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How Does the Sinclair Method Work?

I remember when I first learned about the Sinclair Method in 2017, I couldn't believe that something like this existed. I remembered scouring the internet trying to find information on how this method worked, and honestly if it were too good to be true. As I write this article in August of 2021 – I am happy to say that no, this method is not too good to be true, and I can honestly say it allowed me to feel "cured" of my alcohol addiction.

So in this article, I'd love to tell you a little bit more about the Sinclair Method, including how it works.

The Most Common Question I Get Asked

When I meet people who are new to the Sinclair Method (TSM), often times the first question they ask me is, "Why haven't I heard of this before?"

People are often shocked to learn that there is a scientifically proven way to overcome alcohol addiction that does not involve abstinence, white-knuckling or going to AA meetings everyday. Believe me, I was too.

Even though this method has been around for over 30 years, it is still relatively unknown to the masses.

The reasons for that I will not go into in this article – but one large cause may be that doctors are simply unaware that this treatment exists. This is a crucial piece of the puzzle because in most places around the world people need a prescription to the medication that is used on the TSM called naltrexone.

Most general practitioners (GP) are also not usually trained in addiction treatment and are used to sending their patients with alcohol problems to programs like Alcoholics Anonymous (AA), telling them to go to a rehab center, or just advising them to cut back or quit drinking (yeah, thanks a lot doc! Why didn't I think of that? 😉). As a result of most physicians being uninformed of this life-saving method, countless people (myself included) are being turned down by their doctor for a prescription of naltrexone – the medication used for the Sinclair Method.

Despite the reality of today whereby there is a massive lack of awareness of naltrexone and TSM – I am beginning to see and do believe there is a tipping point. As more and more people learn about this method, and the fact that it has a 78% success rate – which is outstanding considering AA's success rate is somewhere between 5-10%, more and more physicians will adapt it as more patients ask for it.

Rest assured, just because the Sinclair Method is not something you're seeing talked about on the evening news or advertised on billboards, does not mean it's because it doesn't work. In fact, TSM works very well for most people, is inexpensive to do and doesn't require a person to hit a "rock bottom" to get better.

How Does the Sinclair Method Work?

As mentioned above, starting TSM is relatively inexpensive and can be done discreetly from the comfort of your own home thanks to a number of telemedicine doctors who will prescribe the medication through a phone or video appointment.

The first step to getting started on this method is to get your hands on a prescription of the medication naltrexone. This medication may also be under the name of nalmefene or Revia as well. You can find a resource of physicians through the C Three Foundation website.

Naltrexone is a safe, non-addictive, generic and inexpensive medication. Here in the states it's usually about $30 for a one-month supply – and can even be covered by insurance.

The standard therapeutic dose of naltrexone following the Sinclair Method is a 50mg dose. A knowledgable TSM physician will usually have their patient start at a 25mg dose for the first few times they take the medication just in case there are any side effects. Most people tolerate the medication well, however and if there are mild side effects in the beginning, they will usually subside within about 1-2 weeks.

Over time, some people may require a larger dose of the medication. You can talk with your doctor about the dose that's right for you. Again, 50mg is the standard dose for most people.

The actual TSM protocol is quite simple, but it must be followed precisely for people to see success with this method. The method includes taking one 50mg tablet of naltrexone at least one hour before the first drink of alcohol for the day.

The Basic Sinclair Method Protocol

(1) 50mg naltrexone tablet + (1) hour + drink

When someone follows this protocol, the naltrexone tablet interrupts the typical endorphin reward someone would usually get when drinking.

Something I wasn't aware of when I first started TSM was how "rewarding" drinking alcohol was to my brain. It is actually a very pleasurable activity neurologically – which is why it can be so addictive.

For our survival, humans are wired to remember the things that bring us pleasure, and our brains tell us to "do that again." And the exact same thing happens with alcohol. We drink, we get a massive rush of endorphins and our brain (just doing its job! 🧠) remembers that, then it tells us to "do that again." With enough repetition, we begin to crave alcohol (our brain is looking for that reward) and the vicious cycle begins.

When naltrexone is taken in a targeted dose before drinking, it blocks that endorphin rush (reward) from the alcohol. Gradually, over time with enough repetition of TSM, we simply become less interested in alcohol. When this occurs, it causes people to drink less alcohol, crave it less and be able to have more alcohol-free days where they genuinely don't want to drink. Trust me, this whole experience feels like a miracle! 🙌🏼

I know this all might seem wild to some of you reading this – especially if you're just now learning about this method.

I remember when I first learned about TSM I could hardly believe that there could be a time where I wasn't craving alcohol anymore, or had an "off switch" and could stop at just one or two...but, it's true. And I've seen this happen with countless people (myself included) over the years.

I like to illustrate this phenomenon using a cake analogy – who doesn't love cake, right? 🎂

Imagine you have a cake that was just freshly baked that day and you enjoy a slice of it. It's fresh, it's moist and so full of flavor. It's so delicious in fact you might have a second piece. But then imagine that same cake on day seven – it's more stale, dry and not very flavorful. You might have a couple of bites but can choose not to simply because it's not all that appealing.

This is what happens for many people with alcohol through the use of naltrexone and the Sinclair Method. When you start the method you may still really enjoy drinking – and may even over-drink at times as well. But the longer you're on the method – alcohol begins to feel like that stale piece of cake. Sure it brings some amount of pleasure, but you can stop after one or two without having to have more.

This process is what's known as pharmacological extinction – or extinction for short. Because alcohol drinking is a learned behavior that has to do with the opioid reward system in our brain – Dr John David Sinclair (the man who discovered TSM) proved that alcohol drinking can also be unlearned if the reward is blocked. So the process of TSM (or extinction) is allowing a person to gradually unlearn the behavior of alcohol (over)drinking. Over time – this allows a person to regain control over their alcohol consumption – and they can decide how much and when they drink without "white-knuckling" or resisting cravings.

In my experience with process of extinction – once I reached pharmacological extinction (it took me about 9 months on TSM), it honestly felt like the addiction never happened and that my brain was restored. I wasn't thinking about alcohol anymore, when I drank I would only have one or two and not want for more – and most of the time I was choosing to be alcohol-free. I could even be at a party where everyone was drinking, and I wouldn't even have the slightest urge. I was becoming a whole new person (and you can, too). 🙌🏼

Extinction can also allow people to give up alcohol entirely with much more ease because their brain has been restored to the state it was in pre-addiction.

In fact, this is what happened to me. After one year on the Sinclair Method, I just didn't drink again. It's not that I was trying not to drink, I just kept not drinking! Sometimes you hear people say that they "forget to drink" on TSM – I remember thinking, "yeah, right." But, it's true. It happens. You can read more about my story here.

The longer I was on the method, the longer I was going without drinking. By month 9 I was drinking about once a month. Then around the 12 month mark, I went one month alcohol free (without evening trying), then two months, then three and by the fourth month I decided I was going to go alcohol free. I never in a million years thought that would happen... but TSM healed my brain and I found that I actually enjoyed life much more without alcohol. I've been alcohol-free for three years now and I can honestly say I don't miss it at all. Wild, I tell you! 💃

Some Basic Tips for Doing the Sinclair Method

While the TSM protocol (as outlined above) is quite simple, there's a lot more to the journey of changing your relationship to alcohol than many people realize. It's a process, and one that needs time, perseverance, patience and loads of grace. Here are some practical tips that will help you start to navigate your TSM journey:

  • Never skip a dose of naltrexone. This is the "golden rule" of TSM – take the medication 100% of the time that you drink. If you don't have naltrexone on you and are offered a drink – don't drink.

  • Always keep naltrexone on you. You can get a keychain pill holder on Amazon or anywhere in order to keep the medication on you, and be sure to keep it at any place where you may be tempted to drink.

  • Always wait the full hour. This could be called the "second golden rule" of TSM because it's so important. Allowing the medication to set into your system is crucial for success on this method. So please be sure you always wait at least an hour (some people report that waiting longer – 1.5 to 2 hours can be more effective for them) before you have even a sip of alcohol.

  • Log your drinks. This can be very helpful to track progress on the method. Often progress on TSM is slow but steady, and charting your drinks can allow you to measure progress over time, and also just be more mindful of how much you're drinking. Here is a landing page with a drink log you can download to Excel or Google sheets, or you can also download the app version. You can also count your drinks in any other way that works for you.

  • Get a support system. Changing your relationship to alcohol impacts many areas of your life. Having a support system can be very beneficial for succeeding on TSM. So whether that's your family, friends or the online TSM Community, plug into people that will support you at every step of the way.

  • You do not need to take naltrexone on alcohol free days. This is another common question I get a lot. Following TSM, naltrexone is only taken on days when you drink alcohol. If you're not drinking alcohol, you do not need to take naltrexone.

  • Talk to your doctor about re-dosing. If you're someone who may be drinking over a long period of time (say morning to evening, or lunch to evening), you'll want to learn more about re-dosing. Most knowledgable TSM doctors will guide their patients on if or when they should re-dose. This simply means taking a second dose of naltrexone if you're drinking over a long period of time because the first dose is wearing off. For example, many TSM doctors will advise people to re-dose between 6-8 hours after they have taken their first dose if the patient is still drinking. Again, talk with your doctor about this one!

  • Be aware that drinking is a habit and a coping mechanism. For many of us, drinking alcohol has become a very engrained habit and a useful coping tool. And while the naltrexone is very powerful at fixing the biological aspects of alcohol use disorder (AUD), it does not work on the habits or the coping side of drinking. For example, sometimes people might not have an urge to drink (thanks to the naltrexone), but they find that they do it anyway out of habit. These are things that can be addressed gradually on the Sinclair Method, and something you can reach out to others for support on.

  • Your drinking will likely fluctuate on TSM. Most people's TSM journeys will be filled with ups and downs. Some days or weeks they may hardly drink at all, while other days they may drink a lot. This doesn't mean the method is not working, but rather, there may be environmental circumstances or emotional triggers that are driving the drinking. Take a deep breath, chart your drinks and spend time reflecting on the drinking experience. Often these times can be a valuable lesson and learning experience.

  • Give this method time to work. The Sinclair Method needs time to work. For most people, it will take at least nine months to reach extinction. While some may reach it sooner, others may take much longer. It does not mean it's not working, it's just that this process takes time and everyone is different. It's important to just trust this process and don't give up.

The Sinclair Method is a powerful tool for treating alcohol use disorder (AUD). With the success rate of 78%, it could very likely transform the alcohol addiction treatment as we know it. I'm grateful to be a part of this journey, and love to support others in getting free from the grips of AUD. 🌈

Disclaimer: This article is not intended as medical advice. The content found in this article is only my personal opinion and should not be a substitute for seeking medical advice from your physician.

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