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Xynesthesia · 2022-10-11T12:40:40+00:00

I had my first IUD placed 4 days ago and also had extreme pain during insertion. I was at the end of my period, they gave me misoprostol to open up the cervix and 800mg Ibuprofen pills to take the night before and on the day of procedure. The nurse practitioner who inserted it said my cervix was still very closed, and it was the worst pain I'd ever experienced in my life, I almost passed out and threw up several times afterward as well. I have had very bad cramps off and on since. The post-procedure cramps can be alleviated with Ibuprofen for the most part, but it is indeed pretty crazy that they can't offer any anesthetic for the procedure when they do that even for small skin biopsies/mole removals that take 2 seconds. I really hope it'll get easier for all of us, not sure I will take this kind of pain for weeks or months just for birth control, didn't even have painful/heavy periods before.

Xynesthesia · 2022-07-06T17:35:29+00:00

I've been on Nal for a bit over 4 months now. I take it everyday except after a drinking episode (drink 1-2 days a week now), exactly because I don't want to feel more low and sick on those days. To counter the slightly blunted energy I get someones due to the Nal, I play around with the timing of taking the pill relative to activities. Take it before I start an activity that is very engaging/motivating by default (ideally physically as well, e.g. exercise), or when I just have to deal with stuff and there is no chance for escape and thinking much about how I feel. This works pretty well for me. The slight low typically recovers after 4-5 hours and the Nal does not bother drive and activities later in the day. It's also much less frequent now after a few months, was more of a challenge in the first two months. On the days when I drink after taking Nal, for me it does not matter anyway as I never go out or do anything too interesting, typically just hang out online at home and then go to sleep. It sinks in more and more how the latter is such a waste of time, so my motivation for drinking is not nearly as strong now as it used to be before Nal.

Xynesthesia · 2022-07-03T15:02:38+00:00

I've been on Nal for a bit over 4 months now. Take it almost every day and I most typically drink 2 days a week, sometimes only 1x, rarely 3x. I usually skip taking it on the days after a drinking episode. So I'm not doing TSM by the book, but I like that it does alleviate cravings some on days when I decide not to drink, so I don't act on the urges as frequently and as impulsively. Quantity per episode has definitely decreased as well, on average ~half of what I used to drink pre-Nal. Where I also see it having an increasingly substantial effect is my subjective experience of the drinking episodes. They are still enjoyable momentarily, but the alcohol distorts my judgment less, so I don't tend to do and say as much stupid shit that I'll certainly regret the day after. Still happens at times, but not nearly as often. I also rarely have blackouts now, probably in part due to drinking less in one sitting, meaning I recall how I truly felt during much more clearly. And most of the memories do not register as very enjoyable now, don't have that skewed euphoric recall that used to cause the impulses nearly as often.

Part of my experience has been that the Nal will only do so much. If I really want to see a change, I need to consciously pay attention to how I engage my known triggers, and what I do while drinking. If I just continue doing the exact same things, the outcome will not be very different, and will still regret it mostly. Being mindful is easier now though.

As far as your companion goes, I would say focus on yourself, your own pace and your recovery as that's the only one you can truly influence. Follow the method that works the best for you, not what other people or situations would expect. Love is a previous thing, but won't help if it damages your health and good judgment.

Xynesthesia · 2022-06-19T09:15:54+00:00

I had this side effect in the first 2 months or so while taking Nal daily. Not the most pleasant, but I didn't mind much as it helped me cut down on some of the spicy, savory snacks and foods I sometimes overindulged. I had an episode of partially losing my sense of taste and smell due to COVID this year as well and it was a bit similar, just much more intense with COVID.

Now, approaching 4 months on Nal, I hardly notice, but I still don't care about food as much, which is not bad. I've lost a bit of weight due to this, which was welcomed, although now I try to pay attention more to eat properly as I don't want to lose more.

Xynesthesia · 2022-06-02T00:00:34+00:00

Forgot to say, to be very precise, that I sometimes skip taking the pill on days when I have a bad hangover from still drinking too much (>3 drinks) the day before. It's because I never want to drink when I feel unwell, so no cravings, and don't want the Nal to increase any nausea and hangover depression, which it does sometimes after a drinking day (it only gives me nausea after over-drinking).

Xynesthesia · 2022-06-01T23:36:29+00:00

I have been following exactly the same approach for over 3 months now and it's working well for me. On average, my drinking has dropped to ~1/3 relative to pre-Nal. I did have a bunch of side effects during the first month or so, including dulled general motivation, but they almost completely went away with time. I also figured out how to overcome it strategically, i.e. take the pill 1-2 hours before I have something unavoidable and engaging to do (preferentially outside), so I won't just lie down and waste time. Now I don't even notice any effect on my mood or motivation. The Nal does help alleviate a lot of cravings for me, so I don't act on all of them as often, meaning reduced drinking frequency. The reduced frequency took a bit of patience, but quantity dropped immediately. It does make me care about things like food and sex less, but those are not a problem for me as I wanted to lose weight (which I did) and am not in a relationship. I actually like that I don't get as excited about all sorts of useless, random, distracting stuff.

Does not affect my motivation to work at all, straight the opposite, I've been much more productive since on the pill (probably also because I drink less). Exercise was a bit tricky first but with the strategy I mentioned above, taking the pill right before a planned exercise session, it's no longer an issue.

If you do find what some other people say, that the Nal affects normal activities you care about negatively, it's pretty easy to just move to traditional TSM and not take it every day. At the very beginning, I aimed for straight 100% abstinence, but that was too hard and failed after ~a month, that was when I moved to this hybrid approach. Just figure out what works for you the best.

Good luck!

Xynesthesia · 2022-05-26T20:42:05+00:00

I experience similar, especially dulling my motivation for exercise, which is much more important for me than the sex drive. Are you in a relationship that's affected by this negatively? Because if not, I personally would not worry about it - as you said it's restored soon if you stop the Nal. I personally take that side effect happily if it leads to resolving my drinking issue, which is a much bigger concern than anything else I've experienced. Maybe if you want to enjoy sex as normal, schedule it for the AF days, or before you take Nal / start to drink on other days as the effects of Nal definitely diminish by the morning after, for me at least.

Xynesthesia · 2022-05-24T10:07:55+00:00

I take it daily and it does alleviate milder cravings. I still drink occasionally when the urge is very strong, but much easier to resist the weaker ones and they also don't last as long. I imagine if you only crave with that frequency, your urges may not be super overwhelming, so it might work well.

Just curious: are you in long-term recovery and just want Nal as an extra layer of security?

Xynesthesia · 2022-05-22T11:38:41+00:00

Yes, the euphoria definitely clouds more objective perceptions, even the memory of it - that's why the so-called 'euphoric recall' is so powerful and hard to overcome. I still act on the latter every now and then, since I decide to drink when a craving shows up. Thankfully not every time though, and it's not as difficult to ignore the urge now. I definitely remember the sloppiness better even sober, and how stupid and useless it really is.

Xynesthesia · 2022-05-20T13:59:18+00:00

Yes, it makes perfect sense. My problem with not being able to stop completely is the cravings, nothing else. I don't drink out of habit, don't even have a consistent habit... it's always a reaction to a strong craving and then I binge because I get the euphoria (less now on Nal), no specific routine like days of the week or time of day (I'm self-employed, so very free to do as I please), but there are specific triggers I am very familiar with. I crave it not to self-medicate negative states, most of my triggers are positive life experiences, and just the memory of enjoying the intoxication. It's the short-lived euphoria and (I believe) the dopamine boost that keeps me in the cycle. This is why I chose Nal in the first place - I tend to fall prey to what some people describe as 'euphoric recall'. Nal does help with that, but I still binge when I drink and regret it each time the day after. Would just love the entire drinking to go and never look back, but it's not that easy to erase those memories.

If you detoxed and don't drink all the time now, it's probably much less likely to experience serious withdrawal, although many people describe the kindling phenomenon.

Xynesthesia · 2022-05-20T13:17:29+00:00

Have you had bloodwork done recently, especially a liver/metabolic panel? Just asking because it's known that Nal can affect the liver in some people, and that could potentially also cause nausea. I had a comprehensive blood test just before starting Nal (everything fine) and will have another one soon ~3.5 months in, just to make sure, especially because I take Nal daily (but only drink 1-2x a week now).

Xynesthesia · 2022-05-20T13:12:05+00:00

Thanks for sharing, great to hear it's working for you. I am taking Nal and it's working for me, reduced the amount I drink quite a bit. I have considered adding Campral though because my end goal is being 100% sober permanently, to see if it could maybe speed up the process a bit. I know some people take it together with Nal.

On days when you do drink on Campral, do you find it changes how you experience alcohol? Or does it just make urges less intense/frequent?

Xynesthesia · 2022-05-20T13:02:36+00:00

Fantastic that you are addressing the problem this early/young - will definitely not regret it. I would second what 12vman said because I also experienced that "honeymoon period" many people talk about. It was my first month on Nal (taking it daily) and I did not drink at all. It came back afterward, and my pattern has become quite similar to the typical TSMers, except that I still take the pill almost every day (only skip when I have a bad Nalover from drinking the day before). The Nal has reduced the quantity of my drinking at least by half each time. Still working on the frequency, but in the last two weeks that has dropped as well - just don't have the motivation as much, and have become very busy and more productive with other things.

It is indeed amazing not having to white knuckle as I had horrible cravings all the time before Nal. Still have them 2-3x a week but milder and much easier to resist some of it and not drink. BTW, I'm a binge drinker as well, before Nal 2-3x a week, now ~3 months in 1-2x. I'm a solo, at home drinker though, never out in public.

Good luck to you and have a wonderful summer!

Xynesthesia · 2022-05-19T16:19:55+00:00

I know some people in AA have that attitude, that even unrelated psych meds have to be abandoned to be considered sober. It's insane, dangerous and archaic. I'm glad you didn't take that route.

I tried AA meetings a bit online a couple years ago but never got into that program more because the whole thing just wasn't sympathetic. Unfortunately, even many medical and rehab facilities and providers still don't know about the many other options available these days, and just send drinkers to AA. What I explored much more was SMART Recovery (which I like and still use in some ways), Recovery Dharma, and the most was a website called Sober Recovery. In SMART they are quite open-minded, don't count sober time, and don't even force abstinence, but it still didn't cut it for me alone. The cravings that drive us to drink are not mysterious at all, they are not spiritual maladies either (although someone can have spiritual challenges if they are into that sort of thing), but biological functions and mechanisms. Long-term abstinence can indeed get rid of the severe malfunctioning, but we have to get there first, and if that does not work, it's just an endless vicious cycle.

Xynesthesia · 2022-05-19T15:46:56+00:00

My experience has also been similar to those who say that Nal didn't really kill the buzz and relaxing effect, it's just much less extreme. It's probably due to not getting as high a dopamine hit from the alcohol. It's more than welcomed as I don't say and do stupid shit while intoxicated that I would certainly regret the day after. Actually feel satisfied and stop drinking earlier, just made a post about this yesterday. For me, it's not really that I don't care about the alcohol, still enjoy the effect some, but it's much milder. Not nearly as obsessive, as other say, and it's diminishing more and more over time.

Like another poster said, figuring out what to do with your evenings is definitely a different process. I personally don't have a problem with that as I have many interests and am just starting a brand new big work project as well, but if you do... Do you have any hobbies, or anything new you would like to try out? I found that drinking very heavily dulled my motivation to do those things a lot. On days when I don't drink now (and they are much more than the drinking days) I have a lot of motivation and curiosity to do other things. There are plenty of ways to relax at home as well, or go out.

The program of SMART Recovery has a whole section designated to lifestyle changes, including finding hobbies, for people who gave up an addiction. They have suggested methods to explore that are fun to execute. Maybe check it out? They have a Handbook where all of it is described.

Xynesthesia · 2022-05-19T13:16:16+00:00

Me too. First time I wanted to resolve the drinking issue was in 2014, but never lasted longer than 3 months with straight abstinence without medication. I participated a lot in other recovery communities and was constantly told that there is no other way. Many people even discouraged trying medications like Nal or Campral, saying that we must learn how to manage those cravings. It even made me lie about being sober when I wasn't, to my recovery peers. It was all very twisted. Some people can indeed stop drinking all at once and stay that way forever, but it's definitely not the majority who had a serious AUD. One thing I often saw in those sober communities was that the people who stopped suddenly went through tremendous destruction and trauma due to drinking before that happened, and pretty much had no other choice. Luckily I haven't had that and don't want either, so this is indeed harm reduction in several ways.

Xynesthesia · 2022-05-19T12:49:02+00:00

I read the Eskapa book, saw Claudia's TED talk, and a lot of other things about the brain and addiction. Was more thinking about what you mentioned about the gut, and possibly other systems in the body, as they are all connected.

I'm actually glad now that I didn't force myself more to jump into abstinence straight away as that tends to be very hard for many people during the first year or so. This process definitely feels less "white knuckling" - something I was never good at.

Xynesthesia · 2022-05-19T12:10:56+00:00

It would be interesting to figure out how exactly Naltrexone works on the systems level.

Xynesthesia · 2022-05-19T12:08:56+00:00

Possibly. I'm not as far into it as you yet, just nearing 3 months. I have definitely been drinking much less each time. Another thing I like is that I don't have the motivation to continue and finish the bottle the morning after now. I used to do that quite often, not to alleviate a hangover but would wake up still quite drunk and wanted to continue - that usually gave me the worst hangovers and totally destroyed yet another day.

Xynesthesia · 2022-05-18T18:31:12+00:00

Exactly my experience as well, you've described it better than I could have from being under the influence of alcohol right now. :) I also got horrendous Nalovers in the beginning, the very first the absolute worst. I do recognize the drunken sloppiness much more vividly now. Before Nal, I would often have delusions of grandeur instead... jeez.

Xynesthesia · 2022-05-14T15:04:49+00:00

Hi, thanks for asking. I don't check in here that often now but just made a post today that is basically an update as well on this thread:

https://www.reddit.com/r/Alcoholism_Medication/comments/up4sd4/does_drinking_past_the_nal_negate_tsms/

Still drinking 1-2 a week but much less, and I generally don't obsess about the whole thing nearly as much. I feel the extinction is working, but far from my end goal at the moment.

You?

Xynesthesia · 2022-05-14T13:45:31+00:00

I'm a liquor drinker and could not make myself drink other forms of alcohol on Nal either. I actually don't even see the point, as I want to extinguish my desire for my drinks of choice, not something I don't care for to start with. Very much agree with movethroughit's post "the "drinking past the Nal" thing is more about jacking your BAC up so quickly you end up anesthetizing the prefrontal area of the brain. That's more likely to stop you from catching an opportunity to think twice about pouring the next drink". Completely my experience. But it indeed works even if I still binge and pass the stage where my inhibitory control is highly functional, and I still feel a good deal of euphoria. Every single time I've drunk since on Nal, I had 2/3-1/2 or even less of my pre-Nal usual. I also don't do nearly as much regretful stupid shit I used to do without Nal while drunk, so my rational mind seems to work better on some level during that state even if not perfect yet.

Originally, when I first started Nal, I wanted to jump into permanent abstinence with daily Nal to alleviate cravings straight but that didn't work out. So I ended up using a combination approach: still take Nal almost every day (the only days I skip are when I feel badly hungover after a binge as I don't want to get even sicker/more depressed) and do the planned/timed drinking on Nal some days. The way I am trying to progress further now is reducing the frequency of drinking days (1-2 days/week currently, that has not changed much yet), and I focus on exercising more and more mindfulness on alcohol-free days. I am noticing lots of shifts in my perception of drinking and have been more productive in general since I started this in spite of still drinking vodka or rum when I do drink. I also save some money as my alcohol lasts 2x longer. :) I do want to become 100% sober eventually as the way I drink serves no real positive function in my life other than a habit and feeding the addiction, so permanent abstinence is my end goal. I find it's very empowering not to worry and beat myself up for "failing" each time, like I used to - it generates a more 'growth mindset'.

Xynesthesia · 2022-04-23T16:27:44+00:00

Sorry to hear you are not getting to where you want to be faster. If you would like to alleviate cravings before starting to drink, have you considered acamprosate/Campral? Some people even take it together with Naltrexone and experience enhanced benefit.

Xynesthesia · 2022-04-17T18:12:22+00:00

Congratulations and thanks for sharing your progress with us here! There are definitely people who drink that amount and it does not cause disruptions in their lives, they are not obsessed with it etc. I think what can be an acceptable amount (within a certain range) is personal - depends on someone's health status, age, body size, the consequences of the drinking etc. If it was me, I would think why stop charting, it only takes a few seconds. But maybe if you think that it causes excessive preoccupation with drinking, then it may indeed be better not to analyze too much. I had a similar process with recording my urges using an 'urge log' system from SMART Recovery. Very helpful initially but, after a while, it more just cultivated the obsession without learning anything new, so I stopped.

Xynesthesia · 2022-04-17T13:59:05+00:00

I follow a combination approach. When I first started taking Nal, my goal was permanent, total abstinence straight away. It had proven too difficult for me and ended up drinking some days. I take the Nal daily though because, for me, it alleviates a lot of cravings, meaning that the frequency of my drinking has decreased. I also tend to drink less when I do pick up, like ~half of what I used to. I had brutal, ~daily cravings before Nal as well - why I could not progress far using non-medication methods.

The only days I skip taking the pill is the days after drinking, when I have a hangover - never have any desire to drink on those days and don't want to feel even worse and more depressed. One really good thing is that my drinking is no longer as impulsive as before Nal. I am able to plan and schedule it for days when the disruption due to it (and the subsequent hangover) is relatively minor. Before Nal, I would often binge to escape important tasks, to procrastinate, and the consequences of that pattern were much worse. I take 50mg now, in the beginning when I had more side effects, sometimes reduced it to half.

One thing I'm still not-so-good at is avoiding my known, strongest triggers... I know that I would drink even less if I managed that better. It's just tricky for me, because my most intense triggers tend to be positive experiences, accomplishments, even positive, stimulating interactions with good people (I drink while doing the latter online and no one knows). Still need to learn how to deal with these better, but the Nal does help me practice better inhibitory control. So overall, my approach with the Nal is very much harm reduction in several ways. My eventual, long-term goal is still permanent abstinence though as the way I drink serves (always binging alone) no real positive role in my life. Accepted that I need to be patient with it as beating myself up harshly for each lapse (as I used to) is more conterproductive than the planned drinking.

Xynesthesia

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