Part 2 of a 3 part series

Read the complete series of Will’s Journey to overcome alcohol addiction without completely giving it up.

In a previous part of this series, I told you about the process by which I came to realize that I had a problem with alcohol, as well as some of the things that kept me from addressing that problem sooner than I did. In this part of the series, I want to share with you my process of learning about naltrexone and the Sinclair Method, as well as my experiences of going through it over the past several months.

To start with, then, let me give you a little back story that picks up right after I finally admitted that I had a problem with alcohol and needed to do something about it.

As is often the case in life, it was the fortunate coincidence of several random events that came together and pushed me towards considering a new path. In this particular case, it was the kind guidance of a couple of people that nudged me in the right direction. To make a long and very personal story both short and impersonal, I had the good fortune to trip across two very caring people who just happened to have experience with naltrexone as a way to address alcohol dependence issues, and who shared some good resources that helped me chart my own path forward.

One of the people, an acquaintance of mine with a background in neuroscience, pointed me in the direction of a lot of the peer-reviewed literature surrounding addiction and naltrexone based treatments. Some of that information is distilled and represented in the this part of this series to help explain why this particular drug and the Sinclair Method works the way it does. 

The other person who helped me has a very different background and perspective (rooted more in personal experience) and pointed me to some excellent resources from more easily digestible sources. Top on that list was an episode of the remarkable podcast “Radiolab” (Y’all should listen to some of their episodes even if you’re not interested in this particular topic!), and a film produced by a group whose mission was to get the message out about naltrexone and the Sinclair Method. The Radiolab episode, titled “The Fix” can be found here and is free to listen to. The film, “One Little Pill,” can be obtained here for a small cost. Your local library may also have it available for free (mine did!). The C Three and Sinclair Method foundations that produced the film have a wealth of information on naltrexone and the Sinclair Method available for free here and here. For anyone who would like to access primary scientific literature on it, this is a good general introduction written by Dr. Sinclair himself. 

I recommend anyone thinking of engaging with the Sinclair Method listen to the podcast and watch the movie at the very least. The movie will give a good sense of what the possibilities are. The podcast, which covers the general use of naltrexone for alcohol abuse rather than the Sinclair Method specifically,  will give some more background on the science behind the process, a sense of the possibilities, as well as a story from from at least one person for whom naltrexone use did not work.

For me, after doing a fair amount of reading, I realized that the Sinclair Method might be uniquely suited to help me address my problem. After all, it was designed to both encourage reduced levels of alcohol consumption and still allow for continued consumption in a controlled fashion. That latter piece was essential to me, due to my links to the craft beer industry, not to mention my hobbies and social circles. Again, if I had to make a choice between abstinence based treatment and my friends/hobbies/work, I know full well which way that choice would have gone. It would not have gone well…

Having identified a treatment that I thought would work for me led to one of the more difficult parts of the process: Convincing my doctor that this was a valid method and that he should write me a prescription for naltrexone.

For any of you who elect to try the Sinclair Method, you may very quickly find out just how poorly known it is in the medical community. My physician had vaguely heard of naltrexone (though there was some confusion with naloxone, which is a much more ‘serious’ drug used specifically for drug addiction problems), but had definitely not ever heard of its use for treatment of alcohol dependence or abuse. He called up a colleague who specialized in addiction medicine, and she had never heard of it either. She was skeptical of the whole idea, to boot. Fortunately, my doctor is one who is open to conversations about different treatment options, is willing to read literature that I give him, and trusts my opinions due to my background in biochemistry. So, I was able to convince him to let me give it a try. 

If you have this conversation with your doctor, I advise you to go in ‘armed’ with resources for them to learn from, and to emphasize that naltrexone is safe, has no significant side effects, is inexpensive, and is commonly used internationally as a treatment for alcohol abuse. Based on various discussion threads on online forums I have found, these may not be sufficient to convince all doctors, and you might have to talk to a couple before you find one who is willing to give it a try. The C Three foundation link I gave you above does have some resources for finding physicians who are ‘naltrexone aware’, should you need assistance in finding a doctor who understands the medicine and is willing to consider prescribing it. One of my friends who put me on this path went similarly armed to her doctor’s appointment, ready to do battle, only to find that naltrexone is now a covered treatment for alcohol use disorders at Kaiser Permanente, which goes to show that there is progress being made in the US medical establishment on alcohol use disorder treatment options. Knowing a major medical provider now covers naltrexone specifically for alcohol use disorder may also be of interest to hesitant doctors who have not heard of it before.

Once I had convinced my doc to give it a try, it was all ‘downhill’ from there. And, I mean ‘downhill’ in the best possible sense. While there were occasional bumps in the road, and unexpected experiences along the way, the protocol worked almost exactly as described in the “One Little Pill” film. I was pleasantly surprised at how well it went.

So, what happened?

Well, day one was… uneventful. I popped the naltrexone pill, and nothing much happened. I waited an hour, and the only odd thing I experienced was a feeling a bit like … a major caffeine rush? Some jittery feelings, a bit of anxious energy, that sort of thing. But, that passed pretty quickly as I had my first drink for the night.

For that first night, nothing seemed to change about my drinking. One drink turned into two, then three, then… seven. I still got the same rush out of the first couple of drinks that I normally did, and I still felt just as terrible the next morning as I usually did. So, just another day with a drinking problem.

Day 2 seemed a lot like day 1, but … less. Less jittery-ness after taking the pill. Less rush after my first drink, and less desire to drink. Progress! After my fourth drink of the night, I was just kinda … done. I was definitely intoxicated (per normal), but the intoxication was not masked by the rush that normally came with it. Without that warm rush that I normally got at the start of a night of drinking, being drunk did not feel as nice as it had before. Suddenly, I felt drunk – in all its hideous glory. That pretty much stopped me from wanting any more alcohol for the night. So, already an improvement. Almost a 50% decrease in consumption.

Days 3 and 4 were a bit rough. I’m not gonna lie. I spent a lot of both days pretty nauseous and didn’t want much to eat as a result. This could be a coincidence, but both friends I knew who had taken naltrexone remembered the same thing when I mentioned it to them. So, the nasuea was likely a short term side effect of the naltrexone. I still had the desire to drink, even if I didn’t want to eat, and dutifully put away 3 drinks each of these nights. But, again, after 3, I was done. I had no desire for a fourth – something that had not happened for years previously.

After day 4, things smoothed out. The nausea went away, and life returned to normal as far as how I generally felt. What did not return to normal was my desire for alcohol. It’s not as though it was like a switch flipped off with my desire, or anything like that. But, in general, my desire for alcohol was drastically reduced. On any given night, I’d have one or two drinks. If something stressful happened, or if a friend came over to do a bottle share, I might have 3 drinks. But, in all cases, I was drinking much less than I used to and it was easy to do. I don’t remember the last time I had just a single drink and didn’t spend the rest of the night pining for more. But now, I’d pour myself a beer, and that beer would last for an hour or more before I finished it. When it was done, I had no thought of “what’s next?”, which was always the case before.

Interestingly, the other thing that changed over the next weeks was the amount of time I spent thinking about drinking when I wasn’t drinking. In the past, by 11am or noon, I was already thinking about what beers I had at home to try, or what I’d be picking up on the way home to enjoy that night. Was it a beer night? A wine night? A whiskey night? How much was in my budget and how ‘nice’ could my bottles for the night be? Alcohol was in my thoughts from late morning until bedtime most days. But, not any more! 

I noticed a continual shift where, as each week went by, it became later and later in the day that I thought about what drink I’d be having that night. (Notice the singular form of drink there? Yeah. That was a big shift too!) In a lot of cases, I was actually annoyed that I had to make time to stop at the liquor store on the way home to get something so I had something to drink that night in order to continue the protocol of drinking while taking naltrexone. How weird was that???

By just a few weeks into the process, I already had a new normal established. What’s more, it took almost no effort at all to slip into it. It just happened. Amazing.

Now, I’d love to tell you that it was smooth sailing from there on out, but that’s just not the case. Like many (most?) people who undertake programs to address their issues with alcohol, I had my stumbles. I’d be remiss if I didn’t share that little factoid.

One such slip was a camping trip about two and a half months into the program, where a cold night around the fire led to not paying attention to quite how much whiskey I was ‘warming up’ with. This is where I learned an important lesson along the way: Tolerance for alcohol drops off fast when your consumption decreases. At that point, I had been a 1-2 drink a day person for a solid month and a half. Suddenly slipping back to a night of 7+ was… painful. Not only did my body not handle alcohol as well as it used to, none of the ill effects were masked by the high I used to get, since that was held in check by the naltrexone. That was a rough night, to be sure.

That night led to an important realization, however. That was: “Slip ups” are not nearly such a big deal under the Sinclair Method as they are in an abstinence based program. Sure, I drank too much that night. I drank more than I wanted to. I was upset with myself and somewhat embarrassed at my mistake.  But, the feelings of guilt and setback were minimal at best. The unpleasant drunkeness and hangover reminded me why I was trying to reduce my consumption – in spades! As a result, the desire to drink again was lower than it had been the day before. I simply recognized my mistake and resumed my path forward. There was no “come to Jesus” moment, no necessary admission of ‘failure’, no ‘starting over’. Just a solid check-in with myself, a return to the program, and a return to progress. Wow.

So, yes, there have been slips along the way – more than just that one. On the other hand, the successes have outweighed the slips by many, many times over. 

With all that in mind, you might be asking: Where am I at this point?

Well, I’m five months into the program. My drink consumption has changed from 6-8 per night down to 1 or two every other night, at most. Nights when I’m by myself and decide to drink, I’ll have either no drinks or one with dinner. I’ll have that drink because I want the taste, not because I feel an urge, or because I need the rush I used to get. Nights when I’m with friends at dinner, I might have 2-3 drinks. But, those will be spread over 4-6 hours. I used to routinely put ‘em away with friends at about a drink per 45 minutes or an hour. 

In terms of self-control when alcohol is present, I have been pleasantly surprised as well. I just got back from a fairly long trip to the Carribean. Lots of snorkeling, diving, and sitting on the beach for hours were the order of the trip. For those that don’t know, on diving and snorkeling trips in the Carribean, rum punch flows like water after the day’s activity is done. Hand up your mask and fins to the folks on the boat, and they practically hand back down a cup of rum punch while you’re still climbing aboard. Prior to starting this program, there’s no way I’d have said, “No,” and no way I would have returned to the dock in any state resembling sober. Not so this time. I found it pretty easy to skip the whole rum punch thing (it’s actually kinda nasty when you’re not buzzed from the alcohol, as it turns out). Similarly, sitting in beach front bars down there, beers tend to come by the bucket, not the bottle. I’ll admit it. I ordered a couple of buckets while chilling on the beach and reading. Oddly, though, I didn’t drink them. I’d enjoy one or two while I read my book and then not want any more. I’d take ‘em with me back to my room to “save for later.” As often as not, they were still there when I checked out of the room in a day or two. Again, this would have never happened six months ago, and here it happened with relative ease.  It’s not that I no longer enjoyed having a cold beer while relaxing in the sun. That was still great! It’s just that I could do that in a much more… relaxed fashion – spending more time reading my book or watching the world go by and less time with the beer in my hand or at my lips. To be able to go on a long vacation and work through hours and hours of unstructured time and not turn to the bottle was a new, and very nice, experience.

To really put things in perspective, after returning home from that trip and having another month of naltrexone use under my belt, my desire for alcohol is lower than ever. I now find that a bottle of wine, once opened, might last several days before I finish it. I have a bottle of my favorite Belgian strong dark sitting in the fridge. It’s been sitting there untouched for 4 days now – and not because I had a pile of other things to drink instead. I simply haven’t gotten around to it. Again, that never would have happened six months ago.

The one interesting thing I’ve run into that I still don’t quite know how to parse, is coming to terms with how marginal I find a lot of the craft beers to be now that the pleasure/reward system is not firing when I drink them. Don’t get me wrong! The beers that used to be my favorites and that I used to rave about still taste sooooo good. But, there are a lot of beers that, had I drunk them six months ago, I would have thought, “Meh. It’s not bad. Probably won’t buy another one of those, but definitely worth drinking. Let no craft beer go to waste!” Now? It’s more like, “Meh. That’s not really a good example of the style. I’m just not into this beer. I’d rather not finish it and instead ‘save’ that drink for something I really enjoy.” 

Yes, I’ll confess: I’ve dumped more beers in the last five months than I did in the five years before that. But, I didn’t enjoy them, and they weren’t good beers. So, why waste my health on something that does not bring me joy?  It will be interesting to see how this impacts my beer judging activities this coming year…

Outside of measuring success by the simple metric of consumption rate, I can also tell you that a lot of the things that forced me to face my problem with alcohol have also turned around. My weight is back down to where it was 30 years ago when I was a competitive athlete in college. My borderline hypertensive blood pressure has nearly disappeared. I have more energy in the mornings and evenings so I can easily make the time and effort to get back on my bike or my skis and enjoy getting out into nature.

Basically, I’m seeing the tide turn in a lot of unfortunate trends that were tied to my alcohol consumption. And, again, these things have been happening naturally and with not a lot of conscious effort on my part, as the extinction process has been taking hold. It’s really rather stunning.

I guess the final thing I’ll share is this: I have no illusions about where I am. I’m still at the beginning of the road for my transition to re-acquiring healthier and more normal drinking habits. I have about 4 months to go before the extinction process should be done. I can’t tell you I’m a “success” or that I’m “done” with the program. I can’t tell you I’ll never have a problem again in the future.  But, I can tell you that I have a level of control over my drinking that I have not had for probably a decade. I’ve been able to get there with relatively little struggle or sacrifice. Most importantly, I feel like I can pretty easily stay on the path I’m on, all the while not having to say goodbye to my hobbies, my industry related work, my volunteer activities, or any of my friends in the craft world. Those false choices I thought I had to make in order to address my problem turned out to be just that: false. I can have my sobriety and my relationship with one of the best communities of people I have ever had the pleasure of meeting. For that, I have naltrexone and the Sinclair Method to thank. For that, I am forever in debt to a couple of really good people who nudged me onto the right path at the right time.

If you or anyone you know is struggling like I did before embarking on this journey and you think this information could help them, please pass it along. For anyone considering pursuing this route, please have an honest conversation with a doctor who understands the issues surrounding substance abuse and withdrawal. If there are any questions I can answer or any support I can give on a more personal level, please do not hesitate to reach out.

Editors Note: Sommbeer.com is not providing nor is capable of providing medical advice. Further, we are not receiving compensation of any sort from this article. We do believe that change comes from within and that there are many many workers within the craft industry (and world at large) that suffer from alcohol dependency. The hurt extends to friends and family. If this series positively impacts even just one person – it will be worth it.

PART 3 – Retraining the Brain to Fight Alcoholism

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Will Deutschman

I'm a college professor with expertise in biochemistry who gave up doing 'hardcore' biochemistry for brewing science research a few years back. Now I study yeast metabolism and sugar mobilization in malt. Working with students, we have been able to present our findings at professional conferences like the World Brewing Congress and American Society of Brewing Chemists annual meetings. Introducing students to the science behind beer is one of my favorite things to do in the world.

Outside of my "professional" life, I'm a BJCP certified judge, I bike and ski everywhere at every chance I get, and after a day of that, love chilling on the couch with my 2 dogs and 1 cat.

I also salve my need for intellectual challenge by designing and building fun brewing related projects, the best of which is my 100% solar powered brewing setup. #NerdAlert.

Latest posts by Will Deutschman (see all)

• Retraining the Brain to Fight Alcoholism using Naltrexone and the Sinclair Method - 01/02/2020
• My Experiences with the Sinclair Method and Naltrexone to Reduce My Alcohol Consumption - 01/02/2020
• An open letter from a craft beer enthusiast, a sporadic beer blog contributor, a brewing science scholar, a beer judge… and an alcoholic - 01/02/2020