Re-dosing on the Sinclair Method
In this short video excerpt from our Tackling the Tough TSM Questions live stream on Twitch, C Three Foundation CEO Claudia Christian and Executive Director Jenny Williamson discuss the topic of re-dosing on the Sinclair Method.
Watch the full video Tackling the Tough TSM Questions on our YouTube channel.
DISCLAIMER: The contents of this video are not meant to serve as medical advice, but rather, to assist people in asking their doctors questions that will enhance recovery success. Please consult your medical provider before taking any prescription medication or changing doses or frequency of dosses.
Transcript
Jenny: All right. Why can’t anyone just tell me how often I should re-dose?
Claudia: Oh Lord, what a question. Here’s why. Here’s why nobody can tell you, you 120 pound five foot four male, female, who never works out, and eats meat every day, and is on nine other medications, and is 16 years old or 80 years old. There’s a lot of variables okay?
So, I have clients who literally burn through naltrexone in four hours. And how do we know that they’re burning through it? Because their drinking starts to escalate, and they can feel that same buzz that they used to feel before naltrexone blocked their brain. I have clients who only drink in the evening, and only drink for four hours so there’s no question about re-dosing and it’s all good. Every single person is different. There’s people with lap band surgery. There are people who are, have very, very slow metabolisms. There’s people who have thyroid cancer and had their thyroid removed. We don’t know. We are not doctors. We cannot look at every single individual and say you are going to metabolize naltrexone exactly in this manner. It’s kind of an experiment. I’m sorry to say this. To be on the safe side, there are doctors like Dr. Adi Jaffe who says, “well, just re-dose every four hours.” Then there are other doctors who say, “you know what, to be safe for the average person let’s re-dose every six hours.” Then there are other doctors who say, “ah you’re safe for ten hours.”
Jenny: Yeah I have heard from the doctors in our network – four, six, eight, ten, twelve and never, and just there’s no reason for a second dose. So, these are people who, this is what they’re using in their clients, and are having success with them. So the thing is, if you take it sooner rather than later, it’s not like it’s going to hurt you. If you take it later when you need it sooner, then you’re going to experience a little bit of a thing that we’re going to talk about in an upcoming question, which is you know, overwhelming the naltrexone and drinking through it.
“We are not doctors. We cannot look at every single individual and say you are going to metabolize naltrexone exactly in this manner.”
Claudia: Let’s talk. Let’s just talk about common sense for a second okay? Half-life is 10 to 12 hours. You’re relatively young. You work out. You’re in whatever. You’re a normal person. You go on holiday, and you know that you’re going to drink at noon, and you pop a pill at 11 am, and you do drink at noon. And then you go and you take a siesta because it’s Spain. Now you’re gonna go out to dinner. Common sense kind of dictates you know what, it’s been a long time because they eat dinner at nine o’clock in Spain. I took it at 11 am. It’s probably either worn off or wearing off. So to be safe I always say, oh just use your common sense. It’s not going to hurt you to take another 50 milligrams and wait an hour, and then go to dinner. I mean I just think it’s better to be safe than sorry, and I see so many people whose drinking escalates later on in the day because the naltrexone is worn off, and now they’re drinking twice as much as they would have.
Jenny: And then there’s also the situation where even though most of the naltrexone which, the naltrexone’s half-life is 12 [CORRECTION – 4 hours, not 12], the metabolite is 13, and so it’s a combination of the two, which also again brings into your metabolism. But while naltrexone is mostly absorbed by the body, it varies wildly in what’s called bio-availability. Bio-availability for anyone who doesn’t know what that is, the basic concept is you can put as much of a substance into your body as you know, as possible, but only a specific amount is available for your body to absorb and actually use. Which is part of the over supplementation argument that people are taking supplements that are not in a form that your body can absorb, and basically they say you know, we, especially America, has the world’s richest pee.
So you can take 50 milligrams of naltrexone, but you could individually only have five percent of that as a bio-availability, or 40 percent. So what you are absorbing and what your body is capable of actually transitioning to work, it’s vastly different from somebody who’s only getting five percent as opposed to somebody who’s getting 40 percent, and unfortunately there are no tests, even in the pipeline, to determine how a person, how much a percentage of naltrexone a person will have as a bio-available to them. So yeah, better safe than sorry is really a good way to look at it.
So here’s another question that comes around re-dosing that we get. I’d love to hear your thoughts on this – so if I have already decided I’m going to re-dose. My doctor has already said yes re-dose at this time, do I need to wait an hour again?
“Much like in the first dose, you wouldn’t take the first dose with your first cocktail. The second dose has to get into your bloodstream, and to your brain so it can do its job, and that takes an hour.”
Claudia: Yeah you do. Yeah you do, because much like in the first dose, you wouldn’t take the first dose with your first cocktail. The second dose has to get into your bloodstream, and to your brain so it can do its job, and that takes an hour.
Jenny: And some people will say but I’m already drinking, and I’ve already got the alcohol in my system.
Claudia: It doesn’t matter. What I always recommend is you stop drinking, you know, for a period of time and hydrate. Take the pill and hydrate for the next hour, which is also a smart thing to do when you’re drinking that long of a period of time, or any drinking. Alcohol is a diuretic as we know, so you’re losing a lot of moisture. So re-hydrate, wait the hour again, and then resume drinking mindfully.
Jenny: Now there are so many benefits to this, and you know, and yeah I always give the exact same advice. I always say if you are able to wait that hour, do it. If you are not able to wait that hour, wait as long as you can, and then the next time, try to wait a little longer. And work your way toward that hour. First of all, it helps to reinforce the habit of waiting an hour every single time after you take the medication. Second, if you’re drinking for 12 hours, just taking that one hour off and having water, eat something, because food slows your body’s absorption of alcohol. It’s going to give you, put you in a much better position to not continue for another 12 hours, or until you pass out because, just by taking that hour and removing your alcohol and your standard drinks from that short amount of time, that is already reducing your intake. Just through that simple measure.
Claudia: The food idea is a great one to add to the hydration even if it’s a banana or yogurt or something simple, cheese and crackers, because the medication, it just functions better with a lined stomach. And also you’re going to feel better. It’s your blood sugar levels. It will help, you know, even them out a little bit. You’re not going to get hangry or cranky. You’re going to maybe feel a little bit better the next morning as well, having food in your system. You know a lot of people drink in a very unhealthy manner. They drink on an empty stomach to achieve a massive buzz, and I always try to tell people, we’re re-learning how to drink, and how we use this substance, so that’s not a healthy use of the substance. “Normies” don’t drink on an empty stomach to achieve a certain feeling, that’s not what normal people do, so if we’re going to start trying to drink like a normal person then – why are you raising your eyes?
Jenny: Because that is exactly what I used to do, without ever, that is actually unfortunately, even if you never become addicted, that is a pattern, a drinking pattern that can be achieved, and especially in your early 20s when you’re limited on funds. I’m gonna go out with a bunch of friends. I can’t afford eight drinks to get me buzzed, so I’m gonna go out on an empty stomach. I’m gonna drink, and then I’ll have food afterward.
Claudia: But do you see; you see this this is what I mean. This, in this country, in other drinking cultures, we’ve been taught that that’s normal. Where you go someplace where alcohol is served only with meals, like France or some place, and you see people even in in the bars during a cocktail hour, they always have something to eat there, and people always eat some olives. and some crackers and some cheese. and something to line their stomach. That’s just the way you drink alcohol. You don’t drink to get, but the whole point is conviviality, friendship, good conversation. It’s not to get buzzed or shed-faced as soon as possible. That’s the completely drinking culture concept that that we need to stop.
Jenny: Oh absolutely. I mean it’s definitely not healthy. It’s definitely dangerous, but it’s also one of those things that you know, I do want people who are out there thinking that, you know, well these are the ways I’ll know when I’ve gotten there. That you know even people who are not addicted to alcohol can have those moments, and so it’s not, some things are not actually about whether or not you’re addicted. It’s whether or not you recognize that certain drinking patterns are not good for you.
Claudia: Exactly.
Jenny: Even those not addicted can exhibit very, very bad dangerous drinking patterns.
Claudia: Sure, so it’s once again comes back to self-awareness and mindfulness.
Jenny: So the quick summary while we’re waiting if anybody has any questions on re-dosing, this is a great time to type them in there, guys. So while our audience is getting any potential questions together, go ahead and do a quick summary of why people cannot just tell you when to re-dose.
Claudia: I feel like this summary is much like a question number one summary which is, it’s all dependent on the individual, and this is another question that you should be you know, ask your doctor or your provider about, but also it’s up to you to be honest with yourself. Do I feel the medication wearing off and now I’m escalating my drinking because it feels good and I’m chasing that buzz? You know when that’s happening, and you have to be honest with yourself and say I’m not going to go down that road, because this is exactly the kind of behavior I’m trying to stop. So being hyper-aware of if your drinking is escalating, and saying you know what I think the medication wears off around seven hours for me. Great, now we know you should re-dose. And also delay, delay, delay, and that will get you to the point where you won’t need to re-dose because you’re drinking later and later in the day. That’s always a good trick to employ, but in summation, it depends on the individual. You, Jenny and I can’t tell you, precisely you, when you need to re-dose unfortunately. But use your common sense.
Jenny: So we have one comment in here, comment /question from Helen – in the UK our coaches tend to steer us away from double dosing which seems healthier. Now my question on that question is: Are you talking naltrexone or are you talking nalmefene? Because although they’re both abbreviated nal, they are two completely different medications with different half-lives and different durations. Okay. so Helen says naltrexone, because what we’re talking about here is all naltrexone because it doesn’t apply to nalmefene.
Claudia: So Helen that’s interesting that in the UK, which is also a very heavy drinking culture, that the doctors would not implore you, if you go out for Sunday lunch and you’re drinking during Sunday lunch, that they would just think that you’re going to magically come home and go out for drinks at 9 pm and be fine, and not start escalating and doing shots at midnight. That’s something you might want to bring up with your provider in the UK to educate them that it does wear off, and it wears off quickly in some people, so you know, once again for you as an individual you have to use your common sense, and if you have a two activities on one particular weekend or something, where you think you’re going to be drinking, maybe take it into your own hands if you have enough medication. So if you’re not a daily drinker you will have extra pills, and you can use that for a second dose.
Jenny: All right we’re going to go ahead and transition over to the next question.