Disrupt the Urge to Drink With Safe, FDA Approved Medication
Each time you drink alcohol endorphins are released and attach to cellular receptors in the brain. Endorphins reinforce behavior at the reflexive level, and in some people that causes increasing difficulty managing alcohol intake, also known as alcohol use disorder.
Naltrexone is a safe, FDA approved medication approved in 1994 for treating alcohol use disorder. It works by disrupting endorphin activity in the brain and blocking the reinforcing effects of endorphins. Naltrexone was originally designated for constant, daily use, regardless of the patient's particular drinking pattern.
Enter Naltrexone Therapy 2.0 : The Sinclair Method
Using the Sinclair Method, patients take naltrexone only before drinking episodes and avoid it at all other times. That's called targeted dosing and represents a significant advancement in naltrexone therapy for alcohol use disorder, shifting the original dosing regimen from constant, daily dosing to dosing that coincides specifically with an individual's drinking pattern. The result? Robust extinction of the frequency and amount of alcohol intake producing more alcohol-free days and restoration of control over drinking with far less dependency on the medication.
Over time patients report a growing indifference toward alcohol as their cravings and strong desire for alcohol dissipate. The process of extinction occurs gradually over a matter of months, and patients reverse alcohol use disorder back to controlled drinking or stop drinking if they choose.
“Medication assisted treatment with naltrexone, the Sinclair Method, appears to be the most effective treatment for alcohol use disorder at this time.”
Clifford Fields, D.O., Emergency and Addiction Medicine
Medical Provider Video Chat Sessions
You’ll start with an initial video chat medical assessment with your Alcure provider and will have continued, unlimited video chat access to your provider as you progress. We encourage all clients to take advantage of this feature to optimize treatment and reach their goals as quickly as possible. Our platform comes with industry leading, HIPAA compliant security and privacy for video chat and you can video chat from any device.
Video Modules Guiding You Through Our Entire Program on Your Schedule and at Your Pace
We have three video modules delivering over 10 hours of curated content guiding you through our entire program.
Module One is our flagship set of videos and walks you through the details of Sinclair Method naltrexone dosing protocol, key to success. Module One will show you best practices for compliance with the dosing protocol so you become a pro at the Sinclair Method. Module One also includes our downloadable drink-tracking templates with full explainers on how to use them.
Module Two shows you how to harness the boost in endorphin activity from naltrexone during a temporary phase called “upregulation” of the endorphin cellular receptors, which happens when naltrexone eliminates from your body. During the temporary phase, healthy, endorphin-backed behaviors are boosted and reinforced into habit because your body is more sensitive to endorphin release. Endorphins are released from a number of healthy activities ranging from exercise to laughter.
Module Three tackles secondary causes of alcohol use disorder and shows you how to neutralize these causes and start to optimize on your new lifestyle. Our third module covers a wide variety of science-backed and evidence-based behavior modification techniques to move you away from excess drinking.
Not only will you have unlimited video chat access to your Alcure medical provider, but we provide ongoing support through unlimited email messaging with your provider and offer one-to-one coaching upon request.
We're able to meet the unique needs of each client by covering all bases of support, from scheduled video chat meetings and easy messaging with your provider, our courses and downloads guiding you through our program, and live one-to-one coaching available via video chat and email.
Your New Lifestyle
Clients usually report a growing indifference toward alcohol as they progress. As excess drinking starts to take a backseat in your life, you'll begin to open doors with new activities, a new outlook on life and enjoy a new, healthier lifestyle.
Once clients reach their goal they move onto the maintenance stage of Sinclair Method treatment. That involves periodic check-ins with your Alcure medical provider for a reassessment and refill of your naltrexone medication as-needed to suit your new relationship with alcohol.
A word on the difference between daily dosing of naltrexone and targeted or as-needed dosing of naltrexone so its effects are paired with drinking episodes (the Sinclair Method).
Daily dosing of naltrexone has been the primary way to prescribe the medication and that protocol came from pre-1994 medical studies before the FDA approved naltrexone for treating alcohol use disorder. While not ineffective and still suited for some people, daily dosing is not state-of-the art use of naltrexone and ignores medical studies from Finland, where the Sinclair Method was invented and over 60,000 people were successfully treated with it as early as 2006, and more recent studies involving nalmefene (a nearly identical medication to naltrexone currently only available in Europe) from 2013 that also showed targeted dosing (also called as-needed dosing) produces fast, robust and durable results at overcoming alcohol use disorder.
Daily dosing not tied to drinking episodes can end up flooding the bloodstream with naltrexone resulting in a washout effect impacting other routine, daily, and healthy endorphin-backed behaviors. For example, studies show that naltrexone reduces sexual arousal toward attractive faces (Chelnokova et al. 2014), reduces motivation for food intake (Yeomans and Gray 2002), reduces post-exercise feelings of calmness and wellbeing (Daniel et al. 1992), and inhibits social bonding (Inagaki et al. 2016). The goal of targeted dosing is to produce extinction of excess drinking while leaving other endorphin-back behavior alone, and minimize use of the medication. And, another benefit of targeted dosing is the creation of temporary windows of cellular upregulation, which is when endorphin cellular receptors temporarily become more sensitive as naltrexone completely eliminates from the body. During cellular upregulation, patients have the opportunity to boost reinforcement of healthy, endorphin-backed activities such as those mentioned above, take greater pleasure in those activities and strengthen a healthier lifestyle over excess drinking in doing so.
Extinction is focused on retraining the brain and body at the reflexive level so that alcohol no longer brings about reinforcing effects driving the urge to drink. Daily dosing of naltrexone, regardless of a patient's individual drinking pattern, is primarily meant to suppress the entire endorphin reward system and make alcohol less appealing to the drinker. Targeted dosing achieves extinction, which is a reversal process with a distinct endpoint of restoring clients back to a healthy state free of difficulty managing drinking while leaving the rest of the endorphin reward system intact. With the Sinclair Method, naltrexone use also declines in sync with the frequency of drinking, eliminating the need for chronic use of the medication.
Also, FDA guidelines published for U.S. medical providers have not been updated to recommend targeted dosing of naltrexone as an option and many providers are reticent to depart from the FDA guidelines. However, medical providers may legally prescribe naltrexone "off label" for targeted dosing, and it's these providers that opened the gateway for adoption of the Sinclair Method in the U.S.
Finally, some medical providers point to literature stating that a standard dose of 50mg of naltrexone works for 24 hours, suggesting there's no point in targeted dosing since the medication lifecycle is 24 hours. That 24-hour period refers to the blocking effects against of diamorphine (heroin) and not endorphins released from alcohol, which may not be as long (Umhau 2020 at p. 19 "Understanding the Naltrexone Wall").
Click on the links below to see the studies that back our method.
This 2012 Mitchell study, out of the University of San Francisco, proved that alcohol releases endorphins (also called "endogenous opioids") which are the body's naturally produced version of an opioid that simply reinforce the act of drinking. Using naltrexone, which we prescribe to our clients for targeted dosing to disrupt that reinforcement, is the basis of the Sinclair Method.
This 2001 study, put out by the Finnish National Public Health Institute and authored by the scientist that invented the Sinclair Method, explains the basics of what's called pharmacological extinction in the medical literature and how it employs the targeted dosing of naltrexone to achieve extinction of alcohol use disorder.
This more recent European medical journal article summarizes two large-scale patient studies testing the targeted dosing of a second-generation opioid-blocker similar to naltrexone to achieve similar results in extinguishing alcohol use disorder as the Finnish studies produced. In 2014, pharmacological extinction combined with support was officially approved by the European Union's version of the FDA as an effective treatment model and is now widely available for treating alcohol use disorder in Europe.
This 2009 study, from the Waggoner Center for Alcohol and Addiction Research in Texas, explains how the alcohol molecule also mimics GABA, a naturally occurring neurochemical that slows brain neuron firing to produce a calming effect, the reason many people drink. Opioid-blocking medication doesn't block GABA, making extinction of alcohol use disorder relatively effortless. How? The overall drinking experience is not substantially affected. Just the endorphins are blocked, a less noticeable effect.
This 2006 study from the University of Pennsylvania explains how support improves the outcome of medication-assisted treatment of alcohol use disorder by assisting patients in understanding treatment protocol and compliance. Support also assists patients with neutralizing secondary causes of alcohol use disorder that usually bring about the condition in the first instance.
This 2008 study, from the University of Indianapolis, explains the alcohol deprivation effect, which is nearly identical to yo-yo dieting for people attacking a weight issue through will-power alone. With alcohol use disorder, we call this relapse. Our treatment method will eliminate relapse once you cement the habit of as-needed use of naltrexone any time you choose to drink in the future. It's easy to do. The chart below demonstrates the basic yo-yo trajectory of drinking caused by the alcohol deprivation effect. Time periods in which cravings rise due to forced abstinence will vary in length from person to person.