The Sinclair Method (TSM) for Alcohol Use Disorders

Gradually reduce your drinking with the FDA-approved medication Naltrexone

Dr. John David Sinclair created TSM to treat alcoholism. Inspired by Ivan Pavlov, the Nobel laureate Russian scientist who studied animal learning. Pavlov’s dogs got rewards when a bell rang. Pavlov noticed the dogs drooling when the bell rang. As he gave them smaller and smaller goodies, they salivated less. This scientific approach to alcoholism was inspired by Pavlov’s “extinction” process.

Moreover, after examining the causes of alcoholism, Sinclair concluded that it is a learned behavior. He studied the consequences of alcohol withdrawal.  Moreover, he discovered that deprivation does not stop alcohol cravings, but rather encourages subsequent use.

This method advocated “learned behavior” and “pharmacological extinction” over physiological dependence and drunkenness. TSM uses Naltrexone to reduce alcohol cravings. It’s controversial because it prescribes naltrexone along with normal drinking. No need to detox or stop drinking.

Naltrexone Treatment

Unlike other treatments, naltrexone works best when paired with alcohol. If you still drink, naltrexone will help. Even more than someone sober for a week. You can take naltrexone but not drink it.

Also, some people get a lot of reinforcement from drinking. They drink a lot all their lives. Moreover, this becomes an uncontrollable trend. people fight with alcoholism. An example of neuroplasticity

There are two primary ways

The brain changes its circuitry based on experience in two ways. One learns to strengthen habits. The disappearance of non-reinforcing habits. An experiment by Pavlov where dogs learned to salivate at the sound of a bell when food was provided and then the behavior was ‘extinct when food was stopped after the bell rang.

This is how TSM and naltrexone work together. Take naltrexone an hour before each drink. Naltrexone inhibits the endorphins generated by drinking. Drinking loses its appeal.

Moreover, Naltrexone lowers alcohol enjoyment. It is gradually reduced over months. The Sinclair Method permits certain people to socialise without overindulging. Others want complete abstinence but not intense cravings.

In Sinclair’s lab, most alcohol reinforcement utilised the opioid system. Narcotics like Endorphin and Naltrexone are blocked.

An opioid antagonist suppresses endorphin reinforcement in the brain, triggering extinction. Alcohol cravings lessen with time. People abstain or drink infrequently.

In addition, Naltrexone does not reduce alcohol cravings. With an 80% success rate in over 90 clinical trials globally, the Sinclair Method works.

The Sinclair Method Principles

  • When alcohol is consumed, naltrexone inhibits endorphin release.
  • The naltrexone-induced blocked reinforcement diminishes and eventually eliminates the drinking behaviour.
  • The cravings and drinking decrease gradually. There are immediate benefits, but the effects are three to four times stronger after three to four months.
  • The advantages keep increasing as long as you take naltrexone every time you drink alcohol.
  • Naltrexone is not addictive, does not cause euphoria or depression, and has few negative effects.
  • The Sinclair Method works well without rigorous therapy, but it requires education and medical supervision.
  • It’s a lifelong commitment.
  • Positive family history responds well to naltrexone treatment.

The Sinclair Method Research

  • The COMBINE study: a randomized controlled trial. (link)
  • Using naltrexone to treat alcoholism: pharmacological aspects. (link)
  • Endogenous beta-endorphin and enkephalins in ethanol reward (link) (link)
  • Endogenous Mu and Delta-Opioid Receptors for Addiction Treatment (link)
  • GI opioid receptors (link)

Sinclair Method in the Popular Press

Psychology Today:  Drink Your Way Sober with Naltrexone

The Atlantic:  The Irrationality of Alcoholics Anonymous

Sinclair Method Book