Curing Alcoholism? Naltrexone and the Sinclair Method

Curing alcoholism remains in the realm of dreams and medical ambition. There simply is no magic bullet for any form of addiction. However, the use of the drug naltrexone is getting some more traction thanks to the Sinclair Method of use, in which an alcoholic takes one pill before they begin drinking, as opposed to one pill upon waking in the morning. Richard Juman and Dr. Stephen Cox report a 78% success rate when the Sinclair Method is followed to the letter.

Naltrexone is an opioid blocker. It prevents release of the neurochemical dopamine, responsible for the pleasure alcoholics feel when drinking. Sold as Revia, naltrexone got a  horribly bad rap for failing to inhibit an alcoholic’s drinking. It appears now that the primary problem with Revia is how it’s dosed, not the drug itself.  It must be taken in conjunction with drinking; popping a pill an hour before drinking works. Taking a pill in the morning or several hours before drinking starts just doesn’t work. The drug itself only becomes effective when alcohol is coursing through the body. In other words, naltrexone works because the brain’s chemistry alters when alcohol, even small amounts of alcohol, enter the central nervous system. In that state, naltrexone can–and does work.

In fact, when Revia was originally sold, doctors told alcoholics to stop taking the naltrexone if they relapsed. According to Dr. Cox, Revia may not stop an alcoholic from having an occasional drink, but it does stop an alcoholic from binging, or falling “all the way” off the wagon. Taking a naltrexone pill before starting to drink, or at that point an alcoholic knows that drinking is going to become inevitable, is the basis for the Sinclair Method (TSM).  Why haven’t we all heard about naltrexone?  AA is profoundly common in the USA, and the heart of AA is that there is no “safe use,” no “harm reduction,” nothing but absolute abstinence. There’s also no profit motive for naltrexone to be sold or recommended. It’s an off patent drug meaning that it’s available as a cheap generic. There are many professional studies documenting the failure of Revia. Those studies show over and over that taking the pill more than an hour before a person starts drinking is ineffective. The studies that show naltrexone working well invariably have patients take the drug when they feel the urge to drink become overwhelming, or even with the first drink.