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> Suffice it to say that quitting isn't really about willpower. I found this to be my experience as well, which is why I was so interested when I heard about n

> Suffice it to say that quitting isn't really about willpower. I found this to be my experience as well, which is why I was so interested when I heard about naltrexone therapy. More specifically, a course known as The Sinclair Method. [1] The idea is to use the drug an hour prior to drinking (and only then, so if you abstained from drinking that day, you would abstain from naltrexone -- this is where it differs from standard naltrexone therapy that would have you take it every morning regardless of your plans to drink). Naltrexone blocks endorphins associated with drinking and helps to reprogram your brain to no longer seek that neurochemical response. I found it to be highly successful the first week -- I didn't even want to finish 2 drinks. After the first week, it still worked but not as well. And I also realized that the anticipation of drinking was almost as powerful as drinking itself, in that I would feel a "rush" even on my way to buy alcohol. It took about 6 months of naltrexone therapy to finally quit. The funny part is, during that time and when under emotional distress, sometimes I would drink without the medication but it still seemed effective in that I never quite got the pleasure I used to have. I'm coming up on 3 months sober, but unlike past attempts to quit, I have no urge to fight and no desire to drink again (and I am going to keep it that way). I am not a doctor and this is not medical advice, just my story. The other interesting part to me is how rarely naltrexone is used for problem drinking (vs something like AA, which is faith based in more ways than one), and even more rarely is it deployed the way The Sinclair Method instructs (deliberately, right before drinking). > Over time, your brain learns not to associate alcohol with pleasure, resulting in reduced cravings and improved control over alcohol use. [1] https://www.sinclairmethod.org/what-is-the-sinclair-method-2/ https://www.sinclairmethod.org/what-is-the-sinclair-method-2...

steve_adams_86 6y ago
Perhaps the effect of the drug might have carried over to the next day - I’m sure this could be verified, but it’s something I’ve experienced with other drugs. You skip a day, intentionally or accidentally, but your system hasn’t flushed everything out so the drug is still taking some effect.
- chillwaves 6y ago
  It was actually over a longer period than a day. I would like to think that some part of my brain is no longer associating alcohol with the buzz I used to get. It seems far fetched, but plausible? The other side of it is I definitely would feel the "buzz" of alcohol before I actually drank it, such as when I was walking home from the store carrying booze -- I would feel elated. To be clear, the "buzz" I refer to is straight up pleasure, not intoxication. On naltrexone I felt the intoxication without the pleasure. It made me think, is this what it's like to drink alcohol when you are not an alcoholic? Very easy to moderate in that circumstance.
perl4ever 6y ago
It's interesting that (I believe), - bupropion is an antidepressant and an antismoking drug. - naltrexone is an anti-opiate and anti-alcohol drug. - bupropion/naltrexone together is a weight loss drug. After trying bupropion as an antidepressant, I would really like to try adding naltrexone, but my prescriber didn't take me seriously, as I have neither an alcohol nor opiate nor weight problem. I'm fascinated with the idea that when you try to increase a substance in your brain, it "fights back", you get tolerance, the receptors get dulled, and so on, but if you suppress a receptor, then more is produced, which works better in the long run.
- KMag 6y ago
  > I'm fascinated with the idea that when you try to increase a substance in your brain, it "fights back", Well, it's a truism that mostly-stable systems have at least locally corrective responses to perturbations. Back in High School, I was a bit mystified as to why Le Chatelier's principle should be so nearly universally applicable, until I realized that the sample set is extremely biased... if a chemical system isn't even metastable, it doesn't get much broad attention. Stable or metastable chemical systems must have locally stabilizing responses to change. Even for things like combustion reactions, we mostly study stable flames, except for niche studies. I realized there's a generalization of Le Chatelier's principle that's almost a truism for any system that exhibits something approaching short-term stability or short-term bounded oscillation. If some brain state weren't locally corrective, then it would be a transient brain state, and excluded from the most intuitive notion of normal brain behavior. So, we'd expect that for normal brain behaviors, we'd see corrective responses to change.
- thechao 6y ago
  I’ve been losing weight on the SNL diet (about 50kg, so far) — eat less/move more. Kicking the “sugar” habit is the hardest thing I’ve ever done. A few months back (just before the holidays: Thanksgiving, Christmas, all of the birthdays in my family), I got appendicitis. During recovery I was encouraged to eat & couldn’t exercise. I put on 7-8kg in a few weeks. Getting back off sugar onto a healthy diet has been awful. If that drug combo actually works ... I dunno; I’d pay a lot.

steve_adams_86 6y ago

Perhaps the effect of the drug might have carried over to the next day - I’m sure this could be verified, but it’s something I’ve experienced with other drugs. You skip a day, intentionally or accidentally, but your system hasn’t flushed everything out so the drug is still taking some effect.

chillwaves 6y ago
It was actually over a longer period than a day. I would like to think that some part of my brain is no longer associating alcohol with the buzz I used to get. It seems far fetched, but plausible? The other side of it is I definitely would feel the "buzz" of alcohol before I actually drank it, such as when I was walking home from the store carrying booze -- I would feel elated. To be clear, the "buzz" I refer to is straight up pleasure, not intoxication. On naltrexone I felt the intoxication without the pleasure. It made me think, is this what it's like to drink alcohol when you are not an alcoholic? Very easy to moderate in that circumstance.

perl4ever 6y ago

It's interesting that (I believe), - bupropion is an antidepressant and an antismoking drug. - naltrexone is an anti-opiate and anti-alcohol drug. - bupropion/naltrexone together is a weight loss drug. After trying bupropion as an antidepressant, I would really like to try adding naltrexone, but my prescriber didn't take me seriously, as I have neither an alcohol nor opiate nor weight problem. I'm fascinated with the idea that when you try to increase a substance in your brain, it "fights back", you get tolerance, the receptors get dulled, and so on, but if you suppress a receptor, then more is produced, which works better in the long run.

KMag 6y ago
> I'm fascinated with the idea that when you try to increase a substance in your brain, it "fights back", Well, it's a truism that mostly-stable systems have at least locally corrective responses to perturbations. Back in High School, I was a bit mystified as to why Le Chatelier's principle should be so nearly universally applicable, until I realized that the sample set is extremely biased... if a chemical system isn't even metastable, it doesn't get much broad attention. Stable or metastable chemical systems must have locally stabilizing responses to change. Even for things like combustion reactions, we mostly study stable flames, except for niche studies. I realized there's a generalization of Le Chatelier's principle that's almost a truism for any system that exhibits something approaching short-term stability or short-term bounded oscillation. If some brain state weren't locally corrective, then it would be a transient brain state, and excluded from the most intuitive notion of normal brain behavior. So, we'd expect that for normal brain behaviors, we'd see corrective responses to change.
thechao 6y ago
I’ve been losing weight on the SNL diet (about 50kg, so far) — eat less/move more. Kicking the “sugar” habit is the hardest thing I’ve ever done. A few months back (just before the holidays: Thanksgiving, Christmas, all of the birthdays in my family), I got appendicitis. During recovery I was encouraged to eat & couldn’t exercise. I put on 7-8kg in a few weeks. Getting back off sugar onto a healthy diet has been awful. If that drug combo actually works ... I dunno; I’d pay a lot.