The Sinclair Method in Seattle’s The Stranger magazine

Using Naltrexone to moderate drinking as an alternative to AA

The Sinclair Method was featured as the cover story in the December 2018 edition of The Stranger.  Columnist Katie Herzog interviewed our own Brian Noonan, ARNP for the story:

For the first time in my life, I’ll pour a beer out. I physically could not do that before.”

Science backs this up. With Naltrexone, “alcohol becomes non-reinforcing,” said Brian Noonan, a psychiatric nurse practitioner and the owner of Ballard Psychiatric Services. “With repeated trials of drinking without reward, the association of drinking with reward begins to extinguish.” The patient starts drinking less and less often. Some eventually stop altogether.

Noonan practiced abstinence-based therapy for 12 years before he stumbled across the Sinclair Method in a book. He was interested immediately. Conventional therapy and giving his patients a list of nearby Alcoholics Anonymous meetings just wasn’t working. The failure rate was high, and his patients often felt guilty when they’d relapse, perhaps in part because AA and other 12-step programs teach that taking even one drink is a broken promise to yourself. Who wouldn’t feel guilty about that?

Noonan started introducing the idea to his patients. They were interested, too. For these patients, the idea of never drinking again—not today, not tomorrow, not ever—was unfathomable. It would be like never seeing a loved one again. Because Naltrexone doesn’t require you to divorce yourself from drinking, it offered a way out of the cycle without doing something patients thought was impossible.

It’s been three years since Noonan first learned about Naltrexone, and today his practice revolves around it. He’s licensed to prescribe in 20 states, and he consults with patients all over the country via video chat, along with five other health-care providers working under him. (On the day I visited his office in Ballard, he’d just consulted with a man in Colorado who was out snowboarding.) Since making the switch, Noonan says he’s personally prescribed Naltrexone to an estimated 1,000 patients, and about 80 percent of them, he says, have found success.

Unlike AA, where success is measured in the number of days sober, “The only marker for success I have is that the patient feels in control,” Noonan said. “They can drink or not drink in a manner that is appropriate to them. Sometimes that’s abstinence, or sometimes that’s just drinking on the weekends, or sometimes it’s just drinking on special occasions. I measure success by when people are happy about the way they are drinking or not drinking.”

The entire story is here.