What is the Sinclair Method?
Sinclair Method is the commercial name for pharmacological extinction of alcohol use disorder. It’s an emerging treatment protocol using a safe, FDA approved medication called naltrexone but employing an advanced dosing protocol that calls for patients to take the medication 1-2 hours before a drinking episode and to avoid it at all other times. That's a departure from the original prescribed dosing protocol which calls for daily use irrespective of the patient's particular drinking pattern. The method has produced unsurpassed results compared to other models. It forms the basis of the Alcure program to reduce or stop drinking alcohol.
Pharmacological extinction was invented from research sponsored by the Finnish government over two decades ago and the same method, using a slightly different medication called nalmefene, was approved for use in the European Union countries starting in 2014. In the U.S. it's in an early adoption phase, having gained substantial traction among patients and medical providers since 2016.
The Sinclair Method involves taking naltrexone to temporarily block the primary reinforcement mechanism of alcohol that drives excess drinking, and which eventually causes a physical urge or craving for alcohol. Established from PET scan medical studies (Positron Emission Tomography), alcohol consumption will cause a small release of the body’s own version of an opioid, called endorphins, with each sip. Though generally not noticeable, endorphins work as a primary biological reinforcement of behavior, creating a reinforcement loop in some people that gets beyond their control.
Naltrexone is taken only when you drink and temporarily suppresses the effects of endorphins released from drinking, disrupting biological reinforcement during alcohol consumption and allowing for an easy decline in the urge to drink over time. Medically, that’s called extinction. Patients report a gradual indifference toward alcohol and are able to restore control over drinking and eventually stop completely if they choose. There are no withdrawal symptoms. Most patients restore control in 4-6 months and will reach extinction of alcohol use disorder in approximately 9 months.