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Naltrexone and its important role in TSM.

Of all the resources I found , I think that the following information from HAMS.cc sums up best how Naltrexone works with the Sinclair Method...

"Naltrexone has been shown to be highly effective in helping people to moderate their drinking or to quit when it is used according to the Sinclair method also known as pharmaceutical extinction.

In pharmacological extinction (also known as the Sinclair Method) one always takes a dose of naltrexone (50 mg) an hour before drinking alcohol. One never takes naltrexone unless one intends to drink.

Pharmacological extinction works because alcohol addiction is an example of operant conditioning. When you drink alcohol, endorphins are released and reinforce the drinking behavior. Drinking is learned behavior. More precisely, drinking is an example of operant conditioning.

Operant conditioning is normally a good thing because it helps us to learn new behaviors needed for survival. However, in the case of alcohol addiction it has led us to learn a maladaptive behavior.

Pharmacological Extinction works to undo this operant conditioning. You take naltrexone one hour before drinking alcohol. The endorphins are still released, but they cannot bind to the mu receptors because these receptors are blocked by the naltrexone. There is no reinforcement for the drinking behavior. In the absence of reinforcement, the behavior becomes extinguished.

The Sinclair Method takes three months or more to achieve its full effect. However, you should not stop taking naltrexone merely because the alcohol habit has gone into remission. You should always continue to take the naltrexone before you drink for the rest of your life. If you stop taking the naltrexone and drink then the drinking habit will simply re-establish itself.

After three months or so of naltrexone treatment you should be drinking at either moderate levels or abstaining with no difficulty and no craving for alcohol. Naltrexone alone cannot eliminate or reduce alcohol craving. Alcohol craving disappears only when people drink after taking their dose of naltrexone.

It is important that you do not take naltrexone unless you intend to drink. Otherwise you will wind up losing interest in healthy activities like sex or learning or sports. Naltrexone can lead to the extinction of any behavior that is reinforced by the release of endorphins."

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