Julie R's Naltrexone Mini-Journal

Dean Esmay links to an article which reviews current and developing drug therapies.

One of the drugs, Naltrexone (Nal), has shown promise both for folks seeking to abstain permanently as well as those who are drinking moderately or working toward a moderate drinking goal. Julie R., a Moderation Management member, has journaled vividly about her recent experience with it and has graciously agreed to let me share a bit of it with you.

Her experience with it strikes me as similar to that of folks using antidepressants — some trial and error is necessary to find the best dosage, results can vary from day to day, and the drug supports, not replaces, insight and effort — and you’ll see that she describes trade-offs in using Naltrexone, as well.

Dr. Alexander DeLuca, M.D. is a great online source for papers on this topic, updated regularly as new stuff is published.

July 27 2004

I didn’t have a drink last night. It was my first abs night in months, I think. And it may be the beginning of an indefinite abs.

I preceded it the way so many abs periods start, with heavy drinking, which is actually not a very pleasant experience when you’re taking naltrexone. You keep reaching for that high, and reaching, and instead, all you get is stoned, stupid, dehydrated, and hungover. When I finally couldn’t hold anymore, I poured the rest out. When I woke up yesterday morning, I talked into a tape recorder for a while about how awful an experience it was and how much I wanted my freedom from what has become an unpleasant habit.

Thanks to naltrexone, alcohol has lost its value as a recreational drug. It took a while (I started taking it six weeks ago), and it is not an easy process, but it bloody well works if you take it as directed and have effective help for the issues underlying the drinking (sleeping, depression, neurotic fears).

I can’t remember what it feels to drink without nal. Those memories have been replaced by how it feels to drink with nal. Which ain’t all that great. I mean, it’s something — it gets you to sleep, it makes you forget, it relieves anxiety. But if you’re getting adequate support for the sleep and the anxiety and whatever, as I am, booze is a relatively poor self-medication, if you subtract the endorphin high, which nal does.

I suspect that the way it feels for me to drink on nal is the same as it feels for a non-drinker without any endorphin deficiencies or sensitivities to drink. You know, non-drinkers honestly just don’t like drinking as much as we do. If they did, they’d be drinking, by golly.

July 29 2004

I was watching a movie last night, and at some point three characters have reached the cocktail hour at the end of a long day and one of them says, “Harry, could you organize some drinks for us?” And I suddenly remembered what it feels like to drink without naltrexone. Of course I know it’s different, but I generally can’t remember what it was like to drink without naltrexone. Watching others do it on the screen reminded me — all the relaxing and forgetting of the first cocktail. “Let the healing begin!” as the guy in the New Yorker cartoon says as he order his first double martini, dry.

I wonder how long it will be before I have that feeling again. It is entirely my choice when I do or do not.

In the meantime, I’m more interested in figuring out what it is like to live without alcohol again.

I don’t much want a drink, because it would be a drink with naltrexone, which is not all that pleasant. I think I’d like to just stay the way I am for a while, give my liver a break, think things through with a clear head, do my job.

August 19 2004

I regret to report that my drinking is back up to my pre-naltrexone levels. My psychiatrist says, however, that I’ve got so much going on right now hormonally and neurochemically that it’s too soon to call the experiment a failure, and he has encouraged me to keep taking it and see what happens, so I will.

Update

Ooops, it was actually Joe Gandelman, who also writes at The Moderate Voice, who posted the link at Dean’s site. Dean weighed in with a comment shortly after.