Getting Started with The Sinclair Method

TSM is a PROCESS that can take anywhere from 3-12 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.  Pay particular attention to the mindful drinking part of this process as mentioned below.

Dosage

The optimum dosage for naltrexone is usually 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

The optimum dosage for nalmefene (Selincro) is usually one 18mg tablet, two hours 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. Selincro may cause minor skin irritations. Doctors advise their patients to use a pill cutter, and to avoid any contact with the skin.

The medications are at their peak effectiveness for 8-10 hours.  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 protected from the endorphins released from drinking.

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.  Various medical conditions can weaken the response to naltrexone or nalmefene. We are not physicians, so please take advice from a medical physician if you think you may need to explore your dosage options.

Side Effects

As with all medications, some minor side effects can be expected, 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.  Discuss any concerns with your prescribing physician. In most cases, rest assured that these should reduce to nothing over the first week to two weeks.  It may be difficult to differentiate whether any discomfort is caused by the medication, or by a reduction in alcohol consumption.

Mindful Drinking

Mindful drinking often makes 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. Sinclair Method UK Ltd is uniquely placed to help ease you through the entire process of mindful drinking and habit breaking.  Please contact us for guidance.

Between drinks, ask yourself if you really want the next drink. Will it satisfy you or are you satisfied already? 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