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The Sinclair Method: Medication-Assisted Treatment for Alcohol Use Disorder

The Sinclair Method (TSM) is a new way to treat Alcohol Use Disorder (AUD) that uses drugs, specifically naltrexone, to promote recovery. This method has the unique characteristic of allowing people with AUD to consume alcohol while taking naltrexone. Naltrexone can reduce the pleasant effects of alcohol. This differs from conventional AUD treatments, which promote total abstinence from the very beginning of starting treatment.

15 Minutes Read | Published Sep 27 2023 | Updated Jun 19 2024 Expert Verified
Wayne P. Brown
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Wayne P. Brown
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TSM method is completely based on the concept of "pharmacological extinction," which, in short words, entails a gradual reduction in the association between drinking and pleasure. As a result, it may cause a gradual decrease in alcohol urges and intake. The research on naltrexone use for AUD shows considerable promise in alcohol consumption reduction, especially in heavy drinking.

TSM's method stresses how important it is to drink less alcohol and gives people power by giving them a variety of treatment options. This method is an option for those who have difficulty quitting drinking abruptly in programs that focus on total abstinence. It emphasizes a gradual and consistent decrease in alcohol use. In this article, you will learn about this medication-based protocol for treating AUD and how it compares to traditional treatment.

How Is Naltrexone Used for AUD?

The Sinclair Method is the primary way for using naltrexone to treat Alcohol Use Disorder. This method entails taking naltrexone around an hour before consuming alcohol. Unlike standard treatments, which emphasize complete abstinence, TSM allows people with AUD to continue drinking while the drug reduces the rewarding effects of alcohol.

Naltrexone influences alcohol's mode of action by working as an antagonist to opioid receptors. It prevents the release of endorphins that would usually follow from the inhibition of these receptors in the brain when alcohol is drunk. This activity reduces the enjoyment and beneficial effects of drinking, therefore lowering cravings and, eventually, alcohol intake.

In clinical settings, naltrexone is sometimes combined with other treatments, such as therapy or counseling. These treatments complement the pharmacological benefits of naltrexone and concentrate on the psychological and behavioral features of AUD. Regular patient monitoring by healthcare professionals helps them assess the success of treatment and make required changes depending on reaction and development.

By targeting both the biological and behavioral aspects of alcohol dependency, naltrexone provides a complete strategy for treating alcohol use disorder when incorporated with the Sinclair Method. This approach gives individuals a methodical road to recover control over their drinking behavior and helps people cut alcohol intake while keeping a sensible attitude to treatment.

Why is Abstinence Not Required?

The Sinclair Method (TSM) does not require abstinence because it operates on pharmaceutical extinction. This method aims to gradually reduce the reinforcement and pleasure associated with alcohol consumption by providing naltrexone, which, as mentioned before, is an opioid receptor blocker. 

Understanding how naltrexone interacts with the brain's reward system and extinction behavioral principles provides scientific support for this method. The drug naltrexone works by blocking opioid receptors in the brain. These receptors help make endorphins when alcohol is taken. Endorphins play a part in the good feelings and reinforcement that come from drinking.

The idea of this method is that people who take naltrexone before they drink don't get as much pleasure from alcohol. Over time, this continual blocking decreases the urge for alcohol because the brain learns that drinking no longer provides the expected reward. This is known as pharmacological extinction, in which the conditioned response -pleasure from drinking- decreases when the reinforcing effects are continuously avoided. 

In the field of psychology, this approach is also consistent with the behavioral principles that are related to extinction, so it is not only pharmacological but also psychological extinction. In this sense, when a conditioned stimulus -which in this example is alcohol-, is repeatedly offered without the expected reward -which is the pleasure of drinking-, the conditioned response, which is yearning and consumption, progressively vanishes due to a lack of stimulus.

What is The Success Rate of This Method?

The success rate of the Sinclair Method (TSM) in treating Alcohol Use Disorder (AUD) varies with individual and study. According to the official site of TSM, a large number of persons who follow TSM consume significantly less alcohol. This site has indicated that nearly 80% of people see significant declines in their drinking levels after starting TSM.

Numerous individuals assert a significant improvement in their overall well-being, encompassing more than just their alcohol intake. One benefit of their drinking patterns is reducing negative effects, such as social problems or health concerns. While long-term effectiveness statistics for TSM are still being developed, early findings indicate that consistent use of naltrexone within TSM can lead to gradual improvement in the treatment of AUD.

TSM success is determined in part by AUD degree, co-occurring mental health issues' frequency, and the quality of help and monitoring provided by medical professionals. These elements help patients recover control over their alcohol consumption and enhance their well-being, therefore contributing to the general effectiveness of the treatment in this regard.

How Does TSM Compare to Traditional Treatment?

The Sinclair Method (TSM) offers a novel way of treatment for Alcohol Use Disorder (AUD) that, in many ways, opposes traditional methods like 12-step programs. To start, it should be stressed that TSM does not force abstinence; in fact, it lets people drink while using naltrexone, which -again- is a medication that reduces the pleasurable effects of alcohol without demanding quick or complete abstinence. This method is based on pharmacological support, in which the drug blocks opioid receptors in the brain, lessening the reinforcing effects of alcohol and eventually decreasing cravings and consumption over time.

In contrast, established programs like AA encourage complete abstinence from the start. AA's method is based on the existence of a support system and the accomplishment of the classic Twelve Steps, which are based on spiritual and psychological processes to help people be and stay sober. The primary goal is total abstinence, with the premise that even managed drinking can lead to relapse and ongoing alcohol abuse.

TSM is more adaptable and customized, catering to those who may not be ready or able to achieve immediate abstinence. It combines medicine with potentially supportive therapy to address the underlying neurobiological causes of addiction and the psychosocial variables that contribute to alcohol abuse. This is in contrast to AA, which emphasizes a community-driven, abstinence-first paradigm based mainly on group support and a structured program.

TSM is supposed to lead to considerable reductions in alcohol intake, with many people seeing noticeable decreases in drinking levels while following the strategy. Traditional programs such as AA report varying success percentages, but their effectiveness is often measured in terms of maintained abstinence.

TSM offers an alternative for those looking to reduce their alcohol consumption by using medicine gradually. Individual circumstances, readiness for change, and unique therapeutic factors influence the chosen strategy.

Aspect

The Sinclair Method (TSM)

Traditional Treatment

Primary Approach

Medication-assisted treatment for reduction of drinking (naltrexone).

Complete abstinence from alcohol.

Philosophy

Harm reduction and gradual decrease in consumption.

Immediate and total sobriety.

Core Mechanism

The pharmacological approach that blocks opioid receptors.

Peer support, spirituality, and psychological steps.

Medication

Naltrexone is taken before drinking to reduce pleasurable effects.

Usually, medications are not used or are used just during detox.

Abstinence Requirement

Not required.

Required from the start.

Support System

It might include counseling and therapy.

Highly structured, with regular meetings and a community support system.

Success Metrics

Reduction in alcohol consumption and improved quality of life.

Sustained abstinence and participation in AA activities.

Flexibility

Allows for continued drinking while reducing intake gradually.

Strict no-drinking policy.

Individualization

Personalized treatment plans with potential for tailored therapy.

Detox and inpatient therapy could be tailored, then a one-size-fits-all approach with emphasis on the Twelve Steps.

Research Outcomes

Studies show a significant reduction in drinking.

It varies, but success is often measured by continuous abstinence and long-term sobriety.

Spiritual Component

Not relevant.

Central to the AA program.

Monitoring

Requires regular monitoring by healthcare professionals to adjust treatment.

Relies on peer support and personal accountability.

 

Finally, the Sinclair Method is a valid approach that could be used to help people overcome AUD. However, since this is a MAT, professional prescription and monitoring are mandatory to get this treatment. Even though more research is still needed on this method, the use of naltrexone for treating AUD is not new and very promising. 

The psychological and physical benefits of TSM are considerable. If you want professional assistance to decide if this is the right path for you, you can check our Treatment Center Finder to locate the nearest center to you. Finally, it is good to remember that recovery is a long path, and starting ahead is a considerable advance. 

Resources

bullet National Library of Medicine
"Naltrexone and the Treatment of Alcohol Dependence"
Retrieved on June 19, 2024
bullet Mayo Clinic
"Naltrexone"
Retrieved on June 19, 2024
bullet National Library of Medicine
"A Pilot Study of Naltrexone and BASICS for Heavy Drinking Young Adults"
Retrieved on June 19, 2024
bullet Wikipedia
"Extinction"
Retrieved on June 19, 2024
bullet Sinclair Method
"Sinclair Method Success Rate"
Retrieved on June 19, 2024
bullet Advances in Addiction and Recovery
"How the Sinclair Method Changed My Mind About Naltrexone and Alcohol Recovery"
Retrieved on June 19, 2024
bullet National Library of Medicine
"Effects of naltrexone on alcohol self‐administration and craving: meta‐analysis of human laboratory studies"
Retrieved on June 19, 2024
bullet Alcohol & Alcoholism
"Evidence about the use of naltrexone and for different ways of using it in the treatment of alcoholism"
Retrieved on June 19, 2024
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