Saturday, January 11, 2014

Alcohol, Naltrexone, and Pleasure

Some people say there is zero pleasure in addiction.  Is puking fun?  Are hangovers fun?  Is a spouse's fury fun?  Is waking up on the floor fun?

No, of course these things are not fun.  It's quite obvious that the disadvantages of an addiction outweigh the advantages.  That's why we want to quit.

Some people would have us believe that there is no real pleasure in alcohol at all, that any pleasure we think we feel is actually just relief from the pressure of the addiction.  The writer of Naltrexone Confidential has compared it to scratching an itch and to the "aaaahhhhh" feeling of releasing our bladders after being forced to hold them for a long time -- yes, it's a good feeling, but it doesn't mean that scratching or urinating are fun in themselves.

There is a fair bit of truth to this.  There is relief in ending withdrawal, whether withdrawal is consciously experienced or not.  There is relief in ending the Alcohol Deprivation Effect (a topic for another day).  Unfortunately, it isn't the whole story.  Drinking alcohol really does create pleasure, which is why it's addicting in the first place.  If there were no pleasure, who would ever drink it?  We don't drink it because we're thirsty.

When people say that naltrexone removes the pleasure of drinking alcohol, they aren't talking about some blissful cloud of joy.  They mean the simple physical pleasure.  In all people, alcohol causes the release of endorphins which create that warm glow.  That's what normal drinkers enjoy.  That's what addicted drinkers enjoy during the first few drinks.

That's what is described in scientific literature as "euphoria," which does not have to mean some sort of orgasmic ecstasy.  It simply means a good feeling.

That's what naltrexone blocks.

That's why naltrexone works.  If there were no pleasure in drinking alcohol, blocking opioid receptors would not work to let us unlearn the conditioning that alcohol gives pleasure.

Consider cocaine.  It doesn't stimulate the same receptors as alcohol.  Accordingly, naltrexone doesn't do a darn thing for cocaine addiction.

For the non-addicts reading this, I want to reassure you that your loved one isn't simply choosing a temporary pleasure over you.  If that were so, everyone who ever drank alcohol would be an instant addict.  If that were so, nasty consequences like hangovers would rapidly teach your loved one not to overdrink.  Alcohol addiction is a conditioned behavior learned over time, and at this point is pretty much out of your loved one's control.

We do need to be aware of this natural pleasure response, though.  When we drink alcohol after taking naltrexone, that response will be gone.  Our experience of drinking alcohol will be vastly different.  This is exactly how it's supposed to work; if it weren't different, it wouldn't undo the years of learning that alcohol brings pleasure.

The first time I drank alcohol after taking naltrexone was a shock.  Apparently I have fewer opioid receptors than average, because the 25mg starter dose created a stone wall of 100% coverage around them.  The inner beast was frantic, desperate for that reward, leaping madly towards it but running into that stone wall.

Fortunately, there's no way to untake the pill.  Also fortunately, extinction begins on that first occasion and the second time was softened.

Most people won't have such a dramatic experience.  The starter dose doesn't cover all receptors, and so the response isn't blocked so abruptly.

You must reach that point, though.  Your addiction won't be extinguished unless 100% of the reward is being blocked.  Blocking only part of it will strengthen the addiction, not weaken it.

The "You can still drink!" line works to attract people to the Sinclair Method, but it's misleading to some.  Yes, you can still drink, but you won't enjoy it either as you used to in the early days or as a normal drinker does.

Naltrexone is not a normality pill.  You may feel a bit relaxed and mellow, and you may even like that feeling (most people say they just get sleepy).  You won't feel the warm glow.

Not to worry, though.  Once your addiction is extinguished, you won't miss it.  It may seem unthinkable now, but once your addiction is extinguished, you truly won't care whether or not you ever drink alcohol.

Don't worry.  Just be aware.  If you ditch the method when you realize that you can't have the warm glow, you'll never have the chance to reach indifference.


  1. Just so you all know what you might be in for. When I found, on youtube, an interview with Claudia Christian from Dec. 2012 drunk out of her mind telling people how she was "cured" of alcohol addiction by TSM I emailed her for her side of the story. I emailed her and Gary (the guy who runs Naltrexone Confidential) in a very polite manner. I live in Australia, they in the USA and UK.

    Firstly, I was threatened with legal action by Christian - for no other reason than I caught her out. Then I find that a complaint has been made to my workplace threatening my job!!!

    If this is how people react to being questioned about THEIR behaviour on TSM, then one must ask about the whole thing.

    I will make it my business to alert people to these two and the interview that shows I am right!

    If this is TSM then I am its enemy!

  2. Dave, this is not an appropriate place for this comment. Please repost it under the appropriate post (called "Are uncured people TSM failures?" the one following this), and I'll delete the misplaced one.