What Is Pharmacological Extinction of Alcohol Use Disorder?

If you're familiar at all with The Sinclair Method (TSM), you might also be familiar with the term "pharmacological extinction" or "extinction" for short.

TSM and pharmacological extinction are essentially the same thing, but I'd like to share a bit more about what extinction means – especially as it relates to TSM.

Pharmacological extinction is a treatment approach for alcohol use disorder (AUD) that uses the medication naltrexone to help reduce or eliminate the desire to drink alcohol.

Naltrexone is an opioid antagonist that blocks the effects of endorphins, the brain chemicals that produce feelings of pleasure and reward associated with alcohol use.

Over time, the repeated activation of these endorphin pathways through consuming alcohol can reinforce the behavior of drinking alcohol, making it more difficult to stop (☝️ this is how AUD is learned).

When naltrexone is taken before drinking, it can reduce the pleasurable effects of alcohol, making it less desirable and reinforcing.

Over time, this can help reduce cravings for alcohol and make it easier for individuals to reduce their alcohol consumption and drink in moderation, or get to a place of sustained abstinence – without fighting alcohol cravings.

It's important to note that "extinction" does not necessarily mean abstinence from alcohol (many people confuse this on TSM). A person can reach extinction (usually after about 6 to 9 months, or more) and continue to drink moderately, or choose to go alcohol-free.

The great thing is, the choice is up to the individual!

Extinction through TSM is a subjective experience, and usually something that is realized over a period of time.

A few signs of extinction include: 

1. An ongoing sense of regained control when you drink – no more binges
2. No more obsessive thoughts/cravings for alcohol
3. Easier alcohol-free days

Also, be sure to check out this interview with Dr David Sinclair as he explains his discovery of pharmacological extinction of AUD, aka The Sinclair Method (also included above).

Cheers,

Katie