Does anyone know of ANY cases in which naltrexone ALONE (not via TSM) helped cravings

[Greg]

I should probably post this on the Sinclair forum, but thought I'd put it here too in case anyone here may be able to offer an answer.

There are still a few medical sources that are trying to say that naltrexone helps reduce alcohol cravings markedly when it is taken by itself, that is, without also drinking at the same time. This of course is contrary to what everyone who supports The Sinclair Method has stated over the past few years. These are not just doctors who have been told to prescribe naltrexone for abstinent alcoholics, but now include researchers and company leaders with a financial interest in promoting naltrexone as an implant or injection (Vivitrol being one brand name of this).

I was about to dismiss this as marketing propaganda, but then I remembered one or two individual reports here and there over the years, in which alcohol dependent people said that naltrexone when used during abstinence DID actually reduce or eliminate their desire to drink alcohol. Placebo effect or real effect?? If it really does help this way, then it must be able to do something via blocking opioid receptors without alcohol having to be present, which goes against the usual explanation of how it works (i.e that it blocks alcohol-induced endorphin release and reward).

If anyone knows anything about this, I'd be interested to hear about it, since I cannot recall exactly who stated that naltrexone had helped them while sober.

[PJS]

Does anyone know of ANY cases in which naltrexone ALONE (not via TSM) helped cravings

Dead Drunk

I cannot really help you except I have taken Naltrexone when I was drinking and it did no good. I stopped when I heard of deaths involved with Naltrexone. Rather be dead drunk than drunk dead.

[Heavy Fuel]

Does anyone know of ANY cases in which naltrexone ALONE (not via TSM) helped cravings

You may want to check NIH or other medical research archives for studies on naltrexone. An individual is simply anecdotal evidence.

Vivitrol is super expensive, and has to be taken every month. The implant would seem to be the same, every year, a new implant. I can't see how they differ from dosage orally.

PJS, where did you hear of deaths on naltrexone?

EDIT: I did a good bit of googling about nal and death. What I found was opiod dependent and people who did the implant seem to have issues. Nothing concerning nal and alcohol.

PJS if you have other sources, I would be very interested in reading them.

[Poink]

Does anyone know of ANY cases in which naltrexone ALONE (not via TSM) helped cravings

Am currently AF for about 2 1/2 weeks and take 50 mg naltrexone daily. Seems to be helping me. Could be other explanations for lack of cravings. Have been in and out of treatment for years and have had some periods of sobriety in the past but this has got to be the easiest first 17 days of any attempt to quit. Am taking supplements also (mostly vitamins). Maybe at 56 I finally get it. Whatever...am gonna keep taking the nal.

[spacebebe01]

Does anyone know of ANY cases in which naltrexone ALONE (not via TSM) helped cravings

Sorry I cant help you here, but just wanted to say hello and good luck

[spacebebe01]

Does anyone know of ANY cases in which naltrexone ALONE (not via TSM) helped cravings

Hi Greg I didnt realise it was you how are you doing, I am still sober on 50mg bac, campral, and antabuse and have to say the cravings have decreased massively. My problem now is my mood, I am getting pretty depressed and going into what I can only decribe as total meldown over little things, the other day I was trying to make a phone call and for some reason couldnt seem to input the numbers to my phone and I was shouting and swearing and ended up in tears. I can also be really impatient, and seem to be developing anger issues. Over about the past 6 weeks now my doc has reduced my cipralex down to 0 then I have started on effexor which I am taking now still at the lowest dose. I am sick of antidepressants and what they may or may not be doing to me, I have pretty much given up asking the gp about this as he just says the same shit all the time and this is now the second change this year. Over the years I cant think of an ssri I havent tried, if I mention to him that it may just be that antidepressants just dont work for me he looks at me as if Im an idiot and tells me he wouldnt be happy for me not to take them given my history of depression, anxiety and alcohol addiction. The bottom line is Im now scared to not take them. Sorry I have done it again, not answered your question but then waffled on about myself. What are you doing now? I am interested to know

[windycitylady]

Does anyone know of ANY cases in which naltrexone ALONE (not via TSM) helped cravings

Greg! I was thinking about this myself last night and even pricing naltrexone online. How crazy to check in here and find this thread! I was prescribed naltrexone about 10 years ago for cravings. Whether TSM did not yet exist or my doctor was not aware of it, I didn't hear of it until recently. I found it extremely helpful in dealing with cravings. It was like I was looking at the world for the first time through the eyes of a nonalcoholic. I remember it causing nausea, at the time I attributed this to the fact that nal is hard on your liver, though my liver enzymes were fine back then. I would like to try it again, but I'm discouraged by the prices I'm finding online. Anyone know where an uninsured person can buy it cheaply? Also, exactly how bad is it for your liver? Should I find a way to get my enzymes tested again? I have an old bottle of nal that expired in 2007, I think, and I'm tempted to take some to see what happens. Stupid, I know.
Greg, please let me know what your thoughts are and what you've decided to do.

[windycitylady]

Does anyone know of ANY cases in which naltrexone ALONE (not via TSM) helped cravings

Spacebebe, have you tried gabapentin? It's never helped with my cravings, as some here say it does, but it's been very helpful with my medication resistant anxiety and depression. The dose for depression is higher, between 900 and 1800 mg. Good luck and congrats on your sobriety!

[Greg]

Does anyone know of ANY cases in which naltrexone ALONE (not via TSM) helped cravings

Thanks for the information so far folks.

Hi Spacebebe, I'm sober at present thank you, but not about to brag about it until I have more time under my belt. I'm using Antabuse, Campral, Xanax, and L-tryptophan at present. I plan to slowly transfer from Xanax to Valium, then from that to baclofen. I'd stay on benzos except I pretty well know tolerance will set in sooner or later, and I'm worried they will stop doing anything to reduce my cravings once that happens. I'm awaiting baclofen from Virtuous Labs, the guys who sell it in liquid form. I also found by accident that a mild dose of scopolamine (i.e. Kwells travel sickness tablets) seems to work with the Xanax during the evenings to reduce cravings and depression, but that's probably only due to it producing a mild dizziness effect. You see, I am mentally addicted to feeling an altered state every evening, after doing this for over 20 years, rather than a specific addiction to alcohol (although I am more addicted to alcohol than the alternatives). I originally started doing this ritual as a temporary end-of-day escape from depression and anxiety, as well as insomnia. Unfortunately the obsession persisted even when not depressed or anxious. That is why marijuana worked for about 19 months for me as an alcohol substitute. Please note that I am not recommending you or anyone else do what I have done, and the pot had some troublesome psychological side effects in the end. Maybe something like L-tryptophan could help with your depression, and even large doses (eg 1500 mg at night for sleep) don't seem to have any of the SSRI's side effects for me. You could not take it at the same time as most other antidepressants however, because the two could interact to cause excess serotonin (serotonin syndrome). You would also have to wait for some weeks I think after stopping an antidepressant before starting tryptophan. I hope you do find help for depression, as it has always driven me back to getting drunk or high, in addition to my nightly addictive ritual.

Hi Windycitylady, gabapentin is an interesting alternative for depression, and I'd be interested in hearing if it keeps working after some time of daily use. I have found tolerance occurs rapidly to some of its effects (e.g. sedation), but I have not tried it longer-term for depression or anxiety, and don't have any at the moment. I have often thought there is a need for depression treatments that don't only affect serotonin or norepinephrine levels, as conventional antidepressants do.

Your naltrexone experience is of great interest, as it is another story of the drug helping alcohol dependence without being used with alcohol. As far as I know, TSM wouldn't have been known by any non-medical people (or many medical people either) 10 years ago, although it may have been known that naltrexone could stop people going on huge binges if they slipped and had a couple of drinks. I first heard of the method as "pharmacological extinction" but Dr Sinclair's studies did not seem prominent in English language sources until recently, probably largely due to Dr Eskapa's book. Others here may be able to correct me on this bit of history however. As for liver damage, I recall reading that it was mainly doses higher than the usual 50 mg/day that were troublesome, but there tends to be a general warning about this even for 50 mg. You could get your liver enzymes checked again via a blood test if worried. Here in Australia it is easy to get naltrexone prescribed even by a GP, at minimal cost, and liver tests are likewise ordered by GP's. If you can't access it where you are, all I can suggest is looking up the various online pharmacies mentioned on this forum by people who order baclofen, and see if they also have naltrexone. I have ordered a few things successfully from Inhouse Pharmacy but cannot speak for any of the others. Maybe PM Lo0p and ask him, he would know.

As for what I'm doing, apart from what I said at the start of this post, I am now tempted to also try naltrexone without TSM. I did it with TSM but only for a few weeks, way too short a time. I thought it was causing me increased depression, but that may have been an unfair criticism, as my depression worsens at random times. I had also been worried about blocking natural endorphins, so may have convinced myself that the depression was worsening. Others have taken the drug without reporting this, with nausea the only main initial complaint from memory. Naltrexone also interests me due to my generalised addiction to having a nightly high of any sort, since this drug (and baclofen) have been said to help with addictions other than alcohol. Low-dose naltrexone has even been said to help depression by one or two sources I remember reading.

Best wishes to everyone, and apologies for another one of my long posts!

[Doggygirl]

Does anyone know of ANY cases in which naltrexone ALONE (not via TSM) helped cravings

Greg, I don't know if this is helpful - but here is a link to an article on the NIAAA site that references a study called COMBINE. It looks like it is about Nal + Counseling, but might have some info of interest. (I'm not sure - I didn't read the whole thing)

Good luck to you!

Naltrexone or Specialized Alcohol Counseling an Effective Treatment for Alcohol Dependence When Delivered with Medical Management

DG

[Greg]

Does anyone know of ANY cases in which naltrexone ALONE (not via TSM) helped cravings

Thanks DG, I will definitely check this out.

[Ne/Neva Eva]

Does anyone know of ANY cases in which naltrexone ALONE (not via TSM) helped cravings

Hi, Greg.
I've been doing some research for a paper and Nal has been shown (pretty) conclusively to help people maintain abstinence. I haven't found anything about vivitrol, I don't think. I think a cursory search will lead you to some pretty compelling and legitimate very recent research. (Maybe at NYU or SUNY? I can't remember.) (Sorry, New York University and State University of New York)

Also, I've been wanting to say this to you for a very long time, and have in fact posted it and deleted it several times. I know it is bound to piss people off (especially WCL. Sorry sister. Really.) (Edit) I know that you've tried bac in the past. I also know that you've had some unpleasant experiences, and were very concerned about the long term health ramifications.
In the current protocol, using your expansive knowledge and ability to control and maintain a rather rigorous () medication regimen, I really, really believe you will find the answer you are looking for.
I also believe that HDB isn't as necessary if one is looking for a long term solution to maintain control. This is not as controversial as it seems, since all of the early studies have been on LDB and some of them are promising.
I also think that your desire for a high will be accomplished with bac, until you no longer desire it any more. That's the way this thing happens. One day you want to be high, and the next thing you know, you don't.
Finally, I think that there is ample evidence to allay your early and understandable fears and your own experience with this medication. Slow and steady could be the key.
(more edit) I feel a bit badly about saying all of that, and hope it's not overbearing. I thought it might be useful, especially given that you don't spend as much time around here as you used to.

Your commitment to abstinence is remarkable, and I wouldn't say this if I didn't think it would help. I'm not pushing it and have no investment in it. None. Would that I could. (I bet OA and some others feel the same! Geez, I hope that guy gets rich some how. oops! I digress.)

Anyway, hang in there, Greg. I know you will not ever give up, and for that I hold you in great esteem.
I will try not to delete this, and also hope that you will take it in the spirit with which is it intended.

Sincerely and with :ls
Ne

[Bminor]

Does anyone know of ANY cases in which naltrexone ALONE (not via TSM) helped cravings

Greg,

In 2007 during one of my 3 month sober periods back then I was on once daily Naltrexone (50mg per day) for a few of those months. I don't know if it was placebo effect or what but back then it seemed to help with the cravings. I of course eventually quit taking them because I got sick of taking pills and eventually started drinking again. I can't say for certain that it helped but I know doctors are waaaaaay more willing to prescribe this as an anti craving drug than they are to prescribe HDB.

[windycitylady]

Does anyone know of ANY cases in which naltrexone ALONE (not via TSM) helped cravings

So much to say and so little time! I want to echo Ne (hey, Ne!) here and say I am so impressed with your diligence and thourough research. Gonna sort out my thoughts and post again later when I have more time. This conversation has me very excited!

[redhead77]

Does anyone know of ANY cases in which naltrexone ALONE (not via TSM) helped cravings

There is also this, which is a literature review. It's a good article altogether that looks at various pharmaucetical treatment options.

NIAAA Publications

Clinical trials indicate that treatment-seeking drinkers who receive naltrexone at a dose of 50 mg/day in combination with a behavioral intervention have lower levels of relapse to drinking during the treatment period. This effect of naltrexone may be related to a reduction in alcohol craving (e.g., O’Malley et al. 2002).

This might be from the study DG posted, but there's more info in there related to naltrexone in general.

EDIT: And maybe not. The study years are different, although one of the authors is the same.