What if you could Forget to Want Alcohol? | The Sinclair Method

It’s that time of the year – time to welcome
the new year with family, friends, good food and probably alcohol. Here in Tokyo it can be hard to keep up with
the various bounenkai’s essentially “forget the year” parties throughout december. One issue I tend to run into is drinking more
than I initially intended. In college, the intention was just not to
drink so much that I do anything embarrassing, but now it’s more like I’ll go out for
one beer with a friend and the night ends with me drinking three. Or once in a while there’s a celebration
going on so I’ll plan to have three drinks but I end up having six. That’s not too terrible, but it’s the
same issue – drinking more than I intended. So, why is it that some of us drink more than
we planned on start of the night? Of course what’s going on in the brain of
a social drinker versus that of an alcoholic are completely different, but the two may
run into this same issue…just at drastically different degrees. But the big question is: can we alter brain
chemistry to prevent this from happening? Even if you’re totally comfortable with
your alcohol consumption, finding the answer to this question can teach us some very interesting
lessons about how the brain works. The concept to explore here is called “pharmacological
extinction,” but before we get into that, let’s talk about pesto. When I was a kid, everytime my Dad would go
to central Texas for work, he’d come back with some fun foods from a specialty supermarket
up there. He got a couple different things but I specifically
remember Orangina which I really liked, and Basil Pesto which I was sure I didn’t like. Everyone else seemed to enjoy the stuff, …but
to me it looked suspiciously like mashed up oily spinach… So after having skipped out entirely on the
pesto every time my Dad brought it home, he finally convinced me to try the very last
bite of of a new batch of pesto. Based on work from people like Kent Berridge
and Robert Sapolsky, I’m pretty sure this is what was going on in my head: I ended up
eating the pesto, which was an unexpectedly rewarding experience. The flavor of the pesto and bread combination
released some endogenous opioids telling me that this stuff is really delicious, that
I like it. My brain wanted to take a memo of this fact
so we could remember how to get more later. So, dopamine was released in response to the
sensation of reward provoked by the opioid system. It is often mistakenly thought that dopamine
is the neurotransmitter for liking, but as Kent Berridge and his team proved, dopamine
is specifically for wanting and learning what to want, but it is not necessarily the cause
of liking. This 1993 experiment from Switzerland showed
that when monkeys pressed a lever that rewarded them with apple juice, dopamine levels shot
up. However, once they got the hang of the task,
dopamine levels went up when the light came on. So the shot of dopamine that came with the
juice was necessary for reinforcing that behavior – for learning everything that happened to
make the juice come out. After it learned this, a shot of dopamine
would come in response to the light turning on as if to say “Hey that light means we
can get juice. So I know what to do: let’s press the lever!” Kind of like Pavlov’s dogs learning that
bell equals food. However, what’s responsible for the actual
sensation of pleasure and feeling of liking when the juice hits your tongue and goes down
your throat is endogenous opioids. These endogenous opioids would tell the monkey
that drinking juice was pleasurable and rewarding, and then tell the dopamine system to take
note of how to get the juice again. OK So in response to the endogenous opioids
telling me I like the pesto, the dopamine system took note of how to get the pesto and
taught me to want the pesto. So how can I “forget” or “unlearn” this wanting
for pesto? Let’s say my brother wanted to monopolize
the pesto supply; he could sneak a bittering agent onto my slice of bread before I spread
the pesto on it. Dopamine would still cue me to eat the food,
but the wretched taste would blunt the rewarding endogenous opioid response. That would cause whatever bundle of neurons
that are acting as the memo for my wanting of pesto to loosen up their connections a
bit. And, every time I ate the bittered pesto bread,
my wanting for pesto would decrease more and more. That’s the funny thing about alcohol, or
I should say ethanol, by itself it tastes – terrible. I’m sure no one would enjoy everclear diluted
in water. Beer and wine taste good, but that’s an
acquired taste – no kid would think that they taste good. “It’s terrible, nobody drink the beer! The beer has gone bad!” Alcohol is very complex, and acts on all kinds
of receptors having different effects, but one source of the rewarding feeling of it
is its effects on the opioid receptors in your brain, one in particular is the mu-opioid
receptor. Some research shows that the mu-opioid receptor
in specific is responsible for the positive reinforcement that gets people to want and
crave drugs or alcohol. So what if you could block those opioid receptors
from being activated? Your brain would never get that “reward”
signal, and your brain would unlearn to want alcohol. You could go to the bar, sit down, smell the
cigarette smoke, order a beer, taste it and you’d even get some of the effects of alcohol
like worsening motor coordination and slurred speech, but the reward signal that your brain
is expecting would never come. Long story short, you can block opioid receptor
activation with something called an opioid antagonist. On the TV show “the doctors,” they had
a segment about an alcoholic person who drank a bottle of rum a day. He received an implant of an opioid antagonist
Naltrexone – which slowly releases a low dose of the medication over a period of a few months. The aim of this particular method seems to
be abstinence- to keep him from drinking at all. Apparently it has done wonders for him in
the first week in terms of reducing cravings. “I haven’t had one craving, whatsoever “ This
is very promising and it’s fantastic that it seems to be working for this person. But, it may not be the best approach One problem with this study trying to manage
heavy drinking with Naltrexone is that the patients were encouraged to be abstinent while
on the naltrexone. “As you know, it doesn’t work with abstinence,
it cannot work with abstinence.” Here is Roy Eskapa, the author of the ambitiously
titled book “The Cure for Alcoholism,” in which he lays out in detail a treatment
for alcoholism called the “Sinclair Method” and explains the science behind it. However, Dr. David Sinclair, the person who
this method has been credited to, refers to it as pharmacological extinction. The method is simple, you take 50mg of the
opioid receptor antagonist Naltrexone one hour before drinking, and you do this every
single time you expect to drink but you only take it on the days that you do drink “The medicine itself is not curative. You have to take the medicine one hour before
drinking.” As you’d expect from an opioid antagonist,
Naltrexone has been used to try and treat opiate addiction. As this paper way back from 1978 found, there
wasn’t too much benefit compared to placebo for those who took Naltrexone with the aim
to help entirely prevent them from using heroin and getting cravings. However, there was an improvement in people
who disobeyed the instructions — those that went ahead and did heroin while on they were
on the medication. Their cravings started to decrease. Thanks to the medication, shooting up is like
ringing Pavlov’s bell, but no food comes, and this brings the behavior of seeking and
wanting drugs closer to extinction. Amazingly, this pharmacological extinction
method has been shown to be very effective with alcohol. Here is a graph from Dr. David Sinclair in
the Roy Eskapa book showing that in rats, after only 5 “extinction sessions,” that
is a naltrexone plus alcohol session, the rats were already drinking 10 times less than
they normally did. The first double blind placebo controlled
clinical trial on Naltrexone and alcohol from 1992 found that Naltrexone was safe and effective
with the primary benefits being seen in patients who drank alcohol while on the medication. This clinical trial found that Naltrexone
did not reduce the frequency of drinking but it significantly reduced the amount they drank. According to the earlier mentioned book, 90
out of 91 clinical trials found that opioid antagonists like Naltrexone are effective
if extinction is possible, that is if a substance addicted person can use the opioid antagonist
medication and use the substance. When extinction was not possible, as in the
patients had to be abstinent while taking the medication, 36 out of 37 trials found
no significant benefits from the medication. According to the book, it takes on average
3 to 4 months for an alcoholic or alcohol dependent person to lose their dependence
on alcohol through this pharmacological extinction method. According to David Sinclair, the success rate
in his clinics in Finland is about 78% and clinics in Florida had a success rate of 85%. If you’re curious what the experience of
drinking while on Naltrexone is like, a close friend of mine from the states said: “ I’ve
found that I’ve been much more picky with how things taste. So I’ll just waste entire drinks because they
don’t taste good.” And In an email she said: “it just slowly
makes [drinking] less and less interesting.“ By the way, she’s not an alcoholic or alcohol
dependent but sometimes simply drinks more than she intends. So what is it like for an actual alcoholic? “I’m waiting – keep waiting for the feeling
and it’s not coming. You get that first drink it’s like uaahhhh
that felt good. And then it’s like give me more! But when you don’t get it… what is the point?” The Sinclair method could be a very promising
route for people who are alcohol dependent considering the alternative is to essentially
to go cold turkey, detox and go on to wrestle with their cravings for… who knows how long. Considering alcohol use is the 7th leading
risk factor for death and disease globally, I’m hoping this video brings more awareness
to the scientifically sound, but relatively unknown Sinclair Method. Before I close let me point out that I’m
not a doctor and I’m not a pharmacologist, I don’t mean to say that social drinkers
who have two extra glasses of wine at parties should just casually go out and buy this pill. If you’re interested in this, make sure
and do some more research – you can start by reading Roy Eskapa’s “The Cure for
Alcoholism,” or watch the documentary produced by Claudia Cristian about Naltrexone called
“One Little Pill.”

100 thoughts on “What if you could Forget to Want Alcohol? | The Sinclair Method

  1. Hey everyone,
    Let me reiterate that I'm not trying to say that everyone should just go on line and stock your pantry with Naltrexone as if it were a turmeric supplement or something. If this sounds like something you might be able to benefit from, I encourage you to do your research before taking any action – look into possible side effects, make sure you understand precisely when you're supposed to take this, what is an appropriate dose for you and so on. Again, I'm not a doctor – this video is meant to inform, not to make medical recommendations. Some things to keep in mind while reading about this:

    -The Sinclair Method, stated simply is this: Take 50mg of Naltrexone 1 hour before drinking. Do not take it when you are not drinking. Try to avoid doing naturally rewarding things while the medication is still in your system. Remember, other activities like exercise, hugging people, and eating food are felt to be pleasurable and are reinforced through the opioid system.

    Some of Naltrexone's potential for other addictions (food, gambling, opiates) is discussed in the Roy Eskapa book.

    ★"Low Dose Naltrexone," the administration of from 1.5mg to 5mg (one tenth of the Sinclair method dosing), has shown promise for conditions like Crohn's disease and multiple sclerosis and works through different mechanisms having a different spectrum of physiological effects. This video doesn't comment on this approach. On that note, I'm not sure what dosing the implant mentioned around 5:30 was delivering and didn't mean to say Low Dose Naltrexone is not effective.

    Happy New Year!!

  2. also cooking sugar and aspetos makes you get super high (*WARNING IT WILL KILL YOU*) [PLEASE DON"T DO THIS]

  3. This treatment works I and thousands of others have managed to do it ! 2 and a half years later I’m still in control !

  4. Does it stop withdrawal? If not what do addicted people do about wds when they don't drink the required amount?

  5. Where did he get the pesto, I am here in houston and can’t find good pesto other than when I make it myself

  6. Wow with all your videos backed up with countless veritable studies it’s amazing that things like this and carnivore/ketogenic diets are so counter mainstream. Gonna do more research on this method of treating alcoholism and hopefully it will help someone I know who has been resistant to therapy and failed (as most do) from tackling it on their own will

  7. I think the first thing that was completely overlooked in this entire video is the person's neurotransmitters there are many many reasons why person can have defunct neurotransmitter production.

    Finding the root cause of that issue far outweighs popping a pill. It's like putting a Band-Aid compound fracture which pretty much describes the whole of allopathic/ western medicine , Excluding EMS.

  8. I've never really had an attraction to alcohol, so I practically never drink. My coworkers love me when we go out after work because I have zero alcohol tolerance and 8oz. gets me smashed. I never even finish one beer lol

  9. Wow it's kinda like when you enjoy eating a certain type of food but one day it just does not do it for you anymore so you stop.

  10. Varenicline has similar effect on nicotine addition. The first week of use you are told to continue smoking as the dosage of Varencline is increased. By the end of the first week you just stop smoking, because without the reward cigarettes are absolutely disgusting. A minimum course of 3 months is recommended to help kick the habit.
    I have personally found and have heard of others that find Varencline also impacts on other habits such as drinking and eating. I have found some nights where I might usually have 3 drinks, pour one drink have 3 sips and forget it's there. Although alcohol is not as disgusting as cigarettes, without that reward you don't feel driven to keep a glass at hand.

  11. How does Naltrexone compare to Disulfiram? Naltrexone works through negative-reward while Disulfiram works via positive-punishment. It would be interesting to see how they compare. 🤔

  12. For certain people, dealing with addiction is far easier than dealing with the depression that Naltrexone would force so I'm glad it's not advertised as a miracle cure.

  13. There shouldn’t be any thumbs down on this video. Must be angry, active alcoholics giving all the thumbs down.

  14. I was wondering, does advancing age have any significance? I find, at nearly 50, the effect of alcohol just doesn’t seem to be what it was in my youth?
    Yes, i can enjoy a beer, but the desire to continue and get smashed no longer seems to be there. I do understand that i have perhaps felt the price paid for having too many drinks is far higher as you age; no longer can you throw off the effects as you can in your 20s.

    Is it stronger desire and resolve to avoid the effects or is there perhaps a deeper, maybe brain chemical related issue behind this?

  15. Do NOT use Naltrexone without consulting a doctor and psychiatrist, this is SERIOUS medicine…… you can have fallback scenarios with i.e. psychosis.

  16. How that could be unknown???
    My father came of tobacco with
    Champix (varenicline) after 40+ years of addiction.
    It works by a similar effect by blocking nicotine receptors no positive feedback comes.

  17. I've never understood people's liking for alcohol. My parents let us kids taste their drinks when we asked to, and I never liked any of it.

  18. Pshh when you drink like me you do not need any reason other than the way you feel the next day. 6drinks? That’s called a warm up stretch

  19. I forgot alcohol with weed. I just went sober after a summer of profuse dab pen use (possibly K2 is in them?!?). Learned I have alexithymia now. Dont do drugs kids, I'm 15.

  20. Apparently – as we like being pedantic over here – Pavlov didn't do any dog trials with bells. He did many other experiments with dogs, and other researchers did experiments with bells, but that was one combination he didn't do.
    At least according to the QI elves, that is.

  21. I'm using it. Cut my drinking in half almost immediately. You have to use it correctly or it doesn't work. I recommend Sinclair's book.

  22. I quit drinking after 26 years of heavy use following several Ayahuasca ceremonies down in Peru. It's important to work through trauma and heal the gut for proper brain regulation. Psychedelics allow for processing of this often repressed trauma through new pathways thus breaking the cycle.

  23. You’re going to have an increased chance of diabetes, stress diseases, and forget that “cravings” are usually dietary imbalances. Thanks, Nanny Sinclair, but the truth is non-problematic usage of food resembles this really, and that includes alcohol for most..

  24. Apparently when a hypnotist hypnotises someone to quit smoking what supposedly happens is they forget that they smoke

  25. When I was growing up, I was told that setting a limit of drinks and constantly going over it was a sign of alcoholism. It shows a lack of power of being able to stop.

  26. I wonder if you drank non alcoholic beer if it would have a similar effect of not getting you high and weakening the brains association with beer being pleasure bringing.

  27. Interesting video. Even more interesting that in Japan you consider 3 vs 6 drinks a big deal. Places like russia and cis countries? The social norms around alcohol are compleeeeetely different.

  28. For any addiction there is only one "cure"and that is a desire to stop mixed with the willpower to make it happen. It isn't easy but it can be done. Using a drug to stop using a drug is ridiculous and hoping some higher power wii intervene is as childish as believing in the tooth fairy. I realized that it was my decisions that got me there and that it had to be the same to bring me back.
    It worked.
    Maybe, for once in your life , try owning the fact that you are the reason. You are to blame and only you can get you out. Whatever your last name is just add a mental " ist " to the end of it and start believing in yourself. You'd be amazed at how much it can do for you..

  29. How come the Sinclair Method isn't well known by now?! It seems really like the best we've got for addiction treatment, at least for now : ? /headscratch

  30. Feels kinda odd using nalaxone for alcohol lol if anything they should use it only for alcohol instead of opiates….

  31. This could help a lot with food addiction. With food, you must face your "drug" at least one time a day. We need to eat, so this could help with the cravings

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