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Extinction of Craving Alcohol "addiction"

What if you stopped thinking about alcohol all the time? A method for a cure you and your desired relationship is defined by what you want... not by your hunger.  


A cure where you are required to drink to achieve neural reprogramming.

Remarks, Findings & Conclusions by David Sinclair, Ph.D.

In his own words.....

Remarks, Findings & Conclusions  by John David Sinclair, Ph.D 


 The Sinclair Method (TSM) uses the  nervous system’s own mechanism, called “extinction”, for gradually  removing the interest in alcohol and the behaviors involved in alcohol  drinking. Therefore, the technical term for TSM is “pharmacological  extinction.”  (Note: in layman's terms-- this is the "extinction" of one's cravings and desire for alcohol)  

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The key scientific discovery underlying  the treatment was that, contrary to earlier beliefs, detoxification and  alcohol deprivation do not stop alcohol craving but in fact increase  subsequent alcohol drinking [1], [2] . The old idea that alcoholism is  caused by physiological dependence on alcohol, therefore, needed to be  discarded, and a new understanding of alcoholism developed.

Subsequent research showed that alcohol  drinking is a learned behavior[3]. Some individuals, partly for genetic  reasons, get so much reinforcement each time they drink, and have so  many opportunities to drink and get reinforcement, that the behavior  becomes too strong. They cannot always control their drinking; they  cannot “just say ‘no’.”  And society calls them alcoholics.

Laboratory studies indicated that in  most cases, the reinforcement from alcohol involved the opioid system,  i.e., the same system where morphine, heroin, and endorphin produce  their effects.[4]

The brain has two primary mechanisms for  changing its own wiring on the basis of experience.  First, there is  learning for strengthening behaviors that provide reinforcement.   Second, there is extinction for removing behaviors that no longer  produce reinforcement.  The best known example involves Pavlov’s dogs  that learned to salivate to the sound of a bell when the bell was  followed by food, but then had the learned behavior extinguished when  the food reinforcement was no longer given after the bell was rung.
Certain medicines, such as naltrexone,  naloxone and nalmefene, block the effects of endorphin and other  opiates. I reasoned that if alcohol is drunk while one of these opioid  antagonists is blocking endorphin reinforcement in the brain, the  extinction mechanism would be activated, and it would then produce a  small but permanent decrement in alcohol drinking and craving. The next  day, the person would be slightly less interested in alcohol. Eventually  control would be regained, and the person would no longer be an  alcoholic; indeed, they no longer would be interested in alcohol[5].

The Sinclair Method was confirmed, first  in a large body of laboratory studies[6], then in over 90 clinical  trials around the world[7],[8],[9], and most recently in personal  reports by people using it. It has been found to be successful in  about 80% of alcoholics.  This is very high for alcoholism treatment,  but the treatment is not for everyone: some people apparently have a  different form of alcoholism that does not involve the opioid system and  cannot be treated effectively with opioid antagonists.

The Sinclair Method is simply taking an  opioid antagonist before drinking. Naltrexone, naloxone, and nalmefene  are not substitution drugs similar to methadone for heroin addiction or  Nicorettes™ for nicotine addiction. The opioid antagonists are not  addictive, and they do not directly reduce craving for alcohol.  And  unlike disulfiram, the opioid antagonists do not produce an unpleasant  aversive effect. Indeed, the opioid antagonists do not do anything until  after endorphin has been released. Then the mechanism of extinction is  triggered, and the extinction mechanism in turn progressively but  permanently removes the neural cause for excessive drinking.


John David Sinclair, Ph.D., 

Researcher Emeritus

Links to Cites & References

     

[1] Sinclair, J.D. and R.J.Senter. Increased preference for ethanol in rats following alcohol deprivation. Psychonomic Science 8: 11‑12, 1967.


[2] Sinclair, J.D. The alcohol‑deprivation effect: Influence of various factors. Quarterly Journal of Studies on Alcohol 33: 769‑782, 1972.


[3] Sinclair, J.D. Rats learning to work for alcohol. Nature 249: 590‑592, 1974.


[4] Sinclair, J.D., J.Adkins, and S.Walker. Morphine‑induced suppression of voluntary alcohol drinking in rats. Nature 246: 425‑427, 1973.


[5] Sinclair, J.D. Method for Treating Alcohol‑Drinking Response. USA patent  4,882,335 Nov. 21, 1989.


[6] Sinclair, J.D. Drugs to decrease alcohol drinking. Annals of Medicine 22: 357‑362, 1990.


[7] Heinälä,  P., H. Alho, K. Kiianmaa, J. Lönnqvist, K. Kuoppasalmi, and J. D.  Sinclair. Targeted use of naltrexone without prior detoxification in the  treatment of alcohol dependence: A factorial double-blind  placebo-controlled trial. Journal of Clinical Psychopharmacology: 21(3): 287-292, 2001.


[8] Sinclair, J.D. Evidence about the use of naltrexone and for different ways of using it in the treatment of alcoholism. Alcohol and Alcoholism, 36: 2-10, 2001.


[9] Eskapa, R. The Cure for Alcoholism, Dallas, TX: BenBella Books, 2008, 2012.


[10] Christian, Claudia.  Babylon Confidential, Dallas, TX, BenBella Books, 2012.

Sinclair Method for Treating Alcoholism

Alcohol Problems & Solutions 

Online Since 1997              

Sinclair Method for Treating Alcoholism: An Effective Medical Treatment


The Sinclair Method of alcohol abuse or alcoholism treatment is  unique. It enables most alcoholics to drink in moderation. The technique  uses naltrexone or a similar substance.


I. The Sinclair Method

Taking a pleasure blocker prevents the brain from having the pleasure  of a high. Pharmacological extinction (operant conditioning) then  reduces craving for alcohol. Surprisingly, few people in the U.S. have  heard of the Sinclair Method.

The U.S. Food and Drug Administration (FDA) first approved naltrexone decades ago. Now other pleasure blockers are approved and can also be used.


Some Specifics

The Sinclair Method treatment lasts for three to 15 months. After  that, the patient needs to continue taking naltrexone before drinking.  This prevents positive conditioning from occurring. Otherwise, the  pharmacological extinction will reverse itself.


Some Advantages of The Sinclair Method

  • Simple and easy.
  • No withdrawal symptoms.
  • Detoxification unnecessary.
  • Rehab facility unnecessary.
  • No disruption of employment or family life.
  • Can be followed with a person’s own doctor.

Avoiding a rehab is a major advantage. There is no travel, high  expenses, safety concerns, or anxiety about living with strangers.


Effectiveness


Dr. John David Sinclair developed the method. It is the one used  throughout Finland and widely used elsewhere. The reason it’s not widely  used in the U.S. is unclear. It may be the very strong influence of  Alcoholics Anonymous. A.A. insists that alcoholics can never learn to  drink in moderation. However, much scientific research for decades has  proven that most alcoholics can and do learn to drink in moderation.


Most clinical trial evidence suggests that The Sinclair Method may have a success rate of about 80%. 1 That’s much higher than the apparent 5% success rate of A.A.


Why Isn’t the Method More Widely Used?


On the Psychology Today website, addictions expert Kenneth  Anderson raised an important point. “It remains difficult to understand  why so few American physicians, therapists, and addiction counselors are  familiar with The Sinclair Method.”2


Another observer wrote that it will take some time for the Sinclair approach

 “to gain wider acceptance, especially in  the US, where the treatment industry seems dominated by 12-step  ideology. The Sinclair Method is becoming popular in other countries.  It’s now available on the National Health Service in the UK. It’s also  being used extensively in Scandinavian countries such as Finland, with  great success. It is gaining popularity in underdeveloped countries that  don’t have a pre-existing 12-step recovery treatment industry, too. It  is a much cheaper solution compared to inpatient rehab and this will be  attractive to countries without the infrastructure to support  hospitalization for many people.”3


A third suggested that:

  • “The medical community has been largely  unconvinced of the effectiveness of this cure because of the extreme  shift in mindset necessary to accept a treatment for alcoholism that  involves continued consumption. To further cloud the matter, many  studies have been done involving using naltrexone to help enforce  abstinence – a purpose for which it is poorly suited at best. Although  their “failure due to relapse rate” has no bearing on the Sinclair  Method, most doctors see a “this drug failed” result and don’t look to  see how it was used….”4

The reasons for the general lack of awareness of The Sinclair Method  are unclear. But sound science is the basis for the process. More  important, clinical research proves its effectiveness.


II. Resources on The Sinclair Method


Popular Readings about.

Christian, C. Babylon Confidential. Dallas: BenBella, 2016.

Eskapa, R. The Cure for Alcoholism. Dallas: BenBella, 2012.


Podcast by Dr. John David Sinclair

Sinclair, J. The Sinclair Method for Treating Addiction. Shrink Rap Radio


4. Dombeck, M. The Paradoxical Sinclair Method For Treating Alcohol Dependence. centersite.net

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