If I'm reading your post correctly: I believe I'm reading that your wife drinks during the evening and THEN takes a 50 mg nal before bed. Is that correct?

If so, she's totally off the course. You have to take that pill one hour BEFORE your first drink -- not at the end of an evening after drinking.

The naltrexone takes the happy buzz feeling of dopamine release away. If she takes it an hour before drinking, she'll get this effect and over time she'll no longer get the same reward and will drink less.

If, on the other hand, she drinks first and takes the nal later, she's continuing to get total reinforcement for drinking. This method won't work at all for her.

As to the lower libido, if she only drinks at night and takes the nal beforehand, try sex the next afternoon when the nal will mostly be out of her system -- especially if she drinks a lot of water during the day. She might be more interested at that point.

And somewhere along the line, she'll probably be ready to start a long weekend of alchol free days and romantic sex on day 3 could be the perfect ticket for giving her a great reward that isn't alcohol.

Really, you have to help her understand how this process works. Sounds like she's on the wrong track here. Although, perhaps I read your post incorrectly and if so, apologies for that.

T.O,

His wife is not doing TSM, and was told to take nal daily. It makes her tired so she takes it at night. He was hoping for a reason for her to want to do TSM, but all he can do is educate her.

On another note, if she is taking nal daily (unless she has an extremely fast metabolism), I sincerely doubt she is experiencing an endorphin rush from the alcohol (but I could be wrong) and she would be the only one that would know.

This really is a personal experience.

Jaba

Some thoughts:

1. I've never seen TSM work on someone who didn't desperately want it to. If she doesn't, -it won't.

2. We do a lot of things as alcoholics that we find enjoyable. Not a one of them is something that alcohol is not a part of. We center our lives around it, and so our activities as well. If you take away the alcohol, -sometimes those same common activities suddenly don't look so interesting/rewarding/fun. A hard truth perhaps.

3. Nothing kills sex faster than resentment in a marriage. I could see a scenario where she is resentful of the doctor and yourself depriving her of alcohol. Sure, -it' the right thing to do from everyone's perspective but her's. But that leads us back to No.1 Subconsciously, or maybe not so subconsciously, she might be saying: "If you want to get laid buster, let me drink".

That is an excellent point!

I have seen it happen in my marriage. Texasflip, I am not trying to tell you to walk on eggshells, but tread carefully.

If she is willing, have her read the book and maybe she will come to her own conclusion.

If the nal is curbing that desire, it might be hard for her to remember how overwhelming that pull was. We forget so quickly.

On another note, even though she is not doing TSM, she is drinking on the nal. Right now she is having a honeymoon period (were the intake goes down and we feel in control) and that will end and her intake will go up. That might be another good time for her to understand TSM. When my honeymoon stopped I was scared because intake almost went back up to pre-TSM or pre-nal levels.

If she is going to AA or Smart recovery meetings, she may be able to stay commented to being sober. Not everyone falls off the wagon.

Jaba

Welcome Texasflip - I am sorry about the issues that you are having and am glad that you have come here to talk about things - I do agree with Jaba though - unless your wife wants to read the book, or to use the Nal as TSM espouses, then you cannot make her. If my husband kept on at me to do something HIS way, it would make me back off more, and want to not do what he wanted simply because I do not like being pressured. If she is taking the Nal at bedtime, then she probably isn't covered by late evening. Can you mention to her to maybe take it earlier in the evening - and see if she will take it an hour before drinking? As for taking it daily even if she doesn't drink, then you have to let her do that. I found it took many months for it to have an effect on me in that I knew that I needed to have a few days off it. I was probably about 5-6 months in before I could FEEL that it was pulling me down - I am not sure that I have any endorphins - I didn't feel much different when I did or didn't take the Nal - although I did get teary until I had a break from it. I could not have an AF day for a long time though ......

I personally would not go to any sort of AA meeting talking about Nal and TSM - they are very straight in what they talk about - and drinking on Nal is not one of those things.

As far as the sex and libido goes, I noticed no difference on or off the Nal - but it can pull folk down in general which would then possibly relate to the lowered sex drive. Just know that it really is temporary - once she gets through all this and only takes Nal when she drinks - or once she is 'cured', and maybe DOESN'T drink, then things should get back to normal. I drank Christmas Day, new years Eve (just one, poured the second out) and then tried a drink earlier in Jan - but have not had one for over a month now - I just do not want to drink. It took me nearly a year though - so please just be patient with her and take it very gently re trying to get her to do TSM or the whole thing will end up back firing on you. I wish you all the bet.

Hugs, Maggie

Yep, Nal will surely kill the rewards of sex through the same extinction process that it wipes out the booze.

But there is an easy fix. She needs to not take Nal every day. Then, on her off days, make wild love to her. On the off days, she'll get turbo endorphins from the sex and reinforcement will take place.

This enforcement phenomenon is documented. It also pertains to other healthy activities like working out or creating something like art, cooking, crafts, charity, etc. So, doctors orders: splash on some Old Spice, cook her a nice meal, put on some Barry White and....