Lifestyle Fashion

Alcohol, naltrexone, and the magic of drug extinction



The drug naltrexone has been approved by the FDA for the treatment of opiate addiction since 1984 and for the treatment of alcohol problems since 1994. Although many doctors have prescribed naltrexone for alcohol problems since it was approved by the FDA, naltrexone has not been shown to be very effective. when prescribed in accordance with the FDA recommendation to take it daily without consuming alcohol.


However, David Sinclair PhD, a research scientist working in Finland, has discovered a different way to prescribe naltrexone that has shown an 80% success rate in patients prescribed naltrexone and a 90% success rate in patients taking naltrexone as directed. This method of prescribing naltrexone is known as the Sinclair Method. 90% of patients taking naltrexone according to the Sinclair Method stop drinking or become moderate drinkers within three months. No hospital treatment is required and naltrexone is available in a cheap generic form which makes this not only a highly effective treatment for alcohol problems, but also one of the least expensive.


What is the Sinclair method?


According to the Sinclair Method, patients should only take naltrexone when they intend to drink alcohol and should never take naltrexone when they intend to abstain from alcohol. This is in stark contrast to the FDA recommendation that naltrexone should only be given to patients who promise to abstain from alcohol and should be given daily. Also, when naltrexone is taken according to FDA recommendations, it is only slightly more effective than a placebo, which is in contrast to the 90% success rate of the Sinclair method of using naltrexone. Additionally, some research suggests that the only patients who benefit from taking naltrexone as prescribed by FDA guidelines are those who cheat and drink with naltrexone, and that those who abstain while taking naltrexone not only have increased cravings for alcohol. than those who get a placebo, but are also more likely to relapse into serious long-term drinking problems.


The Sinclair method says that you should take 50 mg of naltrexone one hour before drinking every time you drink for the rest of your life. Naltrexone taken according to the Sinclair method is safe even for drinkers who have a high physical dependence on alcohol, as naltrexone causes them to drink less and less per day and thus gradually decrease alcohol without any symptoms of abstinence.


How does the Sinclair method work?


According to David Sinclair, alcohol addiction is a conditioned response. People are conditioned to drink alcohol due to the actions of alcohol on the brain in the same way that Pavlov’s dogs were conditioned to salivate at the sound of a bell. This is because every time you drink alcohol, endorphins are released in the brain. Endorphins are chemicals that are responsible for learning new conditioned responses. This is usually a good thing because the conditioned responses we learn help us survive. However, in the case of alcohol addiction, the conditioned response leads people to perpetuate a bad habit. The endorphins that are released in the brain when people drink alcohol reinforce their drinking behavior and this can lead to alcohol addiction.


Naltrexone totally blocks the effects of endorphins in the brain. If you take naltrexone before drinking alcohol, your drinking behavior will not be reinforced. When a behavior is not reinforced, it eventually disappears. Psychologists refer to this process as “extinction.” Since naltrexone is a pharmaceutical product, the use of naltrexone to extinguish the drinking behavior is called “drug extinction.” Pharmacological extinction of drinking problems by using naltrexone is the Sinclair method.


When we understand that the drinking problem is a conditioned response and that this conditioned response can be extinguished using naltrexone according to the Sinclair Method, it becomes very obvious why the FDA method of using naltrexone is not effective. If a person takes naltrexone every day, naltrexone will tend to extinguish all pleasant behavior that results in the release of endorphins, not just the drinking behavior. This includes everything enjoyable, from reading to jogging to having sex. Also, if one abstains while taking naltrexone, drinking will be the only behavior that is NOT extinguished by naltrexone.


Why is the Sinclair method not popular in the United States?


Since the Sinclair Method has been very successful in Finland, why has it not been widely adopted in the United States?


There are a couple of reasons why this may be the case. Since naltrexone is now available as a generic, drug companies won’t make much of a profit promoting it. Furthermore, American addiction specialists generally seem to shy away from anything that does not involve total abstinence and surrender to a “Higher Power.” Additionally, the 2009 edition of The Physician’s Desk Reference no longer lists oral naltrexone as available for prescription in the United States; only 30-day implants are available. Naltrexone 20-day implants cannot be used to implement the Sinclair Method. It is unfortunate that our pharmaceutical companies took such a gigantic step back just at the time when an extremely effective method of using oral naltrexone was discovered.


Fortunately, there are some professionals in the United States who are now promoting the Sinclair method. We can only hope that this grassroots movement grows and that more and more of us become familiar with the Sinclair Method and put it into practice to help eliminate the alcohol problems that continue to plague America.




Anton RF, O’Malley SS, Ciraulo DA, Cisler RA, Couper D, Donovan DM, Gastfriend DR, Hosking JD, Johnson BA, LoCastro JS, Longabaugh R, Mason BJ, Mattson ME, Miller WR, Pettinati HM, Randall CL, Swift R, Weiss RD, Williams LD, Zweben A; Research Group of the COMBINE Study. (2006). Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence: The COMBINE Study: A Randomized Controlled Trial. JAMA. May 3; 295 (17): 2003-17.


Eskapa, R. (2008). The cure for alcoholism: drink your way sober without willpower, withdrawal, or discomfort. Benbella Books. Dallas, TX.


Heinälä P, Alho H, Kiianmaa K, Lönnqvist J, Kuoppasalmi K, Sinclair JD. (2001). Targeted use of naltrexone without prior detoxification in the treatment of alcohol dependence: a double-blind, placebo-controlled factorial trial. Journal of Clinical Psychopharmacology. June; 21 (3): 287-92.


Medical Economics Co. (2009), Physicians’ desk reference: PDR. Medical Economics Co., Oradell, New Jersey


Sinclair JD. (2001). Evidence on the use of naltrexone and different ways of using it in the treatment of alcoholism. Alcohol and alcoholismJanuary February; 36 (1): 2-10.

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