Sinclair Method Alcohol Program: Can A Medicine Really Get You Sober?
Aug 21, 2023
What is the Sinclair Method?
The Sinclair Method (TSM) is a pharmaceutical therapy solution for alcohol use disorders created by, a man called Dr John D. Sinclair. The Sinclair Method uses a procedure referred to as pharmacological extinction to alter your alcohol consumption.
Pharmacological extinction is just a fancy way of saying that this medicine attempts to retrain the mind with prescription medication, not to connect drinking with gratification. The concept is that you are not addicted to the actual alcohol, rather, you are addicted to the pleasant experience of alcohol consumption.
If drinking no longer uplifts mood, you eventually get bored of drinking it. Well, that's the theory anyway.
A Very Real Problem
Having an alcohol use disorder is a bit different than the odd drink or two, it is a real health disorder.
Alcoholism is a persistent illness of the brain reward system. Disorder in these circuits results in distinctive organic, cognitive, cultural and metaphysical symptoms. This is demonstrated in a person pathologically seeking reward and/or alleviation of discomfort by drug use and other habits.
Alcohol addiction is defined by the incapacity to moderate alcohol consumption routinely. Like other persistent illness, addiction frequently includes patterns of regression and abeyance. With no therapy or interaction in rehabilitation endeavours, alcoholism progresses and can lead to injury or sudden death.
At its core, alcohol addiction is a severe brain illness that steals our ability to appreciate what real pleasure feels like. The Sinclair Method makes use of a medicine, naltrexone, to dampen down this artificial and natural pleasure/reward reaction in the brain.
What is naltrexone?
Naltrexone is a medication that has been authorized by the United States FDA to treat Alcohol Use Disorders since the early '90s.
It is an opioid antagonist, which basically means it shuts down the brain's ability to create pleasure from opioids.
I know what you are thinking... opioids - I don't use them! The term opioid originates from opium poppies that flourish in countries like Afganistan. Opioids don't just come from external sources, they are created within the body all the time. So when you drink alcohol your body creates an opioid response to it.
With the Sinclair Method, you take a tablet (by mouth) one hour before you drink and it acts to block this internal opioid reaction.
Allow me to simplify: you take naltrexone by mouth before you consume alcohol and only before, the naltrexone then goes to work turning off the human brain's opioid receptors. When you take that drink of alcohol, you do not get that same enjoyable experience because your opioid receptors, which are crucial to this process, are out of commission.
Once you lose that pleasant reaction, you will ideally discover that you wish to consume alcohol less and less. The quantity you consume will go down as your desire to consume alcohol does.
How does the Sinclair Method work?
For the Sinclair Method to get the job done, you need to crack the connection between the buzz you feel when you drink alcohol. As soon as your body and brain recognize that they aren't getting the same sensation out of the alcohol you are drinking, your cravings will lessen.
The Sinclair Method also has the added advantage of not being overly-disruptive in a person's life. If you drink socially, you can still do this with The Sinclair Method if you pop naltrexone in advance. I know this may sound too good to be true, and I feel it only fair to warn you in advance that Naltrexone is a long way from being a 'miracle drug'. I will explain more later in the post.
Is it even possible to moderate drinking?
Alcohol is just behind cigarette smoking in its adverse consequences on public well being among habit forming drugs. Drunk-driving is possibly the most notable adverse effects connected to alcohol consumption. Not only do you risk of a fatal accident, 30% of all traffic-related fatalities are connected to drinking, but being caught driving a car intoxicated can land you behind bars.
Another widely known result of drinking is physical violence. Although alcohol is rarely the exclusive reason for social disturbances, it can add ammunition to an already perilous predicament.
Most problem drinkers are not getting into fights or being thrown in the drunk tank. However, that does not mean that alcohol isn't causing major damage to their life.
The Serious Health Risks Of Alcohol
The liver is possibly the most damaged by drinking alcohol. Alcoholic fatty liver disease, a disorder where fat is accumulated where it does not belong in the liver, can result in a more severe problem called cirrhosis, serious scarring of the liver. Around twenty percent of alcoholics will develop cirrhosis due to their drinking.
You do not need to have major medical or behavioural worries to wish to go sober. You may not like alcohol's impact on you or you think that your alcohol consumption is conflicting with your values. If drinking is making you miserable, the best time to act is right now.
How the 'Method' Began
Dr. Sinclair is famous for work with Naltrexone as an anti-alcohol med in The U.S.A. He eventually relocated to Helsinki, Finland. Where he used specially bred medical rodents genetically disposed to alcohol to test his theories.
The Result of The Sinclair Method Studies?
What he concluded was that alcohol addiction is a mastered behavior or if you prefer, a learned addiction.
To get addicted to alcohol you have to ignore some pretty big warning signs, for quite a long time.
Repetition is the mother of all learning. When you ignore those warning signs for long enough you enter the realms of mastery. Many individuals (and rodents too, would you believe?) have hereditary characteristics. These DNA level pieces of code lead them to experience a great deal of "reinforcement" from drinking alcohol.
The genetic coding makes these people experience a much stronger 'high' from the drug. When compared to social drinkers who can 'take or leave it'.
Pavlovian conditioning
The whole theory behind the Sinclar Method is based on the work of Ivan Pavlov. Pavlov is the scientist famous for making dogs drool at the command of a bell.
When trained, dogs treated to a food-based reward after an alarm had been sounded would drool at the sound of the alarm on its own. However, the less well-known aspect of the experiments was this: Gradually, Pavlov would sound the alarm, but stopped feeding the dogs. Eventually, the dogs stopped responding to the audible anchor.
This is called "elimination theory" and Sinclair believed the mastered habits of a dependency to drinking might be eliminated by elimination, as well.
This is where the drug Naltrexone comes in.
Drinking is a learned addiction
Following his initial study, Sinclair speculated that drinking generates reinforcement in the mind in a manner that resembles narcotics.
His study suggested that drinking created reinforcement of addiction by discharging endorphins. These brain chemicals tie-up with opioid receptors in the human brain. So to activate his elimination theory he just had to find a way to stop the receptors from activating.
Success with lab rats
Sinclair used rodents in his tests, making use of a new drug called Naltrexone. Naltrexone is not designed for alcohol use disorders but is instead a narcotic blocker. It is designed to help people addicted to opioids, but it was found to work with alcohol as well.
He started with lab rats and then moved onto human test subjects.
The 'elimination theory' offer by Sinclair appropriately implies you need to drink yourself clean!
The premise is you drink but because of the drug, you don't experience any reward.
This would certainly be the ideal remedy for numerous problem drinkers. However, as the saying goes 'if it sounds too good to be true' etc. Fans of the Sinclair Method will state that is has a 78% success rate. How long that sobriety lasts is another matter entirely.
You have to remember to take the pill
It's essential to keep in mind that you take the tablet an hour prior to alcohol consumption, not just when you feel like it. Gradually, the need to drink alcohol will decrease and folks wind up refraining the majority of the time or periodically have an alcoholic beverage when they want.
You have to carry on taking the medicine prior to drinking alcohol, even when you feel factors are in control.
There are a handful of individuals who do not appear to react to the medicine, and some people might have an excessive liver injury to make use of this therapy.
The problem with taking any drug is it is going to do harm somewhere in your body.
Not a quick fix
The Sinclair Method is not a silver bullet and may take several months to have the intended impact. For some, it will be a total failure, but that is true of any approach.
Some claim that this might be the future of alcohol addiction therapy. It is popular in the United States to call alcohol addiction a "disease" and this appears to be dealing with it as one.
It will take some time for individuals to acknowledge this kind of a revolutionary principle. As it does violate the total sobriety strategy that the majority of therapy facilities recommend people to use.
The Problem With The Sinclair Method
There is no doubt this method has saved countless lives. The people who love it, REALLY love it!
However, there are several major problems with Naltrexone:
- The side-effects from the drug can be quite aggressive
- Naltrexone is deadly to the liver and this needs to be constantly monitored
- If you miss a dose it can trigger extreme relapse
- You need the willpower to take the tablet.
Folks I chat with who use the Sinclair Method frequently state how they battled with the more conventional approaches; I can understand that. I tried Naltrexone and other drugs and it just wasn't for me. The side effects were too horrible to endure, I will come onto that in a moment.
I was fortunate that I managed to quit with my own unique approach.
I believe Bill Wilson might have accepted Sinclair's work. He himself messed around with niacin as well as LSD in an attempt to enhance rehabilitation from alcohol addiction.
AA does not endorse the method
In section 3 of the AA Big Book, it discounts doctors ever being able to use such an approach to cure alcoholism.
I believe if this option had been found in Wilson's lifetime he might have perhaps backed it. Sadly, AA does not appear to support any of the new options established since Bill died. This is unfortunate, as it is the best institution to get the message out to the most number of full-blown alcoholics.
More research required
Actually, I believe this option will take some time to acquire broader approval, particularly in the United States. Where the therapy market appears controlled by the ineffective Twelve-step theory.
The Sinclair Method is becoming prominent in other nations and is now offered on the NHS in the United Kingdom. In addition to being used substantially in Scandinavian regions like Sweden, with interesting results.
It is getting recognition in third world countries that do not have a pre-existing Twelve-step rehabilitation therapy market.
It is a more affordable remedy compared with inpatient rehabilitation. Of course, this will appeal to nations without the facilities to sustain a hospital stay for many people.
Why I don't recommend the method
I don't recommend AA, purely and simply because I tried it and it didn't work for me. I do not recommend or endorse Sinclair's alcohol addiction approach for the exact same reason.
People get very upset when you criticize the approach that worked for them, and I understand why. Beating alcohol addiction is such a monumental and significant process - we can't help but get very passionate about it.
The method we used in all likelihood saved our lives.
Why it didn't work for me
There are many reasons why I believe the concept of taking a drug to cure a drug problem is fundamentally flawed:
- You have to 'remember' to take the tablet - I slowly started relaxing when I would take it and when I would treat myself
- Taking a tablet does not deal with the underlying reason why you are drinking
- Drugs do not change the subconscious beliefs you have around alcohol - it will always remain a magical, mystical liquid that you are not allowed to use anymore.
- All prescription medication comes with side effects and bodily harm. For me, the side effects of Naltrexone were significantly worse than the most awful hangover I ever had. It's hard to take a pill that makes you feel that bad and then steals the pleasure of drinking.
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