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The Paradoxical Sinclair Method For Treating Alcohol Dependence

Mark Dombeck, Ph.D.

Has anyone here ever heard of the Sinclair Method for handling Alcoholism before? I had not ever heard of it before yesterday, and might not have ever heard of it either, but for the podcast musings of Dr. David Van Nuys, the host of ShrinkRapRadio, who recently interviewed Dr. David Sinclair, an American psychologist and alcohol researcher at his home in Finland. Apparently, Dr. Sinclair has worked out of Finland for the last several decades. When you're a researcher you have to do things like move to Finland sometimes; you basically have to go where people are willing to give you money to get your research done.

wine bottles with blue topsAnyway, this is not an essay about Finland; it is, rather, an essay about the Sinclair Method, which is a radical rethinking of traditional treatments for alcoholism. Now, my knowledge of Sinclair's method is limited to what I have learned in Dr. Dave's podcast; I have no direct knowledge of whether or not this treatment actually works. Readers and listeners who get interested in this method and want to try it out need to keep the old saying in mind, "Let the Buyer Beware". Keeping this in mind, however, everything I heard Dr. Sinclair say in that podcast makes sense in the context of the other psychology knowledge I have, so I think this is all worth describing.

Sinclair's treatment method can be quickly summarized. Take an alcoholic patient and prescribe him or her some short-acting opioid antagonist medicine (probably in pill form) that he or she can take before drinking. Instruct the alcoholic person to take one of these pills shortly before they have a drink. Apart from the need to take their pill in advance of drinking, they are to keep drinking as they normally would. They are to do this every time they drink for the rest of their lives. If the alcoholic patients are able to comply, Sinclair suggests that their drinking rates will naturally decline over several months to normal or below normal social drinking rates. There will be no need for detoxification, because detoxification will occur naturally and gradually (and thus safely) over a period of months. There will be no need for psychotherapy such as relapse prevention, or alcoholics anonymous, because the craving for drink will actually gradually and naturally fall off with sustained use of the opioid antagonist medications as prescribed.

That is how the method is supposed to work. Before describing why the method is supposed to work, I want to be sure to define some of the technical terms I've used above so that everyone is clear on what they mean.

The terms used to describe the magic medication are first up for definition. I've used three terms here: "short-acting", "opioid" and "antagonist". Let's start with the meaning of opioid. The opioids are a family of medications that are used medically for pain management, and which are also abused as street drugs for the same pain-management purposes. The opioid family includes heroin, methadone and morphine, and also vicodin, percocet, codine and oxycontin. When you take an opioid, it removes your pain feelings.

The reason that opioid drugs have these pain-removing properties is because they are highly similar to chemicals that occur naturally inside the brain which are known as endorphins which serve a similar pain-relieving, pleasure-producing function (amongst other functions). Endorphins function inside the brain as neurotransmitters; chemicals that serve a signaling function, telling neurons to activate (to be come excited and send an action potential electrical signal down its length) or to become inhibited (and fail to produce the action potential electrical signal). Endorphins in the brain have their excitatory or inhibitory effect on neurons by physically interacting with those neurons. The little molecules of endorphines float from the end of one neuron through a space called a synapse over to the start of another neuron, where there are little structures known as receptors that are specialized to catch and hold the endorphin molecules. The shape of the receptors changes (more or less) when the endorphines contact them. A consequence of the shape change is that a little doorway opens, a little pump turns on, and another set of chemicals are exchanged between the interior and the exterior of the neurons. It is this last chemical exchange that makes the neuron either fire or not fire. Imagine that this sort of thing is happening inside your brain right now a billion times each second (for this is is the normal way neurons function all the time) and you start to see how fantastic it all is.

Anyway, moving on, the opioid drugs like heroin and codeine are what are known as agonists for endorphin receptors. This means, they are so similar in shape at the molecular level to the endorphines themselves that the receptors can't tell the difference between them and the endorphines. The presence of either sort of molecule will open the receptor doorways and start the pumps working.

An opioid antagonist is the opposite of an opioid agonist. An antagonist drug is one that has mostly the same shape as the natural endorphines but not quite the right shape. Antagonist drugs fit into receptors just fine, but they don't open the little doorways or start the pumps. Instead, they just clog up the receptors and keep any opioid agonists that may be present in the area from doing their thing.

Now, if an opioid agonist like heroin produces a feeling of pleasure and freedom from pain, an antagonist drug will have the opposite function. It doesn't create pain feelings, per se, but it does take away pleasurable feelings. This is the key factor that Sinclair is depending upon for his method.

The last term here to describe is "short-acting". Drugs can be either long acting or short acting. Short acting drugs have their effect quickly and then that effect goes away. The effect comes on all at once and can be rather intense sometimes, but then fades away rapidly. In contrast, a long acting drug comes on slowly, and has a mild effect that is, well, long-lasting. Sinclair calls for short acting forms of opioid antagonist drugs, because he doesn't want to have the effect of these drugs to last too long. Imagine the consequences of taking a long-acting drug that reduced the pleasure you found in living your life. Suddenly most aspects of your life would lose their luster and you might become depressed (or at least like your life less). A short acting pleasure reducing drug, in contrast, is just the ticket for what Sinclair has in mind, because he is proposing that this pleasure-reducing drug be paired with drinking. The effect needs to be just long enough to suck the pleasure out of the drink, and no longer. The rest of life should not be impacted. Using a short acting drug allows this isolation of the drug's effect to be accomplished.

So, the short-acting opioid antagonist drug is paired with drinking, and the result is that each drink is experienced as less pleasurable than it would be without the drug. This is where Learning Theory kicks in. Learning theory teaches us that people are more likely to continue a behavior that they find pleasurable and thus rewarding, and that they are less likely to continue a behavior that they find aversive or distasteful and thus punishing. Think back to Pavlov's doggies for a moment. The great Russian scientist was able to teach dogs to drool upon hearing a bell ring, by subjecting them to multiple instances where he rang a bell and then presented food. Over time, the bell sound, which initially meant nothing to the dogs, took on the intrinsic meaning that food had for them. In effect, the dogs had learned that the bell sound meant that they were about to be fed.

Animals and people are capable of learning things, for sure. They are also capable of unlearning things. The process of unlearning things is known as extinction. In the classical conditioning paradigm, learning is the result of a pairing between something that is intrinsically rewarding (such as food) and something that has no intrinsic meaning (such as a bell). To unlearn or extinguish something learned in this manner, you detach the intrinsically rewarding thing (the food) from the other thing (the bell). In other words, you ring the bell a hundred times and never provide food thereafter. Over time the dogs (or people) will learn that the bell doesn't mean food is on the way anymore and there is no reason to drool. You can argue about how to talk about this phenomena of extinction I suppose. Maybe you are unlearning the connection between the bell and the food, or maybe you are learning something new (e.g., that there is no relationship between the bell and the food), but the net result is the same.

So, Sinclair is basically extinguishing the relationship between drinking behavior and pleasure. He has the alcoholic take the anti-pleasure pill before drinking, and then when the drink is actually consumed, it just doesn't have that kick it used to have. Over time, the tight compulsion to consume alcohol just sort of fades away as the brain learns that the thrill is gone.

There is a catch here, of course. The brain isn't stupid, and it doesn't like change. When you take a pill to suppress pleasure, the brain doesn't like that and fights back by increasing the total number of opioid receptors in the brain; a process known as up-regulation. The brain's strategy is basically, that it tries to turn up the sensitivity it has to opioid agonists so as to restore normal functioning. This is no problem so long as you stay on the pills, but woe be you if you go off them and drink. If that happens, well, each drink is going to be better than ever before (magnified as its impact will be by the increased numbers of opioid receptors), and problem drinking will set in again in record time. So, to be clear, once you go on the Sinclair treatment, you are foolish to go off it if you plan on continuing to drink in any way shape or fashion.

The Sinclair treatment attacks the behavioral basis for alcohol addiction; it does not work directly on the physiological addiction itself (e.g., that body dependence which requires gradual detox to remove). Importantly, this treatment is based on learning, and learning can only occur if drinking continues. So paradoxically, it is important, vital even that alcoholics continue to drink while following the Sinclair protocol. If they don't drink and take pills as prescribed, they will not learn that alcohol's thrill has gone flat, and will not stop drinking. The fact that this therapy absolutely requires that drinking continue has got to be terrifying to most treatment providers who are thinking (quite rightly) that excesses of drinking need to be shut down as fast as possible. The idea with the Sinclair method is that the straightest path to the goal of drinking reduction is NOT a straight line, but rather a winding road.

Why have I never heard of the Sinclair method before? If this is so great, why doesn't everyone know about it? The research is not new. Most of it was done in the 1970s and 80s, and apparently, the FDA has studied the method and approved it for use in America over a decade ago (Note: I have not confirmed this – my source for this approval is anecdotal).

Wikipedia (which produces democratic but not always expert or entirely factually correct articles) has this to say:

"Dissemination of information of the treatment has been blocked by all of the existing treatment organizations largely because their existence depends upon the continued use of the treatments that they provide. The "give 'em a pill and send 'em home" simplicity of the system is anathema to our current alcoholism treatment industry. Most treatment centers rely upon inpatient treatment for funding, and would cease to exist if widespread adoption were to occur. Alcoholics Anonymous opposes the treatment on two fronts - the use of drugs and the continuation of drinking...

The medical community has been largely unconvinced of the effectiveness of this cure because of the extreme shift in mindset necessary to accept a treatment for alcoholism that involves continued consumption. To further cloud the matter, many studies have been done involving using naltrexone to help enforce abstinence - a purpose for which it is poorly suited at best. Although their "failure due to relapse rate" has no bearing on the Sinclair Method, most doctors see a "this drug failed" result and don't look to see how it was used....

Other obstacles are more mysterious and tentative. It is guessed that the pharmaceutical company that makes the antagonist does not wish to pursue advertising this treatment because its use would decrease the sales of other more profitable drugs. Although insurance companies would benefit from the decrease in inpatient alcoholism treatments, it is suggested that they would lose money in the long run from former alcoholics who no longer let their health slide until they lose their jobs and their insurance."

There is probably some truth to some of these assertions. I can easily believe that psychiatrists (who are often ignorant about learning theory, not having receiving systematic instruction in that field) might not really "get" how this treatment has its effects and be weirded out by the paradoxical (and even dangerous) instructions (e.g., to keep drinking) that are necessary to make this therapy work properly. Recall that the core of the treatment is essentially behavioral in nature and not biological, even though medication is used to set up the learning. Even so, you can hopefully smell the odor of bias that is present in this above quoted text. Clearly, the author here has a bone to pick with the establishment. As to whether the bone is a reasonable one, I simply cannot say given my present lack of practical knowledge concerning this treatment.

I want to be clear that I am not recommending the Sinclair Method as a viable means of treatment for alcohol dependency at this time. I simply do not have the information I would need to make such a recommendation. Until I have such information in my brain and am convinced by it sufficiently, I can only recommend conventional treatments for alcohol dependence (e.g., medically supervised detoxification and treatment (inpatient or outpatient), relapse prevention psychotherapy, and support groups such as Alcoholics Anonymous. I talk about the Sinclair Method because it is coherent, and it sounds like it might very well work. I offer this explanation as a means of raising awareness of possible alternatives to conventional treatments that seem to offer promise.

People interested in learning more about the Sinclair Method can visit which provides some educational information (although not much more than is available here). There is a little quicktime movie on the site for those who want to see Dr. Sinclair speak, and of course, Dr. Dave's recent podcast is also an excellent source. There is a treatment clinic in Sarasota, FL, apparently (accessible from the same URL), for those who want to pursue this line of treatment. Please consider this stuff "experimental" at this point in time, and "let the buyer beware".

Reader Comments

Australia - - Aug 27th 2019

I've just found out about the Sinclair Method and I am so excited! I am 43 and have been binge drinking since my boarding school years. I am completely sober for weeks but then I go out to or am invited to a dinner party and drink so much it could fell the strongest viking. Needless to say, I have a lot of fun for a while, then I end up doing stupid things and cannot remember anything the next day. So in my case it's the amount rather than the frequency. I just cannot stop myself - and god knows I've tried everything: AAs, psychologist, self-help books, alas to no avail. 

Now: I am so curious to find out more about the method or even start straight away. Does anybody know if there is a doctor or psychiatrist in AUSTRALIA who can help?


Thank you!

Quick fix - Dianne - Dec 23rd 2018

For the real alcoholic, total abstinence is the only answer.

AA isn't for everyone but I have turned my life around. From forever seeking an elusive wild happiness, I now possess a contentment which is priceless

Psychologist who used to have a drinking problem - Tom - Dec 17th 2018

I have read all of the posts and am very happy to hear how many have been helped. I stopped drinking for a month and then started naltrexone while I continued not drinking. I stopped naltrexone about three months later but continued for over a year without any alcohol. I just didn’t have any interest. I started having a drink rarely the following year but had no difficulty having more than one. So technically  I didn’t really use the Sinclair method because I haven’t been drinking enough to make the extinction work. What I can say is that naltrexone is a miracle drug. For it to have changed my need for and relationship with alcohol even after more than a year after I stopped taking it is amazing. I am now taking low dose naltrexone (5mg) as an anti-inflammatory treatment for dermatitis and to prevent my current pre-cancer condition from progressing. I plan to double the dose if I plan on going to a social event. I strongly recommend everyone to google low dose naltrexone.

A couple of minor issues: you need to find a Dr who will write a low dose prescription and a compounding pharmacy to dispense the low dose. I found that I sleep very well but have a bit of an endorphin rebound the next day (probably because the naltrexone wears off after about 6 hrs ) where I am a little “hypomanic.” I am more talkative a bit more emotional including a little euphoric, feeling really happy for no external reason. Nothing wrong with being happier! Be careful. The low dose may not block the euphoric effects of your drinking so you likely will still need to take a normal dose for alcohol use disorder Using the Sinclair protocol. Tom PhD licensed psychologist with many years experience in psychopharmacolog.

smt - Evelyn Lopez - Nov 27th 2018

I dont know where to turn I do not have insurance and Im absolutly adictive to Alcohol, And I need help. Where do I turn to to buy these pills?

Still okay over 5 years later? - Rick - Nov 13th 2018

I read the glowing testimonials on this page with interest. Will any posters who found AA lacking and found this method wonderful please report your progress after 5 years? I would particularly like to hear from Jay, who wrote in 2009, or any former AA member of years standing who has been using this method successfully for over 5 years. Thanks!

Update - Julia from Jan 19,2018 - Julia - Oct 23rd 2018

Hi, I am Julia who originally commented on Jan, 19t of 2018.

I have now been using TSM (the Sinclair method) for almost a year. It has completely changed my relationship with alcohol. Simply put, I do not consider myself an alcoholic anymore, and I do not drink like one. Cravings are non existent anymore. Nowadays, I only drink at social occasions and very moderately, well within the WHO recommended limits.

I recommend to anyone, who considers TSM to read the book The Cure for Alcoholism, by Dr. Roy Eskapa, which explains the sicience behind TSM.

I also recommend to join The Sinclair Method Warriors group on Facebook, which is an amazing, and very supportive group of people, using TSM. Everyone's TSM journey is different, it is definitely harder for some people than for others. So, it is good to be aware that this process is not uniform and presents unique challenges for each individual. The result of the process is, however, the same for the majority and it is called pharmacological extinction of craving.

Reply to Linda Hawkins - Blueberry - Oct 14th 2018

There is a misunderstanding of opoid agonist vs antagonist. Please re-read paragraphs 8 and 9.


Treating Alcohol Addiction - Linda Hawkins - Oct 9th 2018

Just reading what was posted blew me away it is like trading one addiction for another. Opoids? There has to be another way. I don't get it.  No this will really have to be explained in further detail. Sounds like a bandaid to me. Like Xanax that is what that is. Acts fast goes fast. I need more convincing!

You don't have to stop drinking entirely! - Briar - Sep 24th 2018

Chris - 

One of the greatest benefits of the Sinclair Method is exactly that you do NOT need to remain completley abstinent from alcohol. The beauty of naltrexone is that, once you take it, you can still drink all you want - you just eventually won't want to as much.

I highly recommend that you try the Sinclair Method. I know it works both from personal experience and from anecdotal experience at work as a nurse. I have read in many places that people have a hard time finding a health care practitioner who will help with this. I know there is one company in BC that is currently offering this, and a new one in Ontario that is opening soon. 

I totally undertand not wanting to stop drinking entirely - especially at our age. So I definitely recommend giving the Sinclair Method a try


All the Best - 


If it works does it mean one can't drink even at social occasions - Chris - Jul 28th 2018

I am not a quite an alcoholic but I worry I soon will be. I drink every night after work, at least a bottle of wine. It's been a few years I've gone a day without drinking. I know I need to stop. However I am 28 years old and not really ready to give up 100%. Would this method help we just cut back or would it either fail from lack of comitment or stop me ever wanting to drink again? 

I would appreciate anyone's thoughts and advice 

Try it - Mark Cocking - Apr 27th 2018

as a heavy daily drinker, the Sinclair Method was a godsend. I saw my doctor asked for treatment and was given naltrexone and told not to drink. I filled my script Monthly but secretly followedTSM. It worked amazingly and after 1 year I would be lucky to have 2 glasses of wine per week and have put aside enough naltrexone to last me years. Do it you will be amazed. Just take the pill an hour before you drink. 

Canadians can’t order online - Scott - Feb 13th 2018

Just an FYI to my fellow Canadians:  I’ve tried ordering Naltrexone online from about 5 sites now. None can ship to Canada.

Just another testimonial - Julia - Jan 19th 2018

The Sinclair Method does work. I have been a weekend binge drinker for many many years and was used to having a constant discussion in my had about where and when my next drink will be, and how much I can have.

I have now been on TSM for 1,5 months and the results are amazing. The constant discussion in my head - gone; many old triggers like the blinking lights of the local pub - gone; constant fear for my future - gone. The actual drinking dropped more than 50% without any will power or any kind of hard efforts. No blackouts and no hangovers in 8 weeks (and I used to have a pretty bad hangover at least two times a week!)

Thank you Dr. David Sinclair, unfortunately you did not live to see the true appreciation for your lifetime of research on alcoholism, but the time will come! Your work will save throusands if not millions of lives!

Georgia! - Patrick - Sep 27th 2017

Does anyone know of a Doctor in Georgia that uses the Sinclair Method?

Admitting you have a problem is dangerous - FreeAtLast - Dec 9th 2016

A paradox of becoming aware that you have become physically addicted to alochol is that you are in danger of losing your job, your second amendment rights (your doctor's computer record system in the US is actually accesable by the federal government, and they can and do ignore HIPPA) and the overall social stigma associated with the problem.  

But the thought of not drinking five months ago was terrifing to me.  It was like ending a marriage (a distructive marriage, but I didn't realize until I was out of it, just how distructive it was).  I stumbled upon the Sinclair method, and thought "this makes sense."  It didn't ask me to quit drinking, which made it easy to start.  I found a reputable online source for the drugs and have been using it regularly since.

Gradually my drinking got under control.  I decided that I was going to lose weight and thought, ok, no drinking for two months during this program, and there was no internal terror.  Instead I was very positive about it.  That was new.  I am now getting "addicted" to running and yoga.  I have not made a decission to never drink again.  I have a little container that I carry with me which has my Nax in it, but I have not touched in a month.

If you can't afford rehab, or don't want to go through a detox program for fear of some type of repercussions from work, I will tell you I used the protocol perscribed here to taper off:  I monitored my pulse and blood preasure every two hours just to make sure nothing got out of whack.  Yes there are dangers in doing this alone, but there were also dangers in doing it in public.  My desire to quit was strong enough to for me to take the risk, but I did so with my eyes wide open.  That said, just stopping drinking can be deadly, so know how much you have been drinking and weigh the risks vs benifit.

If you are not drinking, do not take the Nax and have sex with your signifigent other or engage in some positive activties.  Get addicted to something healthy and fun.  This is life changing for the good.

Alcohol used to feel like my friend.  It isn't the enemy, it's just my ex-wife and I ignore her drama.

Pleasure Deprivation (?) - Julian Robinson - Jun 3rd 2016

If naltrexone alters the brain's neurohormones that are the basis of pleasure and 'well being', will I become more depressed than I already am? The MD treating me for opiate withdrawal says Naltrexone will give you a sense of well-being! What you've stated implies that the very neurohormones needed for pleasure or a sense of well-being will be blocked. What is the truth regarding the side effects of Naltrtexone?

Thank you for your time,

Julian Robinson 

OMG - loving life - Mar 22nd 2016

Ive been using this method and find that the drinking is so much less, I dont black out because I dont get to that point.  Im not sure an hour is enough time for me to not want the first one so for today Im going to try at lunch so when Im on my way home from work Im not wanting to stop off for a beer or something even worse spending money on gambling.  My doc tells me it will help with the compusive behaviors as well. that hasnt rang true but if I dont drink that desire is so much less that I have so much more control.  Ive been a raging drunk since high school.  started on weekeends but why not add after work to the mix, now any excuse is a good one to me.  Everyone in the family drinks, we even have a bar we all meet at, the neighbors, friend, my coworkers etc. I never get hung over thats my problem.  Im going to continue this method until I can be proud to be me.  I describe myself as a partier, yet hard worker so I justify it, I cant wait to describe myself as a mother, soon to be wife and an honest person.  Good luck to all!!

TSM should be more widely used - Melissa Bruzzano - May 22nd 2015

Thanks for the article.  The Sinclair Method is not a new fad by some quack doctor.  It has been used for almost 2 decades in Finland and has a much better success rate than pretty much all alternatives.  The drug was approved by the FDA in 1994.  The problem is that the vast majority of professionals in the medical and rehab community believe/are taught that abstinence is the only alternative and should be the ultimate goal.  But, the efficacy (success rate) of that methodolgy is quite low - in the teens.  I believe that if more doctors or nurse practitioners would do the research, they would see that this is a viable option for many people.  A person can go to their doctor and talk about being nervous or upset or depressed or unable to sleep and get a prescription for all kinds of drugs to help that problem, but, tell them that you would like a prescription for Revia (naltrexon) to cut back on drinking and the typical response is to refer you to an addiction specialist or rehab center.  There is a huge population of people who wouldn't consider themselves addicts, but, do think that they drink more than they should due to health concerns and there are those who do consider themselves addicts, but the thought of complete absintence or going through a 12 step program is not something they are interested in or think they cannot do.  What is the problem with prescribing this medication for them?  I just don't get it.  This attitude forces people to be their own doctor and just get it over the internet from Canada or India.  That's ridiculous - shouldn't the doctor want to test the patient's blood, liver enzymes, etc. while on the medication to monitor it?  

I use to represent children and one of my clients could only have supervised visitation with her father due to his alcoholism.  He was a good guy and loved his daughter, but, couldn't control his alcohol intake.  He had been in AA for years and always relapsed.  He was told by his doctors that if he didn't quit he would die.  He died when the child was around 10.  That was in 2009.  What if he had been prescribed the medication - by then it had been approved by the FDA for over 15 years.  He would be alive now.  What a pity.  

I urge everyone who reads this article to do the research.  Look up an organization called the C Three Foundation and watch the 1 hour documentary called One Little Pill.  It is not a method for everyone, but, it should at least be something readily available.  

It Works !! - - May 21st 2015

Keep in mind though, behavioral changes are necessary.  The goal is to make alcohol unimportant, and not the focus of your life. That involves making alcohol unappealing, which TSM Will do 

It is up to the individual to decrease or limit alcohol intake an order for the method to be successful.  Ultimately, the joy of life unimpaired by excess alcohol will be seen  for the joy that it is.

true success with this will be not wanting to drink, and that is possible, and the best result of all.

Thank you dr. Sinclair - Donna butters - Apr 28th 2015

After 40 Years of binge drinking naltrexone has been a life saver. In one month I have had 10 drinks. Cravings are gone. I feel great. It has helped to cut down on smoking and binge eating.

It's working for me - Bob - Apr 19th 2015

I discovered the Sinclair Method through online research.

I'm 65, and have been a very heavy drinker for years.  After retiring, I had progressed to the point that I craved alcohol right out of bed in the morning.  ourbon on the rocks--breakfast of champions.  I would sneak miniatures of brandy in my pockets and duck into the stalls in the men's room for a shot when I started getting edgy.  

I knew that AA wasn't for me, and dreaded the withdrawal of a rehab facility.

I asked my Primary Care Provider, who happens to be a Nurse Practitioner to prescribe the Naltrexone, and gave him a copy of the Sinclair research paper that is available on their web site.  His response was, "well, it can't hurt", and gave me the Rx.  After 3 months my liver enzyme tests improved considerably, and my PCP told me that he's used the naltrexone with other patients with remarkable success.  

The effect was immediate.  Six months in, I can comfortably sit in a bar with a club soda while everyone else is drinking and not feel "put upon".  On the other hand, if I want a drink or a glass of wine, it's not a problem.  I have great insurance that pays 100% of the cost of the pills, so I can take one every morning, but I've been going several days in a row without taking the pills as a test, and find that I still don't have the urge to drink.

The key to success is compliance.  You MUST take the naltrexone before any drinking.  I think that printing a copy of Dr. Sinclair scientific paper and giving it to your doc for review will go a long way to convincing them that "it can't hurt".

Best of luck to you.

Finding a physician - - Mar 25th 2015


I live in the Orlando area and I am trying to find a doctor who believes in the Sinclair Method or a doctor who would be willing to do online or phone counseling with me.  I'd appreciate any help ~ thank you! ps  I checked the 3C website but there are no doctors listed for the state of Florida. 



It Really Works - TD - Jan 4th 2015

I started using the TSM method over a year ago after 2,  10 year periods of sobriety in AA.

It started working within 4 times of taking Naltrexone, one hour before drinking. This should be the first step when someone wants to quit or cut down on driinking. I NEVER crave alcohol and drink when and where I want. I also never have more than 2 drinks and never want more. This is the easist and best way to cut back or quit drinking all together.

It's a shame the 6.2 billion dollar rehab industry is more concerned with profits than saving lives because the Sinclair method will save millions of lives with a success rate of 80% compared to the 10-15% success rate of traditional  rehab programs. In addition, the narrow minded culties in AA have been killing as many people as they help for decades as evidenced by the AA success rate of 50%, which has not improved in decades. This is NOT a theory it works.

I have many friends in AA and think it is a great program for many. It didn't work for me. I disliked the hypocracy and found some meetings supporting criminals and criminal behavior as long as the member didn't drink. Bill Wilson talked about only knowing a little about alcoholism when he helped write the AA Big Book in 1938 and that more would be revealed in the years to come. Well, this is truly a cure for the disease of Alcoholism and hopfully those naysayers that haven't tried the Sinclair method will stop knocking what they haven't tried and don't understand.

It worked great for me! - - Jul 3rd 2014

I am an alcoholic and have been in and out of at least a dozen treatment centers over the past 25 years, including a 12 month stay at a homeless shelter that had a treatment program.

Last November (2013) I read Dr. Sinclair's book and immediately got a prescription for Naltrexone from my family practitioner (I did not tell him that I was going to take the pill AND drink, just that I was using it to help with my alcoholism).  My drinking decreased from the start.  Within 2 months I was down to drinking 1 beer per week.  Now I usually have less than 1 drink every 2-3 weeks, and no craving or desire to drink otherwise.  Whenever I desire a drink, I take a pill and have a drink.  I usually no longer even finish a whole beer or glass of wine - and I used to be a homeless shelter drunk!

As far as I am concerned the Sinclair method is a miracle.  

As Advertised - Miguel - May 27th 2014

I started TSM as an alternative to 12 step based abstinence and the results have been nothing short of miraculous.  Am drinking less that 10 % what I used to (~18 drinks/month now) with plenty of non-drinking days. (Over 10 months)

I'm in my 50's, and felt any program was unlikely to help.  Forced sudden sobriety would be nightmarish.  This approach allows drinking to decrease while other behavioral strategies are put into the mix.

I'm now someone who can drink responsibly in gatherings, not act stupid, and don't sit around with a glass of tonic and lime feeling miserable.

Yee-Hah !!



Then why ? - wavesailor - Mar 6th 2014

Then using the same agument.Why would you still go to meetings and talk to a sponcer ?If you want to go back to the "deep pleasure" you just stop going to meetings !!--and relapse like millions do each year in AA.AA says it takes what it takes.And this is different for all the kinds of different drunks.SMART and RR have had much more successs than AA in long tern recovery.But this all or nothing reasoning is what gives you strengh I guess.So I give you that--if it works it works !!.But if someone is helped of this great affliction--I wouldn't downplay any solutin 

List of Physicians - Joanna - Feb 6th 2014

The C3 foundation has now compiled a (user) list of doctors and clincs who are TSM-friendly.

Naltrexone and The Sinclair Method has been successful for me.  I have been on The Sinclair Method since Oct 2013 and am now virtually abstinent as of Feb 2014.

looking for a doctor - - Oct 21st 2013

I need to find a doctor in southern california that will prescribe for TSM. They don't have to reside here, but at least be willing to give us the script. It's our last hope. 

Children and THIQ - - Feb 20th 2012

So you can be born with THIQ on your brain?  If say both parents are alcoholics and have 2 children, they should both have THIQ on thier brain right?  So how can one become an alcoholic and the other drink occasionally?

Naltrexone for alcohol treatment - - Jan 12th 2012

My husband is a psychiatrist, fellow-ship trained addictionologist and will work with patients interested in this method. Only 5% of doc's in the US will do this. It takes a great deal of research and a spine to know what you are doing and buck the "status quo". Any provider doing this will not be popular with his colleagues.

looking for MD - - Jan 1st 2012

I am looking for aMD in New Orleans, Metairie or Kenner LA Who will prescribe naltrexone for alcoholism

Flabergasted - - Jun 8th 2011

It dismays me that a treatment of this kind has been suppressed for so long I have been suffering with alcholism for 10 + years my only options have been AA or rehab Both sucked big time rehab I was ordered to to by the courts for DUI (drunk Under influence) I felt like I was being trested like a child AA turns out to be a meat market where you find potential mate NO

My Mental GP has JUst been alerted to this therapy and was animated to expose me to it I have just now done some extensive reading on the therapy

And Im atonshished it has been around so long

Its all about money why this hasnt been given widespread acclamation

I am now angry that I have been suffering for all this time due stoic doctors phamacuetcal companies and the government

I live in Victoria Australia


Naltrexone works...AA did not work for me - Dawn - Mar 2nd 2011

Naltrexone worked for me.  2+ years sober, and I help others by passing the word to "Try Naltrexone"!  AA did not work for me, I attended for 2 years, with many screw ups, including a DUI during that time.  With Naltrexone, I don't remember my last drink, because I didn't know it would be my last...I had wine left in my fridge for weeks, before I threw it out. I have my life back, and staying sober is EASY!  The only ones that have a hard time understanding how sucessful Naltrexone is for treatment, are those that are AA brainwashed *yeah go ahead and type nasty messages and AA slang...jealous that quiting is easy?....  AA works for some but low sucess rates...on the other hand Naltrexone's rates are high.  I thank God, and my doctor for doing this for me.  Also I'm glad to see California and Alaska using it for their DUI offenders.  The USA is moving forward.

Sinclair Method and THIQ - An Alkie - Jan 13th 2011

OK-I would like to start by using some bullsh** I heard since I was a teenager: I would like to share my experience strength and help other alcoholics. David Sinclair was/is brilliant but that is only part of the story. The first time I heard the words THIQ I was in a rehab in New Orleans, LA. I have since made my way around this Earth drinking myself silly, humiliating myself and always regretting it. AA does not work IMHO unless you are a religious person, a follower, or one of the 20% of the cadavers studied in Houston who had no THIQ in your brain. The latter I consider to be "social situation alcoholics" In this I mean they drank because they were depressed, desperate, sad etc. For them AA is amazing, suddenly the lonely person has friends, purpose, help, a support system and a goal. 

MOST alcoholics are not this type, most of us are the 80% who by accident of nature or (my opinion again) by extreme drinking became THIQ monsters. Why do I say the latter? Well my years of drinking gave me a lot of drinking buddies. Some were Nordic, some Amerindian and others Irish or just seemed to be "born that way". Others like me were NOT born alcoholics. We were "situational alcoholics" escaping horrible childhoods or horrible live situations through alcohol and eventually the excessive drinking (and I remember my day almost to the exact day) we accumulated enough alcohol to now be official THIQ alcoholics. 

The first thing you need to understand is that THIQ is an opiate. In fact there were studies done with it during the Vietnam War to see if it would be a better pain reliever than morphine BUT what they found was that once in the body, it stays in the brain FOREVER. This means I drank for a period so long that I accumulated THIQ which put me at par with those BORN with THIQ which consist of certain racial and ethnic groups due to reasons of evolution ( if you want technical reasons email me). 

So here I am, a THIQ alcoholic. Send me to rehab over and over, tell me I am sick BUT offer me NO cure but rather a religious meeting with a 20% success rate; AA. Tell me abstinence only in a world where alcohol is the grease on the wheels of social lives. I am not religious and I am not able to stick with it but I am " sick" and "one is too many a thousand never enough" WRONG!!!

I do not like pills, I do not like cocaine, I am an ALCOHOLIC and yes I may abuse heroin as well if given the chance. 

Years later I am alone in a new country and lonely. I drink, that is how I meet people. My drinking embarrasses me. I lost my job because of it. I lose more and more and now I am home alone, mid 30's single because I sleep with every guy I like on the first meeting because I have no inhibitions because I am an "alcoholic" That dirty word!

I hate myself, I am irrational drunk. I act like an idiot and know so much about medicine so why can I not cure myself? Why do I always do this, it is killing my liver, my brain and my life. 

Ironically I lived in Scandinavia and could have got help from David Sinclair but did not know this. BUT I do know how to get drugs online because time and again I have had to order Xanax to function when I was working and valium and Xanax to detox myself from my latest bender. 

Fast forward and I find out about "pharmaceutical extinction" What a bulls**t phrase isn't it??? NO not at all. In fact it happens to be the cure for alcoholism. 

I read and read and all I hear is that it is used as a "method of stopping cravings" (excuse me medical field in USA but BULLSHIT you need to get a clue). 

I decide I cannot wake up a week later again with a house full of bottles of wine (it was worse it used to be Vodka) dogs who have been neglected and sh*t all over the house and have not been out in a week and weak and depressed little me with pains near my liver and in my kidneys. Who did I call this time? Who did I write emails to? What is going to haunt me?

As any alkie knows a lot and then the shame comes in and then the guilt but never the healing. We stay, if we can, well enough, long enough to start it all again. 

I decide David Sinclair may have something but for reasons I am not sure he knew. See a drinker drinks, that is a social drinker, feels woozy and happy, stops, continues again and then again he or she will have another or perhaps call it a night. SOMETHING IN THEIR BRAINS SAYS STOP. If they do not they vomit, they pass out, NOT us. So I think back to THIQ and I look into what Naltrexone is. 

Naltrexone is an opiate blocker. I started to think, HOW THE F**K IS AN OPIATE BLOCKER GOING TO HELP AN ALKIE?  Then my lessons from years in rehab took me back to THIQ. "THIG IS THE SAME THING AS HEROIN" Blah blah blah. 

WELL maybe it is, or close enough. Why, after all, do most people feel good after a drink but I feel INVINCIBLE, calm, amazing, euphoric?

IF THIQ is the issue then Naltrexone would be pharmaceutical extinction. On a slower better level. I tried the tablets. Honestly---two drinks and I puked. I felt hot (probably left over opiate THIQ withdrawal) and I felt awful. A pill a day and slowly I was drinking nothing, in fact I liked having a single glass of wine then lost interest. THE PROBLEM for me and many is compliance. I stopped using it, due to the cost, after I stopped drinking. After that the craving gave way to drinking and so I popped a Naltrexone and PUKED!!! Not nice. This is not social drinking, this is Asian lack of enzyme drinking. 

My lesson, Naltrexone is a daily therapeutic aid. IT DOES help but I do NOT believe in pills, I think the implant is best. I have not had one but I believe unlike my expense of having to take them daily to get over the side effects to be able to drink normal (one or two drinks MAX for someone who could drink most men under the table), an implant would help a lot. 

I believe my THIQ can only now be controlled medically. I believe anyone who does not believe in this has not studied it nor tried it. Naltrexone is the CURE to make alcoholics social drinkers. Try it. 

success with The Sinclair Method - - Jan 5th 2011

After 15 years of struggling with alcoholism and trying every treatment under the sun I stumbled upon The Sinclair Method. The science backed by the research in Finland and beyond seemed compelling. I stated the method 4 months ago and my drinking has fallen steadily and substantially to the point where I have gone from drinking uncontrollably every day to drinking just once or twice very moderately per week. The process has been almost unconscious, the thoughts and obsession with drinking have just gradually reduced with very little in the way of effort. The Sinclair Method online forum has many similar stories from others using the method. After years of spending a substantial amount of time and money trying to control my drinking I honestly believe The Sinclair Method to a groundbreaking and the most effective and sustainable method of treatment.

Nice Theory, but that's all it is - - Dec 8th 2010

...because it kills the urge to drink?

sleepless in San Fran...redux. - - Nov 11th 2010

Just to give an update on the past couple of weeks...

My wife's alcohol intake is down significantly...from 7 or 8 drinks a day, to the past two days only 3 drinks in an evening. However the weekend is coming up and those have been problems.

I can't attribute this all to Naltrexone, as I have also been buying a much cheaper wine than my wife is accustomed to. I'm trying to get away from the "yum! tasty grape juice" attractive element that may have been there and also to have cranberry juice available if she wants that.

So we have now been on the program 3 1/2 weeks and I feel that things are starting to get under control a bit. The slope of the curve looks fairly good so far, but I am a little impatient and tentative still...hoping that a huge binge doesn't take hold.


We're on the plan... - Sleepless in San Francisco - Oct 27th 2010

My wife and I have been down all the usual crazy roads and down rabbit holes...911 and Emergency rooms, lost job, friends etc....just completely insane slips off the road into never never land.

We are very,very early into this...twelve days only, but as a thinking person reading the book makes complete sense to me and I am very optimistic. There was actually wine left in the bottle a couple of nights back!

My wife has been through AA and years of therapy and I suppose she's my guinea pig for this nalextrone therapy. I don't think I am a capital "A" alcoholic but in a weird twist-- out of my depression of dealing with her adventures I find that I myself tend to retreat deeper into drink more than I'd like to...I think I may at some point have to give this program a shot myself.

I'll keep you posted.

there IS hope and a method to all this madness - - Oct 21st 2010

I am an alcoholic that had deemed myself hopeless. I experienced all the typical consequenses that you would probably read about including more visits to emergency rooms and detoxes than I can remember, mental institutions, outpatient programs, a few inpatient programs, legal problems, job loss etc... and the list can just go on and on from there. 

I heard about the book "The Cure for Alcoholism" in the last week of my last stay at a 30 day traditional 12 step inpatient treatment center. I was extremely skeptical but desparate. Even after 20 some odd days of being in this 'so called' treatment program, I was still plagued with insomnia, extreme anxiety, panic and of course the overwhelming obsession and desire to drink. One of my co-patients mentioned to me that there was a book that you could read and cure yourself- I thought to myself 'Yeah right, that's a joke. You have got to be kidding me' but there was definitely enough spark of curiosity there that lead me to get the book and start reading it. I had become really friendly with a girl that had a Kindel and asked her if she could order the book, so we did. As soon as I saw the equation naltrxone+alcohol=cure something dawned on me... I had gone to an outpatient program in Manhattan about a year back and was given shots of vivitrol while I was in the program but was told to abstain from alcohol and that naltrexone was only to help the cravings. Of course I drank anyway and lied about it. For a period of eight months I drank with control- maybe a couple of glasses of wine a night if that and more when I was out with my friends if I wanted to. This is nothing being that with my normal drinking habits I am an absolute train wreck and the only way to stop is to detox. This was ALL now making sense. I had already done the Sinclair method successfully and didn't even know it... My relapses started a few months after I left the outpatient program and was not getting the vivitrol shots anymore. I just didn't put 2 and 2 together because I was told that nal was only good for cravings... I felt extremely foolish to say the least. I spent the last week of my stay there reading the book and researching as much as I could on the method with the resources I had available.

When I returned to New York after my 30 day treatment which was at a facility in Texas, I immediately and purposely relapsed and was in critical condition. I was drinking upward of a liter of vodka a day and 40 ounces of malt liquor throuout the night when the liquor stores were closed. I had an old perscription for naltrexone but I couldn't even pull myself together enough to get it filled which was pathetic. I wound up in four emergency rooms in four different hospitals in about a week's time- 3 in the city and one on Long Island. In my last visit to the ER one of the doctors told me that he had never seen an alcohol withdrawal as bad as mine. He gave me some words of wisdom and discharged me. I filled my scrip for nal and started that night. I still had a little bit of Librium and Klonipin left that I took sparingly for the next few days after that b/c I was still experiencing severe withdrawal and didn't want to go into seizures during the day b/c my plan was to only drink nights an hour after taking naltrexone. That's what I did.

I know that in Dr. Eskapa's book there is a 3 to 6 month time frame that is needed for the method to take effect but it has been 30 days for me and the results are astonishing. My intake has decreased substantially. The amount that I'm drinking is still no where near what would be considered normal levels but this says a lot for an alki of my magnitude.

I wish I could honestly say that I am not absolutely repulsed by AA and other twelve step programs but if I did I would be lying- sorry but... Anyway, if that's what works for you and your ok with it, then I say 'Go do it'. I tried that route for 6 years and fell time and time again victim to alcohol. Sometimes I feel like I wasted a ton of time even considering going to anything 12 step based but then I remind myself that maybe this was the best blessing in disguise that has ever happened to me b/c, after all I was turned on to the Sinclair method while in a 12 step program.// ok, I'll stop now; don't want to get the AA junkies too mad.

Anyway, everyday seems brighter and brighter to me now. There is more than just a glimmer of hope, I finally see a solution to all this hell I've been through. Please wish me luck and I wish the same to All.

It doesn't matter how you do it; if it works for you, then go do it.

BE CAREFULLLLLLL! This poison can kill you.

naltrexone - some caveats - funkyfarmacist - Oct 2nd 2010

The discussion on the Sinclair method was very stimulating to read, and there is so much of it, most of it positive. I need to say at the outset that I am using naltrexone for alcohol, and it does work for me. If I have missed the points I am going to make in my posting, ie they have been made by other people, then  my appologies, but the caveats do bear repeating.

1) As naltrexone is an opiate antagonist, it blocks all opiates, especially those taken for pain. When in an emergency situation, eg car crash, where you might be unconscious, emergency teams usually (at least here in the UK) give pethidine (demerol) or diamorphine (heroin) for pain. This will be unable to act as their opiate receptors are blocked by naltrexone, and the pain killers can then cause respiratory depression, which may be fatal. It is essential for anyone on naltrexone as in the Sinclair method, to carry a card with them, stating that they are taking naltrexone, and opiate pain killers are likely to be harmfull. This also is true if visiting your doctor, and he wants to give you opiates.

2) In Dr Dombeck's article he made much of the short action of naltrexone. Unfortunately naltrexone has a very long half life of about 72 hours (That's a long half life for a drug). It means we can treat heroin addicts (for whom the drug was originally developed) on alternate days, as the effect carries over.

3) Naltrexone is not licenced for use in the United Kingdom in conjunction with alcohol therapy, as in the Sinclair Method, and if used for this, it's use will be "off label" meaning, if it goes wrong, you're on your own!!

Apart from these warnings, thank you all for all the postings they were very informative.


funkyfarmacist Leeds UK


Are part of the solution or part ofthe problem? - David - May 28th 2010

Your comment, "The fact that this therapy absolutely requires that drinking continue has got to be terrifying to most treatment providers who are thinking (quite rightly) that excesses of drinking need to be shut down as fast as possible", demonstrates part of the problem in alcohol treatment.  The traditional approach is to tell the alcoholic, "Stop drinking and then get psychological councelling to sort out the underlying issues which make you drink".  Of course, being an addition it cannot be stopped "just like that" and there aren't buildings full of psychotherapists out there waiting for addict to "just stop".  Olivier Ameisen discovered that increasing the dosage of Baclofen, a Gaba B agonist eventually  stopped craving and "cured" himself of "alcoholism".  The treatment requires continued daily maintenance on Baclofen at a reduced rate.  According to what you say then, he has got it right.  Presumably, the brain can only continue increasing receptors to a point and Ameisen is right that one reaches a trigger point after which continued use of the agonist must work.  There is no reason why agonists should not work.  The problem with Naltrexone is that it is a Gaba-A agonist so it is attacking the wrong part of the brain.  The other problem with the traditional approach to alcohol treatment is that it rejects the suggestion that there is a "cure".  Why shouldn't there be?  If as Ameisen says some people just have a chemical deficiency of GHB then supplementing that should stop the addiction that results from the shortage.  Opponents of the theory focus on the use of the word "cure".  Rather than looking into the science behind this discovery they focus on semantics.  Call it what you want, if it stops you drinking for the rest of your life you can call it what you like.  A rose...and freedom from alcoholism by any other name both smell as sweet.

No paradox here. - David Harris - May 26th 2010

The most interesting and exciting thing about the Sinclair Method is its forum which, like that of My Way Out, has become a forum for an even more remarkable medication used to treat alcoholism, Baclofen.  This innocuous drug used to treat MS for the past 40 years, has been found in high dose to completely suppress alcohol craving.  Google the drug and the discoverer of the process, Olivier Ameisen and read the forums.  It is truly remarkable.  My wife has been on Baclofen and it is incredibly effective.  Of course, the problem is that there are so many arrogant professionals who don't actually know what alcoholism is and just want to continue the misery of sufferers that you cannot find a doctor in the UK who will prescribe appropriately.  The way forward is to get it over the internet or go to Spain and get it without prescription.  Alcoholism, or rather Gaba-B dysphoria, is a treatable and curable illness.  Naltrexone is not effective  as it targets the wrong Gaba receptor. 

response ot another comment - joe12pack - May 10th 2010

Contrary to what someone else said, according to Eskapa's book, after extinction occurs, if you drink without naltrexone, you WON"T re-learn the behavior overnight.  But you are supposed to take a Nal before you drink anyway, that way instead of a nasty relapse where you get worse than you ever were before, you just have one more reinforcement session on the sinclair method!  Rad!

Sinclair is working for me so far - joe12pack - May 10th 2010

I've been on Sinclair for 7 weeks.  it has cut my drinking down to 60% of what it was and my numbers continue to drop.  I have less cravings and feel better being no longer obsessed with the idea of being an alcoholic.  I worked AA hard and honest for a year and a half.  It helped in a lot of ways but it didn't keep me from craving and relapsing.  The guilt factor is also huge if you are a relapser.  The Big Book has a passage in the beginning of How it works which states that if AA doesn't work for a person then that person is dishonest.  Well I can only speak for myself, but that is NOT the case with me.  So far so good with Sinclair!!!!!  I still have many AA friends who think it won't work, It's almost like they don't want it to work!  Hats off to anyone who stays sober in AA, but obsessing every day about being "spiritually sick and insane"  does nothing for me.  I want to not worry about it all the time.  Not where I plan to be in a few months, but I already, I don't come to work hungover, puke or obsess nearly as much.  anyone who is trying sinclair should go to  there are good supportive people there and we compare notes.  a lot about the method is being discovered there, some of which is not in the book

Help in Columbus - - Mar 10th 2010

Do you know a doctor in Columbus, Ohio

First Resort - Plain Vanilla - Mar 8th 2010

Daily drinker here - bottle of wine per day. Started TSM last July. My daily consumption dropped to NIAAA "low risk" levels by 12 weeks and after a month or so plateau at 2-drinks-per-day, dropped downt to an *weekly* average of two drinks. That's it: typically two glasses of wine with Friday dinner.

It is practically a crime that this method is not routinely tried as a FIRST resort, before shuffling people off to humiliating twelve-step programs.

AA vs. "the pill" (naltrex, silly! LOL) - The Face of Traditional Treatment (AA) in Nevada - Mar 3rd 2010

I live in Las Vegas.  Each week in Vegas, there are (at last count) close to 3,000 AA/NA meetings ....yes, that's right.  that's PER WEEK!  In Reno, there is roughly 1000 meetings per week.

Sadly, the same people are seen at these same meetings, FOR YEARS.  And those same people relapse regularly, given that they live in a virtual Sodom and Gommorah where alcohol is available literally 24/7 and is often FREE, if you are gambling as well.  I know because I was one of them.

For 20 years, I was on the wagon, off the wagon, on the bender, in the clink.  In and out of rehab, in and out of therapy/psychologists/psychiatrists offices, and in and out of the Triangle Club on Wells Avenue.  (Folks famiiliar with Reno will recognize that reference.)

I have been in and out of jail, a truly "hopeless" alcoholic.

I went to Europe (Finland) for the Sinclair Treatment.  Friends who loved me helped me pay for it. Today, I am a cured alcoholic who chooses not to drink.  I can if I want to.

In the last year, I have had 2 drinks.  Both times, I did not finish my drinks.  I simply ended up not being interested in them.  I have not had any cravings whatsoever and no return of the "demon" I was  supposed to be haunted and tormented with. 

The Sinclair method WORKS.  It just does.  And the wonderful people in AA, and NA, who really do care and mean well, are simply wrong.  Theirs is NOT the only way, and naltrexone does indeed provide the answer.

God bless Finland, God bless Dr. Sinclair and Dr. Eskapa.


America: WAKE UP!!! Stop letting unwittingly ignorant people (no matter how well educated they may seem or be) dictate your future.  This method has a documented success rate of 78-80%.  Numbers do not lie.  Our feelings about sobriety often any relapser will attest!

flawed logic - Open Minded - Feb 10th 2010

Bill W:

You're using flawed logic when you reason that the pill won't work because all the negative consequences of drinking don't deter alcoholics from drinking.  We're dealing with two completely different animals here.  The negative consequences ought rationally to deter an alcoholic from drinking, but they do nothing to attack the base reason why alcoholics drink - to achieve the "high" that alcohol produces in them.  No matter how many DWI's you get, alcohol will still produce the same effects when you drink it.  I don't think anyone would argue that alcoholism is rational; if it were, there would be no alcoholism.   he drug, unlike the negative consequences, actually kills the very thing that drives alcoholics to make the completely irrational decision to drink - the "high" that alcohol produces in them. 

One Way? - Chem Dep Researcher - Jan 12th 2010

I like reading all of the wonderful success stories about the Sinclair Method on this site.  I am involved in chemical dependency research at a mid-western university and am glad to see when our (the research community's) work pays off.  Being a woman who is personally affected by addiction (alcoholism specifically) I feel the need to comment.  From my own experience, there will never be one method of treatment for alcoholism which will be effective for everyone.  I encourage those who are struggling to make the right choices for them.  I have chosen abstinence (it has been 5 years) and I can truly say that I have a wonderful life.  Please, I ask everyone to stop fighting about which method is best.  Both can be good it seems (however I have not heard of any long term, more than 5 year, studies of the Sinclair Method...I can only guess that it works).  The questions should be "Does this treatment method allow me to have a full life?" and/or "Is this treatment method safe for me?" and/or "Do I have professional support with this method and can I stick with it?" 

Alcoholism is a serious disorder.  Please know that help is out there for you.  If the Sinclair Method seems like something that is right for you, then great.  However, I would proceed with caution under the direction of a professional.  Similarly, I ask those of you who are anti-AA or abstinence to sit back and think for a minute.  How can you denounce something that has helped so many people change their lives?  There is more than one way to go about recovery...find your own truth.

UK User - Berni, Lincolnshire - Jan 6th 2010

Hi Again, I first commented on my first day of Naltrexone use on 6th November 2009.  I am still on the Naltrexone and can honestly say I have had more calm and peace of mind in the last few weeks than in the last 20 odd years.  As far as I know naltrexone is not available on the NHS in the UK but to anyone who is considering obtaining it through the internet I can only say that by using a reputable online pharmacy I have had no problems.  The big online pharmacies have so far proved pleasant to use and have been helpful and efficient.  I have had no side effects and on a purely financial level I am spending less on the medication plus what booze I still consume than I was before on booze alone.  I still have a way to go but on the whole, I would say to anyone desperate for help where all else has failed, you have nothing to lose by trying the Sinclair method and, in all probability, SO much to gain.  Good luck and God Bless to you all.   (And HAPPY New Year!  ;-)

I began using Naltrexone 60 days ago - Tom in CA - Jan 5th 2010

So far, Naltrexone has been the "silver bullet" for me! It has been amazing!

I entered an Intensive OutPatient treatment program in November 2009. The Dr prescribed Naltrexone (along with an anti-depressant). I had no information about Naltrexone and  I was not expecting any significant results. Nothing had worked for me in the past and I wasn't expecting anything to work for me then. I was quite depressed, a binge drinker, and I didn't really care if it helped or not. i was only at the IOP program because my family wanted me to go. 

I took the first Naltrexone tablet on a Saturday morning at about 7 AM, along with a slug or two of whiskey.

At 9 AM, I was alone in the house, and I was going to begin my binge ritual of consuming way too much alcohol in way too short a period of time. But a funny thing happened to me as I walked towards our liquor cabinet. It was as if a  "lightswitch" had been turned off. AFTER ONLY TWO HOURS AFTER THE FIRST DOSE! I actually thought to myself, "I don't want a drink right now!" And that made no sense to me because I would never have tried to convince myself to not drink in the past. But a drink just did not sound good to me.

I had no urge to take a drink the entire day after taking that one single dosage. None! Nada! No cravings! No desires! It was magic! I could not believe it!

I took naltrexone consistently for the first 30 days. After that, I have only been taking a naltrexone when i know I might be in a social drinking situation. Then, I have been able to only drink one or two glasses of wine, and stop. Without it being a problem. No urges, no cravings, no desires!

Today, 60 days into this new life, I feel completely normal! I have absolutely no thoughts, urges, or cravings about drinking alcohol!

Am I cured? I don't know yet. Will this work for everyone? I don't know that either. But I know this has been a life-saving event in my life. It is wonderful! I am happy again and looking forward to life. What a change!

Tom in CA



HELP - Anthony Ward - Nov 27th 2009

Would someone please advise were in the UK I can get Naltrexone and onto the Sinclair Method please??

Dr. Dombeck's Note: I do not know whether the Sinclair Method is offered in the UK, but the folks at the Florida based clinic in the United States probably would.  I believe their contact information is available here.  Be careful in proceeding and make sure that you verify the credentials and licenses of any providers you decide to work with.  The Sinclair Method website says that they offer online therapy now, but that strikes me as potentially dangerous and something to be avoided.  Do this in person with a licensed physician in charge if you do it at all.

Another look at the Sinclair Method Pt. 2 - Cured guy from Georgia - Nov 21st 2009

 I had written a lengthy comment last Feb 22, 2009.  Sadly, the formatting was striped out upon posting which makes it very uncomfortable to read.  I would be happy to re-submit it, properly formatted, if the webmaster would permit.

I am approaching the one year point when I started The Sinclair Method and I would like to emphasize that this has been more than a success.  It has been a life changing event, not unlike winning the lottery.  I now see my life through two windows; before The Sinclair Method and after, similar to how many regard their lives' in relation to 9/11.  It has been a sea-change in my life.

I have re-read my comment below and cannot think of anything of significance I would say differently.  If anything, I would recommend that people in the Method find some form of guidance and structure.  Though I fared well without, I saw many drop out of the process for reasons I have yet to understand.  Every program has its winners and losers.  I think a little coping counseling and life coaching would go a long way for many. 

I am essentially a non-drinking at this point in my life.  My wife has a drink every evening and I used to do this with her but quickly realized that I would be living with Naltrexone in my system continuously.  It was an unintended benefit.  I suffer absolutely no craving for alcohol.  The next drink I will probably indulge in will be bringing in the New Year. 

Naltrexone and The Sinclair Method is as close to a magic pill for an alcohol addict that I can imagine.

Dr. Dombeck's Note: It is our policy to strip out Microsoft Word formating so as to try to approach a homogeneously formated set of comments.  Without doing this, each person chooses their own font sizes and the comments end up looking messy. 

This method works - Rapper - Nov 20th 2009

I believe most of the negative parts of an alcoholics life are caused by the alcohol.

This method works!! That is it. No argument. If it reduces an alcoholics consumption 50%, is that a success? I believe it is. It is not an EXCUSE to drink. It is a way to drink enjoyably and responsably. Alcoholics are allowed to enjoy their lives just as everyone else is. We don't have to feel guilty every time we want to have a drink, with this method. You won't go full fledged relapse.

Dr. Bombeck, I believe you should do some follow up articles on this. This could save billions of dollars and millions of lives. If that could happen, would you do it?????

Wish me luck - Berni, Lincolnshire - Nov 6th 2009

I have studied the Sinclair Method in Dr Eskapa's book.  From starting out deeply sceptical I have to say I was so fascinated I thought that after 30 years of the misery of this disease I would like to try it.  As a UK resident I understand the treatment is not offered from our GPs and mine is not the sympathetic type anyway.  So I have just bought some Naltrexone from the internet and I'm going to take my chances without medical supervision (though with the full support of my wonderful and long-suffering husband).  We've studied the book and I think I'm reasonably sensible and I shall monitor myself carefully but any risks I may be running, to me, cannot be as bad as the slow death to which I have been drinking myself to date.  AA didn't work for me and I cannot count the amount of times I've climbed on the wagon, only to fall off again.  I'm starting with the first couple of days at a half-dose and have just taken the first dose and opened my drinking diary at the first page.  Wish me luck, those of you who have already succeeded and I hope and pray I may number myself amongst you all in a few months' time.  If anyone is interested in how I get on I'm more than happy to oblige.

To Brit0ny re: sinclair method - EileenNY - Oct 26th 2009

There is a website dedicted to people trying this method -, not to be confused with which is the official site.

People track their progress and offer support.

I have been on the Nal for about three weeks and, so far, the results are amazing. I am also a binge drinker in my early 50's and I thought I would never be able to get a handle on this.

Check out the website; you'll be glad you did, I think.

Good Luck.



Sinclair Method sounds like a dream come true - Brit0ny - Oct 14th 2009

Having just this week spent 3 days (this is day 3) sweating out a miserable 2 month binge I have come to the computer to search for anything new that might help me to overcome my desperate craving for alcohol.

When I say binge, I mean in addition to drinking far to many beers every single night (and morning/day too sometimes) I have an urge (knowing I am going to wind up extremely sick or worse, in a hospital) I still wind up adding wine. Luckily, for about a year I have been able to abstain from falling back to liquor but after the fit of drinking I just went through I know it is just a matter of time before I run across a bottle of the ole bourbon and it is just too irresistable to resist and bang, dead or back in the hospital.

I have been drinking heavily since I was 26. I have been trying to quit since I was 28. And I have quit so many times it is not funny. I am early 50's now and as much as I have wanted to quit I have somehow maintained my drinking even while holding a job and marriage.

Anyway, make a long story shorter I am now not working. Not due to alcohol but my drinking has increased. At least when I worked I would stop during the week at least during the day if not always at night but come the weekend..WHEEE!

I have been reading about the Sinclair method and have to admit that it sounds like an absolute dream come true for me. I really cannot believe that I have not heard about it before especially from someone at the last treatment center I was in since it was only 4 years ago. (I have practically died coming off alcohol binges without medical help since vowing to not go back to a center).

I have tried AA many times and it is still just as foreign a concept to me as it was the first time that I entered.

I guess my question here would be can a person be too far gone for this method to help them and if not who should I see about acquring an rx for the drug? Can my GP give me a prescription for it? She knows of my alcoholism but I have not really told her the true extent of my problem.

Thanks for any help and I hope that someone read through or skipped to the last part and can answer my question.

Dr. Dombeck's Note: I'm not any sort of expert on the Sinclair Method for treating alcohol dependence, but it is apparent to me that the method involves a treatment protocol, not just a medicine.  If you are interested in receiving this treatment, I think your best bet would be to access it from the source (e.g., a clinic that offers the SM) and not just your general practitioner.  I appreciate that it may be difficult or impossible to travel to the nearest clinic that offers this treatment - I believe there is one somewhere in Florida - but you can call them at least and ask if they have any recommendations for practitioners who are trained in the method local to you. 

Trying the method - - Sep 9th 2009

As somebody who was an AA'er for 5 years and now has been relapsing for almost 3, I went back with my head low and enjoyed the meetings.  BUT, I could not get rid of the craving.  I tried to stop, periodically get a day or two but would just drink the next day as much or more. 

The concept of de-addicting the brain makes sense.  It has proven to be effective 80% of the time, whats there to hate?  Campral seems to have too many side effects and is the Johnny come lately to the party.  If Naltrexone works then lets use it,...oh I forgot, the industry needs us to be sick and using the pharmaceutical industries faves such as Campral...Too bad,...I'm getting Naltrexone and will go to Sarasota if I have too!

TSM 4 months on. Progres reort - Tommy - Jul 4th 2009

Dear Editor

I last wrote on 28  Feb 2009.

Thank you for your advice BUT.,

There is no dangerous detox with the Sinclair method The curative process is gradual and all the scientific principles underlying the process show that it works without counselling.

I did not want to proceed without my normally supportive GP's help, but since he does not know anything about TSM and the appropriate use of  Naltrexone, he would not prescibe. I do take the precaution of carrying a note in my wallet saying that I take Naltrexone. This is just in case I should have an accident and require opiates.

I have the benefit of being an Industrial Chemist by profession. Even without my training, it is easy to check that my supplier, River Pharmacy uses the reliable Sun Pharma's Naltrexone, trade name Nodict. 

As to my progress, fantastic.

I would hesitate to say that I am fully cured, however...

I have carefully followed TSM taking my Naltrexone one hour before drinking.

Rather than drinking on and off from breakfast time to bedtime I have only had a daytime drink on four occasions in the last four months. On each occasion I have taken the Nal one hour beforehand.

I have had too much to drink on two evenings in four months. I am not sure why this happened,but it is a lot better than excessive drinking almost every day and night.

Typically I now find control much easier. I could always take a few days off, maybe a week or two. But then, the longer I was off the sauce, the bigger the binge when I returned. Now I probably drink about three times a week. There is not the problem of continually thinking about the "next one". And no rebound effect.

I was able to go out with my wife for an Italian meal the other night and have a couple of drinks with the meal. The big difference was when I returned home. Instead of heading for the wine and then the whisky as per usual, I had a cup of coffee, and after a good night's sleep woke up without a hangover. In other words I seem to have gained control.

There is one problem. I just cant drink as much as before and when I do try I cant take it. 

TSM is the only solution to alcoholism that I have found that has sound scientific research with published peer reviewed papers.

Thank you Drs Sinclair and Eskapa.

ps   It is now 10.30pm Saturday, and have I had a drink of alcohol today? Well not yet, time for the decaff coffee!

Good night.


It works! - al - Mar 13th 2009

As a former daily 24x7 drinker having been through rehab and to countless AA meetings/working the 12 steps to little success...I am now in to my 5th week of Naltrexone therapy and not drinking today...the third day this week.  I have no withdrawal symptoms and no desire to drink. 

As per 'bill w's' comment:

"Unfortunately, alcoholics actually like the feeling of being drunk and taking a pill to prevent that enjoyment is the very reason that an alcoholic would not consistently take that pill - because he or she wants to feel good."

Speaking as an alcoholic I disagree - chronic alcoholics do not drink to feel good - they drink because they have become conditioned to.  Besides surely a diminishment of 'buzz' from drinking is a small price to pay in the short term for living a far better quality of life and to all intents and purposes being cured of the addiction?


Sinclair self-help. - JR - Mar 2nd 2009

Three brief comments.  First, the editor is obviously correct about the risks of using prescription medicines otherwise than under medical supervision. 

Secondly, if you are acquiring Naltrexone "privately" (as in, for example, through Internet sources) you need to be sure that you are getting the genuine, proper-strength, clean product.  Naltrexone hydrochloride is patent-expired, and is now manufactured by a number of firms apart from the original main producers (DuPont).  Of course, there are very many respectable manufacturers of all sorts of drugs around - but the presence of multiple manufacturers reinforces the importance of being sure of your source.  Also, consider the following, from

"Naltrexone’s primary use in veterinary medicine and wildlife management is as an antagonist of opiate agonists such as carfentanil, etorphine, and butorphanol. It has been sporadically used to treat repetitive behavior such as stall weaving in horses, lick dermatitis in dogs, and feather picking in birds."

Like many human medicines - generics especially - naltrexone is used in veterinary practice.  In naltrexone's case this use is, it appears, quite extensive.  While, again, most of the stuff produced for or used in a veterinary context is perfectly all right, some may be presented in a way less than suitable for humans and, in any event, the veterinary area provides another opportunity for the circulation of less reputable products.  Finally, of course, the "private" prescription drug market is a bit like Shiloh Ranch on "The Virginian" - full of cowboys - except that these cowboys are happy to sell you any old rubbish as a "genuine" drug, as long as you part with your money.  I would say, if you must source Naltrexone privately, be very, very careful.

Third and final point - I am not familiar with the drug prescribed by your doctor, but I would not be so sure that the Vitamin B is not doing you any good.  True, it will not stop you drinking - but then, I doubt whether this was the objective of your doctor in prescbing it.  Excessive drinking is known to drain your body of Vitamin B2 (Thiamin), and Vitamin B12 is now generally seen as useful in fighting the damage done to the brain (resulting, for example, in memory loss) both while "maintenance drinking" and after abstinence (or moderation) has been attained.  These vitamins can be helpful, even if you have not yet managed to stop drinking.  For myself, I had one major and prolonged relapse after my initial "stop".  The drinking was, for a period, almost as bad as ever.  However, the mental effects (memory lapses, inappropriate sleep pattern, confusion, blackouts and all that) did not feature to anything like the same extent as had been the case towards the end of my period of untreated abusive drinking.  I put this down at least in part to the fact that, during the relapse, I maintained the high vitamin supplement regime approved by my doctors to support my projected recovery, which included substantial supplements of vitamins B2 and B12.  Of course, the only truly effective way to arrest (and perhaps reverse) the brain damage is to stop your drinking or, at least, bring it under control.  That having been said, whatever you do, I would suggest that it would be in your interests to take the vitamins.

Thankfull, I am all right now - though I am still taking vitamins.  I wish you the very best, and hope that you will find a response to your difficulty that works for you.

Best wishes,


Beginning The Sinclair Method - Tommy - Feb 28th 2009

I have been borderline alcoholic for many years.

Last month I bought Roy Eskapa's book and consequently I asked my  (UK)doctor for help and requested Naltrexone.

He did not know Naltrexone and prescribed Campral and Vitamin B. This has been of no benefit to me at all.

I have ordered Naltrexone privarely and hope to begin The Sinclair method next  week. 02/03/09

I hope to provide my objective experiences if anyone is interested.


Editor's Note:  I can appreciate your frustration but also feel the need to advise you that taking prescription drugs without a prescription and without the explicit guidence of someone trained and licensed in the safe use of medications (e.g., a physician or similar health professional) is not a good idea.  You could put yourself at great risk of (self-) harm.  Detoxification from alcohol can be dangerous if handled incorrectly.  Cold turkey can be deadly.  By all means pursue the Sinclair Method, but please do so safely and under the supervision of a licensed physician.  I don't mean to dampen your enthusiasm by saying this.  I will welcome your further reports on this experiment, but simply hope you will find a way to do it with appropriate supervision.  

Another look at the Sinclair Method - Cured guy from Georgia - Feb 22nd 2009
Dr. Dombeck’s assessment is completely full of his own contradictions.  I believe he should go back and read his article again.  By no means was this an objective analysis or review of Sinclair Method but it did deserve a little more investigation than I believe was used to write this article.I am a cured alcohol addict.  I am using the Sinclair Method.  I have had a background in drug and alcohol treatment but left the field for many reasons, most notably a better source of revenue.  Along the way I acquired a post graduate degree and make well into a six figure income, am married and a father of three though I don’t know how long the income will keep coming in the present economic conditions.I won’t take the reader down into the weeds with a rehash of the inner workings of the brain in relation to the endocrine system though I am quite sure it is endorphin and not endorphine.  If anything, we Sinclairians are seeking to no longer be “endorphines”.  I will present the phenomena of alcohol addiction from an experiential observation of one addict, myself.First, I was not born addicted to alcohol.  I can distinctly remember in my adolescent years drinking on par, illegally with my under-aged friends.  As someone who always felt as an outcast and was very insecure, drinking with these friends was an honor.  For once I was able to talk with the “cool” kids and the chance of getting laid was no longer a pup-tent fantasy.  Life was setting me up for alcoholism and I complied dutifully by abusing it every chance I got. For me, alcohol was truly a magic elixir.  Somewhere deep in my brain, my endocrine system decided to reward me with a little shot of endorphin (actually I taught it to) every time I  simply thought of drinking.  And it is that endorphin release that I have become addicted too!  The alcohol is just a triggering mechanism.  I told my endocrine system that drinking was very, very good for me and it swallowed it up lock, stock and barrel.  What a chump!  But that is what separates me from normal drinkers like my wife.My wife is a intelligent woman, school teacher and the mother of our kids.  She has never had an addiction to alcohol.  For that reason, I use her for my “control.”  We have always talked about our alcohol experiences together.  I am fortunate that she does not view the phenomenon judgmentally.   I am an exceptionally high functioning addict though I have not always been that way.  I have recorded in detail what we both experience in relation to drinking.  When we go out to dinner, we will both have a pre-meal drink.  I begin to anticipate this drink before leaving the house – she doesn’t.  When we sit at our table and our first drink arrives.  To me it is Christmas morning and that drink is from Santa.  For my wife it has no significance.  If I were to arrive at the restaurant and discover they did not have alcohol, I would be strongly disappointed.  She would have a coke and not notice.  After two drinks, my desire to drink would increase five-fold.  She would state that she had enough and anymore would actually take away from her experience, not enhance it.  At this point, I am more interested in her reaction than my own.  "Why, if you liked the first two, do you want to stop now?", I ask her.  I am having trouble comprehending this.  I hear her words but they are not registering.   She explains that in one sense that it is like having drank two big glasses of water when she was thirsty and being handed a third glass – she “kind of” feels full.  I ask her to explain “full”.  Does she feel bloated?  Would another drink make you feel nauseated? We were drinking cocktails so the liquid volume was miniscule.  She says that "full" might not be the best word.  She says it is more like “satisfied and complete” so I ask desperately wanting to understand, “wouldn’t another drink just make you feel a little more satisfied and complete?”.  She thinks for a second and says, “No. I think I would go from feeling good to feeling anxious.  It wouldn’t be fun anymore and I would want the feeling to go away.”  I am making her uncomfortable because she is not able to articulate her experience any more clearly and is starting to become defensive.  But I am not done yet.  I ask her, in her own words, what she is feeling right now from her drinks.  She says that she feels a little glow similar to how she feels after love-making.  She could easily take a nap, if available.  She says the “barbs” of the day have been dulled and the universe is a little more friendly.  I let her off the hook and do not make her explain herself.  I relate to her my experience and she is looking at me like she hears it but her eyes are a little squinted like she isn’t completely registering.I tell her that after the second or third, I have this “stoked” feeling that I don’t want to surrender at any cost.  She turns the tables on my and asks, “what is stoked?”.  I say, “powerful and in control”.  She tells me I am always powerful and in control!  I explain that that may be true but there is still a little guy in me from the past that still has anxieties and I think he gets quashed when I drink.  She says that I am psychologizing and that that doesn’t make sense.  If my goal is to quash the inner child, then I should lose the desire to drink once the child is “put to bed”.  Why would I want to drink more?  Okay, I back away from the “inner child” thing and go back to just feeling more powerful.  I explain that once I start “thinking” about drinking, this machine comes on that says, you want more of this.  I experience two forces, the heightened desire and then the reward of fulfilling that desire.  You know, the horniness and the orgasm except that there is never a real climax. Once that desire is heightened, there is a tremendous fear that I may lose the capacity to keep fulfilling it.  For that reason, I keep drinking at an accelerated pace to insure I will continue to get this “power/stoked” reward.  That phenomena switches early in the drinking experience from desiring the feeling to fearing its loss.  For the rest of the night, I will do all I can to insure I have enough alcohol inside me to protect this “stoked” feeling.  If at any time, my drinking is disrupted, I go into panic mode.  This powerful and very in-control husband’s spine turns to goo and I want to curl up into a fetal position and stick my thumb in my mouth.  The goal of every drinking experience is to imbibe enough until I dull my consciousness enough to stagger off to bed.  What a pleasurable experience.  My mistake is that I am trying to explain my addiction in rational terms.  I later learn and believe the “why” is strictly electro-chemical.   Now you may believe that I have not known sober life, but that is not the case.  I have had various bouts of non-drinking for as long as twelve years.  I am also able to go white-knuckle sober through brute will-power.  But at various levels, there is always a pebble in my shoe.  Often it is a dull little irritant reminding me that I “cannot drink.”  The edict alone is a lingering nag on the best of times and in AA we whistle in the dark and knock on wood, hoping to keep the pebble compartmentalized.  Other times, the pebble is a boulder covered with barbs that gnaws at my inner “sole” with every step.  Trust me, I have been sober far longer than not since the inception of my drinking career.  Fast forward to last winter.I decide it is time to do something about my drinking again.  I don’t care much about the self-deprecation that is inculcated in AA.  Their disease model makes little sense and has no scientific backing.  I am told I was born alcoholic because I acquired an addiction to booze.  I ask if I am also born a heroin addict, even though I have never touched it?  I explain that I am quite sure that I would become addicted to heroin, cocaine, meth and a plethora of substances even though I had never touched them.  My argument was to de-glorify alcohol and put it in its proper place.  It is an addictive substance so why should people not become addicted?  But then I take it a step further.  At our meetings we have two severely addicted gamblers.  We are a small community and have to make do with the limited recovery resources we have so gamblers are welcome in AA meetings.  I also have had gambling addict friends.  We even have one sex-addict and he does make us all shiver with his weird stories.  So now I begin to think, it is obvious that gamblers are not addicted to money - the paper and coinage of legal tender.  And the sex guy talks more about masturbation as we blush, than anything else so exactly what substance is he addicted to? (don’t even go there)  What is going on here?  I reach the conclusion that I am addicted to the same non-substance stuff that the gamblers and the sex-addict are addicted too though I am more comfortable relating to the gamblers.  That other guy just gave me the creeps!  Shortly after I read Sinclair’s book.  Bingo!  Endorphins.I will pick up the pace here and simply say that I went on Naltrexone per the Sinclair Method.  After a couple of months my wife and I go out for fine dining at a very nice restaurant.  I have been tracking my alcohol consumption and discussing the phenomenon with my wife all along.  She is intently interested and likes the idea, if it works.  She would always give up drinking (not requested by me) when I stopped so there would not be any alcohol in the house.  But she is thrilled that I can sit beside her and drink as she does.  If I were to relate to the reader my drinking experience, I might as well cut and paste my wife’s description from above.  I take my Naltrexone one hour before we go out.  By the time I get to the restaurant, I am  not very interested in drinking.  We order our usual cocktails and I don’t even finish mine before our entree arrives.  After dinner, we order our second but I am not that interested in drinking it.  We begin talking to the people beside us about the food (we are at a Japanese hibachi place where several sit together) and I am completely absorbed in the company which I would never have been before unless it was a lady with six inches of cleavage!  When we get up to go, I notice that half my drink is still on the table.  She is right.  I just feel complete.  The drinks had their effect.  I feel a little warmer and the barbs of the day have been dulled.  I want the feeling to stay right here – no more.  I sense that if I drank more it would ruin it.  Like eating too many slices of pizza where you end up wishing you had not eaten any at all.  I am sated!  We go home, watch a few hours of TV and go to bed, still feeling a little bit of that warm glow as I drift to sleep.  My last thoughts of consciousness are, “thank you God for letting me experience normal life again.”Now Dr. Dombeck, here is where we differ and I really think you are off the mark.  Actually I am less than impressed with your entire article in that it lacks consistency and intellectual support.  First, it is true that I will take Naltrexone for the rest of my life, whenever I choose to drink.  But you fail to see the secondary paradox here.  Once extinction is well in effect, the interest in drinking becomes “normalized”.  The beauty of the Sinclair Method is a double-edged sword in that using the Method will bring you to the prize but the prize just isn’t that important when you win it. You are also wrong and this is a fallacy that I would hope a “doctor” would not fall for, but you did just the same.  This whole pleasure-pain mechanism is worthy a re-examination.  There is nothing pleasurable about craving alcohol!  If you think crawling up the walls, shaking in your boots with your mind hyper-focused on the next drink is pleasurable than I would have to call you a masochist.  I now experience the pleasure of drinking alcohol as you do, assuming you are not alcoholic.  For some strange reason I don’t miss drinking to oblivion, passing out on the couch and being hung-over until noon to only repeat it the next day.  Where you fall short is the belief that I was addicted to alcohol.  If that was true than my card shark friend is addicted to paper tender and that ditzy babe I used to date years ago was addicted to bingo cards.  No, we were all addicted to the same thing.  We simply had different delivery vehicles.  And it is that elusive addiction that Dr. David Sinclair gave me the means to drive to extinction.  The idea that I would miss that is so ludicrous that I am willing to use a word like “ludicrous.”  You truly were not able to understand Sinclair’s PodCast.  I suggest you listen to it again and take notes this time.   My belief is that the addiction mechanism is what drove me to drink.  In my mental model, I see it as an impersonal automaton that it triggered by, in my case, the thinking of alcohol.  Once that mechanism comes into being, my psycho/emotional state play no role.  I am a deeply integrated individual with a healthy self-esteem which I paid for through the nose.  The addiction machine couldn’t care less about the content of my mind and soul.  Feed me Igor!  Feed me!  Or as Sinclair eloquently says, “those rats never listened to a single thing I had to say and yet they quit drinking”.The Sinclair treatment attacks the behavioral basis for alcohol addiction; it does not work directly on the physiological addiction itself (e.g., that body dependence which requires gradual detox to remove).How is the cessation of the release in endorphins NOT a physiological change?  And over months I reduced my intake to a few drinks a week.  Would not you call that detox?If they don't drink and take pills as prescribed, they will not learn that alcohol's thrill has gone flat, and will not stop drinking. The fact that this therapy absolutely requires that drinking continue has got to be terrifying to most treatment providers who are thinking (quite rightly) that excesses of drinking need to be shut down as fast as possible.…but woe be you if you go off them and drink. If that happens, well, each drink is going to be better than ever before…That thrill you speak of is an indefatigable craving.  I can barely wait to get that back!!   You use the expression paradox rather loosely but how many of today’s scientific advancements would be regarded as paradoxical, say 50 years ago?  It is only a paradox if one believes one is addicted to the alcohol.  I refute that premise.The idea with the Sinclair method is that the straightest path to the goal of drinking reduction is NOT a straight line, but rather a winding road.  My goal is the extinction of addiction.  The reduction in drinking is the after-effect.  I have no interest in what some therapist goal is.  Based on the cost for their treatment, it seems there goal is rather apparent.   I am now at a place where I can take or leave alcohol.  That has always been a phrase my wife used and it used to sound like gibberish.  There just is no attractive force to going back to being addicted.  Don’t you see?  The cycle is broken.  The is not sobriety.  This is extinction.  I have been sober and a sober drunk spends the rest of his/her life walking through a minefield made of alcohol.  Even the lovable Bill Wilson succumbed in his later years.  He was fighting the wrong beast.  He was fighting the alcohol.  The very mechanism to “want-to-go-back-to-old-ways” is gone.  I don’t miss that mental pop-corn machine one iota. Why would I ever WANT to drink without taking Naltrexone? Sinclair has brought about a life-changing metamorphosis in me.  I am living, walking, loving and working proof of its efficacy. Since this article written in 2006, I will give it the benefit of the doubt.  I don’t know what data was available then.  Having said that, I still think the article was a hip-shot at someone that has brought something very wonderful to many of us. Also, you link a recovery center that many of us do not ascribe too.  I do not see any reason or benefit to paying $3500 to participate in the Sinclair Method.  Just as the addiction process is impersonal and could not care less about my mental state, such is the extinction process.  You take the pill, drink as normal and the rest will take care of itself.  If you want to go tell your shrink about it, feel free.  The extinction will work with or without the shrink invoice.  If a patient suffers from severe mental or physical mental illness that requires intense therapy then that individual is probably not a good candidate for the Sinclair Method.  Naltrexone compliance is non-negotiable and therefore the candidate should be reasonably sane and mature.  The others can pick up white chips. I speak only for myself.  My opinions are entirely my own and may not be in accordance with Drs. Sinclair, Eskapa and anyone else in the field of addiction studies.

Online Community - Matt - Feb 9th 2009

A free and open online community of patients who are using The Sinclair Method can be found at  Dr. Roy Eskapa, the author of The Cure for Alcoholism, is a member and stops in from time to time to answer questions and give advice.  In addition to the message boards, the site contains excerpts from the book, an omitted Q&A chapter, audio and video interviews with Dr. Sinclair and a lot of other information.

Recently Dry - Recently Dry - Feb 9th 2009

I hope this Sinclair Method is for real, but I have deluded myself about alcohol so many times that I am going to stick with abstenence as long as I can.

3 weeks ago I quit drinking and got a naltrexone implant as extra insurance.  After reading more about naltrexone, I came across the Sinclair method on the web & it makes a lot of sense to me.  On the other hand, the alcoholism literature suggests that our afliction comes in more than one simple variety, so things that work for one person may not work for all.

Some soul searching lead me to ask the simple question ...  If it is for real and I could reset my brain to the way it was before addiction, then would I want to continue as a social drinker?  My honest answer is that the appeal of resetting is that I could drink for pleasure again without facing the consequences of advanced drinking.  Given the pain that drinking has caused me and my family, that seems like a pretty big risk for a pretty weak advantage.  Having been badly burned I think abstenance is the goal for me.  Social drinking is just not that valuable to me.

Best wishes to all of you.

Scott - It Works - Matt - Feb 5th 2009

Scott Said:  I find it very funny how these addicts want so much to continue there use that they search the internet for anything to allow them to do just that.  Whether or not this Sinclair method works is not the question, the question is why do people seem to think that they have to have one or two glasses of wine at dinner or drink after work with co-workers? 

Scott, it's not about continuing to drink.  It's about quitting drinking or getting it down to a safe and sane level (whichever happens) without cravings, discomfort or withdrawal.

The Sinclair Method does exactly that.  I'm almost three months into this and my drinking is a fraction of what it was last November (when I posted below).  I drank 6 or 8 drinks every night starting on my drive home from work.  I now have 1-3 drinks every other day or so.  I expect that to continue to go down as the next few months go by.  When I don't drink, I usually don't crave it at all where before, the cravings were irresistable.

If you're not drinking, I wouldn't start in order to do this.  But for those who are, this is a great way to get it under control without the pain usually associated with quitting.

Someday Sinclair will win a Nobel Prize for this.

It works !!! - Jay - Feb 1st 2009

I had tried everything, been everywhere and failed dismally. My fear of never being able to have a drink again often got the better of the discipline of AA. I also did the expensive rehab and watched afterwards as one by one my co-patients failed. 10% success rate at rehab 5% with AA alone. 

Having had a fairly miserable time of it, and nearly lost everything around me, I stumbled across an article about this method. I bought the book and realised very quickly why this drug is not well known and not widely used. The drug is generic, which means it is of no worth to a big Pharma company, and the method could quite literally wipe out traditional methods of treatment for alcoholism. I can't say the same for other addictions as I don't have them, but for alcohol it makes a great deal of sense.

I have avoided every other sort of drug therapy during my time as a drunk as I knew in my heart that the "depressions" that I had were purely to do with alcohol and it's chemical reaction with my brain. I was diagnosed as bi-polar at one of the rehabs I went to, but still refused because I knew that, even if i was, whilst I was still drinking or craving drink, none of the so called mental issues could be addressed. 

I also began to resent the AA and all that it stood for. Replacing one obsession with another was not really how I had envisaged spending the rest of my days. If what I had was a disease, why was I going to church to treat it? Why was I not going to a Doctor. After all, if I had any other disease, would I go to church ?

My view of AA is that it was "invented" at about the same time as we were giving cigarettes to people as a life improving substance. Things have moved on a little since then as has medical science. We are now using similar drugs to Naltrexone to help with Nicotine addiction, it makes sense really that there are possibilities with alcohol.

So, I found a Doctor, had my liver checked and started the course of Naltrexone. First day 25mg and then to 50mg after it had been established that there was not extreme adverse reaction. 

The rules seemed simple, never drink without having taken a pill an hour before and never take a pill unless you are drinking. Monitor your cravings and consumption, an go about your life in a normal way and let the rest take care of itself. The one warning, which I would implore all to heed is that when you do not take the pill after a sustained period of taking it, you will feel the urge to satisfy your cravings for stimulation with something. Do something healthy, like have sex, go to the gym, eat a good meal, and you will have changed your brains cravings for something that won't wreck your entire life. Sounds too simple to be true, doesn't it ?

The other thing to consider is that once you have started on this method, you can never drink again ( if you wish to ) without having taken a pill. My considered view of that is comparing it to a condom. Takes some of the enjoyment away (male thing) but prevents any further complications. To me it was much better than going to an AA meeting every day and lamenting.

So, here's what happened. Within a few days I noticed that the beginning and ending of my drinking had changed. ie, I didn't go at it with the vigour that I had done for the last 15 years. The fact that you have to wait a little after taking the pill helps, but I really didn't have the desire to hit it to get that quick high and continue trying to sustain it. The end of my drinking changed as well. I really could leave a bottle half full. No kidding. Effortlessly I could go to bed without completely demolishing every last drop of alcohol in my house. My unit consumption had halved in a very short time really and with absolutely no effort or cravings at all.

The other thing that has changed is that I no longer buy alcohol on a daily basis with the "must buy enough" attitude. Any drunk worth their weight will know exactly what I mean. When we buy alcohol, we look at the possibility that we may run out and buy more just in case, ending up drinking the lot anyway. This and other learned behaviours seem to be much less of a concern, and I can now comfortably imagine my house with just 2 bottles of beer in it and not panic that there will not be enough to last an evening.

My over all consumption is drastically down on what it was. I am not going to pretend that I am out of the woods yet, but it would take me days now to drink what I did in a night, and that is all done with no discomfort, humiliation, meetings, rehab, craving etc etc. Most importantly, I am at home, happy with my wife and kids and this drug is not expensive at all. It costs me the equivelent of $50 a month. That is small change compared to what I was spending on wine.

I have had absolutely no side effects what so ever, and because it is a short acting drug, if I did, then it is out of the system very quickly.

 For those who have tried and failed, this one is impossible to ignore. For those who have never tried, this is one of the options available to you. For those who wish to venture down the "abstinence makes the mind grow fonder" route, let me tell you for a fact. This is easy and painless and doesn't require you scratching old wounds at all.

My view now is, having been the AA route. Leave the past where it is, learn how to live again and be thankful that you can. Relearn your drinking and the rest will fall into place. Dwelling on the past is a risk to you and everyone. Good on those who have fought over years for their sobriety, I don't knock you, but you know as well as I do that you are a drink away from being "out", and one of those hopeless drunks that are prayed for at the beginning of every meeting.

This method means that the fear of never being able to drink is taken away and you can get on with the very important task of living. As I said, I nearly lost it all. This drug gave it back in spades and with no effort.

Welcome to a new age of treatment. Goodbye to the industry as we know it. This drug will create a revolution I am convinced. If it worked for me, it can work for anyone.

Good Luck 

Huh? - Scott - Jan 30th 2009


I have been on Naltrexone for around three and a half months and haven’t consumed alcohol for four months.  I had been trying to quit drinking on my own for a good year before I checked in to a conventional in-patient treatment center.  They recommended that I try Naltrexone, It has worked very well for me.  I find it very funny how these addicts want so much to continue there use that they search the internet for anything to allow them to do just that.  Whether or not this Sinclair method works is not the question, the question is why do people seem to think that they have to have one or two glasses of wine at dinner or drink after work with co-workers?  It is tough to not drink around drinkers but it’s an addict’s way of showing self-discipline which they have not been able to exhibit while drinking which is the reason why their addicts.  If you are so deep into the effects of alcohol that you need to see a doctor to get help than you probably should abstain from drinking for a while anyway to let your body recover.  Withdrawal symptoms are horrible, but they might show the user that maybe it’s not the thing for them and treatment facilities help with these symptoms. If you had a spouse that beat you senseless daily and you in turn got a divorce would you hang out/spend time with them if you were guarded by a police officer or would you choose to abstain from seeing that person for ever with the help of a restraining order or moving away.  I look at it like this Naltrexone is my restraining order alcohol is the abusive spouse.  Alcohol has hurt me in so many more ways than it has ever helped so even if I could drink like a "normal person" why even give that abuse a chance to come back into my life.

you DO feel the effects - Matt - Nov 1st 2008

>>>Unfortunately, alcoholics actually like the feeling of being drunk and taking a pill to prevent that enjoyment is the very reason that an alcoholic would not consistently take that pill - because he or she wants to feel good.  <<<

When you take Naltrexone and drink, you DO feel the effects of the alcohol.  You can and will get drunk if you drink.  Naltrexone does not affect how alcohol makes you feel.

What naltrexone does is block the opiod receptors in your brain that are responsible for the addiction.  You can't feel this happening - you just feel like you're drinking.

Over time (3-6 months), alcohol gradually loses its appeal and the addiction simply disappears.  You just don't feel like drinking.  At that point if you were to drink without naltrexone, you wouldn't go back to heavy drinking immediately.  It would as if you had just started drinking.  You could get re-addicted but it would take some time.  Dr. Sinclair suggests 6 months, but Dr. Eskapa suspects it could be shorter than that.  For that reason, Sinclair cautions that you should never drink without having taken naltrexone.

You haven't read the book or the studies behind it and you know it.  Please don't come here with your uneducated assumptions and discourage people from trying a treatment that might work for them.  You sound like an AA cult member, drowning in your helplessness.  You might want to live with the cravings forever, fighting your addiction day-by-day, but others don't have to.  It is possible to be a former alcoholic and this is one way to do it.

credentials - Matt - Oct 31st 2008

Biil W said:  "Yes... and that's why it doesn't work."

And you are basing that comment on what, exactly?  Seriously, do you know of some research that contradicts the 72 studies that suggest that it does work?

What, precisely, are your credentials?

Sinclair Method - Janie - Oct 2nd 2008

Ten years ago I tried the "Sinclair Method" and can tell you that it saved my life and my marriage. After many years of heavy drinking and being outcasted and labeled an "alcoholic" -- I am a social drinker -- and by that I mean that I have one or two drinks once or twice a week or a month. Yes, I do take the naltrexone as I need to. And I go to Neuro Assisted Recovery in Sarasota once a year for a refill on my meds. I would not say that after ten years, that the Sinclair Method is "experimental."  I would say that the recovery world has been slow in catching on to what has been a "cure" to me.

Book on the Sinclair Method Just Released - Roy Eskapa, Ph.D. - Sep 19th 2008

Alcoholics Can Drink Their Way Sober

A medical cure for alcoholism - without abstinence, detox or rehab - but which gradually removes the craving for alcohol, is being hailed as a life-saver for millions of alcoholics.

The Cure for Alcoholism: Drink Your Way Sober Without Willpower, Abstinence or Discomfort

Author: Roy Eskapa, Ph.D.

Foreword by: David Sinclair, Ph.D.

BenBella Books, Dallas (September, 2008)

..... rejects the pervasive belief that alcoholism is incurable without total abstinence. Instead, this authoritative book publishes a detailed account of 70 major clinical trials which prove beyond doubt how a treatment known as the Sinclair Method removes the underlying biological cause of craving and compulsive drinking. 

For more information see: 

Take Pills, Add Contemplation of Values - Linda - Jun 22nd 2008

I had been a two-bottle-of-wine-per-night drinker for many, many years. Recently I began to develop the classic alcoholic tremor and I was suffering from blackouts almost every night. I was not available to anyone, including my family, after 6PM. I decided that my health was really beginning to suffer--up to that point, I saw no reason to quit---so, I detoxed quite successfully with valium a few weeks ago. I am currently taking naltrexone daily to thwart cravings. I feel great (the tremor has disappeared!!)--I am delighted that I am not drinking two bottles every day of the best cheap wine I could find--I don't miss that old life--I love staying awake at night to watch a movie or a great documentary with my husband. BUT, honestly, I see no reason to give up a nice glass or two of wine with dinner once or twice a week. I intend to find a way for this to happen. Naltrexone will help--BUT I really think alcoholics need to think about what their value priorities are. Read Stanton Peele--he doesn't agree with the alcoholism-disease connection--so he gives thoughtful therapeutic ways of thinking about what kind of life you really want to have. The BEAST--"alcohol"--can dominate and push every other value out of the way--IF YOU LET IT--but I really believe that Peele is right--YOU ARE IN CONTROL. Before detox, I couldn't find the "I" --now that the fog has cleared I'm going to change my life to suit ME--not the abstinence hounds or the BEAST!!! TAKE CONTROL--use modern pharmacology (nalrexone) and a new way of thinking--see Peele. Good luck!!

Linda (06/2008)

Sinclair and Spice makes everything nice? - JR - Apr 8th 2008

Very doubtful.  An alcohol control program based on the continued comsumption of the Evil Spirit? What would one's Liver think?  Could this end up being another excuse to keep drinking?  I am pretty open-minded on these matters, but I would need pretty good evidence before I could commit myself to this method.  As it is, I Just Don't Drink ...

 Best regards,


Sinclair Method Worked for Me - Brenda G - Apr 7th 2008
I went to the and inquired about their program. Because I could not attend their program in person at Sarasota, Fl I was offered a "package" that included all the information necessary for my family doctor and a therpist of my choice to run me through the sinclair method program. OMG what a difference my life is now! It has been almost one year since I have had a drink and I sincerely feel that I will never drink again. God Bless the program and the people at

Author With Publisher Needs Comments on Sinclair Method - Naltrexone - Dr Roy David Eskapa - Dec 14th 2007

I have written a book on the Sinclair Method. I have a leading publisher in the US ready to go to print September 2008.

However, we need to interview physicians and patients who have used Sinclair's extinction program with naltrexone for over a year. 

This treatment can help millions who cannot control their drinking and you could contribute to society by coming forward.

If you can help, please contact Dr Roy David Eskapa by email

Many thanks

Dated 14 December, 2007 

heroin - lisa - Jul 7th 2007
i got the vivitrol shot for heroin abuse 2 weeks ago and i want to use so bad....what is it wearing off?

It works because... - David of SF - Jun 4th 2007
Actually what the method does is retrain the brain over a period of time to not associate drinking with pleasure.  The connections in the brain that associate drinking begin to break down, so the treatment over time gets the brain to stop wanting the drink in the first place. The other side effects of drinking begin to take the place in the mental memory of the drinking (being tired, sleepy, heavy feelings).  So the goal is to make the drinker actually not want to drink.

The method has been way more effective in treating alcohol addiction than most other traditional methods.  It won't by itself attempt to fix your life like AA does, but it is one piece in the puzzle.  Bill was a great guy and I still think if one can, it is the best way, but add the sinclair to the mix and you hit it on both sides, physical and mental and I think one's higher power would support that.


Is alcoholism so complex? - Steve - May 21st 2007

Deap-seated, yes, about 30 years in my case.  Complex?  Not for me.  One drink just leads to another.  I am self-medicating on Naltrexone and I find it 100% effective in stopping me drinking, except where there is already copious alcohol in my body (ie if I wake up drunk it takes lot of "trex" to turn the tanker round!)   But once I have eliminated the alcohol, trex keeps me good.  I sip wine then lose interest.  Magic!

The Sinclair method sounds good.  The only problem, as I know, is that sometimes you don't want to take the magic pill, you just want to get slaughtered.  But maybe that will go away with time.

All the best to board contributors here

Steve, UK


Vivitrol - Greener - May 19th 2007

There is also an extended-release monthly shot of Naltrexone, called "Vivitrol," for people who may be tempted to skip taking the oral Naltrexone pills before drinking.

 This would insure the extinction behavior occurs, since the Naltrexone is always present in their system.

Love it! - June R. - May 19th 2007
"The idea that somehow, someday he will control and enjoy his drinking is the great obsession of every abnormal drinker. The persistence of this illusion is astonishing. Many pursue it into the gates of insanity or death."

-- Big Book of Alcoholics Anonymous, Page 30

While I may sincerely pray that researchers find a cure for alcoholism so that others may not have to suffer, I must admit that my prayers for a cure have the ulterior urging that I may someday drink normally.

But I'm an alcoholic... What's the point of drinking normally? 
I agree whole-heartedly with Bill W.  Thanks for this article... it reminds me of my alcoholic obsession!  When the Kudzu-cure hit the online search engines, it kept me busy for a little while too. And I couldn't help looking at our Georgia kudzu-covered trees with a bit of nostalgic reminiscing and entrepreneurial enterprise...

Nice Theory, but that's all it is - a theory - Bill W - May 4th 2007

Wouldn't it be great if we could just take another pill to fix such a deep-seated and complex issue such as alcoholism?  Yes... and that's why it doesn't work.  If it did - alcoholics would be lining up for the treatment.

Unfortunately, alcoholics actually like the feeling of being drunk and taking a pill to prevent that enjoyment is the very reason that an alcoholic would not consistently take that pill - because he or she wants to feel good.  Years of conditioning from drinking and the subsequent feelings of escaping problems (although it causes more) and feeling good cannot be wiped out by a mere pill.  If that were the case, then the negative consequences that inevitably result in an alcoholics life would be a good enough deterrent to stop.  But, amazingly, blackouts, car crashes, violent episodes, and even murder cannot stop an alcoholic from drinking.  So, why would a pill?