Key Takeaways
- The Sinclair Method uses the medication naltrexone to reduce the pleasure of drinking alcohol.
- Naltrexone blocks the effects of endorphins released by drinking, making it easier to drink less.
- This method is a medication-based approach that helps people reduce drinking without needing to quit completely.
What if there were a way to train your brain to drink less without having to quit cold turkey or take the path of total abstinence? The Sinclair Method is an increasingly popular option that takes a gentler approach to curbing drinking. It relies on medication to make drinking feel less pleasurable, reducing the urge to drink and making it easier for people to limit their consumption.
This approach was introduced by John David Sinclair, a researcher who discovered that naltrexone could be used to block alcohol-reinforcing effects. It is sometimes described as targeting naltrexone to use only when needed. The Sinclair Method is an option if you want to reduce your drinking, but don’t necessarily want to abstain from alcohol altogether.
Overview of the Sinclair Method
Unlike many traditional approaches to alcohol recovery, the Sinclair Method is a medication-based approach. By administering naltrexone prior to consuming alcohol, the pleasurable feelings that drinking usually produces are blocked.
Because people feel less pleasure when they drink, they often find it much easier to drink less. In some cases, they completely lose the urge to drink at all. While this approach is less common in the United States, it has become much more widely used in Europe.
Naltrexone is a synthetic drug that blocks opiate receptors in the brain. It is used for treating opioid addiction as well as alcoholism. Nalmefene is similar drug that is available in Europe.
Other Medications to Stop Drinking
However, the Sinclair Method is not the only medication-based approach to alcohol recovery.
Campril ( Acamprosate) is another FDA-approved medication that helps people stop drinking by reducing the craving for alcohol. Antabuse (disulfiram) is a medication that has been used for many years, but it works very differently. Antabuse does not reduce craving, but by making people sick if they drink any alcohol, it can help them stay abstinent
While naltrexone is also taken before drinking alcohol, it does not cause illness. Instead, it simply makes it so drinking no longer produces an endorphin rush or “buzz”. Without those pleasant feelings, the brain eventually stops associating drinking with pleasure.
This is known as pharmacological extinction. In operant conditioning, rewards increase the likelihood that a behavior will occur again. When it comes to addictions such as alcohol use disorder, consuming alcohol is the behavior and the release of endorphins is the reward. When the brain unlearns this association, pharmacological extinction occurs.
History of the Sinclair Method
Sinclair first observed the effects of naltrexone on drinking behavior in his animal research. In animals that had been trained to drink alcohol, they would press a lever repeatedly to obtain it. Sinclair found that if the longer they were deprived of alcohol, the more they would press the lever.
He termed this phenomenon the alcohol deprivation effect, likening it to the increased alcohol cravings that make it hard for people with AUD to stay abstinent and avoid a binge.
He also discovered that administering naltrexone before drinking would eventually extinguish the drinking behavior. Later research also demonstrated that naltrexone had a similar effect on humans with alcohol use disorder who wanted to drink less.
Despite what some critics suggest, the Sinclair Method doesn’t encourage more drinking. Instead, it offers a way to help reduce the rewards of drinking so that it’s easier to gradually quit or reduce drinking over time.
How It Works
The Sinclair method works by reducing the reinforcement that people get when they drink alcohol. One of the reasons why alcohol addiction happens is that people experience a rush of endorphins when they drink. Because drinking makes them feel good, they form an association between alcohol and pleasure.
Naltrexone is effective because it blocks the pleasurable feelings people have when consuming alcohol. Because drinking is less rewarding and reinforcing, it becomes easier for people to limit their alcohol consumption and reduce their alcohol cravings. If someone uses naltrexone consistently whenever they drink, over time, they can stop their excessive thoughts about alcohol and free themselves from the symptoms of their addiction.
The actual process for using the Sinclair Method includes the following steps:
- Taking naltrexone one hour before consuming alcohol
- Consuming alcohol as usual
- While drinking, the naltrexone blocks pleasurable feelings, and you may feel like drinking less
- Continuing to use naltrexone 100% of the time you consume alcohol
- Eventually, as you take your drinks, you will notice that drinking is less rewarding, and you may drink less or stop altogether.
Researchers do not fully understand how naltrexone reduces alcohol cravings. It blocks certain opioid receptors in the brain and influences dopamine, a neurotransmitter, which is believed to help block alcohol’s reinforcing effects.
Pros and Cons
Like any other treatment method, the Sinclair Method has advantages and disadvantages that you should consider before you decide if this approach is right for you. Some people may find that it is a flexible and effective way to cut back on drinking. However, it’s not the right fit for everyone.
Pros
The Sinclair Method can help people reduce their drinking without quitting entirely. This can be an appealing option for people who want to drink socially on occasion but want to cut back and gain greater control over their alcohol consumption. By helping people drink less, it reduces the harm they experience from alcohol.
It can also serve as a step toward sobriety while minimizing the need for medically supervised detox in residential alcohol treatment. Unlike some other more expensive treatment options, the Sinclair Method is cost-effective and can be done at home.
Research also suggests that it can be very effective in helping people reduce their drinking. According to Sinclair’s own research, the use of naltrexone in the treatment of alcohol use disorder can have a 78% efficacy rate.
Other potential benefits of the Sinclair Method:
- This approach can get people who are unwilling to completely give up alcohol to keep their drinking at a safer level.
- Because it gradually reduces alcohol consumption, people are less likely to experience serious alcohol withdrawal symptoms, including delirium tremens (DT).
- It is a more affordable treatment alternative compared to more intensive and costly inpatient or residential treatments.
- Since people are actively involved in their treatment, it may help people feel more empowered and in control of their drinking and alcohol recovery.
Some people may find that this approach to recovery, without the pressure of perfect abstinence, makes quitting drinking more manageable.
Recap
The Sinclair Method is an affordable, realistic, and flexible treatment option that has a high rate of success.
Cons
Extinction takes time, and even occasional reinforcement can serve to maintain a behavior. In order for the Sinclair Method to be successful, it is important to always, without fail, take naltrexone before consuming any alcohol.
That’s often easier said than done.
Some other possible downsides of the Sinclair Method:
- People who drive while under the influence of alcohol may experience worsened coordination while taking naltrexone.
- Treating alcohol use disorder with medication only may remove someone’s motivation for personal growth through other treatment methods, including 12-step programs.
- In some cases, people may mistakenly believe that their doctor condones continued alcohol use.
- Some people may develop a false sense of confidence in their ability to drink safely without getting intoxicated.
As Verywell Review Board Member Dr. John Umhau notes in an article published in Advances in Addiction & Recovery, the Sinclair Method requires a lifetime commitment. While it minimizes cravings, it is essential to remember that people also drink for other purposes, including social reasons, boredom, habit, and as a way to dampen emotional pain.
Naltrexone is not simple or easy “cure” for alcohol use disorders. It needs to be used correctly and consistently in order for it to be effective.
People can also relapse after pharmacological extinction. If a person consumes excessive alcohol to the point that it bypasses the “naltrexone wall,” a point at which alcohol use becomes pleasurable again, they may experience a relapse to alcohol use.
Regular naltrexone use can also increase the sensitivity of opioid receptors, a process known as upregulation. As a result, drinking alcohol can feel much more rewarding if naltrexone use is suddenly stopped. This can cause excessive drinking, which is why consistently using naltrexone before every drink is critical for success.
Side Effects of Naltrexone
While naltrexone is usually tolerated well, it can have side effects that can range in severity. The most common side effects involve increased nervousness, muscle or joint pain, headache, nausea, and upset stomach. In most cases, these side effects are mild and lessen with time as people become more accustomed to the medication or can be minimized by taking the medication with food.
More rarely, severe side effects can include blurry vision, diarrhea, confusion, drowsiness, stomach pain, and vomiting.
Liver toxicity is another serious risk of naltrexone. Symptoms include unusual bleeding or bruising, dark urine, yellowing of the skin or eyes, and pain in the upper right part of the abdomen. If you experience such symptoms after taking naltrexone, you should contact your doctor immediately.
Is the Sinclair Method Right for You?
If you are interested in trying the Sinclair Method, start by talking to your doctor. They can discuss your current drinking behavior, medical history, and treatment goals to better determine if the Sinclair Method might be a good fit.
The Sinclair Method might be a good option for you if you:
- Are committed to making changes to your alcohol use behavior
- Have adequate social support
- Are willing to adhere to your doctor’s instructions and take your medication every time you plan to consume alcohol
- Don’t have a seizure disorder
- Don’t have liver disease
In some cases, the Sinclair Method can be a great start toward recovery. Because it engages people with alcohol-treatment professionals, it may help lead people to better recognize the extent of their problem while also giving them the hope and motivation to keep working toward giving up alcohol.
It’s important to note that the Sinclair Method requires medical supervision, since proper timing and dosing is the key to its effectiveness.
The Sinclair Method is not the only medication-based treatment approach. Depending on your own situation, you may find that another type of medication might work better for your needs.
