The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
In this post, you will read about the ten most common challenges I see people experience on the Sinclair Method. There is also a video at the end where I explain these challenges in more detail. I share these with you with hopes that it will help you recognize these challenges and avoid them to the best of your ability on your TSM journey.
1. Anticipating that you will be part of the 20% that the Sinclair Method doesn’t work for.
Most people know that the Sinclair Method is touted at having a roughly 78% success rate. So of course when most people see that, they immediately stop and ask, “what if I’m part of the 20% it doesn’t work for?”
This is a really common fear for people because as humans, we are wired to look for “danger” as part of a survival mechanism to keep us safe and alive. So understanding the benefits and risks of something is quite normal and important for our safety.
But it’s one thing to recognize danger and do your best to avoid it, and it’s another thing to be engulfed by fear of this danger and carry it around with you. So to the best of your ability, realize that yes, the reality is that this method doesn’t work for all people… but it does work for most people, so odds are in our favor. And perhaps you can use that fear to motivate you to stay compliant, stay committed and do everything you can to make this method work for you.
I recognize also that people might have this fear because often when we stumble upon TSM it seems too good to be true. Also, many of us have tried countless other ways to quit or reduce drinking without success. So maybe we anticipate yet another let down. Again, try to keep the faith and recognize that this works for most people… and it’s unlike any other treatment method that is out there today.
2. Anticipating that you will have side effects / or starting at a full 50mg dose of naltrexone.
These two sort of go hand in hand. Sometimes before someone starts on the method, they read about the side effects of naltrexone and get scared that they too will have side effects (common side effects are nausea, depression, headache and insomnia).
For this reason, this is why all TSM doctors I know will start their patients on a 25mg dose (sometimes even less) of naltrexone. This allows a person to acclimate to the medication and avoid any side effects they may experience. For most people, even if they have side effects in the beginning, they will go away after they have taken the medication for a week or two.
☝️ Looking for additional support as you change your relationship to alcohol? Check out The Sinclair Method Community for people, resources and courses to support your TSM journey.
3. Expecting immediate results.
I regularly get emails from people discouraged on the method because they didn’t see their drinking change after the first few days or few weeks on TSM. I think sometimes people view the medication as a ‘magic pill’ that will immediately erase the problem of alcohol addiction. And while many people may refer to naltrexone as a magic pill because of how it works to powerfully erase alcohol use disorder, the truth is that it takes time, persistence and patience to achieve lasting success.
It’s important to remember that you did not develop an alcohol use disorder overnight, so odds are it will likely not go away overnight.
Most TSM doctors I know recommend a full nine months to see major changes in your drinking. For me, it took me about 8 months to reach “extinction” and I quit drinking fully after one year. I’ve seen others who take two or more years to reach extinction, and some who reach it in four months (though that type of fast response is quite rare).
So, be patient with yourself. This method takes time. The most important thing is persistence and compliance.
4. Not following the TSM protocol 100% of the time.
This one is a biggie that causes huge barriers in reaching success on this method. What commonly happens is a person will not follow the specific protocol of TSM – they might skip taking the medication sometimes when they drink or they might not wait the full hour after taking the medication to drink.
These behaviors are just roadblocks to success on TSM. Sometimes I see people in the online communities complaining that TSM isn’t working for them, yet they are still not being 100% compliant. In my opinion, that is the first step to success on the Sinclair Method. If you’re not being compliant 100% of the time, it’s going to be hard to make real progress. It only confuses the brain and doesn’t allow the new neural pathways to form as they need to.
Imagine if you were creating a walking path in the woods. You work for several days to shovel a clear and clean path – forging a way forward. You make great progress! Then imagine you go in and shovel all the dirt and leaves and debris right back onto the clean path you just made. Sure, there might still be a visible path and not all of your progress is totally wasted, by why would you do that? It’s just making more work for yourself.
Not complying on this method can be a valuable learning experience for people… where they realize how powerful the medication is, how well it works and how dangerous it can be to drink without it.
5. Using alcohol to cope or to “chase the buzz.”
Many of us who have struggled with alcohol have used this as a way to cope. Whether that means coping with a long day at work, managing the day-to-day stress of life, a death of a loved one, a divorce, childhood trauma and so on.
So when we get started on the Sinclair Method, all of these psychological and emotional wounds don’t just go away and in fact, the less we drink the more we need to learn how to face these challenges.
When this reality sinks in, people might not be ready to face these things so they continue to drink heavily (with or without naltrexone) in order to maintain the same coping ritual. This is where habitual drinking can come in – meaning after someone starts on TSM they might not feel like they want to drink, but they do it anyway because they don’t know what else to do or it is a familiar coping mechanism for this.
Here, it’s important to be proactive at exploring new ways to cope. I always compare our ability to cope like building muscle at the gym – the ability to cope is something we are naturally born with. And the more we practice coping in healthier ways, it will strengthen our “coping muscle” and make it easier for us to face life’s challenges without the crutch of alcohol.
If you find that you’re still leaning on alcohol too much, consider seeking outside support to deal with the issues of why you’re drinking.
6. Taking naltrexone and drinking on an empty stomach.
From my personal experience and what I’ve seen with others – taking naltrexone and drinking on an empty stomach can cause a person to drink more than if they were to eat a meal with the medication or before drinking.
This might be common sense to some of you reading this. When we have more food in our stomach, we absorb alcohol more slowly and therefore don’t get as intense of a buzz. The same is true for drinking on naltrexone. I have known people on this method who deliberately did not eat when they were drinking so they could get a bit more of a buzz. This is not helpful for the overall objective of TSM.
But if you are someone who wants to cut down on drinking more and haven’t tried eating a meal before you drink, you might consider adding that into your TSM protocol.
7. Drinking hard alcohol on the Sinclair Method.
This is not a hard and fast rule – but more often than not I have seen hard alcohol be a hindrance for people on the Sinclair Method. Because hard alcohol is so strong and it is very easy to drink huge amounts of alcohol in a small amount of time, it can in a sense “overpower” the effects of the naltrexone medication. This can cause a person to get to a high level of intoxication without feeling the effects of the naltrexone giving them that “stop” signal. When drinking hard alcohol, a person might feel like they have hit a plateau with the method and that it’s not helping them to make more progress. If this is you, consider taking hard alcohol out of the equation for now and just stick to beer, wine or cider.
Now I also know of people who have been able to drink hard alcohol on this method, and my advice would be if you are drinking hard alcohol – make your drinks weak, drink slowly and incorporate non-alcoholic drinks between alcoholic drinks.
8. Not re-dosing on naltrexone if you’re drinking over a long period of time.
Of course I am not a doctor so this is not medical advice – but you may want to ask your doctor about this. As for myself, I have talked with a number of TSM doctors about redosing on naltrexone if someone is drinking over a long period of time.
Re-dosing can be helpful because we start metabolizing the medication as soon as we take it, so after many hours of drinking the effects of the medication at blocking the endorphins from alcohol are not as strong. So some doctors will advise a person to take a second dose of the medication if they are drinking over an extended period of time.
For example, if you are starting drinking at 12pm so you take your naltrexone at 11am, if you are still drinking at 6pm, some TSM doctors would advise that a person take a second dose of naltrexone.
I personally have known a handful of people who were doing well on the Sinclair Method, but then were able to “binge drink” on naltrexone because they were drinking over a long period of time and did not take a second dose.
9. Not rewarding yourself on non-drinking days.
Many of us have spent years or decades turning to alcohol for our ‘reward’ after a long day or at a best friend’s party. That’s why when we get on TSM and start to drink less, it can feel like we are losing a best friend (even though it might have been a very destructive best friend).
That is why I believe it is so important that we reward ourselves with other pleasures in life when we’re not drinking so that we can learn to experience other pleasurable experiences in life and stop associating so much pleasure with alcohol. This is especially true for alcohol-free days so we can re-learn simple joys and pleasures of life and feel like we are earning a “reward” for choosing not to drink. By doing so, it will reinforce that behavior and cause us to more and more turn toward things that are rewarding because (thanks to naltrexone) alcohol is no longer giving us the reward it once did.
So be sure you are rewarding yourself for success with this method! It can be as simple as getting an ice cream, a nice meal, watching a funny movie, buying yourself a nice outfit, going for a bike ride or taking a hot bath. Be good to yourself as you make these changes and improvements in your life. By doing this repeatedly over time, it can make it easier to let go of alcohol and turn your attention to healthier rewarding behaviors and activities.
10. Not celebrating the little wins and successes on the Sinclair Method.
For most people, success on the Sinclair Method comes in small, incremental ways that happen day by day. For example, when you drink you might be drinking more slowly, drinking later in the day, drinking less frequently or less quantity and thinking about alcohol less in general. These are all small changes that will continue to build up over time with compliance on this method.
I often get messages from people saying they feel like TSM is not working for them – and when we examine what has changed in their relationship with alcohol, often there are changes they are just subtle and the person has dismissed them as insignificant because maybe they were expecting massive change to happen all at once.
This is why it is crucial to notice and celebrate all of the little successes and changes when you’re on this method. For most people, with time these small changes add up to big results after several months on TSM.
I always like to think about it like a weight loss journey. If you wanted to lose 20 pounds, hopefully you wouldn’t expect to lose it in a few weeks. Why? Because you’d be just setting yourself up for disappointment by having an unrealistic expectation. Most weight loss experts will tell you the healthiest way to lose weight is slowly over time – for example a pound a week.
The same thing is true for the Sinclair Method. You will likely not lose your desire for alcohol overnight, but rather in small subtle ways you will see your relationship to alcohol shifting and morphing into something else.
Give it time. Be patient. And celebrate every single small success.
Lots of love!