I just recorded an interview with a skilled and very experienced Functional Medicine and Naturopathic MD by the name of Diane Culik, who can see patients via telemedicine throughout the country.
As I was looking through her website I saw an intriguing tab that said “Become a Social Drinker”, so I asked her about it and it turns out she regularly uses Naltrexone to curb cravings for alcohol based on the work of David Sinclair PhD.
Here’s the deal from their website curb-cravings.com:
David Sinclair PhD spent 30 years doing research on alcohol addiction and discovered a revolutionary concept called The Alcohol Deprivation Effect. When an Alcoholic is deprived of alcohol, (which is the Hallmark of the Abstinence Model), the cravings for alcohol actually Increase rather than Decrease. This explains why the Abstinence Model is so ineffective. It does not lessen the cravings, it increases the cravings.
Dr. Sinclair worked with easily addicted rats and found that the prescription medication Naltrexone would, over time, decrease the rat's cravings for alcohol when given one hour before each alcohol exposure.
Later studies confirmed in human subjects, that this same technique also worked to block cravings with an 80% success rate, when the Naltrexone was taken one hour before drinking.
The Sinclair Method prevents the uncontrolled cravings that otherwise have led to recurrent relapses and repeated need for expensive inpatient treatment and therapy, and uncomfortable withdrawal symptoms.
None of this is necessary with using Naltrexone and The Sinclair Method to Curb Cravings for Alcohol and this technique has also has been used in cocaine and sugar cravings.
The Sinclair Method has been used in Finland for over 18 years and has helped an estimated 70,000 people recover from alcoholism.
The "Curb-Cravings" protocol of Drs. Culik and Fischer follows the program as developed by Dr. Sinclair and as discussed in the book by Roy Eskapa PhD titled The Cure for Alcoholism: The Medically Proven Way to Eliminate Alcohol Addiction.
The way this works is that addiction depends on the release of endorphins, chemicals that trigger our pleasure centers.
Naltrexone blocks our bodies own receptors that are triggered by alcohol and other addictive substances and experiences like sugar, pornography, etc.
Naltrexone has a long history of use in medicine to reverse the effects of narcotic overdose. It completely blocks the effects of narcotics like morphine, heroin, cocaine, etc, and can be life saving in overdose, so it’s ever present in every ambulance, ER and hospital.
Of course if you block the receptors before you use the drug, it won’t trigger a desire to consume it. Although it does block the high that comes from drugs like morphine, cocaine and heroine, it does not block the desirable effects of alcohol.
You can still get tipsy and still get drunk - just as easily.
The only difference is that the alcohol will not push the big red addiction button that sits in the brain of so many people.
After some time the cravings and desire for overusing alcohol will wane, and at that point patients can skip days of naltrexone, which is important since you do want those receptors to be triggered naturally by healthy things like human interaction, a game of volleyball on the beach, a romantic dinner, etc.
But on days that the patient drinks they would keep taking the naltrexone, and gradually try to lower the dose.
Eventually some patients can try dropping the naltrexone entirely, but I would give it a couple years, because that’s how long it takes to really deeply rewire the neural pathways of deeply ingrained habits.
So why doesn’t anyone talk about this method? Why do med schools not cover it? Why have most doctors never heard of it?
The answer is obvious, and depressing:
The only mainstream medical offering for alcohol addiction is Antabuse, a medication that makes you kind of “allergic” to drinking alcohol - the way it works is that you feel incredibly sick if you have a drink.
So the basic idea is to kick the habit entirely and never drink again - too bad if your Catholic.
And of course there is AA - Alcoholics Anonymous, where again the only solution is complete abstinence.
For people who do not want to be completely abstinent, usually because they enjoy alcohol and are deeply embedded in cultures, family and friend groups that revolve around the consumption of alcohol, the above two options are less than appealing, which is why many people simply refuse to try them.
There is another less famous 12 step program that might be illustrative of the problem: Sexaholics Anonymous (which probably had a surge in popularity after Tiger Woods pulled the sex addiction card during his infamous apology).
As with alcohol, most people don’t want to completely quit sex, they just want to control their urge for it so it doesn’t take over their lives.
They want to indulge the way a normal person does, enjoying it in moderation.
Regardless of the specific substance or experience that is addicting, all addictions route through the same chemical pathways, so naltrexone can probably be used not just with alcohol, but also with addictions to anything: sex, drugs, food, porn, gaming, social media, etc.
The dosing is 50 mg a day taken an hour before the first drink of the day. Occasionally people need to titrate up to 75 or 100mg, and even less often some sensitive souls need to start at much lower doses, even as low as 1 mg, and slowly titrate up.
And that’s it, patients don’t need to try to cut back, it just happens naturally, at least 80% of the time (that 80% number seems to show up in medicine a lot, I see it all the time treating Long Haul and Vax injury online).
For the other 20%, I would suggest Eft, NLP, medical hypnosis, the lightning process or perhaps some people really do just need to be abstinent - it does appeal to some, most people probably know someone who swears by the 12 Steps, I certainly do.
Finally there are some studies that suggest there is no really safe level of alcohol consumption, though the research isn’t that robust, as most studies lump together tiny amounts as at Catholic Mass with 1 whole drink.
There are also oft-cited studies suggesting a benefit for heart disease, but that may be simply a side effect of the human connection and conversation that are known contributors to health and that alcohol helps lubricate.
Some people deeply believe they should completely avoid alcohol and others believe it is a religious staple that should be enjoyed in moderation.
Thankfully for the latter group there is actually a way to control addiction and achieve social drinker status.
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A friend is conducting an alcoholism intervention for someone tonight and her business takes her to Scranton, PA, where the low dose naltrexone conference will be held next weekend at the Hotel Anthracite. Perfect timing publishing this article. This will be directly helpful to my social circle. Way to go, Dr. Haider.
Mutual friends are already your ivr customers. We all appreciate your work.
Excellent article, very well done. I might add that acupuncture should be considered as well, at least as an adjunct therapy, as there is a preponderance of evidence showing the endogenous release of endorphins, enkephalins, and numerous other changes demonstrated in the blood and brain that are extremely beneficial to a variety of conditions and syndromes. Thank you Dr. Haider and team for the excellent work that you have done and continue to do.