My doctors and I are trying a rather unorthodox approach to treating my alcohol use disorder (AUD). That’s what we call it in 2016, by the way. Not alcoholism. That term is only used by God based 12-step programs (and the uninformed general public, partly due to the pervasive nature of the cult called AA).
This is a standup comedy bit by Doug Stanhope that captures my opinion of AA rather nicely.
So, what crazy technique is Brian utilizing? It’s called the Sinclair Method:
The Sinclair Method (TSM) is a treatment for alcohol addiction that uses a technique called pharmacological extinction—the use of an opiate blocker to turn habit-forming behaviors into habit erasing behaviors. The effect returns a person’s craving for alcohol to its pre-addiction state.
TSM consists of taking Naltrexone or Nalmefene one hour before your first drink of the day for the rest of your life as long as you continue to drink. Naltrexone (or Nalmefene) chemically disrupts the body’s behavior/reward cycle causing you to want to drink less instead of more. The Sinclair Method has a 78% long-term success rate.*
Studies have proven that TSM is equally effective with or without therapy, so patients can choose whether or not to combine TSM with therapy. The physical results will be the same.* Extinction usually occurs within 3-4 months.*
About one quarter of those on TSM become 100% abstinent. Those who continue to drink will have to take their medication prior to drinking for as long as they continue to drink.
So, it has been 5 days since I started this plan. I go about my day as normal, then around 5PM I’ll have one pill of Naltrexone. I’ll start having drinks at 6PM as I start to unwind, browse MindSay, YouTube, etc.
However … it’s different.
There is no endorphin rush. When someone like me has that first drink, we can feel that rush that start at the scalp and goes all the way down to the fingers – just a awesome feeling that alcohol creates within us. But that simply doesn’t happen when I take Naltrexone – or just about one tenth as strong, or less.
I still become altered in many ways typical of someone drinking alcohol. My judgement is impaired, motor skills weakened, and I certainly couldn’t drive. But I don’t feel good/pumped up. I don’t feel bad; just .. not the same as drinking was before.
Normally when I drink, my rate of “next drink” generally increases, wanting more and more. It is less so with Naltrexone.
I went to a launch party for a random startup last night. It was downtown Mountain View so I was able to walk there. It was for a Touring/Travel startup, so I donned some random costume of mine, mostly stolen from my Burning Man gear. Kilt, desert boots, LED blinkies, headlamp, and whip. The last of which they made me check at the door. No weapons in the nightclub. It’s a noisemaker technically, but whatever ;)
I ended up knowing and reconnecting with at least ten people. I was not expecting to see so many people I knew. It was good. A couple people I didn’t even know approached me (“Hey, aren’t you the Hacker Dojo guy?”)
It was good for my self-esteem. And I wouldn’t have gone if I wasn’t a drinker. Think about that. Sober Brian would have been lonely and sad on a Friday night. Instead I .. I am glad I went.
Going sober really alienated me from friends and 2015 and largely contributed to my depression the last year.
If for no other reason alone, this social benefit of TSM makes it worth it in my mind.
And – if things go well -- I’ll lose interest in drinking within 3 months. How crazy is that.
I did have 5 drinks at the bar, which yeah is a lot, but normally I’d have six or more. And I left my last beer 2/3rd full! I never waste alcohol. Wow!
Pharmacological extinction. Pretty fascinating.
I learned about this approach from this documentary:
One Little Pill
I even got in touch with the actress, Claudia, and she’s been giving me advice on the Naltrexone. She has 132 credits on IMDB including Babylon 5. Strangers want to help me more then my family and friends. Sigh. But I’m happy for the support I do have, and I’m actively trying to grow that support circle.
So that’s one of the six prescription medications I’m on. Ha.
The other new one is Abilify / Aripiprazole. It’s an antipsychotic a.k.a. second generation tranquilizer. I feel more … tranquil? Heh.
This is powerful stuff. I take just 1mg at 9am and 1mg at 1pm. 1mg; that’s just like a keybump of coke.
It’s supposed to help with not wanting to die all the time, which I’d like. I fall back to “i hate myself”, “I want to die”, “I wish I was dead”, “i hate my life” so quickly, it’s terrible. Like I’ll remember some past social interaction that didn’t go so well (either recent or years ago), and the anxiety will overwhelm me to the point where one of those four thoughts come in. So fucking lame. I’m not hearing voices – these are my own thoughts caused by, well, thinking these things heh.
Then, I’m on another medication I’m ramping up on, lamotrigine, but it’s going to take a while to titrate up to the theraputic dose so I’m not going to bother writing about it yet.
TL;DR: Anyway, that’s my update. In summary, I am still insanely depressed, a one or two out of ten, but am hopeful and optimistic about medications help improving the situation while I expand my support circle.