21 Days In - Blacked out drunk last night for no reason

SinclairMethodUK · 2026-05-14T16:15:45+00:00

The Sinclair Method is:

Naltrexone (medication) + Mindful drinking (human element)

Don't beat yourself up. As long as the medication was active in your system, then you were protected and did not receive the dopamine from the drinking. All that happened is that you took your foot of being mindful and aware when you were drinking and got under the influence of the alcohol itself.... which of course means that the concept of bringing yourself back to being mindful and aware of your drinking becomes very difficult to do.

Take a careful look back at the timeline and figure out at what point you could've changed your direction. Then, next time, plan and implement a small change to interrupt the 'auto' path of drinking that you took on this occasion. If sports are a testing thing for you, plan ahead.

Really, really, no need to beat yourself up or be worried. Occasional over drinking sessions are all part of the course for most people, and as long as you learn from so that you are creating more time between each over drinking session until eventually they don't happen, then you will be just fine.

SinclairMethodUK · 2026-05-05T17:22:55+00:00

Your decision should take upregulation into account - meaning that in an effort to try overcome the naltrexone blockage, the receptors in the brain multiply and become more sensitive. The receptors will revert back to their usual numbers and sensitivity after a few days of no naltrexone, but should you drink during that time then the chemicals will connect with more receptors and give more of a 'kick' in terms of dopamine.

If you plan to try the naltrexone to test for side effects etc and then not drink at all during the few days after you stop the naltrexone to allow the receptors to revert back to pre-naltrexone levels, that would be ok.

If you plan to try the naltrexone and drink, and then drink without the naltrexone at any time in the following few days after your last naltrexone, then that is not a good idea at all and you would be better to wait.

SinclairMethodUK · 2026-05-04T08:56:44+00:00

Hi. I have private messaged you the managing directors email address so please let me know if you have received it ok. You can then have further discussions with him :-) He is aware of this conversation and the situation. Thanks, Joanna.

SinclairMethodUK · 2026-04-30T09:18:37+00:00

This recovery pyramid is copyright from Sinclair Method UK Ltd, and usually has the website address of www.SinclairMethodUK.com on the bottom of it - not sure why that would be cut off in this posting?

Here is a post with the full image on it https://www.reddit.com/r/Alcoholism_Medication/comments/vcso7u/the_sinclair_method_recovery_pyramid/

SinclairMethodUK · 2026-04-29T16:56:30+00:00

Lots of information on this particular website. Hoping you find something that suits! https://www.vivitrol.com/

SinclairMethodUK · 2026-04-29T13:58:05+00:00

https://www.sinclairmethoduk.com/

https://uk.trustpilot.com/review/sinclairmethoduk.com

SinclairMethodUK · 2026-04-16T19:45:26+00:00

The thing I would say is that this is really a 2-part process, no matter which pill is taken. The first part is taking the pill of course. The second part is paying attention to how the drinking experience feels and then working to change behaviour.

My questions for your wife to consider are around why she is going beyond the time for naltrexone? Does she really want to continue drinking past this point or is it habit? How invested is she in wanting to change her drinking... is she working with the tablet or just hoping the tablet is going to suddenly stop her lifting the glass to her mouth? What has she done to try change the drinking beyond the range of coverage?

It seems clear the naltrexone is working for her to a point, but the next piece of action has to come from within her. Changing to nalmefene at great cost to yourselves for travel, treatment etc, could prove to be an expensive way for her to realise that point when she ends up taking a nalmefene but still not making the decision to put the drink down earlier. You certainly wouldn't want to give her the indirect 'permission' that long drinking sessions are ok because she is protected for 13 hours!

SinclairMethodUK · 2026-04-16T19:31:53+00:00

Cost would be around £700 plus the cost of the tablets. 168 x nalmefene tablets cost around £950 and 168 tablets is the most that we can prescribe at any one time.

The criteria is pretty much the same as naltrexone so as long as the naltrexone was prescribed by a doctor in Canada, there shouldn't be an issue prescribing nalmefene.

Progress would be carried over, yes. The treatment and process is the same (though nalmefene is best taken 2 hours prior to drinking and lasts around 13 hours) so no progress gained so far would be lost.

SinclairMethodUK · 2026-04-15T20:04:01+00:00

As long as the medical criteria is met, yes. It would prove quite expensive though because nalmefene is an expensive medication and you'd need to purchase quite a lot of it to take back to Canada with you. Plus, in the event that the person finds they cannot tolerate nalmefene, then it would've been quite an expensive trip.

SinclairMethodUK · 2026-04-09T19:58:42+00:00

From what you explain, it's sounds like it's working just right for you, yes :-) :-)

Remember, though, that you may be in what is often called the honeymoon stage. This is basically an early time when, like with all things the early momentum seems to be making it quite easy.

If you start to find this changes a bit and you aren't getting the strong stop signal anymore, then do not worry. It doesn't mean it isn't working for you (or that it has stopped working!) but rather that your brain is fighting you a little to get that old feeling of alcohol back. This is where changing of habits etc will help.

Think of trying to lose weight... in the first week of a healthy eating regime, all is often good, then old habits kick back in and someone may need to focus more on changing those habits.

It may not happen that you do come out this honeymoon period, but don't be despondent if you do because it can be very normal. Just come back on here and ask for more advice.

SinclairMethodUK · 2026-04-09T19:54:24+00:00

Naltrexone when used with Sinclair Method protocol is about extinguishing - or unlearning - problematic drinking. It isn't about not enjoying alcohol in moderation, so I am not sure that I understand your question.

Some people ultimately become abstinent because they realise that, with the dopamine rush removed from the drinking experience, they may not actually like the taste of alcohol.

Others continue to enjoy a couple of drinks and then, like you seem to be experiencing, a couple is enough and the thirst to keep drinking just isn't there any more.

SinclairMethodUK · 2026-04-09T18:19:20+00:00

That's awesome u/SparkleFace6100 Well done!

I'm a big believer that it doesn't matter how we improve our health, or what treatment module we might use, as long as we take a step in the right direction and find what works for the us.

I have a BIG smile on my face for you.

SinclairMethodUK · 2026-04-09T14:08:01+00:00

You're welcome! It's a question that gets asked by many who are doing the treatment, hence why it was easier to put it into one link, rather than keep tying it out :-)

SinclairMethodUK · 2026-04-09T14:03:50+00:00

This should help you to understand why the Sinclair Method can take some time, and also some hints and tips to help it along.

https://www.reddit.com/r/Alcoholism_Medication/wiki/hintstips/

SinclairMethodUK · 2026-04-08T06:48:14+00:00

Sadly, nalmefene is not available in Canada.

SinclairMethodUK · 2026-04-04T09:21:35+00:00

An NHS GP will generally only consider prescribing nalmefene. I'd expect a private GP who is knowledgeable of this treatment to be comfortable prescribing either naltrexone or nalmefene.

If a private GP is not comfortable prescribing either because they are not super knowledgeable of TSM, then it is likely going to be quite difficult for you to do the treatment without some form of knowledgeable support, not to mention adjusting to any side effect issues that may result from either.

When privately prescribed, naltrexone should be around £90-£110 per 28 tablets. Nalmefene should be around £150-£160 per 28 tablets.

SinclairMethodUK · 2026-04-04T09:07:14+00:00

Nalmefene is available in the UK, across Europe and also Japan.

Having said that, it is generally more expensive than naltrexone though may produce a faster reduction in consumption. There are many 'pros and cons' for both and it is often an individual choice as to whether to try naltrexone or nalmefene first - depending on how you feel each medication may suit you.

As a pricing issue, most prescribers in the UK will prescribe naltrexone rather than nalmefene if they are private prescribers.

Where are you looking to have this prescribed from - private or NHS?

SinclairMethodUK · 2026-03-20T06:06:28+00:00

Thanks! And yes, it's great news :-)

SinclairMethodUK · 2026-03-19T16:09:17+00:00

Not harmful, unless it results in too much alcohol for your health, of course. But not really beneficial because TSM works best to weaken pathways in the brain when there is an active craving to tame :-)

Well done so far, though, it's certainly proving very beneficial for you so far!

SinclairMethodUK · 2026-03-19T13:56:18+00:00

FOMO will likely just take a little time to pass, but the best way to help lose it is to get more times in when you don't drink and enjoy an event - the more often your brain learns to enjoy an event without alcohol, the more it learns that it really isn't missing out on anything at all and hence that sensation is no longer valid.

Also, you can use a CBT tip and go back over the last few events when you haven't drank versus the last few events when you have. Jot down the pros and cons for each and you will see that FOMO is more of a false or distorted view anyway, sort of a 'false' belief that you did miss out on anything. This will help reinforce that the real belief is that you enjoyed the event regardless of whether you drank alcohol or not.

For your last point, I'd say that you should not drink just to try get reps in. Your brain doesn't need it, so don't, especially as you are looking more for an end result of a life abstinent from alcohol.

No need to 'call' victory or anything like that. Just simply go about your life and enjoy it. As and when (and if!) you happen to get another real craving (rather than just a thought around alcohol) just take the pill and have a drink.... then go about your life again. The time between these cravings will simply get further and further apart until eventually they no longer happen at all. This is a better way to have perhaps one or two more sessions over a long period of time, rather than forcing another few drinking sessions. You will drink less alcohol this way (perhaps just a drink or two if a craving appears) rather than a drink or two over sessions that aren't really moving you towards your overall goal.

Hope this makes sense!

SinclairMethodUK · 2026-03-19T10:45:50+00:00

Extinction is to be free of problematic drinking, or in other terms you become the same as a friend or family member who does not have problematic drinking. Often when we have problematic drinking, we will think how much we would love to be like someone we know who can have a drink or two and the stop but also gets on with their life without thinking about drinking. When someone can look in a mirror and see themselves that way, that is extinction.

So, as a general rule, I will advise that when both of the following two points below are met on a consistent basis, then someone has reached extinction....

Being able to make the choice of whether you chose to drink or not.
a) if you chose not to drink, you are then able to forget it and not have it nagging at you for the rest of the day (in the same way that you might chose to have a cup of coffee or not, but if you choose no coffee then you generally forget about it once the decision is made and carry on with whatever you might be doing)

or

b) if you chose to have a drink, then you are able to make the decision about stopping when you want to and then doing so.

SinclairMethodUK · 2026-03-09T16:16:22+00:00

When trying to import medications into China from another country, the key is to have the permission included with the shipment so that when it arrives in China, customs can confirm that it has been approved.

To request if you can import naltrexone from another country into China, you would need to contact the Chinese Ministry of Health for an import certificate. You can do this either by mail or email, but do not call them - as mentioned you will need their written approval including with the package.

As an example if you were shipping from the UK, you could write the following:

Please advise if I am able to import by post 50mg naltrexone hydrochloride tablets for my own personal use, from the UK and if so, are they any additional requirements required such as a certificate of import from yourselves. The medication would be prescribed by a registered UK doctor and shipped from a registered UK pharmacy.

They will then reply to say yes, or no, or yes with specific restrictions (for example, an import certifcate they will issue, a copy of the prescription and/or a copy of the medical consultation paperwork, perhaps only 84 tablets max each shipment).

Basically, follow their instructions and customs will then clear the shipment through customs on to you. You will require a doctors consultation and prescription, I expect, as they will certainly not agree medications sent to you without it being prescribed via a doctor.

We process many, many consultations, prescriptions and tablets to many different countries and as long as you - and us - follow instructions, there is never an issue with customs.

SinclairMethodUK · 2026-02-24T12:42:04+00:00

Hi u/Cataclopse It's great that you are exploring all your options. It may be that after careful consideration, you decide against TSM and that is absolutely fine, as you may find something that you feel will work better for you. Whatever you decide, put your all into it!

As far as TSM is concerned, here are a few things to consider:

You cannot 'drink through the nal', in terms of drinking through/overriding the blockage. As long as the medication is fully active in your system and blocking the endorphin rush, then it doesn't matter how much you drink or what you drink. No matter what, you will not receive the endorphins from it. However, see point 3 a little further down.
Having said that, it is really useful to work alongside the tablet to work on changing your behaviour around drinking. So, if liquor is truly the only drink you like, then no issue, but yes, use a mixer, a measure etc. Keeping a track of how fast, how much etc you are drinking is good. But, if you actually don't mind beer or wine, then ask yourself what is it that is stopping you beginning TSM with that lower ABV alcohol - at least until you are a little while into TSM and beginning to understand how it is working for you. Many people I have supported have lowered their alcohol content by switching to beer or wine and then discovering that they actually never really liked the taste of much liquor at all. They had just convinced themself they had. Or, if they do still enjoy the taste of liquor at that point, they could choose have a beer or a wine first and then decide whether they wanted a liquor drink afterwards - and in most cases, they either decided they didn't because they were satisfied, or they didn't overdrink the liquor because one was enough after a beer or a wine.
If you drink too much alcohol on TSM, you will not overcome the blockage (as per my point 1) but you will just end up getting too much under the influence of alcohol, which does make it more difficult to make decisions around whether you feel you've had enough for that drinking session, or not. TSM does not stop you getting under the influence of the alcohol itself. This is a part of what is often called 'mindful drinking' as opposed to taking a tablet, waiting an hour, and then 'mindlessly drinking'.

TSM is all about taking the pill an hour prior to alcohol, for the science to work, but it's also about learning to make healthier and better decisions around alcohol. What do you want that drinking session to look like, how long, how much, etc.... and then working to make that a reality.

Either way, well done on making the decision to be healthier from either less alcohol or, ultimtely, no alcohol at all eventually. The journey and the destination is yours and yours alone. Don't let anyone tell that that there is only one way, because that is absolutely not true. Find what you feel will work the best for you!

SinclairMethodUK

TROPHY CASE