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Tuesday, December 31, 2013

My Cure

Constant Reader, you have hearkened unto the tale of my drunken misery.  List now as I tell you how I found the way out, left the cage of alcohol, and became the Unchained Mouse.

Making a Plan


The only glimmer of light was my knowledge that I had abruptly become unaddicted while pregnant.  I had once believed that we chased highs because we had nothing better in our lives, but now I knew better.  Not only did I have a great number of better things in my life, I knew for certain that biochemistry was a vital piece of the puzzle.

That clue led me to targeted naltrexone, aka the Sinclair Method.  I considered baclofen as well, but targeted naltrexone was clearly preferable in several respects:  the drug was safe, it was easy to get, and it wasn't needed forever.  There are other good methods with a strong success rate -- and the most successful ones are eerily unknown -- but the Sinclair Method was the right choice for me.

Commitment mattered.  I decided, wholeheartedly and without reservation, to follow the protocol faithfully for six months no matter what.  There were a few exceptions, such as if I had had one of the rare serious side effects, but those were both so uncommon and so obvious that there was no point in adding disclaimers to the commitment.  Six months.  No matter what.



You Never Forget Your First


On the first time of nal + al, I didn't manage the full hour.  I white-knuckled for 45 minutes before I cracked.  I expected that first beer to bring the usual rush of euphoria, that "aaahhh" feeling that I needed so badly.

Instead, that first time was indescribably frustrating. I craved alcohol desperately and I was drinking alcohol, yet the craving did not abate even slightly.

Fortunately, there's no way to untake the pill.  Once it has been swallowed, the swallower is physiologically unable to feel the euphoric effect of alcohol.  At least for that evening, the drinker is stuck -- and during that evening, the brain takes its first steps towards unlearning the idea that alcohol brings pleasure and relief.  There is no pleasure and no relief.

For that reason, some people try it once and ditch the idea.  They'd hoped that they would still be able to enjoy alcohol, and that the pill would just somehow cause them to have the early a-few-drinks experience without going overboard.  It doesn't work that way.  Drinking on naltrexone is very different from drinking without it.

The commitment mattered.



Seeing It Through


I just had to power through that first time and the next couple after it, based on the strength of my commitment. The good part is that it only requires one instant of willpower, just long enough to swallow the pill.  Well, okay, and a little more to wait for an hour.  Fortunately, no other time is as rough as the first -- extinction begins on that very first night.

Some people build constraints into their lives.  For instance, someone who habitually grabs a drink immediately after getting home from work may take the pill while still at work.  I had no such convenient pattern, but I pushed through it because I had to.  My system was simple:  On one day, take naltrexone and drink.  On the next day, don't take naltrexone and don't drink.

After that first time, which really was rather awful, it became easier.  The second wasn't so bad.  After a surprisingly short time, the drive lessened enough that waiting an hour no longer seemed so onerous.  I even found myself realizing with surprise that, gee whiz, it had already been an hour and I hadn't even been thinking of the upcoming alcohol.  Much of the extinction happened early, and the struggle was blessedly eased long before complete extinction was reached.

A six-month commitment turned out to be overkill in my case.   I'm glad I committed, though.  "Trying" the method could have led to ditching it after that first miserable experience.

I was a relatively fast responder.  I wasn't one of the fabled "three-pill cure" folks, but it was only about five weeks from out-of-control drunkenness to complete extinction of the desire to drink.  In the Sinclair Method's terms, I was cured.



Hey, Wait a Minute . . .


The real kick in the shorts was that I had this idea on my own.  Lo these many years ago, while confined in the Minnesota Model rehab and listening to them rattle on about Higher Powers and dopamine somehow affecting each other, I asked if a dopamine blocker wouldn't take care of this dopamine excess problem.  The big bad addiction rehab expert said no, not unless you took it before you drank . . . which was, of course, precisely what I was asking.  He was just too hung up on Stepping to understand the question.

The other kicker is that knowledge that TSM had been patented in 1989 and deployed clinically since 1991.  Although I would have rejected TSM in early youth, I would gladly have embraced it by my late twenties.  DUIs 3-6 did not have to happen.  The career stall did not have to happen.  The prison term did not have to happen.  The frantic internal struggles did not have to happen.  The threat to the deepest and most meaningful relationship of my life did not have to happen.  Whatever damage my drinking did to my son's preexisting problems did not have to happen.

None of it had to happen.

One pill.  Five weeks with one pill.

Three decades of struggle.  Five weeks of increasingly easy treatment.

Three decades.  Five weeks.

So . . . yeah.  I don't drink and don't want to.  I'm indifferent to it.  I'm cured.

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