I will be refilling my husbands prescription for the 4th time tonight, which puts him at around 12 weeks. I say "around" because when he travels (when he's out of my sight) he isnt always so good at taking his Nal.

He does not measure his nightly / weekly consumption; I try, but it's hard to "eyeball" how much is left in the bottle. His consumption does not appear to have dropped at all, and in the past 2 weeks seems to even have ramped up a bit. He can easily drink between 350 - 500 ml every night.

I finally asked yesterday if he thought the pill was having any effects at all, and he said "honestly? I hate to say this but I think it's the opposite of what we're hoping for. Every time you hand me that pill, my first thought is "woo-hoooo, I get to drink in an hour!". He likened that pill to the bell for Pavlov's dogs. He gets a pill and starts salivating for his whiskey...

Is that normal? I'm trying to keep my chin up, to remind myself this will take probably a good year, but it's hard when he tells me things like that!

Worriedwife, keep at it. I was just reading some of bob's posts. It took him 16 weeks before he saw a big dip and now he self-described cured.

Having said that, I do not believe this method works the same for everyone. Even Eskapa mentions a 78% success rate, which means a 22% failure rate, which is not insignificant.

There are also other medications to explore: I would certainly be looking at Baclofen, Topomax, Campral and other meds if TSM isn't working at all after at least 9 months to a year.

Best wishes.

I know we need to be honest with each other but geeeeeesssssss! I wish we could stop telling people that this MAY not work, that they MIGHT want to explore other options etc. etc......after all this guy has only been on the stuff for 12 weeks!!!!!

Don't stop, don't get discouraged, don't explore other options, don't even worry about your husband drinking more - after all he was pounding it back before!! Measuring and tracking is NOT necessary for this to work. RELAX!!! The fact that he's not worried, that he feels more comfortable around booze is a GOOD thing. It gets rid of all the guilt, all the hiding, all the fear....this is GOOD. Now your experiment with him and Naltrexone can proceed without all the worry and strife.

Have we forgotten that Naltrexone works SILENTLY? And of course Pavlov's dog salivated when he rang the bell. But the dog stopped salivating when Pavlov reversed the experiment! Be patient!!!!

Good, sound , advise, BGH. Totally agree. The more we stress, the more we stress. Slow & steady wins the race! Win this race!!! Only go slow. Make sense??

Just my personal opinion, but:

1) MAKE HIM MEASURE HIS GODDAMN UNITS. This is a complex cure for the most debilitating condition in many people's lives. But someone can't be bothered to take a few seconds for each drink to keep track? For hard liquor, pour it into a shotglass first-- that's one unit.

Yes, there have been people on the forum who say they didn't measure units and became cured. But they are in the minority. Measuring units is, in my personal opinion, essential to TSM success for many reasons: a) it makes you realize just how much you're drinking on a daily, weekly and monthly basis, and that realization can help you see how your lifestyle, decisions and behaviors facilitate a physiological addiction to alcohol, and b) it lets you track progress.

2) Naltrexone, when it works, gives alcoholics something that "normal" people have: control over alcohol. It's still up to us to exercise that control. This means ALWAYS taking the pill and also seriously trying to exercise that newfound control over drinking (i.e. realizing when you're drinking out of habit or out of cravings). Don't expect the pills to make all the decisions for you.

Early on in TSM, it's common to "drink as normal" and just get hammered all the time, but from what I've seen on the forum, an attitude of "I want to get this problem under control" is necessary to achieve success with TSM. Most of the "cured" on this forum have made statements backing up the assertion that just taking the pills isn't enough, despite what seems to be implied in Eskapa's book.

IMO from my own research on the science of TSM and conditioned response, it is well documented that a conditioned response is harder to negate if the reinforcement is off and on. A read a study where animals who's reward was taken away completely became "unconditioned" when thier reward was not given on a consistant basis. (They just gave up trying.) *I dont really feel like looking up the studies on this, but you can google it.

On the other hand, animals that were given a reward 1 time out of 10 would continue thier behavior, just because they knew eventually the reward would come. *I dont really feel like looking up the studies on this, but you can google it.

Along these lines, we must remain consistant with the NAL to ensure that there is NO ENDORPHIN reward for the first drink and there after.

Remember what NAL does for us, it stops the positive reenforcement we all get from drinking alcohol. In time, AL will become a take it or leave it activity. (Which is what has happend to me.)

The Golden Rule must be applied. ALWAYS TAKE YOUR NAL ATLEAST 1 HOUR PREVIOUS TO HAVING A DRINK.

You said he isnt so good about taking his NAL on business trips? Well sorry to say this, he needs to get serious about this and always apply the Golden Rule. If he isnt applying this when he is out of your sight then Id have to say he isnt too serious about it. Maybe Im reading your post wrong but Ive seen too many people come here concerned about thier results when in fact they haven't been sticking to the TSM plan. And in no way do I mean to be offensive, I wouldn't bother posting this if I didn't care.

Just my two cents.

Keep pushing.

hap

Indeed, intermittent reinforcement is the most powerful of all reinforcement schedules. If you intermittently take Nal and drink, you are getting an even stronger dose of opiate reinforcement because of the phenomenon of up-regulation of opioid receptors in the brain. This potent cocktail facilitates addiction/dependence. Remember the behavior (drinking without Nal) does not lead to a sweeter high, it's rather the pure reinforcement of a compulsion to insanely 'work that lever' (in our case the elbow) in effort to chase a high that was never ever really there in the first place.

Yes, as I reconsider, I think the last posters are correct - HOWEVER - let's cut this poor wife some slack. She seems to be the one putting in most of the effort and personally I wanted to reassure her a bit...being someone who is trying to get a loved one to actually care enough to DO the program. There are some drunks who sort of want to stop but they perceive the effort, even to take naltrexone, as just another burden. Sliding down into the hell of total drunkeness can have a certain appeal in some people - it's so easy to give up and shut off all the hassle they see around them - and the nagging from loved ones too.

Depression and low-self esteem often follow along with alcohol abuse and the effort can just seem too much.

But thanks to the last few posters I do see that this must be an all or nothing effort. Sadly just as we may love people who stuggle, we simply can't energize them for very long. After the thrill of the pill fades, there must be that personal effort - and the desire to quit has to overcome that lethergy that long term alcohol abuse brings.

BGH, I assume those comments were directed at my comments. I do feel the need to be honest because it appears that TSM does not work the same for everyone and for a few it does not work at all. In that case, it is a good idea to explore other options because there are other medications and methods that may help. However, as I stated in my post, I believe way more time is needed in this particular case. I was certainly not suggesting this guy quit after only 12 weeks.

I also agree with the last few posts: a very high level of compliance is necessary for this to work, especially when you are just starting out (i.e., the first several months if not years).

Thanks everyone for the input. I had a "low" day when I posted and hadn't checked this thread as often as I should have.

First, thank you BGH for your "lets cut this wife some slack" comment, that literally brought tears to my eyes. I knew this would be a long and slow journey, sometimes a little encouragement goes a *really* long way. I guess I'll buckle in for the ride because it's likely to be a bumpy one.

Out of curiosity, might I ask of the folks going through this - how do your loved ones best support you? Do you prefer to battle this on your own because it's hard for others to understand, or do you have a good support system? What makes a support system good?

Anything I can learn from you that may help our journey - I'd be grateful!