If you suffer from alcoholism and are told there’s an easy way to “cure” it, I’m sure you’d be intrigued and willing to try such a method. However, what if you were told that your chances of maintaining long-term sobriety with this method are minimal, the side-effects are numerous, and it’s possible you will end up struggling with a more powerful addiction as a result of utilizing this source of treatment? Would you still consider such a treatment for your alcoholism?
Unfortunately there’s a lot of misinformation out there about having an “easy-way-out” of dealing with one’s addiction. With increasing popularity, the Sinclair Method claims to be this “easy- way-out”. While many people are embarking on this form of treatment, it is important to understand what exactly this method entails, what medication is utilized and its side-effects, why it’s possible that the Sinclair Method won’t work long-term for a “true alcoholic”, and what are some of the best, proven approaches for treatment of alcoholism and addiction.
The Sinclair Method and Alcoholism?
Before diving into what the Sinclair Method is, it would be helpful for one to first understand more about what this method is trying to treat: alcoholism. Alcoholism is characterized by the inability to manage drinking habits. This can include common signs of: being unable to control alcohol consumption, craving alcohol when not drinking, making alcohol a priority (above personal responsibilities), behaving differently after drinking, and spending a substantial amount of money on alcohol.
Furthermore, as defined by Dr. William Duncan Silkworth, alcoholics portray three unique characteristics:
- Alcoholics have a physical allergy to alcohol– when alcohol is consumed, a physical reaction takes place within the body, putting an alcoholic in the position of having a “bodily craving” for more alcohol
- Alcoholics have a mental obsession over alcohol- a “true” alcoholic (not just someone who abuses alcohol and can stop with great will-power), is preoccupied with thoughts about alcohol (how to get it, how to not get caught, how to control it, how to avoid it)
- Alcoholics have a “spiritual malady”- as described in the Big Book of Alcoholics Anonymous, without alcohol, a person with an alcohol use disorder will become restless, irritable, and discontent.
As such, when a mental obsession takes over, a physical allergy kicks in and the person struggling with alcohol abuse will drink more than intended (no matter how much they’ve sworn off drinking or over-drinking in the past).
What is the Sinclair Method?
The Sinclair Method (TSM) is a treatment program that uses medication-assisted (naltrexone) to help someone with alcohol use disorder to moderate or quit drinking. Developed by Dr. John D. Sinclair, TSM uses “pharmacological extinction” to reteach the brain, through the use of medication, to no longer associate pleasure when consuming alcohol. The psychological concept behind this method is that people drink because of the pleasurable experience associated with drinking (e.g., it fires off the pleasure/reward centers in the brain) and not because they are actually addicted to the alcohol itself. Therefore, it is thought that by medicating oneself with a drug that breaks the link between alcohol and pleasure, one is thought to be “cured” of alcoholism and stop compulsively drinking in order to satiate the reward center in the brain.
Essentially, someone who is thought to have an alcohol use disorder will take medication (Naltrexone, also known as ReVia and Vivitrol), prior to drinking alcohol and because this medication blocks the feelings of euphoria in the brain, the person drinking will begin to dissociate drinking from its pleasure side-effects. As wonderful as this all sounds, can alcoholism really be cured by just taking a pill, though?
What You Need to Know about Naltrexone Medication (ReVia and Vivitrol)
So after understanding The Sinclair Method and distinguishing if one might possibly have alcohol abuse issues, it can be helpful to understand the medication one takes when participating in this method before making a decision to go down this route of treatment. Naltrexone, the medication utilized to treat both alcoholism and opioid dependency through the Sinclair Method, comes in two forms: a pill form (ReVia) and by an extended-release injection (Vivitrol). ReVia can easily be administered at home daily, while Vivitrol must be administered by a licensed physician. However inconvenient Vivitrol may seem to the patient, one shot will last around 4 weeks, making it a more viable option for people considering this approach. To better understand the key ingredient in both ReVia and Vivitrol, naltrexone, it is important to understand that naltrexone essentially blocks out other opioids from interacting with the brain’s receptors. While many people confuse naltrexone with naloxone, naltrexone blocks the effects of most opioids from entering the body while naloxone reverses the effects of opioids.
Because of the nature of naltrexone, individuals with opiates still in their system when taking this medication can go into a precipitated withdrawal, which is essentially the same thing as an opioid withdrawal but instead of being brought on gradually as one is detoxing off opioids, this type of withdrawal will be brought on almost immediately. The danger of this is that anyone with alcohol or opioid dependency needs to be completely clear of drugs in their body. As such, most physicians will only administer this drug if the person has not taken drugs/alcohol for at least 7 to 10 days. Furthermore, ReVia has quite an extensive list of side-effects. These include:
- Joint pain
- Sexual problems
- Liver damage
- Respiratory infections
It is important to note that naltrexone does not eliminate withdrawal symptoms experienced from alcohol or opioids. Additionally, because it blocks the pleasure center in one’s brain from experiencing euphoria while drinking or using drugs, some people may try to consume a dangerously large amount of drugs/alcohol to achieve their desired effect. As such, it is not realistic for someone wanting long-term sobriety to take these meds to combat their addiction. In fact, it may actually be more fatal to them to take naltrexone for recovery purposes.
Does The Sinclair Method Work to Treat Alcoholism?
Based on Dr. Silkworth’s research on the characteristics of alcoholism, as stated previously, one might accurately conclude that taking a pill will not fix the physical allergy, mental obsession, or spiritual malady that takes place for a “true alcoholic”. A “true alcoholic” needs to be stated because this sort of disorder requires different, more rigorous attention than someone who drinks “too much” but can stop drinking with will-power alone (even if it may be difficult for them at first). Someone who truly suffers from the effects of alcoholism will continue to suffer until the physical allergy, mental obsession, and spiritual malady are well-balanced and managed through a healthy recovery program. As such, although the pleasure centers may be temporarily shut down during the process of taking medication and drinking, the alcohol abuse disorder will still be activated within the individual. Furthermore, the reality is, if someone is forced to take a pill before they drink to alleviate experiencing pleasure from drinking, it is highly likely that if their abuse is at a point of being unmanageable, they will forgo taking the pill in order to negate not feeling those euphoria-inducing side-effects. It would take rigorous discipline in order to take something that would deter them from experiencing the high from activating the reward center in their brain.
Although The Sinclair Method may appear on paper to be the one-step “cure-all” treatment plan for people suffering from a substance abuse disorder, the reality is that the Sinclair Method is significantly flawed by it’s lack of understanding about the true nature of the disease of alcoholism and drug addiction. First off, how could one assume that a true alcoholic would comply with the medication dosing schedule? Because an alcoholic is seeking pleasure from drinking, taking a medication that makes them sick while drinking would just further prevent the user from taking the medication in the first place. Even if someone religiously takes their medication, the “up-regulation” (the result of the brain attempting to balance opioid receptors while taking the medication, thus flooding the brain with opioid receptors in the brain to compensate for the diminished opioid receptors when taking the medication) caused by naltrexone can set someone up for failure if by chance they miss just one dose of their medication and take a drink. With the increased opioid receptors in the brain from the last doses of medication, the pleasure center will be “over-activated”, thus sending signals that drinking is even more pleasurable than last remembered.
Why the Sinclair Method Isn’t Endorsed by Most Drug/Alcohol Rehab Centers
The truth is, the Sinclair Method is often not endorsed by rehabs that view alcoholism and drug addiction as a disease of body, mind, and spirit. That is to say, that addiction has deeper roots than merely just the act of drinking. While the Sinclair Method may (partially) address the body aspect of alcoholism, it neglects to address the “restlessness, irritability, and discontentedness” that an alcoholic, almost inevitability, experiences without proper treatment. That means that for someone with a serious addiction, other treatment methods with a holistic, well-rounded approach prove to benefit them more when recovering from addiction and maintain sobriety for the long-run. This holistic treatment approach typically includes treatment in an inpatient/intensive outpatient drug/alcohol rehab, working a 12-Step Program with a Sponsor, and attending support group meetings. Furthermore, utilizing individual, group/family counseling can benefit someone with the disease of addiction.
Although the Sinclair Method may appear to be a “one-step-cure-all” method, it merely scratches the surface of addiction and most likely will not provide a lasting solution for long-term sobriety. Investing in yourself and your sobriety requires additional assistance through more all-inclusive treatment modalities that address all 3 characteristics of an alcoholic/addict: the physical allergy, mental obsession, and spiritual malady that an addict inevitability experiences. Don’t delay seeking help. You deserve to live a life free from the bondage of addiction.