Can Naltrexone Make You Drink More Alcohol? The Truth About TSM

When following the Sinclair Method (TSM) with naltrexone, some people may notice that they drink more alcohol initially. This phenomenon can be concerning, but it's important to understand why it happens and what it means for your treatment journey.

Why You Might Drink More Alcohol on Naltrexone

Dr. Joseph Volpicelli, a leading naltrexone expert, explains that while it is theoretically possible to drink more on naltrexone, it rarely happens in practice. The concern often stems from a misunderstanding of how naltrexone works. Unlike with opiates, where some individuals may try to overcome the blocking effects by increasing their dose, alcohol's sedative effects make it difficult to 'drink through' naltrexone.

When you take naltrexone and drink alcohol, the expected euphoric effects of alcohol are diminished. Instead of feeling energized or buzzed, you might feel tired or even nauseous. If you try to push through and drink more, it often leads to increased fatigue or even blacking out before achieving any sort of 'high.' This experience usually discourages further attempts to drink excessively.

Does Research Show That People Drink More on Naltrexone?

No, research does not show that people drink more on naltrexone when following TSM. Clinical studies have consistently demonstrated that naltrexone, when used correctly, leads to a reduction in both the frequency and quantity of alcohol consumed over time.

Key Findings from Research:

• Reduced Heavy Drinking Days: Studies, including those by Dr. John David Sinclair and other researchers, found that naltrexone significantly reduces heavy drinking days and overall alcohol consumption.

• Diminished Reward Response: Naltrexone works by blocking opioid receptors in the brain, which reduces the pleasurable effects of alcohol. This makes drinking less rewarding and naturally decreases the desire to drink more.

• Gradual Reduction Over Time: According to research, individuals following TSM often experience a gradual decrease in their alcohol consumption as their brain learns to disassociate alcohol with pleasure through the process of pharmacological extinction.

• Meta-Analyses and Clinical Trials: A meta-analysis published in JAMA (2014) reviewed multiple clinical trials and confirmed that naltrexone significantly reduces alcohol cravings and the risk of returning to heavy drinking.

Common Reasons for Drinking More on Naltrexone

1. Chasing the Buzz: Some people may initially try to drink more to achieve the same feeling they got from alcohol before starting TSM. However, most find that the buzz doesn't come, leading to natural reductions in drinking over time.

2. Habits and Rituals: Drinking patterns are often deeply ingrained habits. Even if the pleasure of drinking is reduced, the habit itself may continue until new coping mechanisms are developed.

3. Emotional Coping: Many people drink to cope with stress, boredom, or other emotions. On naltrexone, the 'reward' of alcohol is diminished, but the habit of using it as a coping tool may still persist temporarily.

Frequently Asked Questions (FAQ)

Can naltrexone make you drink more? No, research does not support the idea that naltrexone causes people to drink more. Instead, it helps reduce cravings and the pleasurable effects of alcohol, leading to less drinking over time.

Why does it feel like I'm drinking more on naltrexone? This might happen initially due to ingrained habits, emotional triggers, or attempts to chase the buzz. Over time, these behaviors typically diminish as the brain adapts to the effects of naltrexone.

What should I do if I drink more on TSM? Ensure you are taking naltrexone as prescribed, reflect on your drinking patterns, and seek support from a community or program like Thrive Alcohol Recovery.

Is drinking more on naltrexone a sign of failure? Not necessarily. It can be part of the adjustment process. Many people experience fluctuations in drinking habits before seeing a steady decline.

What to Do If You Are Drinking More

• Take Naltrexone Correctly: Ensure you are taking naltrexone as prescribed, typically one hour before drinking, to achieve a full therapeutic level in your system.

• Reflect on Your Drinking Patterns: Consider if you're drinking out of habit, boredom, or to manage emotions. Bringing awareness to this can help shift behaviors.

• Build New Habits: Focus on alternative activities and coping mechanisms that don't involve alcohol.

• Seek Support: Engaging with a supportive community, whether through coaching, peer support, or programs like Thrive Alcohol Recovery, can make a significant difference.

Conclusion

While it is possible to drink more alcohol on naltrexone, it is not a typical outcome for most people following the Sinclair Method. With proper medication adherence, habit change support, and social resources, many people experience a natural decline in alcohol consumption over time. If you're struggling, it may help to connect with a program that specializes in TSM to ensure you're getting the most out of this treatment approach.

Disclaimer: This article is for informational purposes only and is not intended as medical advice. If you have concerns about your alcohol consumption or the use of naltrexone, please consult a healthcare professional. Always follow your doctor's guidance when taking any medication.