4 Common Reasons the Sinclair Method Might Not Be Working (and How to Fix Them)

I’ve worked with more than a thousand people on the Sinclair Method (TSM), and I’ve seen it transform lives. But I’ve also seen some people struggle to make it work. If you’re feeling frustrated or stuck, know that you’re not alone. In my experience as a TSM coach, there are a few common reasons why this method doesn’t work as expected—and more importantly, solutions to help you get back on track.

1. Not Following the Method Correctly

This one might seem obvious, but you’d be surprised how many people start TSM without the right information. I’ve met so many people who were prescribed naltrexone but weren’t given clear instructions—or worse, were given incorrect guidance.

Common mistakes include:

• Not taking naltrexone before every single drinking occasion

• Drinking too soon after taking the pill (not waiting the recommended 60+ minutes)

• Skipping doses and reinforcing old drinking patterns

TSM is powerful, but it requires consistency. The good news? If you’ve been using it incorrectly, it’s never too late to get back on track!

💡 What to do:

• Set phone reminders to take your pill before drinking.

• Keep naltrexone in visible places (like your purse, wallet, or kitchen) so you don’t forget it.

• If you’re unsure whether you’re following the method correctly, reach out for expert support!

For a deeper dive into naltrexone effectiveness, check out our blog: Why Isn’t Naltrexone Working for Me? Insights from Dr. Joseph Volpicelli

2. Expecting Quick Results

A common roadblock I see is impatience. Some people experience a “honeymoon phase” where their drinking drops rapidly, only to see it creep back up again. Others feel like nothing is happening at first and get discouraged.

TSM is a gradual process—it’s not a quick fix. It rewires your brain over time, reducing the urge to drink and changing your relationship with alcohol. For many, it takes months to see real, lasting changes.

💡 What to do:

• Track your drinking habits. It’s easy to overlook progress when you’re not keeping track. Even small reductions mean it’s working.

• Be patient. The average time to reach extinction (where cravings are eliminated) is 6-12 months, though everyone is different.

• Adjust your expectations. It’s normal for progress to feel slow at times. What matters is the overall downward trend in drinking over time.

3. Not Being Fully Ready for Change

I’ve worked with people who wanted to change but weren’t truly ready. They were still using alcohol as an emotional crutch, numbing out stress, or drinking to escape.

Here’s the thing: TSM makes it easier to change, but it doesn’t do the work for you. You still have to make conscious choices to reduce drinking and reshape habits.

💡 What to do:

• Ask yourself: Am I drinking for fun, or am I drinking to escape? If it’s the latter, explore healthier ways to cope.

• Make small, intentional changes. Try delaying your first drink, swapping out some drinking occasions for other activities, or exploring new hobbies.

• Be kind to yourself. Change takes time, and it’s okay to not have everything figured out yet.

4. Trying to Do It Alone

One of the biggest mistakes I see is people trying to do TSM without any support. Yes, the medication is a key tool—but having guidance, encouragement, and accountability makes a huge difference.

I’ve seen so many people struggle on their own, only to thrive once they plugged into a community or got coaching. TSM is a different approach than most people are familiar with, so it’s normal to have questions along the way.

💡 What to do:

• Find a support system. This could be a coach, an online community, therapy, or even just a trusted friend or family member.

• Ask questions! There are so many resources available—don’t be afraid to use them.

• Know that you’re not alone. Others have been exactly where you are and found success. You can too!

If you've feel like you've mastered everything above, you might find this post helpful: Why the Sinclair Method (TSM) Might Not Be Working for You

Who Is the Sinclair Method NOT Ideal For?

While TSM works for most people, it’s not the right fit for everyone. Here are a few cases where it may not be the best approach:

🚫 People who want immediate abstinence: TSM is designed for gradual reduction, not quitting cold turkey. If you want to stop drinking immediately, other treatment options may be more suitable.

🚫 People expecting a quick fix: TSM is a process that takes time and commitment. If you’re looking for an instant solution, you may get frustrated with the slow progress.

🚫 People with severe dependence and withdrawal symptoms: If you experience withdrawal when stopping alcohol, you may need medical detox before starting TSM.

🚫 People unwilling to take the medication as prescribed: Naltrexone needs to be taken before every drinking occasion. If you’re not able to commit to this, the method won’t be effective.

🚫 People with medical conditions that contraindicate naltrexone: Some health conditions or medications can make naltrexone unsafe. Always check with a doctor first.

Frequently Asked Questions (FAQ)

❓ How long does it take for TSM to work?
✅ Answer: Most people see progress within a few weeks, but full extinction of alcohol cravings usually takes 6-12 months.

❓ What if I miss a dose?
✅ Answer: Take naltrexone as soon as possible before drinking. Skipping doses can slow progress and reinforce old habits.

❓ Can I quit drinking immediately on TSM? 

✅ Answer: TSM is designed for gradual reduction, not immediate abstinence. If you want to stop drinking right away, other methods may be more suitable.

❓ Do I need support while on TSM? 

✅ Answer: Having a support system can significantly improve your chances of success. Whether it’s coaching, therapy, or a community, support makes the journey easier.

Final Thoughts

If you’re struggling with TSM, don’t give up! Many people hit roadblocks before seeing success. The key is to be patient, follow the method correctly, and seek support when needed.

TSM is a game-changer—but like any change, it requires effort and persistence. If you’re looking for guidance and a community to help you succeed, I invite you to check out the Thrive Alcohol Recovery Program.

Cheers to progress, one step at a time.

— Katie

Medical Disclaimer: 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. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.