No worries, Larry, TSM IS real. It hasn't become well known for a variety of factors. Let's address that first.
One, despite the cost of the pills ($5 each here in Canada), the drug is no longer owned and patented by one single pharmaceutical company; no monopoly = no massive profit incentive to promote it, so they simply don't care because they can't make billions of dollars from Nal like they can with other newer drugs. The sales reps are not encouraged, then, to promote it to the doctors.
Two, there is a fair bit of background knowledge and information that the doctors themselves have to learn in order to understand how Nal works (the Extinction process etc.) Believe it or not most Family physicians depend on the Pharmaceutical sales reps to educate them about the new drugs they are promoting. Since Naltrexone is not promoted as I described above, the sales reps have little incentive to push Nal, especially given the limited time they have in front of the doctor, which is 5 to 10 minutes tops. They need to push the newer patented profitable drugs in order to keep their jobs---and to make the big bucks for themselves and their companies.
Third, many doctors cannot in good conscience prescribe Nal---and encourage---their patients to keep drinking! Imagine the guy who gets drunk while taking Nal and kills a few people in a car accident on his way home. The Insurance company representing the ones killed will be thrilled to know that the guys doctor told him to drink!!! See the complication/conflict for the prescribing doctor here?
Fourth, while Dr. Eskapa's book (The Cure for Alcoholism) states that the Sinclair Method has a 75 to 80% success rate, the fact is that in real life, out here away from the scientific controlled medical studies, the "real" success rate is closer to 30%. The main reason for that 50% difference is due to what the medical field calls, "Patient Compliance". Did you know that of all the people who are suffering from chronic diseases in developed countries like ours, that only about 50% actually do what the doctors tell them to do!? Only HALF the people take the medication as prescribed or do the other things the doctors tell them to do! This is one of the biggest problems that doctors are faced with....just getting the patient to do the things they say in order to get well. Naltrexone patients are no exception to this sad fact of human nature! But don't let that 30% statistic frighten you! If you take your Nal as prescribed and as described in Eskapa's book absolutely and without fail (like
never forget to take the Nal at least an hour before you drink---never, ever, forever) then YOUR personal compliance to that puts your chance of success back up into the 75 to 80% range!!! That's how it works.
So there you go, Larry....that's why The Sinclair Method hasn't stormed the world---yet. I think that in time it will, as it slowly but surely becomes better known, through expanded physician education, and as the results are widely seen and demonstrated in people just like you and me. We may all need to do a little bit of our own shouting from the roof-tops as well!
I'll comment on the other questions and concerns you have a little later.
Take care and keep on keeping on (KOKO) your Naltrexone journey!