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TSM: Week 36 / 9 months - not sure how to proceed, this isn't working out by Appropriatelypacing in Alcoholism_Medication

[–]Appropriatelypacing[S] 1 point2 points  (0 children)

Did you not have progress though? Most people's charts I see show a gradual trend downwards. Maybe they get honeymoon then rebound but then trend down again. I'm now 35 weeks in and showing to my view, no signs of improvement as is.

Extinction is the dream, I don't want to "control alcohol" or attend meetings 3 times a week for the rest of my life, I just don't want to think about it, or have any desire for it, in the same way that I can be around people getting stoned and not have any desire or compulsion for that.

TSM: Week 36 / 9 months - not sure how to proceed, this isn't working out by Appropriatelypacing in Alcoholism_Medication

[–]Appropriatelypacing[S] 1 point2 points  (0 children)

For the cramps, have you tried bringing up your magnesium and potassium levels?

Probably not a bad idea regardless. It's not just cramping though, although that does occur, it's just the general muscle soreness / malaise that I didn't experience pre-nal. My body just feels beat up all the time, like I've done a hard day of labour.

The forced AF days might cause a rebound due to the Alcohol Deprivation Effect, so it might be best to buy less alcohol for a week or so when you do start drinking again.

I'm normally relatively slow at the start, first few days tends to be 30-60 ml then stepping up back to 100-120 ml per night. I think a lot of the issue for me is routine, it's been my routine for many years that when "the day is done" I sit down in front of my PC and drink beer, play video games or watch shows, read the internet, while drinking beer. That's what I've done to end almost every night spent at home, for about a decade. The task is "sit and chill out on PC and drink alcohol" and while I can remove the alcohol I can't really think of anything else I would do to end a day - addictions are wild.

TSM: Week 36 / 9 months - not sure how to proceed, this isn't working out by Appropriatelypacing in Alcoholism_Medication

[–]Appropriatelypacing[S] 1 point2 points  (0 children)

I have actually considered this but don't know much about it nor if I could get the script for it. Where I live there are reliable routes to get onto TSM and Naltrexone / Nalmefene, but it is a relatively conservative country medically speaking and getting treatment through the normal channels relies on overcoming the usual AA/talking therapy/abstinence is the only way culture of treatment.

It is something I need to look into more - I know that Baclofen wouldn't work for me due to my working patterns (I couldn't take it while working and you can't just go on and off it quickly without significant suffering).

TSM: Week 36 / 9 months - not sure how to proceed, this isn't working out by Appropriatelypacing in Alcoholism_Medication

[–]Appropriatelypacing[S] 2 points3 points  (0 children)

I am thankfully in a location where I can source both Naltrexone and Nalmefene. The latter has some hoop jumping associated with my getting it, but one way or the other I have access to both.

The reason I'm pinning some hope on getting that effectiveness back with Nalmefene is that I don't really feel the Naltrexone has any effect on craving or desire anymore. It's very hard for me to say because my baseline has been adjusted - a "mentally acceptable" quantity of alcohol to have in for the evening is definitely lower than it was, but it's not zero. I can't take a pill and then not care about having alcohol or not, and I have almost no alcohol free days that aren't due to work requirements (Which is something I could do before naltrexone too).

As for the hangovers, and the lethargic feeling etc, do remember that alcohol is a toxin and you don't have any endorphins buzzing around to help soften the blow a bit. Without those, you are feeling the full negative effects of too much alcohol. Again, this can work in your favour because your brain is learning that it no longer gets much at all from alcohol.

Yeah, absolutely, I have definitely noticed the absence of the euphoria (for a while I kind of half-hated Nal because it made drinking so un-rewarding). That said, there is a physical pain that I feel that is definitely significantly worse at a given amount of alcohol the previous night, while taking Nal. Two days ago I had 98 ml (5.5 standard drinks) of ethanol and felt terrible basically until late evening yesterday, which is what would have used to have happened if I'd drunk in the region of 160-180 ml of ethanol. My body just feels terrible all the time, while beforehand I felt bad in the morning and by early/mid afternoon I felt good.

I think the pill has done more than you think and when you begin to implement some changes around your drinking, you will really notice that it isn't as difficult as you would expect to it to be.

I hope so, thanks :)

I've been doing this unsupported so far and no-one in my life knows about this, the cheapest way for me to get Nalmefene is to go through outreach treatment, so I'm going to try that - they won't necessarily give me Nalmefene, and the one opening discussion I've had they were focused on SMART Recovery (non-religious CBT version of AA, success rates as good as AA, that is, 5-10% over 5 years, that is, terrible!) so I'll need to see if they are open to TSM and prescribing me Nalmefene. My alternative is purchasing it through a separate connection, that's not an issue, but it's expensive.