The Sinclair Method vs Daily Naltrexone: What's the Difference?

Sometimes there can be confusion when someone starts on naltrexone treatment following The Sinclair Method with regards to WHEN to take naltrexone. ⏰

Here are the three most common questions we get at Thrive on this topic:

• Do I take it every day?
• What time of day do I take it?
• Should I only take it when I plan to drink?

I'll answer these questions based on my personal experience with the method, as well as what I've seen with clients over the years. I'll also hyperlink a couple other resources on this topic that you might find helpful.

The Sinclair Method vs Daily Naltrexone 

The short answer is this: If your doctor prescribes you naltrexone following The Sinclair Method protocol (which has been clinically-proven to be the most effective way to take naltrexone for alcohol use disorder), then they will likely advise to take the medicine in a targeted dose one hour before drinking.

Following The Sinclair Method protocol:

• The medicine is only taken before consuming allowing (at least 1 hour before)
• It is not taken on alcohol-free days

Learn more about the research behind this specifically treatment protocol in this study here.

In his research, Dr David Sinclair demonstrated that this is the most effective way to use the medication naltrexone to treat alcohol use disorder. You can learn more about it in the book The Cure for Alcoholism by Dr Roy Eskapa, we also cover this in our video courses).

Here's a few reasons why The Sinclair Method is the most effective way to use naltrexone for treatment of alcohol addiction:

• According to research, when naltrexone is taken 1 hour before drinking alcohol, it allows the medication to reach peak levels in the body at the same time that alcohol is being consumed. This can result in a greater reduction of the pleasurable effects of alcohol, which can help to reduce the desire to drink more
  
  
• Naltrexone blocks the brain's opioid receptors, which reduces the rewarding effects of alcohol and can eventually lead to a reduction in alcohol consumption. Over time, the brain learns to stop associating alcohol with pleasure and reward, which can lead to a reduction in cravings and a decrease in the desire to drink.
  
  
• On alcohol-free days when patients are not drinking – the opiate blocker naltrexone will not be in their system. Therefore, they will not be blocking the rewarding effects from others things in life – like food, exercise and time with loved ones. That means they can experience the reward reinforcement from these activities. 

☝️ This is CRUCIAL to habit change over time.

Often people also ask, "Will naltrexone impact other pleasurable activities in life too? Will it make me not enjoy exercise, sex or food anymore?"

The short answer is no, not really, and here's why: 

• Naltrexone works by blocking opioid receptors in the brain that are involved in producing feelings of pleasure and reward, which can reduce the pleasurable effects of alcohol consumption. However, the reward pathways for exercise and food involve different mechanisms in the brain than those involved in the reward pathway for alcohol, which is why naltrexone does not block the reward from exercise and food.
  
  

• The reward pathway for exercise involves the release of endorphins, which are natural opioids produced by the body. Endorphins bind to opioid receptors in the brain, which results in feelings of pleasure and a "runner's high." However, naltrexone has a much lower affinity for the endogenous opioids, like endorphins, compared to exogenous opioids, like alcohol.
  
  

• Similarly, the reward pathway for food involves the release of dopamine, a neurotransmitter that is involved in feelings of pleasure and reward. While dopamine interacts with opioid receptors in the brain, it does not interact with the same receptors as alcohol. Therefore, naltrexone does not block the reward from food.

As a Recovery Coach for people using The Sinclair Method, I have encountered a few clients who reported that if they take naltrexone daily long-term (6 months or more) they do start to feel the "blahs" – meaning they might notice an impact on their mood.

This is another reason why Dr Sinclair stated that targeted naltrexone is often the better choice – so that the medication is not in the person's system every single day. (☝️ That is, assuming that most people will continue to reduce their drinking over time the longer they are following The Sinclair Method protocol. So even if they start the treatment as a daily drinker (like I did) they will not be a daily drinker forever).

That's why another benefit of targeted naltrexone is that over time – a person takes less medication since most people are drinking less often through this method.

If you're not working with a Sinclair Method provider, naltrexone may be prescribed daily because that's the FDA-approved "on-label" way to prescribe the medicine for alcoholism. However, The Sinclair Method is an "off-label" way to use naltrexone. Any doctor can prescribe a medication "off-label" however some may be unaware of the targeted dose approach.

When is daily naltrexone beneficial?  

In an interview with Brian Noonan, PNP, founder at SinclairMethod.org, he states that daily naltrexone may be beneficial for some people in the beginning of The Sinclair Method, for example if they struggle with medication adherence (the Golden Rule of the method) or if they are daily drinkers. But over time, many people prefer the "targeted" use of naltrexone so they are only using the medication when they drink alcohol.

Alternatively, some research has also shown that naltrexone may help reduce alcohol cravings in people who are abstinent (I've heard this from individuals as well), however, in Dr Sinclair's research as explained in The Cure for Alcoholism, the results with this approach were not very promising.

I hope this helps you better understand the difference between targeted naltrexone following The Sinclair Method verses daily naltrexone.

If you're ready to get started on The Sinclair Method – or if you'd like more specific guidance so you can have success with the method – then you should join us inside The Alcohol Freedom Program. The program is private, done from home and on your schedule. Click here to learn more and get started.

Of course, this is not medical advice. Please chat with your doctor about how you should take naltrexone. Inside Thrive, we've partnered with telemedicine doctors across the country who specialize in naltrexone treatment for alcohol use disorder.

Cheers,

Katie

Medical Disclaimer: The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this platform.