What is the Sinclair Method?
Naltrexone for Alcohol Dependence
The Sinclair Method for Alcohol Use Disorders is an evidence-based treatment for problematic drinking developed by Dr. John D. Sinclair. Unlike traditional treatments that require complete abstinence from alcohol, the Sinclair Method allows you to continue drinking alcohol at the beginning of treatment.
In fact, treatment success depends on the continued consumption of alcohol in combination with the prescription medication Naltrexone.
Naltrexone is at the heart of the Sinclair Method (TSM) for Alcoholism. When you take Naltrexone prior to drinking, it blocks endorphins, the naturally occurring opiates in the brain, from being released when alcohol is consumed.
When the endorphins are blocked, there is no “buzz” or rewarding experience, and the alcohol doesn’t make you feel the pleasure that drives you to drink excessively.
Over time, your brain learns not to associate alcohol with pleasure, resulting in reduced cravings and improved control over alcohol use. Naltrexone must be taken at least one hour before your first drink.
There are no meetings, chips, or higher powers with this program, although your provider may recommend some types of counseling.
“We have at our disposal a treatment which has been demonstrated to be safe and effective. It should be used now.”
Abstinence Not Required
With the Sinclair Method, there’s no need for you to stop drinking completely, if that isn’t your goal.
If you’ve ever tried abstaining from alcohol, you know how awkward it is to be the only one not able drink. You may decide to turn down invitations to these events, because you feel that your abstinence makes you different than everyone else. On the other hand, you know that if you were to start drinking, you’d likely lose control and behave in ways you regret. Now there is a third option.
The Sinclair Method allows you to participate in the normal customs of our culture that involve alcohol. As long as you take Naltrexone one to two hours prior to your first drink, you will eventually be able to maintain control over your drinking.
You may decide to have just one drink, or you may have a few. Your decision will be appropriate for the circumstance. You may even decide to have zero, if that’s your choice on that day.
What is the Success Rate of the Sinclair Method?
The Sinclair Method has been confirmed to be effective in more than 90 clinical trials around the world and observed to be successful in approximately 80 percent of problem drinkers. It is considered standard treatment for alcohol dependence in several European countries.
It may take time for this approach to gain wider acceptance, since the concept goes against the total abstinence approach that most treatment centers and specialists endorse. However, science is on the side of the Sinclair Method.
“In order to fix the problem, you have to actively teach your brain that alcohol use does not result in pleasure.
Time alone does not change the addicted brain.”
Why Abstinence Does Not Work
The Sinclair Method does not ask you to never, ever drink alcohol again. Isn’t that a relief? Research on the brains of humans and animals addicted to alcohol tells us the same thing about abstinence: It makes the brain more preoccupied with drinking and increases cravings. This is known as the Alcohol Deprivation Effect.
Abstinence does not work because the alcohol-dependent brain will not rest until it has a drink. This is the reason members of AA have to go to meetings the rest of their lives. Even though they haven’t had a drink in ten years, the brain that became addicted to alcohol remains addicted to alcohol.
This is why AA is correct when they state that even if you haven’t had a drink for 20 years, if you slip, you begin drinking right where you left off. It reveals to us that abstinence does not change the fundamental neurobiology of addiction, no matter how long you’ve gone without a drink.
Alcohol Deprivation Effect
At some point, most alcohol-dependent drinkers are unable to fend off the urge to drink, no matter what they try. When people do drink after sustained abstinence, it is more often than not a self-destructive binge characterized by larger quantities of use than before they stopped. This is also a part of the Alcohol Deprivation Effect.
Operant Conditioning
The basic reason that this occurs is that the neurological disorder (i.e. addiction) that develops after repeated drinking is primarily about the association your brain has created between alcohol and pleasure. This is called Operant Conditioning, which is a type of learning. When you drink, the pleasure you get is from the release of endorphins.
Pharmacological Extinction
This un-learning or pharmacological extinction occurs every time you drink with naltrexone, because your brain gradually no longer associates alcohol with pleasure. Eventually, your brain will lose interest in alcohol, and you will find that you can take it or leave it.
Abstinence does not teach your brain this lesson, because as far as your brain is concerned, the last time you drank alcohol, it received its fix of endorphins. This is true even if you haven’t had a drink in over a decade.