The Sinclair Method (TSM) is an alcohol reduction program that uses Naloxone (Nrexone) to reduce alcohol's endorphin reward, combined with intentional alcohol-free days that help the brain learn to function without alcohol, kickstart natural endorphin production, and prevent plateaus in recovery. Alcohol-free days are essential because they provide the brain with alternative experiences and coping mechanisms, allowing it to rewire its response to alcohol cues and triggers. The method works through three mechanisms: interrupting real-time reward, reducing cue-triggered responses, and decreasing motivation to continue drinking. Recovery is gradual and personalized, with side effects typically subsiding within the first week or two, and emotional processing being a natural part of the healing journey.
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Sinclair Method Q&A with Bruce and KatieAñadido:
Y it's one at a time blind. I'm learning to live finding my way. Step by step I'm breaking away with every pore. I'm claiming my life. It's TSM.
I'm ready to thrive.
It's TSM.
All right, here we are. Hi, Bruce. How are you?
>> I'm very good. We've got some sunshine in Scotland.
>> Oh my gosh. How often does that happen there?
>> Once a year.
>> So, yeah. No, we get it occasionally, but it's never warm. So, it's it's we've got sunshine, but it's not I've still got a big thick jumper on where >> Yeah. Yeah.
>> Everyone else in the UK is in shorts and t-shirts at the moment.
>> That's funny. Does that weather get you down at all when you don't see the sunshine very often?
>> No. We live in an absolutely beautiful part of Scotland, so it's you you kind of got to balance it out a bit where you get you've got the weather. You either live in further south. We live in the very north of Scotland. So, uh you either live further south and you get the weather, but you've got the busyiness where I I prefer the countryside and the >> Yeah. Yeah.
>> What do you call it? Cattle. Cattle and sheep and deer is much Yeah.
>> Yeah. It's a beautiful I mean I recent rec recently watched a movie on Amazon.
I can't remember the name now, but it was set in Scotland and I was like, gosh, it's so beautiful and remote and amazing cliffs and I don't know exactly what it looks like where you are, but that movie really captured it.
>> Yeah. Yeah. Well, you need to come across one day and >> Yeah, I would love to >> get you the the lane tartan. There must be a lane tartan somewhere.
I don't know what that is.
Well, welcome everybody. It's been a while since we've done a Q&A. Um I don't I think it was last year sometime with Bruce. Um so it's really good to be back. We are streaming on Facebook and YouTube and a couple other places. So welcome everyone from wherever you're joining from. Um, this next hour is really a chance for you to hang out and listen if you'd like or if you have questions about the Sinclair method, you can drop them in the chat. We would love to answer your questions. Uh, Bruce and I have both been in the field for many years and of course I have my personal experience with the method and Bruce's background is interesting because he comes from the traditional recovery and treatment space. So, welcome to everyone who's here. Um, I see we have a comment here from can't Teresa maybe. I hope it's sunny more than that. I will be be in Edinburgh next month. Oh, cool.
Someone here is going to be in Edinburgh.
>> Perfect time. Perfect time. July, August, Edinburgh is absolutely beautiful.
>> That's so cool. Enjoy your trip, whoever is going there. Great to have you here.
>> Okay, so again, if you guys joining have questions, you can drop them in the chat. Um, I wanted to ask you something, Bruce, that has been coming up lately. I feel like there's always different themes that kind of populate inside Thrive's program. Maybe you notice that working with people as well. Uh recently, one of them is kind of a discussion around the benefits and importance of alcohol-free days on TSM.
Uh was curious your thoughts on that.
Um, and when you're working with clients, like how do you frame alcohol-f free days in a way where, you know, they don't feel pressured to do them if they're not quite ready, but also they understand that they're important to ultimately healing through TSM.
>> Good question. When you start that one?
Okay. Um, so yeah, alcohol-f free days, it obviously everything that we're doing is an alcohol reduction program. So what we're doing is we're reducing people's alcohol intake. We use drink logs and drink diaries with clients. And so initially what we're doing is we're working people through habitual change that then reduces their alcohol intake.
And we don't focus on the numbers although we we keep them. We focus on the habitual change which then as a secondary effect it drops the numbers off. Um so as people are reducing down the way um depend every single person we work with you use a different something on the habitual track you push the hour back for when they start you stretch out the drinking you have a 15 minute gap between the drink or 20 minutes or half an hour gap.
>> Yeah.
>> Or you change you go from hard liquor to wine or beer or or something. There's loads of things that you can do when the drinking starts to get lower. Um, sometimes it happens very naturally and sometimes we will deliberately consciously say to people, okay, now we need to start working towards an alcohol-free day. But again, that's where the coaching comes in because we've got to make sure that we do it at the right time in the right place. You you don't want to do it too soon. You don't want someone going from drinking two bottles of wine seven days a week to going to an alcohol-free day.
>> You've got to reduce it down carefully and slowly. But when we get people onto alcohol-f free days, the main role of the alcohol-free day is that it's producing um we want people some people just want to get through it as quickly as possible. So they think if I drink and take the pill and drink and take the pill and drink, the whole process will work quicker. But I I sit down and I say, "We've got to have alcohol-free days in between of that because your brain has to learn what it's like as part of the process not to drink on given days, which is one for the habitual side, but also for the neurological rewiring of the brain, it needs to learn there's going to be days when I'm not drinking and be very comfortable with it. And then thirdly, it needs to have the um the natural endorphins. So what we're trying to do is is wire up the na or kickstart the natural endorphin because my pet subject when people are drinking alcohol it's producing a huge amount of endorphin. So when we're lowering the amount of endorphin from the alcohol and then on an alcohol-free day we're removing that endorphin completely and we want to kick fire the the natural production of endorphin. So on days that people aren't drinking, we'll say, "Listen, go for a run, go for a gym, um take the dog out, play with your grandkids, play with your kids, uh listen to some music, do something that produces natural endorphin." And because we want the brain to go back into that old circuit of of natural endorphin.
>> Yeah. Yeah. Really well said. And I I just like think back to this often from my own personal TSM journey. And um really like I think alcohol-free days, they were daunting for me in the beginning because I was a daily drinker.
And so I started very small. I had one in the first week and then I was drinking six, seven days a week and then I'd have another one. But I knew I think from reading the book um the cure for alcoholism it talked about you know the wash out day the day after you've taken elrexone and the power of alcohol-free days and your brain is kind of ripe for learning new activities and um I could just see the contrast especially the more like probably not in the first like month or two of alcohol-free days but the more consistent I was with them there would be days where I'd be like yeah I think I'm going to drink and the option would be there on TSM them. But then I would be like, "Oh, you know what? Actually, going on that hike and like having a tea and cooking dinner sounds better, watching a movie sounds better." It's like I could my brain could weigh the options and alcohol was one of them, but then I would have these experiential memories of other things I'd been doing and practicing on my alcohol-free days. And I find with clients that if they, you know, if they don't have any alcohol-f free days and they're on TSM for a while, they may still be reducing their drinking, but eventually they often hit a plateau because their brain doesn't have any other frame of reference for options outside of drinking. And drinking is still the default choice or the default habit even if the craving isn't as strong. I know I hear a lot and maybe you do too, people say like, "Oh, I didn't feel like drinking tonight, but I did so anyway." Yeah, but I to Nrexone, but I I didn't even really feel like it or I was going to stop at two drinks. I didn't want anymore, but I kept drinking anyway. And um to me, that's kind of the sign that Nrexone is doing its work on the pharmacological piece of, you know, rewiring the brain or heading toward pharmacological extinction, but then the habits haven't quite up quite caught up yet. And I think that's really like the power of alcohol-free days, especially if we're intentional with them. And it doesn't have to be some grand gesture like, oh, I'm going to go out and take a rock climbing or something. Even for me, there would be days it would be a busy day and I'd be like, I'm just going to turn on music and dance in my living room for 20 minutes or something. And, you know, do doing something that was giving my brain um endorphins. So, thank you for speaking to that.
>> How long How long did it take you to get to an alcohol free day? I know everyone's completely different, but >> yeah, it only I got it in the first week and it wasn't uh and it was interesting because my doctor back then, she was a TSM doctor and she even told me try to drink every day for the first 30 days on the medication to establish like a baseline like of consistent use of Nrexone so your brain can kind of learn um the extinction process or whatever she said. But I just remember she told me to try to drink every day for 30 days. And as a daily drinker, that was like music to my ears. I was like, "Cool. I'll definitely do that. No problem." Um, but by like four or five days into the treatment, I there came a day where I was getting off work and I was like, I don't really feel like drinking. Like I could have the urge was there, but it wasn't this overwhelming urge where I was like racing to the store to pick up wine and opening the bottle as soon as I got home. It was less. The urge was less. And so I kind of forced myself in a sense to after work I went I didn't know what to do. I was like, "Okay, I'm going to go to the beach. I live in a coastal town. I walked on the beach, went to the store, got dinner, cooked dinner, had just kind of a relaxing night at home, and that was my first kind of uneventful alcohol-free day, but it happened in my first week on the method. Um, and then I was back drinking again, but then I would have another one maybe the following week or two weeks later." Um, and then gradually built from there. I would have two in a week and usually I wasn't doing backto-back alcohol-f free days right away. I would have like, you know, one on a Monday and one on a Thursday or something like that. It was more inconsistent. But yeah.
>> Yeah.
>> And I see someone here, >> right?
>> I just want to read this real quick. She said, "Nice to see you. Been following you, Katie, for the last 5 years.
Finally started TSM three months ago."
That's amazing. So cool you got started.
Let us know if you have any questions.
>> I love that name as well. Jagad Dambber.
I'm impressed you could pronounce that.
>> I'm from Africa originally. Has nothing to do with Africa this name, but it's >> Oh, >> it's >> right. You're from South Africa, right?
>> East Africa, but >> Oh, yeah. Nairobi, right? Or >> Yeah. Yeah.
>> Yeah. Born and bred.
>> That's so cool. Yeah. Thanks for being here.
>> So, >> um, were you gonna say something?
>> Um, >> I thought I interrupted you.
>> No, I don't think so. Okay.
>> So, what's going on in the UK with what you guys are doing um with Rethink Drink and helping people on TSM? How are things?
>> Yeah, good. Good. It's always it's be the exactly the same in the States as it is here. The the biggest challenge that we have is just like you every day that we're working with the program, we're seeing the success that's happening with it.
>> Yeah.
It's just absolutely mindblowing and and I again same as yourself. I'm seven and a half years I think into this now and I would I thought that seven and a half years down the track if I I would I thought I would have been got used to the whole process. But I'm more excited about it now than I was seven and a half years ago. And and I think a lot of that comes down to we've learned so much over the years. Um the little things like how to walk someone through a program, how to put a program together just like you're doing. Um the the biggest challenge we're finding is happening in the UK at the moment is that uh Nrexone is becoming more readily available.
>> Um and without support and the support side of it, >> you've been through it all in the states for number of years, but without the support side of it. um the number of people that will try it for a period of time, they'll see initial reduction, they'll see things happening, but when they don't have a support program like Thrive or through ourselves here in the UK, >> the number of people that we hear, oh, I tried that for a while, it didn't work and I >> um and it's so sad to hear that. I wish personally I I wish there was regulation that could be put into place in America and in the UK just to say listen great medication does um like you say it does all the heavy lifting for you but you still need to have a reduction program. You need to have people or a group or an organization or training or something that talks you through it.
>> Yeah. because there are so many things that um I'm going to a party this weekend. What do I do? Do I drink more?
Do I drink less? Um I had a drink last week. I I had an extra two or three drinks at my wedding party last week.
What do I do? Um I'm going on holiday in a week's time. Uh when do I redose?
Don't I redose? Uh there there are a thousand1 questions that come up and if you don't have an organization that is experienced not someone who is experienced in therapy work like a counselor or a doctor but someone who has the experience of nrexone >> and TSM specifically because I get messages from people all the time like multiple a week of like oh my doctor had me taking this in the morning and I was drinking at night or my doctor after 3 months months, it wasn't really doing anything. So, my doctor took me off it.
And having those kind of just not knowing what to expect with the treatment and like time really is your friend with the treatment and it's not an overnight fix and there are ups and downs. I think that can just help people to understand and feel like they their expectations are managed and so they're not disappointed, they're not quitting too soon, they're following the protocol correctly. Um yeah, all of that is so important >> and and I think one of the most important things I'm learning at the moment is that as someone is reducing I mean if we care what I say here but but if someone is just getting the medication and they're drinking uh I don't know what you'd call a bottle of scotch a day >> you've got to make sure you have in my opinion an ethical moral, whatever the word is, to make sure that as that person is taking Nrexone, that's lowering the reward, that's lowering the alcohol intake, that that person is safe. So, as someone is reducing down the weight, you've got to make sure that there's no risk of withdrawals. Um, you've got to make sure that that person is coping emotionally and psychologically. Um, you've got to make sure that there are are uh lots of other medical conditions. So that there might be medical issues that start to come up. Alcohol can mask a whole bunch of stuff that when the alcohol is reduced or taken away, there's a whole bunch of stuff going on underneath, whether it's emotional, psychological, or medically or something else um that people need to make they need to know that there's a a place that they can turn to to get support.
>> Yeah.
>> And it's vital, I think.
>> Yeah. I I just put out a video yesterday and one of the things I mentioned in it was for people to get support on the method in whatever way like from my view having somebody who can empathize with you understand what you're going through understand what this process looks like and walk you through it and also understanding that like for me as I look back on my journey the first maybe four or five months on TSM I was like so secret about it I told my husband a month in but I didn't really tell many other people in my life. I was like, I'm just going to get this medication and figure this out like on my own. I had so I had 10 years of like shame from my drinking that and plus when I when I first learned about Nrexone and I tried to get a prescription. No doctor would prescribe it to me. So that just like compounded the shame of like, oh, I'm a horrible person because I have this problem and they won't even help me.
They just want me to go to detox. But I just remember being like, I'm going to figure this out on my own, like holding on to the medication. And then I was humbled a few months in when all of that stuff started to surface. For me, it wasn't necessarily physical issues, though there were some things. It was a lot of emotional stuff that I didn't even know I was drinking to repress and numb out and um memories surfacing. me realizing ways that my life had been built from a foundation of somebody who was drinking every day for 10 years and all of the things that I would have to change to really embody this person of who was you know a normal drinker who didn't run to alcohol every time, you know, life got hard. And so there's just there was a lot more to deal with than I bargain for. And I mentioned in the video like I realized a few months in like I opened up this can of worms when I started on TSM. I was like this was a lot more than what I was like bargaining for. I just thought this pill would help me drink less. And as it started to do that, that's where like the work came in of me realizing how much my identity was attached to my drinking and how it was my main hobby, my main passion.
Everything in my life revolved around it. And so like a very there was very uh emotional side of like kind of breaking up with alcohol as I had known it. Um, and not to say I was like had the goal to go sober alcohol-f free. It was just like it can't serve the same purpose that it has in my life for so long. And that was a process that took time. It was very emotional um because there wasn't like a TSM support out there that I started going to therapy um to kind of talk through some of this stuff and get help and make some life changes that I needed to. I see um JGA says she goes to TSM meetups. Um, that's I started that group many, many years ago. Bruce used to come on in the middle of the night because I was just hungry for support from people who understood it. They weren't going to judge me, you know. Um, yeah, real life support. So, I I think it's just helpful for people like especially if you can work with someone who understands TSM and isn't going to demand you to cut back faster than you're ready to or insist that you be sober or condemn you if your ultimate goal isn't abstinence. Um because talking about it helps lift the shame.
There's a wonderful quote by Bnee Brown around, you know, shame thrives in secrecy. Uh but if you speak it out, it can't survive. Something along those lines. I kind of butchered it, but um yeah, I just want to encourage people recognize that your AUD kind of wants to keep you isolated and keep you in shame, but to get support from people who understand so you can talk about it and be honest. That's another thing. feeling the ability to be honest with people and they're just going to hear you and support you and love you and um not judge you. Um all of that's super important.
>> And we have um we we have a we work alongside we have a psychiatrist that we work with and we have a counseling or a therapy organization we work with as well. So the as people are coming through our process we then we can assess pretty quickly whether there are underlying issues or situations. So we can then signpost people onto it.
>> But there is also the other thing that I learned that was really important was from rehab I was always taught that people drink because of anxiety and depression. Now with some cases that's that's the reason. now and with with AUD there are so many there are ex-military people there are uh I don't know what you'd call them in America ambulance and fire brigade and police and >> all the people who are seeing stuff on a daily basis that is you and the normal person working in the office wouldn't see there are some people that going through childhood stuff there's there are it's it there is so much that needs to be dealt with that needs to be dealt with carefully and with with experts s.
So we're across here in the UK, we're not qualified to do a lot of that work, but we make sure that people are signposted to the correct places and to the right the right people.
>> Yeah. Um but saying that though and it's also the other side of that that side of it is very important and the other side is that there are some people who literally they might have had lots of periods of abstinence in the past and when they get on nrexone with the support of what to do when to do it and how much to reduce they quite comfortably and easily just drop down through the stages. So for some people they don't need additional therapy and support.
>> Yeah. Uh there are some people who do, but the the beauty of the support side of it is to work out which category you fall into because therapy and support for some people is the best thing in the world for that person at that time.
Therapy and support can be the worst thing for someone at that period of time as well.
>> So and that decision needs to be made by professional people. Yeah. So, uh, so it's, yeah, there's just so many different there are so many different >> nuanced. It's so nuanced >> and it's so personalized, too. Like, that's something else that I think is important to realize and I have just witnessed that firsthand with my own journey and then walking with others through it. I just see how personal the treatment journey is for different people. And you know what one person is doing for their own success wouldn't work for someone else and vice versa and the length of time it takes people and you know we bring in baggage and history and drinking habits and all of that. And so, um, yeah, like once you start taking the medication and kind of lay that foundation of doing TSM correctly the first few months, um, in our program, we kind of break it into phase two. And phase two is really where a lot of the like you've mastered the TSM protocol, you're doing that correctly, you've got that under control. Phase two is like where the habit change work begins and the um, you know, intentional drink reduction or alcohol free days or things like that. And it's a longer phase. It's more difficult. um people go through it at different, you know, timelines, but um I think it's just good for people to be aware that that's uh something that comes up for most people on TSM. And in fact, the video I put out yesterday, too, it's it was really talking about like when reality sets in and like the newness of TSM wears off and we're not as excited about this new treatment that like we've never heard of. I just see that so many times with people and it was true for me too of like you know the newness of TSM kind of wears off after a couple months and we realize there's more work to it than just taking a pill before drinking and it can kind of be disheartening or defeating and we're like oh man um but just it it happens for most people and I think it's part of any like change you join a diet program and you're super gung-ho gung-ho and excited and then the newness wears off and you're like oh there's I've got to keep doing all this work. Um, but with TSM it's gradual which is nice. Um, just want to jump to the comments. I see Joe is asking can you speak on Nrexone and blood pressure? I personally cannot speak on that. If you're a member in our program Joe um we hold a monthly Q&A with Dr. Vulpachelli. He could speak to that question next uh month. It's the second Wednesday of the month. Um just anecdotally I haven't if I I can't really recall if I've had any questions on Nrexone and blood pressure. So, I don't know if you're having an interaction there or not or what's going on, but that's not something I see come up very often or if it has at all. Have you seen anything like that, Bruce?
>> I was going to ask Joe when I saw that, could you, if you're okay to do it, could you put a little bit more detail in? Is do you feel as if the nrexone is causing high blood pressure or are you asking can I take nrexone with high blood pressure?
um there could be a number of different things that come from that. If it's possible, could you just put a little bit more information into it? Um or does the reduction in alcohol or if you've got a little bit more information then always remember though that we're not medically trained so we can answer it with any experience but as Katie is saying if you could put a little bit more detail >> that might might help. So, >> and I see someone here is from the UK watching. Day four on the meds for me.
Awesome. Some side effects, but then expect them to go away. That's great.
And that's an important point just for most people to know if you have side effects in the beginning. Um, what I've observed and what the research shows, it shows that the side effects typically go away within the first week or two. And hopefully you're working with a knowledgeable provider who can kind of work with you on the dosing and the timing and how to let your body gradually adjust to the medication. Um, I've seen people who had even horrible side effects. They were like throwing up from Nrexone in the beginning, but their doctor worked on their dosing and in a couple of weeks they had no more side effects. So, appreciate you bringing that up.
>> So, okay. Thanks. And Joe, thanks for that. Uh just curious how it impacts blood pressure. I do have hypertension.
So curious always uh again it's might be slightly different in the states Joe but whenever you get prescribed nrexone you'll always have a obviously a medical prescriber that prescribes it. So, anything to do with medical stuff, medical questions, anything that comes along like that. Um, that question is specifically for people who are or for the medical side of things. In regards to my experience with it, um, I've never known uh nrexone to impact uh blood pressure or have an issue with with hypertension. However, that's un unmedical advice and it's also with a tiny amount of information. We don't know anything about your medical background, your medical history. So, that's a question that can be put to the doctor that Dr. Valpachelli that Kate's talking Katy, sorry, Kate, that's a British way of saying it, Kate.
>> Um, uh, or speak to a prescriber as well. I I don't uh I haven't come across it, Katie. I don't know if you have.
>> Like I said, I don't like there's no Usually people will have questions about Nrexone. Um and like I've heard answers from Dr. Vulpachelli on her Q&A that come up, but that one I I don't know if it's ever come up. Um so again, Joe, if you're a member in Thrive's program, we can refer you to a doctor who prescribes and can answer it, or you can join our monthly Q&A with Dr. Vulpichelli where um it's kind of an open table and you can ask any question you have about Nrexstone and he's been researching it and using it for 30 40 years um and is happy to talk through these things. And by the way, Bruce, it sounds like something's like your microphone. I don't know if it's like being tapped or something, but there's like a background noise. Just FYI. I don't know if if others are hearing it or not, but it's um yeah, something's going on.
>> One, two. Can you hear it now?
>> No, it seems okay now.
It was almost like the it was being like tapped or moved or something. Um, yeah, there we go. That's it. That's >> That was me tapping.
>> Okay.
>> I've just plugged in.
>> Let me know if it happens again and I'll I'll uh see if I can do something with it.
>> Okay. I just want to make sure people can clearly hear you so it's not muffled.
Uh, all right. So, let's see. Jaga, I'm sorry. It's J. Br. Bruce, how did Jagadama >> Jagadama >> Jagadama >> Jagadama?
>> Since I am pretty sure extinction burst just happened for me, I am interested to know more and if it will happen again.
Um, so are you talking about kind of like the honeymoon period of uh feeling like you're kind of a few months into Nrexone and you were seeing results and then now it feels like you're regressing a bit. Is that what's going on? Just want to clarify what you mean by extinction burst.
Anything you want to say to that, Bruce?
>> Yeah. And if that is the case, just I'll just answer a quick question as well just for and because there'll be other people asking. When people start on Nrexone initially, you normally see a reduction in the first uh in the first two to three weeks and then it levels out. And like Katie is saying, I keep wanting to call you Kate tonight for some reason. What what's going on?
>> That's what my in-laws in French in France call me. So cuz hey kid kids kid >> um it was a major spike now no desire.
Okay so uh extension burst.
Okay so when you say an extens extinction burst can I ask what you mean by that?
Uh, have you seen a big reduction or is it a big increase? It was a major spike.
That makes it sounds like it was a major increase, not a decrease.
>> Yeah.
>> Can I ask a question? Did you see a decrease in your alcohol or did you see an increase?
Now, no desire.
So come back to >> something one of our members shared a little while ago that always stuck with me too kind of related to this like and she related it because she was going to a dog trainer and the dog trainer said that as they're training and that this is not human but it kind of relates to TSM. As they're training a dog and they're learning new tricks or learning new behaviors, they'll gradually progress and learn those things and they'll be what they called an extinction burst where all of a sudden they're regressing back to old behaviors again as if no training had happened.
And it usually happens toward the end of when the new habit finally sticks. So I don't know if that's what you're referring to. Um >> some drinking more. Yeah.
>> Yeah.
>> Okay.
>> Yeah, that can happen. Did you want to speak to that, Bruce, or you want me to?
>> Yeah. I mean, that's one reason for what Katie is saying. Um the the other things that can happen is depending on how long you've been on Nrexone, you're always going to see spikes. It's always going to happen. um you you're never going to go through the rest of your life on Nrexone without seeing any spikes. And that we call them spikes on a drink diary. So if someone's reduced, you're going to you're going to constantly have have spikes. You're going to have weddings, birthdays, um you're going to have not many funerals hopefully, but you're you're going to have Thanksgiving, you're going to have Christmas, you're going to have stress. Uh okay, so it's just before that. Um you're always going to have something. The the question that I will always ask people if things have increased or your drinking has increased at any stage is um have you been compliant? Chances are the answer to that one is yes. Uh if the compliancy is there that's great. Secondly, it can be the an event. It can be a birthday, a wedding, um an anniversary, it can be Christmas, Thanksgiving or it can be uh something stressful that happens in life. So, it can be um a a a breakdown in a relationship. It can be a marriage breakdown. It can be the loss of a loved one. It can be stress at work is a is a big one. Now, if you've reduced down the way and you haven't really hit any life issues as you've been reducing down the way, you've got comfortable with the reduction level and dealing emotionally with less and less and less alcohol. So, if you then suddenly hit a period in your life 100% compliant, perfect. Um, so if you then uh hit the hit a lower level and there's something happens in your life that hasn't happened during the reduction, what's going to happen is you're going to revert back to your old habitual way of dealing with it, which is drink a little bit extra. But here's the beautiful thing about Jagger, sorry about Jaga Dambo. I'm just reading the thing. Here's the the beautiful thing about the process is as long as you stay compliant, you cannot reverse any part of the process. You cannot do it. So, I won't go into the whole neurological side of it, but as long as you're past 3 to four months on the medication, then the when you when you when as long as you've taken your pill, if you have a day where you drink a little bit extra, it doesn't matter. uh because your the brain has still leared under whatever condition that was the brain is still getting a lower endorphin reward and that's what gives you the long-term success. So um if it goes up always know it will come back down again. It will always come back down again whether that's a day, a week or a month depending on the scenario or situation.
>> Yeah. Yeah. And it just something Dr. Vulpachelli has really kind of taught me. He's our medical adviser at Thrive and he does monthly Q&As and so he kind of dives into the nitty-gritty neuroscience of how Nrexone is working and Nrexone according to him and his research is working in really three different ways when we use it for alcohol use disorder. So we're taking it before drinking. It's interrupting the reward we experience real time when we're drinking. Um second, it's also working on cues and triggers. So, if you're on Nrexone and you walk by your favorite bar, you get that endorphin rush, thinking about drinking, anticipating it. If you've got Nrexone in you, it's um responding to that trigger in a different way. It's not as triggering often times over time. And then also when you are drinking because it's interrupting the reward loop, it's also reducing the motivation to keep going for another drink and another drink. So, all this to say that, you know, like just I think this kind of happened in my case. Um, I don't know if you can relate with this, but I had a lot of drinking sessions on Nrexone at home. Um, that was like my preferred way to drink. So, I was drinking a lot the first few months on TSM at home and not very much when I would be out and about.
Few months of drinking at home on TSM.
The lure of having that bottle or two of wine by myself, it wasn't really there.
like I wasn't really as interested in drinking at home unless it was like with a meal or with my husband or something.
But if I went out because I hadn't had as much experience on Nrexone out at a bar or out socializing, I would still binge drink in those settings and be like, "What the heck is Nrexone not working?" But I think for me in hindsight, it was being in a different setting, a different environment, less practice drinking on Nrexone. I have social anxiety just naturally. Um, so that was like another reason I was being driven to drink more in that setting.
Um, so I think it's important for us to be aware that when we're on Nrexone and TSM, this is why we tell people typically to give it a year for full results. Some people will get there faster, some will take longer. But just having that in your mind because like Bruce was saying, you know, if you get through Christmas and your birthday and summer and fall and winter and all of those familiar triggering seasons and events and things and you give yourself a a time to practice drinking on Nrexone in all of those settings, it gives your brain a chance to experience those cues and those drinks on Nrexone. Um, like yeah, I've seen it like in our program.
I've seen people do like well in the winter they're reducing and then summer comes on and all these summer occasions and they're drinking a lot more or vice versa, winter comes on and Christmas and they're drinking a lot more just because they haven't been on Nrexone in those seasons and times of their life. So, it's helpful to expose yourself to all of these different triggers, all of these different drinking environments with Nrexone to let your brain experience, okay, I'm drinking at Christmas, but I'm not getting the same reward again. If you haven't experienced that yet, your old memory might still be there of like, oo, drinking around Christmas is fun, and I get drunk and all of that. I hope that makes sense.
I was just going to go back Katy if it's okay just to Mary >> Mary Mary boil as well. She she was asking I'm one of those people that have been on null and GABA. Uh I feel like I'm failing because I'm seven months in but I still drink every night. My doctor said I might always drink. I go to group meetings. Um the quite difficult to answer Mary without specific details and questions and everything else. However, there are some general things that can go on there. So when you're taking nrexone, it's lowering the endorphin reward in the brain and rewiring the pathways, therefore removing the craving. So the the process like Katie was saying is you'll see an initial reduction and then it will level out. So the question that I would have for you is did you see an initial reduction when you started on Nrexone and did it then level out and at that stage um it's absolutely vital that I I would say at this stage the group meetings are absolutely fantastic but I would try and get in touch uh if you're in the states get in touch with Thrive.
I can say this for Katie because I get no benefit from this, but I would get in touch with Katie uh and get yourself a coach and get your coach to run through two or three sessions with you and just to run through and get some more specific details. The majority of the time if someone's dropped and leveled out, it's because they they're struggling on the habitual side of things. And it's yes there are some very very and in the groups the groups are amazing for group dynamics to learn things from other people and to pick up tips and tricks from other people but it's also very important to have someone who is experienced in the process like a coach who can then sit you down and say okay tell me a little about how long when did you have your last drink when did you drink how often do you drink what time did you start drinking and that things like that and the coach can put something very very specific say to you Okay, this is what you need to do next. And so it's not that you're failing at it at all. The medication is doing what it's doing. You just need someone to say, "This is your next step.
This is what to do next." The one of the challenges with lots of the the secret is to do little change over a period of time, not do too much too quickly. And that's where a coach will come in handy, especially if you're six, seven months in and it's leveled out. Um, don't give up on it, please. Whatever you do, don't get up. It It works. You You just need to have a little bit more guidance.
>> Yeah, that was great, Bruce. And especially Mary, feeling like you're failing. Um just want to encourage you first of all to give yourself grace. And I mean, in my view, your doctor telling you that you might always drink. That's not all doc if if doctors aren't trained in TSM and how to work with patients through this. Sometimes they say things that aren't the most helpful or most accurate. So that coming from your doctor, I'm not sure what the whole story was there, but um I don't think that's necessarily true. 7 months in, you know, there's still time on TSM to see changes. And like Bruce said, really kind of dissecting your personal habits around why you're drinking, when you're drinking, what you're drinking, and all of that. you're on GABA, so I was curious if you're drinking like primarily if you check in with yourself each night, and maybe it's different dayto day, but are you drinking primarily for relief from like anxiety?
Are you, you know, drinking to cope, to fall asleep, or are you drinking for the excitement, endorphin, euphoric effect of it? Um, you know, when you're drinking for relief, like using alcohol to sleep or cope with anxiety and things like that, even on Nrexone, we can still get the benefits of alcohol in that way.
can still cause us to fall asleep. It can still cause us to not feel as anxious in the moment. So, we can still be in the habit of drinking to cope with those things. For example, even with Nrexone on board because we're still getting the benefits from alcohol in that way. I hope that makes sense. So, that's where it becomes important to gradually start practicing other coping skills um so that alcohol is not something you're relying on in your evening routine in that way anymore. And it's gradual. It's not an overnight thing. It's like again working with a coach, they can be super specific of like, okay, if you're starting drinking at this time, let's delay it a bit and have you do this instead first, for example, to start practicing other coping skills. Um, I I yeah, try not to feel like you're failing. I we have members in our program who take years to reach their goals on TSM, and that's not true for everybody, but usually throughout that time, they're still gradually reducing their drinking. They're having more alcohol-free days, but they're just not exactly where they want to be yet. Um, so try to give yourself grace and yeah, if you're if you're not working with someone that's really experienced with the method, I would really encourage you to reach out for support just to get some specific guidance so someone can specifically understand what you're um going through.
>> Absolutely. Yeah. And and then there's SJ um GP would not prescribe for me after decades and evidence of me trying everything. reason was due to guidelines. When I asked for the guidelines, he didn't know. Went private online UK. Um, unfortunately, that's standard in the UK. The there's lots of different depending on which part of the country you're in. Uh, if you're in the south of England, they'll start rating it as a red medication and therefore they just won't do it. It comes up up on their screen. It comes up on their computer and they just half the time they don't know why they can't prescribe it. it just comes up as a red medication. Um the other places they have some kind of guidelines. Up here in Scotland they have very few guidelines except uh they can do it if they want to. It's just they choose not to because they don't know enough about it. Um so I went private online. So SJ the only thing I would I would say to you is is um absolutely fantastic. Uh unfortunately here in the UK uh it needs to be done privately at the moment.
We're hoping it's going to change in years to come. Um the only thing I would say to you is please make sure that you get um some support. Whoever is prescribed for you in the UK, please make sure that they're giving you onetoone support. So >> yeah, and just to follow up with Mary, um I read further down your comment that you're very self-aware. Congratulations on that, by the way. You're Yeah. You're drinking out of habit. After your marriage ended, I continued to drink.
Sadly, my marriage is when I started drinking. Started drink. Yeah. And again, forgive yourself. Give yourself grace. Don't beat yourself up for this.
Like, alcohol is one of the most effective coping tools in the moment.
It's readily available. It's easy to lean on it. So, a lot of people drink for that reason. Successful, wonderful people. It has nothing to do with who you are as a person. You went through something very traumatizing with your marriage ending. So, um, don't beat yourself up. That's okay. Um, and just recognize that, okay, it sounds like that is maybe one of the primary reasons you're drinking out of habit to cope with the trauma of your marriage ending.
And nrexone can help with that to an extent, but nrexone won't help with the, you know, habit change, the developing new coping skills. In fact, a story I often tell from my journey, I had a day on TS, my TSM journey that was very memorable where I was very emotional and angry and upset. And I was a few months into TSM and I was like, I'm going to drink because that was always what I did to cope with uncomfortable emotions. So, I was ready to take Nrexone and drink.
Um, but I stopped myself and I was like, I don't want to be somebody who has to rely on alcohol every time I'm upset. It was just this like epiphany I had around like no longer wanting to have that chain to alcohol that I needed it every time something hard happened because life is hard. It's just always going to be that way. Um so in that moment I was like, "Okay, well I want to drink to kind of escape. Like what else can I do to cope with this?" And I gave myself permission to just delay my drinking by a couple hours and see how I felt afterward. And what happened is I ended up riding the emotional wave of the uncomfortable emotions. The emotions subsided and after a couple hours I was surprised to find that I didn't even feel like drinking anymore because Nrexone had been working to chip away at the urge and craving in my brain. You know, the months I'd been on it. That was just one example. It's not like I was perfect after that. But it's these moments where we give ourselves chance to practice other coping skills little by little by little so that we can break the link between relying on alcohol as our primary coping tool. Because what's happened with you Mary I think primarily is your brain has learned that alcohol is the answer when tough emotions come up that's like the simplest thing of what happened what has happened when we have AUD our brain learns that and the beauty of TSM is it can unlearn that but we also have to feed it other learning experiences and we do that little by little um Mary if you're a member in our program we have a couple videos on this like breaking the alcohol or breaking the link between alcohol as a coping tool that could be really helpful to watch um So yeah, I hope I hope this advice helps.
>> So yeah, massive and um Wayne Wayne, my man, how are you Wayne?
This man Katie is the one of the most incredible men that I've ever met on TSM. Um hi guys, Wayne here. Rethink Drink. uh since taking Nrexen, drinking down, blood pressure down, absolutely fantastic, emotions all over the place, getting better every day, habitual side, very real.
Uh 45 years of drinking. Um >> one day, uh Katie, you need to get this man on as a guest. Not at the moment.
>> He's still going through the process, but uh Wayne just is an absolutely incredible guy. um his story and his background is just absolutely mind-blowing. The the levels that that he has dropped um just absolutely amazing. Um so emotions I I work with Wayne all the time, Katie, and Wayne is always talking about he has watched almost every single video of yours. I think not every video, but you've got hundreds of >> Hi, Wayne. Nice to meet you and thank you for being here.
Um, is there anything or any wisdom that you can give him because I'm obviously working with him. So, um, >> yeah, >> about the emotional side of it, how to it's getting control of that emotional side.
>> Yeah. Um, I just saw too he mentioned the blood pressure down. I'm guessing because he's drinking less. Someone else was asking if Nrexone impacts blood pressure, but that's certainly true. I had high blood pressure too from my drinking and I was almost put on a medication for it. So, I'm glad that you're seeing that as well. Emotions all over the place. Yeah. Getting better.
Um, I'll tell you what. I cry. I mean, I'm a woman. Maybe this is different, but I cried a lot uh on my TSM journey because I feel like I was numb every day for 10 years, and I didn't allow myself to feel uncomfortable emotions or even good emotions. like an a realization I had I think after I reached extinction.
I was like I think my alcohol addiction prevented me from really truly experiencing true joy. Like I would get the excitement and euphoria from drinking but because I was so numb from the alcohol. Like I couldn't tap into true joy especially like you know I would drink at night or during the day if it was my day off. The next day I'd recover in the morning think about drinking start drinking again then drink. And that was just my life for so long. So I wasn't really in tune with my emotions. And like I mentioned earlier with that story of learning to feel emotions again and sit with them rather than escape them. Um any difficult emotion I would be like almost like okay cool. I'm going to drink. Like just in two more hours I can drink. And I would just kind of like detach from myself and focus on the drink. And then I would drink and just numb out even more. So it's expected that emotions are all over the place. I just want to say that like that's very normal. um allow yourself to feel them. My mantra that I uh used a lot was the only way out is through. Um speaking to the other individual here who's, you know, drinking to cope with the end of a marriage, it's like as humans, we're built to naturally deal with all of these range of emotions that come up in ways other than addictive substances. But when we rely on alcohol for so long, it truly becomes our crutch and our coping muscle becomes feeble and weak. And so recognizing that we're just out of practice with coping with life, you know, naturally. And the more we can gradually practice it with consistency, little by little, the stronger that coping muscle becomes, and the more we're able to deal with life's challenges, um, you know, as they come up. And it's interesting, you know, now, like I haven't drank in almost eight years. I've gone through so many emotional ups and downs throughout that time. And it's just every time I'm going through something hard, I'm like, it's crazy. I don't want to drink right now.
Like there's no desire at all. And whenever you listen to people in traditional recovery, there's always like stories of like fighting the urge and not, you know, being afraid of the trigger or they did relapse. But for me, it's like the wiring has just like been severed to where alcohol doesn't even compute as an option when I'm upset anymore. Um that was because of Nrexone and TSM, but also a lot of just strengthening my coping muscle little by little, letting myself feel emotions, realizing that the only way out is through. I've got to go through it. And I think being able to trust yourself and rely on, you know, not having to rely on anything when hard life gets hard, that's like an exhilarating experience and quite a freeing experience just to know like, okay, I don't need the alcohol right now. Um you know, to cope.
Um, it happens little by little, but um, it it takes practice.
>> The amazing thing that I've heard you say there that I've never heard in the process is whenever we talk about emotions, we always talk about negative emotions, but you just said something just now that also you you didn't know how to experience the positive ones.
I've never thought of that.
>> Yeah, it's I think I realized this. I was reading some of Bnee Brown's books when I was going through TSM and something she said it just like spoke straight to me where she said, I'm going to butcher her quote again, but it's like we can't selectively numb our emotions. When we numb the bad ones, we also numb the good ones. And I was just like, bingo. That is exactly true. Like that is why when I wasn't drinking, I was miserable. And when I was drinking, I'd get that like momentary euphoria from it, but then the buzz would wear off and then I'd be depressed again. And so the ability to feel true joy of like looking at a sunset or going on a nature walk or being with loved ones, I couldn't do that because I was like, "Is there alcohol here? Where's the alcohol?" Or I'd be like, you know, getting drunk already. It was just, yeah, I I don't think I could really tap into that true joy um because I was so numbed out for 10 years.
>> That is an incredible truth. That's just my head's just gone pop.
>> It's true.
>> It is. It's absolutely because whenever we talk about the emotional side of it, we always go to the negative.
>> Yeah.
>> The the negative emotions. And yes, they're there. We're not denying they're there, >> but we never talk about okay, the the positive sides, the having fun, having joy, like you said, the sunset.
>> Um, amazing.
>> Yeah.
>> Absolutely. Mindblowing. And it uh part of this challenge too is learning to have fun without alcohol. That was hard for me because alcohol was the social lubricant. And again, I'm not like a majorly extroverted person. I have some level of social anxiety. I think maybe all of us do. Um so learning to genuinely be able to have fun without needing alcohol to kind of be the, you know, again, social lubricant that reduces our inhibitions and things.
That's a process as well, especially if we've been relying on alcohol um for that for so long.
Um Jagadanda is asking which one of her books are you referring to? I read several of them. I want to say that quote is from maybe Braving the Wilderness. If you search that quote, it should refer to the book it was from, but I think I haven't read her stuff in several years, but I remember I did like two or three audio books of hers um probably in 2018 or 2019.
And and just from a a ma a male point of view as well, Katie, I hope this doesn't come out wrong for I don't know what I can say nowadays and what I can't say, but I'm going to say it from from a male point of view and it's not the case with every every male, but I think it's also very very important for men to understand it as well because it's it's part when I used to manage in rehab centers, we had it with staff as well as as guys who were in the rehab and Uh we in rehab we were working with guys who were just out of prison. They were in front of the other guys. They were all big and butcher and burly but you get them on their own and they were and and and we had a or I started a motto in the rehab and I said tears are good. Tears are part of the process and the so whenever we were working with the guys in rehab and it's the same with TSM.
It's okay men it's okay to cry. Um, it's okay to say, "Listen, I'm struggling with this. I'm not coping." And to >> we call it a blubber in this country. I don't know what you call it in the States, but it's okay to do that. Um, and a lot of with with us men as well, a lot of disappointment and let down and fear comes out in anger. And to cover that anger, a lot of people will consume alcohol to as a part of that process.
>> So, it's like a pressure valve. If you if you let go of that pressure valve, when I it's a different subject, but when I came off drugs, I remember I literally for 12 hours sat in a bed and cried for 12 hours.
>> And and I I couldn't figure out I thought, "What is going on with me?
What's going on with me?" But I just I had hidden behind substances, in this case, it's alcohol, for 10 years, >> and I've not dealt with anything along those lines. So, it was like a pro it sometimes it's part of the the process.
And when you've when you when it's happening, it's great. Even if you're getting therapy, the the worst thing that I found with therapy is every time I went to therapy, I told the therapist, I said, "I'm not coming back here. Every time I come to you, you just make me cry." And that was a real butch thing to say to girl. Um, but please know men, it's part of the process and it's okay to do it.
>> Yeah.
Yeah. And it's interesting. I am working with a client inside Thrive right now who they had been doing like pretty well on TSM and had been on it for a while had reduced their drinking down to just a couple days a week. But what they were doing is they reduce too quickly and like you said that pressure valve where they were kind of in the habit of like okay I'm not going to drink five days of the week and then I'm going to drink on the weekend. And just what you were saying, like they have kids, they have work, they have a busy life. And they were the ones that self-identified like I just feel like it's my way to like let my steam out at the end of the week or let the I forgot how they said it. It was like a pressure valve analogy of like that's my way to do that. And so throughout the week all this pressure is building up and then alcohol is the way to kind of release that. I certainly did that too. It was like I would work all day and deplete myself and feel exhausted and I'd be like at least I have the alcohol to look forward to. And I think part of this healing, yes, is crying. And it's also learning to listen to our needs moment to moment and meet our needs moment to moment. Check in with ourselves because we're so, at least for me, I was so used to like abandoning myself just like with my drinking. I would just be so out of touch with like how I was feeling because I always had the drink to look forward to. So I wouldn't take care of like do I need some rest? Am I hungry?
Do I need hydration? Do I need time alone? And it was just I'd go go and kind of be a doormat for everyone. And again, this is me personally as a woman.
Um I was so insecure from my drinking. I had no confidence. So I was just like allowed people to treat me poorly. And then I'd like run home and cope with it with the alcohol. So I think part of this healing is learning to meet our own needs moment to moment and be more in touch with our emotions and not just numb out and escape them all of the time. Um but yeah, crying was part of the process for me for sure. I I spoke with a a business guy yesterday and run runs a big business. He's got 200 members of staff. He's got three kids.
Uh he's married and and then his wife went away for the weekend and he had a little bit of a blowout. He took his pill and he and he had a bit of a blowout. And when I came and he he said, "I didn't want to speak to you today. I didn't want to speak to you." And I said, "Why not?" And he explained to me and I said and I said, "No." I said, "That's it's okay to do that. You took your pill. You're fine." But what I said to him and I said, "Listen," I said, "what you've got to understand is that when you're at work, you're the boss.
You're the boss of 200, 300 people, whatever he's got. Uh you're a business partner. You when you go home, you're dad. When the kids go to bed, you're husband. And you have to have time for you. You have to give yourself time to to have time for you. And you need to put it in." He's a businessman. I said, "You need to put it in your diary. you you need to diary time for you so that you can just go out I'll call him Jimmy you can go out and be Jimmy and whether that's going camping in the woods or if it's taking your nrexone and having a few extra drinks because you have to do that otherwise all you're doing in his scenario is giving giving giving giving giving and said you've got to have time for yourself where where it comes back to you >> yeah absolutely Yeah, it it sounds cliche and like you hear it in sobriety circles a lot I think too but it really is true of just yeah learning to feel your emotions learning to take care of yourself that is really part of this journey because otherwise we can just keep running to alcohol to kind of numb and cope out and not deal with the emotions or things that come up. Um, yeah. And so many people, women and men, have crazy schedules of kids and work and just so much going on. And when alcohol is like the one thing they have that feels like me time and my reward, that's a difficult habit to break. Um, and I think why TSM is amazing is it can be done gradually, not all at once. You can gradually, you know, learn to take care of yourself in other ways. And especially as the desire to drink weekends, it just becomes easier to, you know, choose other options. You're not forcing it or white knuckling it, but just honoring the fact that that's a very real uh challenge a lot of us go through of like this is the one thing that I love and I look forward to. And um but it has its dark side as well.
That's for sure.
>> And what was I going to say? Um the what we talking about? I can't see on there.
Uh yes. The the the beauty of Nalrexone and the Sinclair method is it takes science. It takes medical research.
And that's very black and white. It's a case of this is what's happening. You drink alcohol, it produces the biology, the neuroscience, the science, the medicine. It's a very very structured, organized, methodically, scientifically trained model of of neurological process.
>> Yeah.
>> The other side of things is we're we're human beings as well. So you have to put the two together. The science on its own is not enough.
>> It has to have the two linked together.
the person. We've be careful how I say this. We've realized over the years that abstinent-based models that rely purely on the human being and their emotions and psychological side is not enough.
We've realized that taking the medication on its own is not enough.
There has to be a join coming together of the two.
>> Yeah, that's a good way to put it, Bruce.
Yeah.
Oh, this has been such a good um conversation with everyone. Thank you so much who has joined. Um hopefully we'll be back again before too long. Uh we were usually doing these about once a month, but life happens and but thanks to everyone for joining. Um if you would like support on the Sinclair method and you're in the UK, please reach out to Bruce at rethinkdrink.co.uk.
They have an amazing Sinclair method program where they support people and they can refer you to a doctor for the medication. Um, and of course in the year US we I run Thrive um thrive alcoholreovery.com which is a specialized uh Sinclair method support program as well. But I just want to thank you everyone who joined. If you joined late, you can watch the replay.
You can rewind it and watch the full thing. Um hopefully we'll see you again before too long. Any final words from you, Bruce, before we wrap up?
>> Nrexone works. It's not your fault. It's a neurological condition and with support uh it's beatable very very beatable >> absolutely again thanks so much everyone for joining um I see is there a Sinclair method program in Canada technically in Thrive's program we can support Canadians but we don't have a doctor um we work with in Canada specifically but you should be able to get it from your doctor there um but reach out to me if you want to go to thrivealcoholreovery.com you can contact me there and I can send you any resources I have. Okay.
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