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The Sinclair Method for Alcohol Addiction

The Sinclair Method is an evidence-based approach to treating alcohol addiction. Developed by Dr. John D. Sinclair, it involves using naltrexone, an alcohol addiction medication, to gradually decrease cravings for alcohol over time.It is a 12-step alternative approach for people who want to learn to control their drinking without abstaining completely from alcohol, although many people find that they stop drinking after completing this program.

13 Minutes Read | Published Sep 27 2023 | Updated Feb 26 2024 Expert Verified
Emma Collins
Written by
Edwin Gomez
Reviewed by
Emma Collins
Written by
Edwin Gomez
Reviewed by

What is the Sinclair Method?

The Sinclair Method is a non-traditional treatment for alcoholism that allows you to continue consuming alcohol, with the idea that you will gradually reduce your drinking until you learn to drink in moderation or achieve total abstinence.

Most methods of alcoholism treatment, including support groups like Alcoholics Anonymous and alcohol rehab programs, require that you quit drinking as soon as you begin. This can prove extremely difficult for some people and may deter them from joining or attending the program. Unlike these traditional approaches, the Sinclair Method doesn’t require you to quit drinking if that isn’t your goal. That said, with the Sinclair Method, you meet with a provider virtually and set your own drinking goals, so every person gets individualized care.

How Does the Sinclair Method Treat Alcoholism?

A key component of the Sinclair Method is the use of naltrexone, a medication approved by the Food and Drug Administration (FDA) for the treatment of both alcohol use disorder and opioid use disorder.

Naltrexone binds to endorphin receptors in the brain and blocks the pleasurable effects of alcohol. You must take it at least one hour before you plan on drinking. Then, when you have a drink or several at a social gathering, you won’t feel the positive effects, such as euphoria or relaxation or a “buzz.” If you follow this regimen, over time, you will stop associating drinking alcohol with a rewarding, intoxicating experience, which will in turn decrease alcohol cravings and motivation to drink.This process helps you unlearn your compulsive behaviors and gain control of your drinking.

If your ultimate goal is to stop drinking entirely, then naltrexone can help you maintain abstinence and prevent relapse. But if you want to gain control of your drinking and maintain a healthy, moderate habit, then the Sinclair Method can help.

Throughout your participation in the Sinclair Method, you have periodic appointments with your provider to discuss your experience, drinking log, side effects of naltrexone, and prescription refills, as well as any concerns or questions you may have.

The Treatment Process

In order to get started with the Sinclair Method, you will schedule your intake evaluation through a secure online calendar. Your intake assessment will be with a doctor via a 30-minute video call. In your first appointment, you and your doctor will discuss the following:

  • Your alcohol use and any past attempts to quit or control drinking
  • Medical history, including liver disease, drug allergies, or chronic conditions
  • Mental health history
  • Your treatment goals, such as moderation or abstinence

During your first appointment, your provider will also make sure you understand how the Sinclair Method works. They will teach you about:

  • The role of endorphins in problematic drinking
  • Naltrexone, how it works, potential benefits, and risks
  • Drinking logs
  • Liver functioning tests

After your call, your provider will order your naltrexone to your preferred pharmacy, and you can pick them up at your earliest convenience. You’ll receive enough naltrexone doses to last until your next appointment—typically a 30-day supply. You must attend your next appointment in order to receive a refill.

Follow-Up Appointments

Your follow-up appointments will be anywhere from 2 to 4 weeks after your initial evaluation. These appointments will be shorter than your assessment—only about 15 minutes. You and your provider will discuss:

  • Naltrexone side effects and how well you are tolerating them
  • Naltrexone refills
  • Your drinking log
  • Your thoughts and feelings
  • Any additional questions you may have

Liver Functioning Tests

There is a slight chance that naltrexone may cause liver damage, although the risk associated with naltrexone is still much lower than that of alcohol. If you already have liver damage, due to cirrhosis, hepatitis, or another cause, you may not be a candidate for naltrexone. But don’t worry, there are other options for medication.

If you do have a healthy liver and choose to take naltrexone and receive treatment through the Sinclair Method, you may want to get periodic blood work done to monitor your liver functioning.

How Long Does the Sinclair Method Take?

There is no set time frame for the Sinclair Method. It may take anywhere from a couple of months to over a year, depending on you and your needs. The important thing to remember is that change doesn’t happen overnight—unlearning your compulsive drinking takes commitment and adherence to your treatment plan. If you do that, chances are you will experience a significant reduction in alcohol cravings and an ability to control or quit drinking.

Even if you see great results and are happy with your reduction in drinking, you will want to continue taking naltrexone before drinking indefinitely. This is so you don’t suddenly return to feeling the pleasurable effects of drinking and relearn the same compulsive pattern of behavior.

Does the Sinclair Method Work?

According to the results from eight double-blind clinical trials, the Sinclair Method was successful in about 78% of people who followed the method exactly as directed, taking their naltrexone about an hour before drinking. Success was measured in these studies by a significant reduction in drinking.

Side Effects of Naltrexone

It’s important to note that if you consume a large amount of alcohol after taking naltrexone, you are still likely to experience the negative consequences of binge drinking, such as a hangover, poor motor control, or slurred speech. But you won’t experience a pleasurable intoxication, so there shouldn’t be any motivation to drink to excess.

Naltrexone is a safe, non-addictive medication, but as with all medications, it may cause some side effects, many of which are relatively mild and well-tolerated by patients. Common side effects of naltrexone include:

  • Headache
  • Drowsiness
  • Nausea and vomiting
  • Dizziness
  • Reduced appetite
  • Joint paint
  • Cold symptoms
  • Sleep disturbances
  • Toothache

Severe naltrexone side effects include:

  • Pneumonia
  • Depression
  • Serious allergic reactions, such as trouble breathing, chest pain, or swelling of tongue, mouth, face, or eyes
  • Liver damage as indicated by severe stomach pain, yellowing of the whites of your eyes, extreme fatigue, or dark urine
  • Severe reactions at the injection site, such as lumps, blisters, or open wounds

If you experience any of these severe adverse effects, call your doctor immediately. You may need to stop taking naltrexone.

Is the Sinclair Method Right for You?

Different approaches work for different people. The Sinclair Method might be right for you if you:

  • Are highly motivated to change your drinking behaviors
  • Don’t want to quit drinking cold turkey
  • Want to learn to drink in moderation
  • Experience strong cravings for alcohol
  • Have a healthy liver
  • Are okay with paying out of pocket for treatment

The Sinclair Method requires you to be motivated to change because you must be disciplined enough to take naltrexone every time you are going to drink or else the approach won’t work. You must also be willing to monitor your progress with your coach and be honest and open about your challenges and feelings.

Conversely, the Sinclair Method may not be the best option for you if you:

  • Don’t want to pay out of pocket for treatment and/or would rather use your insurance
  • Prefer quit drinking cold turkey
  • Want immediate results (the Sinclair Method may take several months)
  • Experience severe naltrexone side effects

If you aren’t sure whether the Sinclair Method is right for you, you may want to search for a traditional alcohol addiction treatment program that can help you achieve and maintain abstinence with a combination of medications, psychotherapy, behavioral therapy, group counseling, and more.

Find an Alcohol Addiction Treatment Program

The Sinclair Method isn’t right for everyone. If you would prefer an abstinence-based treatment program for alcohol addiction, call our helpline at (800) 429-7690 to speak to a rehab advisor—they can help you find a program that works best for you.

Resources

bullet Sinclair Method (2021)
"What is the Sinclair Method?"
Retrieved on August 17, 2021
bullet Sinclair Method (2021)
"FAQ"
Retrieved on August 17, 2021
bullet Substance Abuse and Mental Health Services Administration (2020)
"Naltrexone"
Retrieved on August 17, 2021
bullet Sinclair Method (2021)
"How it Works"
Retrieved on August 17, 2021
bullet Sinclair, J.D. (2001)
"Evidence about the use of naltrexone and for different ways of using it in the treatment of alcoholism. Alcohol and Addiction, 36(1): 2-10"
Retrieved on August 17, 2021
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