What is Extinction of Alcohol Use Disorder?

Extinction is the cornerstone of the Sinclair Method. It’s a term from the field of Behavioral Science and refers to conditioning of behavior. Sinclair Method treatment involves the extinction of behavior shaped by Classical Conditioning.

Classical Conditioning was first discovered from the famous Pavlovian dog experiments where it was proven that you could elicit a reflexive response in an animal by associating a stimulus known to cause a reflexive response, like food, with what’s called a neutral stimulus over and over in what are called learning trials.

In the Pavlovian experiments, Pavlov paired the sound of a bell tone with spraying meat powder into a dog’s mouth over and over. Meat powder would make the dog salivate reflexively. And to be sure, the dog had no conscious control over whether it was going to salivate or not. It just happened because meat powder is food, a stimulus that, from evolution, innately triggers salivation in animals (including us).

By simultaneously spraying meat powder in a dog’s mouth and sounding a bell tone over and over, the dog began to reflexively associate the bell tone with food. After many learning trials, Pavlov removed the meat powder and just sounded the bell tone. And what happened? The dog would salivate in response to the bell tone alone. What was once a neutral stimulus, the bell tone, was now physiologically significant to the dog. Once the bell tone was sounded, the dog would reflexively salivate.

So where does extinction come into the picture? An acquired, unnatural response such as salivating in response to a bell tone can be broken down through a process called extinction. If you were replicating the Pavlovian dog experiment, you would just unpair or disassociate the bell tone from the food powder consistently, over and over, and soon the dog’s salivation response would taper down and vanish. The dog would return to what’s called “baseline” behavior and the bell tone would return to being an insignificant, neutral stimulus.

With alcohol use disorder, the body releases endorphins as essentially an immune response to the intake of alcohol, which is a mild toxin. Endorphins are simple neurochemicals that reinforce behavior and are also released in response to pain. If you pair them with anything you can build-up, through Classical Conditioning, a reflexive response to what should ordinarily be a neutral stimulus, like in the Pavlovian experiments.

The Sinclair Method extinguishes alcohol use disorder by blocking, through the targeted dosing of naltrexone, a safe, FDA approved medication, your endorphins that are released each time you sip alcohol. In effect, by taking the medication consistently each time you drink, you are accomplishing an extinction session because you are unpairing or disassociating the alcohol from the effect of endorphins.

Patients report a gradual indifference toward alcohol over time and the frequency and volume of consumption of alcohol go down. Eventually, patients lose their strong desire or craving for alcohol and are said to have reached “extinction” of alcohol use disorder.

Some patients are baffled by how well the process works. But, you can now see that it’s all based on simple, established science.