The Sinclair Method: Using Naltrexone For Alcoholism
The Sinclair Method created by Dr. John David Sinclair and publicized by actress Claudia Christian.
Why did we forget about Naltrexone? In the practice of medically-assisted treatment for alcoholism and opioid addiction, naltrexone is rarely prescribed. Yet, several decades ago, naltrexone was promoted as the solution to alcoholism. Somehow, doctors stopped talking about it and stopped prescribing it over the years. Now, thanks to Dr. Sinclair and Claudia Christian, we are talking about it again. While there are controversial elements to Dr. Sinclair’s pharmacological extinction method, The Sinclair Method (TSM) may be one of the most important developments to come along in many years.
When medical doctors are silent.
While it is important to have some faith in our healthcare system, we all have a sense that to some degree, it is heavily influenced by the profit-motivated pharmaceutical companies. When a drug’s patent is expired, we suddenly have a sense that it is old and less effective and may have more side effects. Naltrexone has suffered from this fall into obscurity. Similarly, acamprosate, another medication to treat alcoholism, is now generic and quickly being forgotten. There are always going to be new and improved drugs on the market. Yet, the fact is that some of the older medications are not only still good, they have decades of strong evidence in their favor. Newer meds may turn out to be unsafe or no better than older, proven meds. As an older medication falls out of favor, newer med school graduates don’t see it being used and don’t learn about it. Because of this, naltrexone for alcohol dependence and opioid dependence has almost been forgotten. Doctors don’t offer it, they don’t discuss it, and in many cases, they refuse to prescribe it due to being unfamiliar with it.
Claudia Christian and Larry King.
Larry King discussed the topic of The Sinclair Method with Claudia Christian on a special program about rethinking alcoholism. This was again, a big boost in the discussion of Naltrexone and its potential in treating alcoholism. By reducing alcohol craving, alcohol addiction becomes a more manageable condition. Sinclair describes the effect as pharmacological extinction where the naltrexone interacts with opioid receptors to reduce cravings. This is a big break from traditional alcoholism treatment which does not depend on long-term medication and does not allow for any alcohol intake. Most rehab facilities promote complete abstinence and following the 12-step program of Alcoholics Anonymous. TSM would not be consistent with such programs.
How would it be best to implement Dr. David Sinclair’s method?
The concern with doctors sending patients home to take naltrexone and drink moderately is the risk of relapse. What if it simply does not work? Who is enforcing the protocol. While it is possible for TSM to work at home, it may be best for alcoholics to seek TSM-friendly rehab programs that can provide Dr. Sinclair’s method under strict supervision.
One Little Pill – A Documentary
This movie tells the story about successes with The Sinclair Method. It was made in 2014 and features Dr. David Sinclair and Ms. Christian speaking about how TSM can be used with a 78% success rate for treating alcohol addiction. Ms. Christian gives her account of how she overcame alcoholism with The Sinclair Method. This is a high success rate, compared to non-medical and even medical treatments for various forms of addiction. They talk about how naltrexone can be used in conjunction with limited alcohol intake to modify drinking behavior.
Is the Sinclair Method a safe method?
This is a good question. How safe is it to tell an alcoholic to continue drinking? Traditional thinking on alcoholism is that naltrexone use can help to reduce cravings, but alcohol drinking should be discontinued immediately. Patients should be detoxed and told to not drink alcohol anymore. Heavy drinkers are at risk for serious physical consequences from drinking alcohol. There is the risk of relapse and further dangerous behavior. Yet, what is the success rate of traditional rehab? Clearly, further research must be done on both The Sinclair Method as well as abstinence-based treatment using naltrexone. Placebo-controlled clinical trials should be performed to demonstrate, once and for all, if we should be using The Sinclair Method in mainstream medicine.
Is naltrexone habit forming? Are there serious side effects?
When a doctor tells a patient that they will get a medication to help them quit alcohol, the patient may be concerned they will get addicted to it. For example, if a patient stops drinking and starts using a drug such as Valium, it may be as if they have just traded one addiction for another. In fact, some addiction experts call benzodiazepines, such as valium and Xanax, “alcohol in a pill”. Naltrexone is not in the same category at all as those sedative-type drugs. There is no concern about sedation or getting high from naltrexone. In fact, naltrexone usually has few if any side effects. It is not addicting at all.
Should patients wait to get naltrexone treatment until more studies are done on The Sinclair Method?
No, not at all. Naltrexone is very safe. If you have a problem with excess alcohol consumption, you should see a doctor and get started on Naltrexone. I believe that it is appropriate for the doctor to tell you to stop drinking altogether. The doctor may recommend a brief period of alcohol detoxification. Naltrexone is safe to take right away for most patients. And, most patients can keep taking it long-term.
What about the Vivitrol shot?
Vivitrol is an injectable form of naltrexone. The shot lasts for an entire month. The benefits of Vivitrol is that it is long lasting, so patients do not have to worry about taking the little pill every day. It helps them to not miss daily doses. Also, like Dr. Sinclair and Ms. Christian, Vivitrol has helped to spread the word about naltrexone being a viable treatment for both alcoholism and opioid addiction. Yet, the downside is that Vivitrol is expensive and it can be difficult to get extended insurance coverage. The promotion of Vivitrol has led to the perception that the naltrexone pills are not effective. The fact is that the naltrexone generic tablets are very effective and very affordable.
So, can a little pill really help me to quit alcohol and end my alcohol dependence?
Naltrexone is not a miracle drug. It is an effective treatment that can help many patients. If you are determined to drink alcohol excessively, you may not have success with naltrexone. You may have success if you have made a commitment to quit drinking alcohol and you also take naltrexone to block the opiate receptor and endorphin reinforcement associated with pleasurable activities such as drinking.