEX or STERINOVA or TEVA or whoever else manufactures the drug and maybe not another. The additives and binders.

Its interesting, GP's in Canada hit up coaching you for AA and therapists or rehab, as the front line approach is assumed that you are depressed or anxious so you get the modern fad pill of the antidepressants. No shit you are depressed and have anxiety... its withdrawal and dependency. Beware of Pristiq (desvenlafaxine) as it increases drinking. At second base you get Naltrexone 50mg daily (health Canada doesn't approve the Dr. Sinclair method but once you have it you do as you will with it). Not sure how Canada differs because every package is x-rayed and any mail that is pill sized if screened as we have an opiod epidemic happening here. Now in my case I had done my 90 in 90 AA, 3 rehabs all of different types and had therapists and a psychologist doing biofeedback with like a skull cap and gel and sensors all over my body. So my GP didn't blink an eye at me trying naltrexone as I proved my point. I chose Campral first as I was abstinent at the time and had done some research and wanted to the combo. Though they really don't like that as they both hit the liver. More on that later in the post. So like @Baclofenmansaid, you really only get it if you are active with therapists, psychologists or CBT groups. Canada is similar but not the same in this regard to the UK. Quite closely aligned in practice but maybe a bit more liberal if you find the right ones, like Baclofen man said, "Find a new one". My GP is young so he has more addiction education than the oldschoolers and impressed by how much research I do. My goodness the tech in the new clinic my GP has. The specialist has the experience and the willingness to go off label.

If you can get that far, by getting Naltrexone you can start to push harder. Naltrexone here even if you are drinking still is prescribed so long as you are active. Stop your therapy, eventually the script won't get filled. This country is connected and monitors what you are doing between doctors and your pharmacist (if they are competent) unlike the states where people double and triple fill scams. It really pays off to have open minded doctors that can see what each other are doing. It can save your life. That would be another reason I steer away from ordering from out of country unregulated and controlled. But with no options I suppose I would take the risk.

Convincing your doctor to combo that with Campral (333x2 three times a day) can be a challenge; it took me a week for him to do his research (blood tests to show I was sober as its a maintenance/repair drug). Those are the two Health Canada approved medications. Of course if you are persistent you can get what I've been able to experiment with by seeking myself and my GP's referrals to bump you to see a specialist (tap your resources in your therapy sessions at the local detox or non AA addiction center). I assume you have that in the UK.  I use both of those drugs concurrently and that was my mainstay for many months but it was not good enough. Soooo.... lapse.

Advancing further as I am convincing and research everything bloody thing. The specialist decided to also put me on Mirtazapine which has cross for anxiety/major depressive disorder and off-label anti craving and gaining weight. Awesome, perfect Body Mass Index now. Appetite back. Could sleep. Then you get used to it and you feel OK.

I experimented for a month with baclofen but was never given a script over 30mg a day so I kind of didn't want to run out mid titration so I stopped (my goodness it made me drowsy). Likely didn't give it a good enough chance and neither my GP or the specialist approved of it. I at this point knew as much as them and me and my GP joke around and talk seriously about interactions and modern therapies. He's learning a lot, I think he likes it! Having both communicating is better than one misguided and afraid to try new things alone.

We need more doctors like him as there is an epidemic not only in alcohol but opiods killing multiple people daily here. We are modernizing from AA slowly into programs like SMART and CBT programs, there is even an alcoholic house that if you are a member you get their brew one glass of beer an hour.  Because its better than homeless people wandering stealing. Thats pretty far in stretch of the layman's acceptable practice, but its proving to work. Same with heroin in BC. Drug reform is happening. I don't necessarily agree with letting anyone smoke pot for no reason. Like we need more high people driving around. AA's track record is abysmal. 5% at one year, and likely 1% at 5 years success. And such a horrible life reliving awful experiences of yourself and others. Its like living hell on earth in my theories. Science has moved forward dramatically. The big book was written a long time ago and says (i could go and get the book and the quote), but essentially "science has not yet found a cure". Well I'm pretty sure everyone is chemically a little different and there is not a one patch fits all but damn we have some cool stuff happening around the world. Look at Portugal, France and the Netherlands. That was a tangent, sorry. Oh the specialist is an egomaniac but whatever he prescribes so deal with it!

I had a nasty life situation that was made all the worse by a drug called Trintellix here and Brintellix (long story about people getting the wrong med because the name was similar to another drug) elsewhere which is written all over this forum and My Way Out.  Turns out it can make you increadibly emotional and sink you deeper into depression for a percentage of the population. I stopped everything as kind of a self sabotage and reality sets in as you sober up and life is chaos picking up the pieces mixed with getting off of a (bad for me) antidepressant. Stopped my Naltrexone and everything else so I could feel drunk because I was not happy at all. This made for some seriously messed up things happening, like drinking over the withdrawals of meds. End result I used Diazepam to come off (again) from 40oz Vodka a day. Started nal immediately and valium, then the rest all back up again after 72 hours with astonishingly very little side effects, no hallucinations, odd buzzing noises, did have the shaky spoon spill for a week. The doctors were a little afraid of me saying I was doing it outside a monitored detox, but I have done this dozens of times and sobering up with other messed up people is not my cup of tea. Thanks Ensure (the drink) and soup so I could eat again. Slam myself with some B1 (thiamine in large doses as you don't absorb it while drinking). Get my head on straight. Spend a month or two waiting for the specialist (busy man) and watching my perfect blood tests come back to normal. Some tests go as far as like 7 vials of blood. Most of the time just 2. We can check online the next day. Takes me a month to come back to normal.

Now back to meds, this one for me was the switch --- Gabapentin (Neurontin) was added on the last visit to the specialist. I think I'm at about a month into Gabapentin 900mg and have no interest in drinking and don't even think about it at all. Still tapering down the 5mg valium so up the GabaP, down the V. I am indifferent to alcohol at this point. The fact I'm dedicated to forums, and have friends and I find pharma and how this works fascinating, so I stick around. :) I probably could go without the Campral. So as I said I would get back about liver effects of Naltrexone in relation to other drugs. Gabapentin is processed by the kidneys, so if you are duplicating medications you don't want to hit the liver to hard if you want to level out your AST/ALT/RBC/BUL/etc. So processing it works differently.

In summary is I have like 1000$ in Naltrexone and likely the same in Campral. The other drugs are cheap (GabaP and Mirt). So much stock because of a nasty relapse. Specialist wanted to add Cipralex on top of this all but that drug scared the shit out of me while I was detoxing once. It is not designed for withdrawal. So I have not yet started it as I feel spot on, so why add more. In fact slowly take them down until I feel malaise. 

Gabapentin is like gold to me now, check out the reviews at drugs.com - Gabapentin for ALC Withdrawal including some testimony of continued use. Pretty soon my benefits run out and Campral is gonna get kicked off the list as the new benefits don't cover it. Have 6 months supply in case I need it in the future. I wasn't quite ready to quit as for fear of withdrawal effects when I started this journey, but was filling anyways. Same goes for when I relapsed, so I got tons of these drugs. I don't count days but I do know one lapse and one hard relapse occurred. I know why and when, which is why the CBT is advised with Naltrexone and I was not practicing or participating, missing appointments, etc.

Took 11 months of persistence and referrals to get all this setup. Gabapentin script up to 1800mg a day (using 900-1200mg), Mirtazapine 30mg to 45mg at night, Campral (standard 666mg three times daily), Naltrexone (50mg) every morning (why because its there and I have a crap load of it as a designed safety net).

As admitted alcoholics, we have reached a point where alcohol is no longer a pleasant experience or it just takes too much of a toll physically, socially, emotionally, financially, intimacy, trust... We all know.

So a tip, use drugs.com or webmd.com and research what these off label drugs do. There is kind of a wink wink nudge nudge so if you actually say to the doctor you are experiencing a symptom that the off label drug is approved for, he/she will prescribe it. They cannot ethically and legally otherwise as I think Baclofenman said. If you don't say it, you don't get it. For an example I was told to say to my GP that I have back spasms as that's the health canada approved use for Gabapentin. So look up off label drugs and claim you have one or more symptoms if you want to experiment. But educate yourself before and use drug interaction charts and swap meds around to see what interactions go on (on the website, not in your body). For example I can't take over the counter Calcium because its 95% of the time mixed with Magnesium. Magnesium kills off Gabapentin's effects, just like smoking kills off mirtazapines effects. No one tells you this because they don't know. Neither told me that. You need to read a lot and link things together to essentially self prescribe things for yourself (be cautious). Read the experiments, read about brain chemistry, read about trials and how they are conducted and their success rates. Gabapentin is unusual as it can be used as a direct replacement for valium for the initial withdrawal, I like it, so I continue to use it.

After lapse after lapse after lapse. I took control of the situation and worked with my doctors. I absolutely despise what alcohol does to me. So sheer determination brought me too this point. Ignoring all the indoctrination and scorn of others "white knuckling" it. F it. Nothing else worked, so meds it is. Its not weakness of character, its actual damage we have incurred on ourselves that requires the meds. Feel no shame. Learn.

= Freedom.

Hope that helps you a bit in terms of the way to approach your doctors and what you need to do if you really want out of the trap. I am not a doctor, this is just personal experience. Long post, rambled! Hope it wasn't preachy.  Good luck OP @Alcofree.

Edited by empyr3al
Answer the actual question!
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Epic post @empyr3al

I just wanted to touch on a couple of comments I found association with

14 hours ago, empyr3al said:

My GP is young so he has more addiction education than the oldschoolers and impressed by how much research I do.

I had a very similar experience with my GP. Honestly, I don't think she had any idea what Baclofen does, how it works and the type of patient it serves. In a way this was a my cue........

14 hours ago, empyr3al said:

But educate yourself

She was open to suggestion and yes, maybe influenced in fact. As I suggested earlier in the thread the fact that i had been and told her prior, I was going to start Baclofen, EMAILED her a my own opinions and findings, although a strong reliance ;) on This. As you say the elders of the practice would have jogged me on, no doubt - Her words, "it is obviously doing you good, I am happy to support (prescribe) you. 

14 hours ago, empyr3al said:

I am not a doctor, this is just personal experience. 

I am often cautious of anecdotal evidence, however when it is good, it is better than anyone can learn at medical school

Great input, thanks

Regards

 

Bacman

 

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Emp, the fact that you are able to post your experience puts you in a different category from my wife.  We are not talking about the same illness.  My wife has damage to her hypothalmus from a massive stroke which left her partially paralyzed on her left side.  She found she could not, then, control her drinking.

She was prescribed all the meds you mention.  However, her days consisted of drinking a large glass of vodka at 6 am, followed by the rest of a bottle of vodka so that she was unconscious by 10:30.  I would phone her from work to see if she was awake and sloshed or asleep.  Usually, I would return home after picking our son up from school to find her unconscious. She would wake up long enough to prowl around the house, shouting like a lunatic and maybe throwing things around the house, terrorizing us, before getting enough in her to go back to sleep.  She would wake up in the middle of the night, shouting and screaming as though possessed by demons.

It's interesting to read your post, but, frankly, it has little or no application to my wife's situation and I don't appreciate your comments about me which suggest that I go on and on for no reason.  Baclofen not only worked where nothing else did, it worked miracuously in a life transforming way, almost immediately.  It's not perfect, but it's the right drug for my wife.   No drug is going to work to change the life issues that down and out alcoholism has landed one in, ie., alienation of family, social work involvement, criminal convictions, unemployment, liver damage, loneliness and isolation.  All  of these issues work to drive people like my wife back onto the bottle.  Lack of support and understanding, trying to pigeon-hole people with serious illnesses, disparaging their treatment, ignoring their achievement in getting their lives back and suggesting, somehow, that their success is an illusion put forward by their husbands or family who are just irritating windbags with no real insight into the problem doesn't help either. 

Say, here's an idea.  I'll send you a pair of my wife's moccasins and you can walk in them...see how it feels to be comatose-drunk for weeks on end with the police banging on your door and dragging you into a paddy wagon.

Sorry if this post comes across as being a bit hostile.  I'm happy for your success but we are still at a point where the medical profession is not responding to this illness properly and we still don't have a good idea of why some people do respond to baclofen and others do not.  We don't even have a good idea of what the "illness" is.  You should be aware, however, that there are other long time posters here and on MWO who have used alcohol and become alcoholics because they suffer from diagnosed and serious, sometimes life threatening, neurological conditions.  I have no doubt, although I don't know the science of this, that alcoholism damages various aspects of our neurology and it may do so differently for some, or compound existing conditions...  Until we get to grips, properly, with the raft of health and neurological conditions associated with/caused by/causing a person to resort to alcohol, we're just going to go round in circles in terms of which drug is better for whom.

Edited by Otter
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@Otter, I am sorry.  I was out of place in regards too your situation.  I apologize.  I don't even see your post on this thread, so maybe I included you inadvertently because Baclofenman included you on this post?  This is NOT like what you describe in the other threads!  Maybe we should keep it as the OP's initial topic.  I probably should have posted my post elsewhere.  Again I'm sorry I referenced you and will in the future not make any comparisons and didn't intend too...  I don't think I implied you go on and on.  Talk all you want.  We do both agree though that there is a big problem with how mental health is addressed and I think I have posted about Silo'ing as pigeon hole's in other threads in direct agreement with you.  I am not being aggressive and in fact trying to be empathetic.  If someone gets something from my experience, thats awesome.  It's not applicable to you.  I wish you the best and your wife the best to be completely honest.  

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I didn't mean to upset you.  I think you just stepped into something inadvertently which touched a nerve.  

There's been a long running "battle" going on here, at MWO, and referenced in Ameisen's book between supporters of baclofen and those pushing Naltrexone, and now Nalmafene.  The two drugs work in very different ways, on different parts of the brain.   One, Nal, is an antagonist of the Gaba A receptors.  Baclofen is an agonist of the Gaba B receptors.   Obviously, if a person has a problem which responds to Nal but not baclofen, then they don't have a disorder related to the Gaba B receptors, whatever that disorder is and however it came about. 

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Yeah, I did understand coming into these forums there are politics and higher level disagreements on neuro-chemistry.  I wasn't upset.  General misunderstanding and I'd prefer to stay out of the fights.  I understand what studies have been done and sci-hub was a heavy contributor to my knowledge.  I know generally which drugs do what to which parts (or we speculate as in Campral and Gabapentin).  Calcium ion voltage gates, Gaba A's and Gaba B's.  I think you knew that about me as I used to talk a lot about them early on when I was doing heavy research.  There is not a one patch fits all.  I use NAL daily, but not did not do Dr. Sinclair, because I can and I don't suffer SE's (might start hop scotching days to see what happens) as I don't know what exactly I can remove first if ever (risking sobriety).  I use Campral because I can for the moment with benefits (shot in the dark as it does really nothing noticable).  Bac made me sleepy and I don't think I need to hit Gaba B quite that hard.  Gabapentin doesn't really affect either specifically, but Gaba B affinity possibly?  So I have tried a variety to see what my issues are.  Its all shots in the dark until something possibly sticks.  My doctors were fools before I started managing things myself.  Others need to explore themselves and read everything and come to their own conclusions.  Some things are irreparable and its management, if even possible.  So many buzz words in the rehab and mental health industry and misguided false prophets of drugs or "this book will cure you".  DSM-IV and DSM-V labels.  In my case (as its only me that I can speak of), NAL could be what assists and the Gabapentin, second line attack and is just calming the anxiety (potentially stopping creating new synapses, which is scary), Mirtazapine the depression and craves. Could by the synergy of them.  I don't know.  I just know I have no interest in drink.  Heavy topics.  Don't want to step on anyones toes.  Ever since a bad car accident about 13 years ago at extreme speed things have been different and hard alcohol became the self medication instead of beer and enjoying a bottle of scotch here and there on weekends .  I embedded my head into a windshield (not cab forward design).  Shaped like a cantalope in the shatter free glass.  Been trying to get and MRI or fMRI to see if there is damage; but that is difficult.  I don't know what I'm exactly addressing in my head, but what I'm doing is working for me.

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