How the Sinclair Method Works

What is the Sinclair Method?

Knowledge of alcohol’s effects on the brain has paved the way for drug-based therapies. One of them is the Sinclair Method (TSM).

The method is a medication-assisted treatment named after its creator, Dr. John David Sinclair. It’s commonly used in several European countries but isn’t as popular in the U.S. 

The Sinclair Method uses naltrexone. This is a drug that blocks the pleasurable effects caused by alcohol. 

The goal is to gradually lose interest in alcohol over time, leading to complete abandonment of drinking habits. 

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How Does the Sinclair Method Work?

The Sinclair Method has three basic principles:¹

1. You still drink alcohol while taking naltrexone: The drug won’t work if you abstain from alcohol before or during treatment. 
2. Only take naltrexone if you will be drinking: You should take naltrexone one hour before drinking. Then, you’re free to drink as you wish.
3. Continue the treatment indefinitely: Studies have shown that naltrexone is safe and effective for curbing alcohol cravings. You won’t experience withdrawal symptoms if you stop both alcohol and naltrexone. However, you may relapse if you drink again without naltrexone.

Alcohol Abstinence and The Sinclair Method

Naltrexone works by blocking the pleasurable effects associated with drinking alcohol. You’ll reduce your consumption until you completely lose interest in alcohol.

The Sinclair Method does not require you to stop drinking. This is because naltrexone won’t work if you take it during abstinence. In other words, it’s used to curb alcohol cravings, so the alcohol needs to be present. 

This is also true for similar drugs like naloxone and nalmefene.^{1, 2}

Pharmacological Extinction

The Sinclair Method uses a mechanism called ‘pharmacological extinction.’ 

Those who drink heavily are conditioned to crave alcohol. But since naltrexone blocks alcohol’s pleasurable effects, the desire to drink decreases. 

As a result, many people taking naltrexone reduce their drinking until they no longer do it on a dangerous level. Some may eventually stop the habit altogether. 

Naltrexone won’t be effective if you abstain from alcohol before or during treatment. This is because naltrexone won’t have any effects to block. In other words, the process of pharmacological extinction won’t happen. 

The Sinclair Method does not always cause people to quit drinking alcohol completely. It may just help them moderate their drinking.

What is Naltrexone?

Naltrexone is a medication used for treating both opioid and alcohol use disorders. It can be taken as a pill or injectable.

It’s an opioid antagonist that blocks opioid receptors in the brain. This means you won’t feel the euphoric and sedative effects of opioids. Some examples of opioids are heroin, morphine, opium, and oxycodone.

Naltrexone has been used for treating opioid addiction since the 1980s. It also has a similar effect against alcohol addiction.³

In 1994, the U.S. Food and Drug Administration (FDA) approved naltrexone for alcohol addiction treatment. In 1996, the World Health Organization (WHO) released a publication about the safety and effectiveness of naltrexone for treating alcohol dependence.^{1, 4, 5} 

Naltrexone isn’t addictive. The medication doesn’t activate the euphoric feeling caused by addictive drugs. It also doesn’t prevent you from getting drunk. 

Unlike disulfiram, naltrexone doesn’t make you feel sick when drinking. It just blocks alcohol’s pleasurable effects and trains the brain not to expect anything from drinking.

Side Effects of Naltrexone

Naltrexone may cause side effects like:⁶

• Stomach problems, like vomiting, stomach upset, and diarrhea
• Headache
• Joint or muscle pain
• Nervousness
• Exhaustion
• Sleep problems

If you experience any of these symptoms, stop taking naltrexone. Consult your doctor to adjust the dosage or change the medication. 

How to Take Naltrexone

Here are some general directions on taking naltrexone:⁷

• Take a pill once a day, an hour before you drink 
• Don’t skip pills
• Don’t take extra pills
• Don’t stop the medication without your doctor’s advice
• Follow other instructions from your doctor

Naltrexone’s Interaction with Other Drugs

Opioids are also pain relievers. Naltrexone will block not only the euphoric feeling but also the sedative effects of opioids. 

Those who take naltrexone should inform their doctors, surgeons, or dentists. They will be given other non-opioid pain relievers for injuries or medical procedures.

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How Long Does the Sinclair Method Process Take?

The effects of the Sinclair Method may kick in within a few months to more than a year. Some people feel an immediate decline in alcohol cravings. For others, the change is gradual. 

While the time varies, most people eventually lose interest in alcohol.

In most cases, people take naltrexone for at least 12 weeks. However, doctors decide the duration of use based on needs.⁷ 

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How Effective is the Sinclair Method?

This approach gives people a choice: to abstain or to moderate their drinking habits.

The Sinclair Method has a 78% long-term success rate. This is significantly higher than most traditional alcohol treatments.¹ 

Can You Do the Sinclair Method By Yourself?

It’s possible. However, the Sinclair Method requires utmost patience, self-discipline, and a positive outlook. Better results are usually seen in those with supervision. 

If you decide to apply this approach by yourself, ensure that you follow the directions. Also, only buy naltrexone from reputable sources. 

Alternative Addiction Treatment Options

While the Sinclair Method is effective for certain people, it’s not a complete cure for alcohol addiction. Other people don’t even respond to naltrexone. 

Here are some other treatments for alcohol addiction:

Behavioral Treatments

These approaches are also called alcohol counseling. There are several types:⁸

• Cognitive behavioral therapy (CBT): This is done one-on-one with a therapist or in small groups. The focus of this therapy is to identify the feelings and situations that led to alcohol misuse. You are also encouraged to develop coping skills in situations that might trigger alcohol problems.
• Motivational enhancement therapy (MET): This is conducted over a short period. The focus is to identify the pros and cons of seeking treatment, make a change plan, and develop skills to stick to that plan.
• Marital and family counseling: This involves spouses and other family members. Studies have shown that solid family support increases the chances of maintaining abstinence as compared to individual counseling.
• Brief interventions: These are short and time-limited sessions. They can be done one-on-one or in small groups. The counselor provides details about your drinking behavior. Then, you’ll get feedback and work with the counselor.

Medications

Aside from naltrexone, there are two other medications approved in the U.S. for alcohol addiction:

1. Disulfiram: It blocks alcohol metabolism. This action can cause unpleasant effects like nausea and skin flushing. These undesirable effects may lead you to stop drinking.
2. Acamprosate: This drug is used to maintain abstinence among alcohol-dependent people who no longer drink.

Naltrexone, disulfiram, and acamprosate can be used alone or in combination with behavioral treatments. However, not all people respond to medications. 

Mutual Support Groups

Some people find joining mutual support or self-help groups helpful. Examples of such groups are Alcoholics Anonymous (AA) and other 12-step programs. 

The group members share alcohol-related problems and help each other voluntarily. Joining these groups will be more effective if combined with professional-led treatments.