The Sinclair Method (TSM) is a doctor-led approach that uses the body’s own ability to unlearn addictive behaviours. By harnessing a process called “pharmacological extinction”, TSM helps individuals regain control over alcohol, reducing cravings and harmful drinking without requiring abstinence from day one.
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A clinician checks your health, medicines and suitability before prescribing.
Follow the dosing and timing instructions your prescriber gives you. The approach aims to reduce alcohol’s reinforcing effect over time.
Your coach helps you notice habits, work through practical difficulties and follow your plan.
TSM is based on decades of scientific research into how the brain’s opioid system reinforces drinking. Through targeted medication and behavioural change, this method empowers lasting freedom from alcohol dependence.
As defined by Dr John David Sinclair: “The Sinclair Method uses the nervous system’s own mechanism, called ‘extinction’, for gradually removing the interest in alcohol and the behaviours involved in alcohol drinking. Therefore, the technical term for TSM is ‘pharmacological extinction.’”
Decades of research revealed that alcohol dependence is not simply about withdrawal or deprivation. Alcohol drinking is a learned behaviour, reinforced in the brain’s opioid system each time alcohol is consumed. For some, genetic factors and repeated reinforcement make quitting extremely difficult, even when the consequences are serious.
Drinking alcohol triggers the release of endorphins, your body’s natural opioids in the brain. These endorphins activate the brain’s opioid system, which reinforces the desire to drink and leads to powerful cravings and compulsion.
The Sinclair Method interrupts this process by using a prescribed medication to block opioid receptors. When you take naltrexone before drinking, alcohol’s reward effect is blocked. This process, known as pharmacological extinction, retrains your brain over time so that drinking becomes less desirable and control is gradually restored.
Pavlov’s learning experiments offer an analogy for how associations can change. The analogy helps explain the idea; it is not clinical proof of this treatment’s effectiveness.
A doctor checks suitability and explains how and when to take the medicine before drinking. Follow your own prescription.
The treatment aims to reduce the rewarding effects that reinforce drinking. You still feel the alcohol: it does not prevent intoxication.
With treatment and practical support, the pull of alcohol can weaken over time. Progress differs between people.
An explanation of the approach, not personal medical advice. A doctor decides whether treatment is suitable; a coach supports you through your programme.
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An introduction to the Sinclair Method, clinical assessment and the coaching support around treatment.
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In the follow-on reviews, 75% reported drinking less, including 44% significantly less. These reports do not predict an individual outcome.
Patient-reported, unaudited outcomes from 664 follow-on reviews with 514 SMUK patients, October 2020–October 2026. These are responses from patients continuing in treatment, not a controlled trial or a success rate for everyone who starts. The control and wider-benefit figures come from 210 online forms. Individual results vary.
See the patient-reported results and press features →Read more: A beginner’s guide to the Sinclair Method · How habits and support fit into treatment
Naltrexone has a clinical evidence base for alcohol dependence. That does not make every naltrexone study a trial of the Sinclair Method or of SMUK’s programme.
NICE guidance on alcohol dependence covers prescribing alongside psychological support; it is not an endorsement of SMUK.
Speak first with a senior coach. Dr Rachael Jolley and Dr Janey Merron provide the medical assessment and prescribing decisions. Meet the people involved in your care.
Meet the team
A 15-minute conversation with a senior coach. Ask questions, explain what you want to change and decide whether to go further.
If you choose to go ahead, a UK-registered doctor reviews your health and medicines and decides whether treatment is suitable.
If prescribed, arrange your medication with the dispensing pharmacy. Medication is paid for separately from the programme.
Your coaching, practical learning and private community help you work through your programme.
Onboarding is usually within 48 hours, subject to suitability, your availability and clinical availability.
DOCTOR-LED CARE
EVIDENCE-BASED RECOVERY NO FORCED
ABSTINENCE
PERSONALISED TREATMENT PLANS TRUSTED
CLINICAL EXPERTS SUPPORT
EVERY STEP
Free. 15 minutes. A conversation, with no obligation.
The Cure For
Alcoholism