You have been searching for a Sinclair Method doctor, which means you probably already know the usual options. You may have tried some of them: meetings that asked you to accept a label, programs that demanded you quit before they would help, and willpower, again and again, until the willpower ran out.
If those methods did not hold, that is not a verdict on your character. In fact, it may simply mean that the method did not match the problem, because the problem lives in brain chemistry, not in willpower.
The Sinclair Method (TSM) takes a different path. It is a medical treatment that works with your brain chemistry instead of against your character, and you do not have to stop drinking to start.
What is the Sinclair Method?
The Sinclair Method is a way of treating alcohol use disorder with naltrexone, a medication that blocks opioid receptors and, by doing so, is thought to block the reward alcohol produces in the brain. You take one naltrexone tablet about one hour before drinking, every time you drink. That is the core of it.
There are no group meetings. There is no label, no requirement to stand up and tell your story, and no demand that you promise never to drink again. There is a medication, a simple rule, and a physician who follows your progress closely.
One safety rule comes before the simple rule. Naltrexone is an opioid blocker, so it is never started in anyone who is taking opioids or is dependent on them, including anyone on Suboxone or methadone, because it can set off severe withdrawal. The question on opioids further down explains why.
Yet, over weeks and months, something happens that most people do not expect. The pull toward alcohol grows weaker, drink by drink, until many people find they simply want it less. This gradual unlearning is called pharmacological extinction, and a longer explanation of it is in The Sinclair Method: using naltrexone for alcoholism.
How does naltrexone taken before drinking retrain your brain?
Alcohol reinforces its own habit. Each drink releases endorphins, the brain’s internal reward chemicals, and each burst of reward strengthens the wiring that says alcohol matters.
Craving is not weakness. It is learning, and what the brain has learned, it can unlearn.
Naltrexone blocks that reward at the receptor level. When you take it one hour before drinking, the alcohol still arrives, but the payoff does not.
So what does the brain do when the reward stops arriving? Think of a vending machine that takes your money and gives nothing back. You might try it a few more times. Eventually, you stop feeding it coins. While this is not a perfect analogy, pharmacological extinction works much the same way: when drinking stops paying, the brain slowly stops asking for it.
This is why the medication is taken before drinking rather than instead of drinking. Each medicated drinking session is not a failure of treatment. It is the treatment.
Why is abstinence not required to begin?
Most treatment asks you to change before it will help you. Quit first, then we will talk. Hit bottom, then you qualify.
The Sinclair Method reverses that order: it helps you first, and change follows. You begin while you are still drinking, because drinking with naltrexone on board is exactly how extinction happens. Neither a detox stay nor a stretch of sobriety is a prerequisite, and the first step can be a telemedicine visit.
This matters for safety, too. A person who has been drinking heavily every day should not stop abruptly, because sudden cessation after long heavy use can be dangerous. A gradual, medically supervised decline is gentler on the body and far more likely to last.
Some addiction medicine organizations, still closely tied to twelve-step thinking, minimize medication approaches like TSM. Dr. Leeds respectfully disagrees. A method that meets people where they are, and works with the brain instead of shaming it, belongs at the front of alcohol treatment, not at the margins.
Still, patients who also attend meetings are welcome to keep attending. The practice does not require meetings and does not make them part of the medical treatment, and nothing here asks anyone to give up what is helping.
Is the Sinclair Method only for severe alcohol use disorder?
No. In fact, this approach suits people across the whole range of drinking concerns.
It helps people with alcohol use disorder, including those who have tried to quit many times. It also helps people in the territory often called gray area drinking: no dramatic bottom, no crisis, just a nightly habit that has grown larger than you want and harder to put down.
You do not need to qualify for a diagnosis to deserve help. If drinking takes more from you than it gives, that is reason enough.
One more distinction shapes everything Dr. Leeds does: physical dependence is not addiction, and with alcohol the two often travel together. The Sinclair Method addresses both at once, gradually tapering the dependence and the learned behavior in the same slow motion. It follows the principle behind every service in this practice: when a gradual medical path exists, use it.
What can you do when your spouse or partner cannot stop drinking?
If you are reading this page for someone else, start here. A spouse or partner who cannot stop drinking is not doing it to hurt you, and they are not doing it to the family. They have a medical condition, driven by craving and compulsion, and once the first drink of the evening is poured, the condition often decides how the evening ends.
The advice families are usually given is tough love: withdraw support, issue ultimatums, and put the person out until they hit bottom. Unfortunately, tough love is not just ineffective. It is dangerous. Kicking a person out or cutting off basic support pushes them away, often into exactly the circumstances where people get hurt, and if you are too forceful, you will lose the conversation entirely.
Harm reduction is the better frame. Harm reduction means protecting a person’s safety until they can get out of harm’s way, and for a family it means learning what keeps your partner safe tonight while the longer work of treatment begins. That is support without pushing them away, and it is what Dr. Leeds asks of families.
And looking after your own safety and your own sleep is not abandoning your partner. It is what keeps you able to help.
Treatment can begin at home, while your partner is still drinking.
Fortunately, getting help for a partner who cannot stop drinking does not mean sending them away. Naltrexone under the Sinclair Method can begin at home, by telemedicine, while your partner is still drinking, with no rehab stay and no time away from work or the children.
You do not have to wait for your partner to be ready before you learn the options. A concerned spouse or family member can have a confidential consultation with Dr. Leeds to understand how the treatment works before ever raising it at home, and a more informed conversation is a calmer one. Later, a family member invited by the patient is welcome at visits, though never required.
Some situations are emergencies, and nothing on this page should delay a call to 911: a person who cannot be woken or is breathing slowly after drinking, an injury or a fall, or severe confusion, hallucinations, fever, an irregular heartbeat, or a seizure after a heavy daily drinker stops or cuts back suddenly. Get emergency care first. If anyone in the house is thinking about suicide, call or text 988, the Suicide and Crisis Lifeline, at any hour. The treatment conversation can wait until everyone is safe.
What is it like to work with a Sinclair Method doctor?
For the person who will be taking the medication, this is what the practice looks like. Dr. Leeds runs a concierge telemedicine practice. You work directly with Dr. Leeds at every appointment, never a substitute provider, a coach, or a rotating cast of strangers.
Appointments are weekly, by video or audio, and can run up to an hour. Between visits, you have 24/7 text access for urgent questions, and treatment happens from your own home, on your own schedule, in complete privacy. In-office visits are available in Fort Lauderdale for patients who prefer them.
There are no group meetings, ever. Dr. Leeds treats patients as intelligent partners who set the pace and direction of their own care, and he counsels and coaches within the medical visits themselves, toward the activities and interests that make life feel worth changing. There is no separate counseling program, and patients who also want a therapist are referred out.
Some patients follow TSM while continuing to drink. Others prefer taking naltrexone daily as part of an abstinence-based plan. Both paths are respected, and the whole program can be delivered remotely: you can read more about starting naltrexone and the Sinclair Method by telemedicine, including what the first weeks look like.
Frequently asked questions
What is the first step?
A telemedicine visit. You do not have to hit bottom, call yourself an ‘alcoholic’, or check into a residential program before you qualify. You start where you are, with naltrexone taken before you drink, and you keep living your life while the craving is extinguished over months rather than in one dramatic week.
How do I know if a Sinclair Method doctor is the right fit for me?
A Sinclair Method doctor should offer time, privacy, and a plan built around you. Dr. Leeds provides weekly appointments of up to an hour, 24/7 text access between visits, and no group meetings of any kind. If you want a physician who treats you as a partner rather than a case file, that is the fit to look for.
How long does the Sinclair Method take to reduce cravings?
Pharmacological extinction is gradual by design. Many people notice their drinking pattern loosening over the first months, and the deeper change tends to come later, on a timeline that varies from person to person and that no one can promise in advance. Dr. Leeds tracks progress with you week by week.
Do I have to attend meetings or accept a label to start the Sinclair Method?
No. There are no group meetings in this practice, and you will never be asked to introduce yourself by a diagnosis. The Sinclair Method here is a private medical treatment between you and your physician.
Is the Sinclair Method an option for gray area drinking?
Yes. Gray area drinking, the space between social drinking and severe alcohol use disorder, is well suited to this approach in Dr. Leeds’ experience. You do not need to wait for things to get worse before getting help.
Can I take naltrexone if I use opioids or take Suboxone?
No, and this is the one hard stop in the method. Naltrexone is an opioid antagonist, meaning it blocks opioid receptors, and the FDA prescribing information for naltrexone tablets lists it as contraindicated in anyone taking opioid pain medication, anyone physically dependent on opioids, including people maintained on buprenorphine (Suboxone) or methadone, and anyone in acute opioid withdrawal.
The reason is precipitated withdrawal. In an opioid-dependent person, a blocker displaces the opioid from its receptors quickly, all at once as far as the body is concerned, and the label warns that the resulting withdrawal can be severe enough to require hospitalization. The label recommends an opioid-free interval of at least 7 to 10 days before starting, including tramadol and opioid-containing cough or diarrhea medicines, and notes that people coming off buprenorphine or methadone can remain vulnerable for as long as two weeks.
So, Dr. Leeds asks about every opioid, including pain prescriptions, before naltrexone is prescribed. If you take buprenorphine for opioid dependence, that treatment stays in place, and the question of alcohol is handled in a consultation, where other approaches can be discussed.
The label carries two more warnings. After naltrexone is stopped, tolerance to opioids is lower and an old dose can cause an overdose, and trying to override the blockade with a large opioid dose can cause coma or death. If you ever need emergency care while taking naltrexone, tell the treating doctor, because opioid pain medication will not work as expected.
Can the Sinclair Method lead to stopping alcohol completely?
It can. As cravings fade, some people settle into occasional drinking that no longer runs their week, while others discover they no longer want alcohol at all and choose abstinence. Naltrexone can also be taken daily from the start for people whose goal is not to drink. The goal belongs to you, not to a program.
How to begin
To begin, send a message through the contact form at drleeds.com. An initial consultation is the usual first step, for the person who is drinking or for a spouse or family member who wants to understand the options first. Consultations are paid sessions, by video or audio, and they are discussions rather than medical visits, so they do not establish a physician-patient relationship. Prescribing and ongoing medical management with naltrexone are available to patients located in Florida.
You have already done the hardest part, which is looking for a better way. The next step is one message.
This article is educational. It is not medical advice, and reading it does not create a doctor-patient relationship. Decisions about starting, continuing, or tapering any medication should be made with your own physician.
About the physician
Dr. Leeds is an osteopathic physician providing concierge telemedicine care focused on benzodiazepine and z-drug tapering, psychiatric medication deprescribing, opioid dependence treatment, and alcohol use disorder. Dr. Leeds works directly with each patient, with weekly appointments and 24/7 text access between visits. He serves on the medical advisory board of the Benzodiazepine Information Coalition and hosts The Rehab Podcast on the Mental Health News Radio Network. Medical management is available for patients in Florida. An initial consultation is the usual first step.