The Sinclair Method – Hints and Tips

This article is to give those new to The Sinclair Method (TSM) a good understanding of what constitutes good practice for TSM.  If you find that your drinking is not reducing as quickly as you would like it to, you may benefit from the following hints and tips.

This posting is for information only and is not intended as, and should not be taken as, medical advice. Please consult a physician.

PLEASE READ THE PATIENT INFORMATION LEAFLET THAT COMES WITH YOUR TABLETS IN FULL BEFORE TAKING ANY TABLETS.

IF THE LEAFLET IS NOT IN A LANGUAGE YOU UNDERSTAND, PLEASE READ THE APPROPRIATE LEAFLET IN ENGLISH FROM THE LINKS BELOW.

NALTREXONE: www.medicines.org.uk/emc/PIL.25828.latest.pdf

NALMEFENE: www.medicines.org.uk/emc/PIL.27612.latest.pdf



The Process.

TSM is a PROCESS that can take anywhere from 4-8 months to reach full extinction of cravings, or even longer for some people. Therefore, patience is vital. In the largest majority of cases, it is completely unrealistic to expect incredible success after 2 or 3 weeks.

 

Compliance.

Compliance with the prescribing instructions is 100% non-negotiable. Do NOT drink without the medication and the required waiting time.  If you accidentally forget to take the tablet, you will know it when you take the first drink as you will feel an extremely strong 'hit' from the very first mouthful.  Stop drinking immediately.  Take the tablet, wait the required time, and then complete the drink - paying particular attention to the mindful drinking part of this process as mentioned below.


Dosage.

The optimum dosage for naltrexone has been found to be one 50mg tablet, one hour prior to drinking. For the first couple of times, eat a meal beforehand, drink lots of water, and take half a tablet to allow your body to adjust to any side effects. If you are taking the Nodict brand of naltrexone, please always wait 90 minutes prior to drinking to allow for the thicker coating that this brand has.

The optimum dosage for nalmefene (Selincro) has been found to be one 18mg tablet, two hours prior to drinking. For the first couple of times, eat a meal beforehand, drink lots of water but take the full tablet as Selincro should not be broken in two.

As with all medications, there may be some side effects as the body gets used to the medication.  You can read more about these in the Patient Information Leaflet that is included with your medication, or discuss them with your prescribing physician, but in most cases rest assured that these should reduce to nothing over the first week to two weeks.

There will always be a few exceptions to the dosage rule in terms of the amount, as with any medication. These may include those who have had gastric bypasses, or women who suffer from PMS, for example, as various medical conditions can weaken the response to naltrexone or nalmefene. We are not physicians here, so please take advice from a medical physician if you think you may need to explore your dosage options.

Both tablets give a drinking period of approx 10-12 hours from the time you take the tablet. This is not a target in the sense that it gives permission to drink for that time! It is a guide time during which you will be fully protected from the endorphins released from drinking.


Mindful Drinking.

Mindful Drinking has been found to make the TSM process smoother. You will wish to start off on TSM with the most solid foundation you can. Mindful drinking means taking the tablet, waiting the required time and then drinking your first drinks slowly. Recognise and appreciate that the endorphin 'hit' from the drink is missing.

Between drinks, ask yourself if you really want the next drink. Will it satisfy you or are you already satisfied? If the answer is yes, then continue with the next drink, always being mindful. If the answer is no, then act on this new-found ability, and put the drink down. Get up and do something else. This can also be aided by not having the bottle close by as you drink - put it back in the fridge or cupboard so that you have to get up to get the next one.

Until mindful drinking becomes second nature, then it is suggested that you begin TSM with no distractions. When you are ready for that first drink, switch the computer off, the TV off and the phone off. Concentrate solely on you, the drink and your thoughts. If you wish, write down how it feels.


Positive Reinforcement.

On days you don't drink, or when you feel that you can begin to have a day or two without drinking, ensure that you take part in an activity that releases endorphins. This can be a walk, exercise, sex, eating a spicy meal..... anything that is an endorphin releasing activity.

Without the medication blocking your receptors, this 'good' endorphin release will feel particularly good. Over time, the combination of blocking the 'bad' drinking endorphins, but allowing the 'good' endorphins will help swing your brain away from craving alcohol. Your brain will naturally begin to crave what feels rewarding, and since drinking no longer feels rewarding, you will begin to want the activities that do provide good reward.

 
Types of Drinker.

TSM has an extremely successful outcome for the majority of different types of drinkers, providing compliance with the method is followed.  Dr Sinclair's definitive explanation of TSM, along with clinical evidence on its' effectiveness can be found here.  


If you are a daily drinker, continue your normal drinking pattern using the above suggestions.

If you are a binge drinker, it is suggested that you do NOT try white-knuckle your way through the cravings as this will make it almost impossible for you to drink mindfully when you do cave in. Instead, take the tablet at the first sign of craving and employ the above suggestions.