Delayed post from me - came back here to see if anyone had mentioned TSM and they hadn't so I'll do my infomercial thing.
I would highly encourage you look into The Sinclair Method. It's based on the work of Dr Roy Eskapa and a book called The Cure for Alcoholism.
I struggled with alcohol for all of my adult life. Trying every thing possible to moderate or stop - AA, hypnosis, strange chinese herbs, counselling until I was blue in the face but The Sinclair Method worked like magic. For years now I have been entirely indifferent to alchohol and and my life is so much better for it.
The Sinclair Method also changed my life. It seemed like I had tried every single thing possible, AA, hypnosis, strange chinese herbs. The Sinclair Method seemed too good to be true, but I can't believe how well it worked. I am not completely indifferent to alcohol. It seems strange to think that this same head of mine used to crave it so.
Lockdown has really shown up how my 7 year old struggles with his maths work set by school. I've gone back to basics with him and have been drilling him on simple numeracy until he can do it effortlessly using some flash cards I bought and some iPad apps (DoodleMaths, DoodleTables - can't recommend them enough).
Since then he has sailed through all of the new parts we're learning. I really expected it to be much harder than this, but it seems like not fully understanding some basic concepts and having confidence with basic numbers makes all the difference for really understanding the why of all the concepts that are build on top.
In about 6 weeks of me spending around 30 mins to an hour each weekday he has gone from refusing to look at a maths problem to being confident with it.
If you're one of those for whom AA didn't work I would encourage you to look at the The Sinclair Method. It has changed many lives for the better (including mine).
This is how I quit and it's a profoundly disappointing and discouraging thing that this is not more broadly known. I should have quit 15-20 years before I actually did and had I known about The Sinclair Method the first time I was subjected to AA and did that instead, I'm convinced I would have been able to quit then. However, I wasn't aware of this and continued drinking for another 17 years.
What worked for me is developing an esophagus condition that makes drinking alcohol or coffee result in instant burning pain. It was so easy to stop drinking, multiple times, when that surfaced.
This is a significantly-incorrect, surface-level understanding of the "Sinclair Method". As another poster noted, naltrexone (or similar) prevent one from feeling much of anything from alcohol (though you'd still be physically impaired...). Without any dose (drink) --> response (pleasant-feeling) relationship, users tend to stop drinking significantly (because drinking doesn't really do anything)...
The "Sinclair Method" is, basically, to promise to take naltrexone (or similar) 30 minutes or so before you ever take a drink. That way, if/when you drink, you never feel the "drink" and your mind can return to normal.
No drug will "make you stop drinking" (though disulfiram may make you want to do so); the Sinclair Method attempts to remove your interest in drinking.
I got HPD from a fairly large dose of 4FA once. I had persisting light sparkles pretty much exactly like the first image in the article.
I researched online and discovered the term HPPD but information was extremely sparse then. I see there's a fair amount more now which is encouraging.
From the advice I found I got myself some Lion's Mane supplement, meditated and exercised a few times a week. A few weeks later I just kind of forgot about it and noticed one day that the HPPD had disappeared.
The effect wasn't hugely detrimental on a practical level, but it was very strange coming to terms with the fact that this may well be a permanent change.
Came to the comments to look for this post. I completed TSM myself not so long ago. It has been nothing short of life changing. Seemed too good to be true, but really doesn't seem like there's a catch.
If you need help with the alcohol I can't recommend The Sinclair Method enough. Absolutely life changing for myself and many others. https://reddit.com/r/alcoholism_medication
The article mentions naltrexone. Dr Eskapa's research of using naltrexone led to The Sinclair Method. His book is called The Cure For Alcoholism. He has made it available for free download here, https://www.dropbox.com/s/60fs7gmvbyzs1kk/Cure%20for%20Alcoh... (please do support him and buy the book if it is of use to you and you have the means)
The Sinclair Method shows that for many people alcoholism is simple chemistry and the addiction can be "unlearned" by taking naltrexone (a cheap patent free drug) an hour before drinking.
In my experience, yes. I previously took it for alcoholism. I found it very broad acting. I stopped drinking compulsively. I also became indifferent overeating, smoking cigarettes, sex, and pretty much everything else compulsive.
I've heard of people using it off label to lose weight.
For me it is a very strong & powerful drug, but I also know of others where it did not seem to work. I've heard if you have a family history of alcoholism it is more likely to work.
Honestly, doing something "an hour before" doing something compulsive might be a placebo that trains people to delay doing something destructive. Once that happens, it is much easier to stop doing it completely. I imagine if there was a diet that said "drink a cup of water before eating that cupcake" it might be equally as effective for compulsive eaters.
Addiction is an "every minute" kind of thing. Sometimes you can put something off for an hour, or know that e.g. dinnertime is the time we open the wine, so you can wait. But then after an hour, it's still there, and another hour, and another, and then you break down and give in when it is late or you are alone. Which then negates/resets any value gotten from the initial delay. So I don't think this is a placebo at all.
Speculating about the drug's performance vs placebo is an argument from imagined evidence -- in this case contrafactual. As with most drugs, placebo is the benchmark naltrexone had to beat to demonstrate efficacy.
Also note when researching - many people prescribe naltrexone to be taken every day along with abstinence, and infact when taken this way it's shown to be no better than a placebo. When taken as per The Sinclair Method it has been shown to be over 85% effective.
Many alcoholics are already quite adept at delayed gratification, whether it be waiting until they get home for the night before pounding 5-10 drinks, or even waiting for loved ones to go to sleep so they can "hide" their habit.
Addiction isn't a soft lack of will but an iron surplus of it despite perennial invectives; it's antifragile. Any cessation/treatment regimen/regime imposed on someone else merely reinforces their drive.
And heck, "dry drunks" can go the rest of their lives pretending alcoholism isn't having a negative effect on their lives and the lives of those around them.
It's an AA term. The narrative is that you are still an "addict" even if you are sober if you haven't dealt with the underlying emotional and psychological issues e.g. worked the steps.
Interestingly, many prescribe naltrexone along with abstinence, and say the drug should be taken every day. In clinical trials when taken this way it is shown to be no better than a placebo, but in trials when taken as per The Sinclair Method (ie, pill only taken an hour before drinking) it is shown to be far more effective. Here's some links to some studied - http://www.c3foundationeurope.org/clinical-trial-evidence/
People undergoing The Sinclair Method often find there are two parts to their addiction - the chemical part, and the habitual part. Sometimes once the chemical part is extinguished they also have the habitual part to stop.
The habit/chemistry dichotomy is also part of giving up cigarettes.
There are questionnaires you can take to reveal how much your addiction is chemical led e.g. do you smoke first thing in the morning (when the chemical levels are low) or do you smoke as part of some routine.
>In clinical trials when taken this way it is shown to be no better than a placebo //
What levels of effectiveness is that. Placebo's are reported as being pretty strong medicine: no better than placebo is pretty good if your placebo is effective in 40% of cases for example.
Naltrexone is an opioid receptor antagonist, so it has a very plausible mechanism of action. It disrupts alcohol's effects on the brain when you drink after taking naltrexone. This disruption can cause the alcoholic to quit (or significantly reduce consumption) naturally over time.
From a lot of proximity to this behavior in all of it's forms, there is no one solution and alternative habit forming that creates a mindful pause is one of them.
Unless this drug has a 100% success rate I take the placebo observation as a valid one. But it should not 100% discount the drug efficacy out of hand either.
Hah. Oddly enough this tallies with my experience - about 5 years ago I ended up buying a box of modafinil and took them periodically before work. Someone asked me about what I thought of them and I reflected that I wasn't sure if it helped my work or not but that it meant I could beat my phone Chess app on a harder difficult setting than usual when I played on the way to work.
You may be an under-responder. With modafinil there seem to be large populations that are over/under-sensitive.
I bought a box about 4 years ago as well to see if it helped at work. I turned out to be sensitive to it and later investigated studies linking my genotype with sensitivity (specifically a pleiotropic SNP in the COMT gene rs4680/Val158Met). Most sequencing includes this well-studied SNP in the panel if you're curious.
Starting with a "normal" 200mg dose was a disaster. Anxiety, shaking, racing thoughts, nausea, and arrhythmia all struck on the ride to work and lasted 10 hours.
With 50mg taken right after breakfast, I was able to achieve some notable effects and feelings of extra productivity but even a small amount of caffeine or alcohol within 18 hours would make me sick. It proved to not be worthwhile and I quit after a month.
I have some similar experiences myself. I take modafinil for narcolepsy.
A 200mg dose makes me really sleepy. A 50-100mg dose makes me more alert, especially with a small amount of caffeine. A larger amount of caffeine with 50-100mg makes me sleepy again.
How did you get the sequencing done? I know I've been tested for the gene associated with cataplexy (HLA-DQB1*0602 I think), but not sure about the others you mentioned.
I would highly encourage you look into The Sinclair Method. It's based on the work of Dr Roy Eskapa and a book called The Cure for Alcoholism.
I struggled with alcohol for all of my adult life. Trying every thing possible to moderate or stop - AA, hypnosis, strange chinese herbs, counselling until I was blue in the face but The Sinclair Method worked like magic. For years now I have been entirely indifferent to alchohol and and my life is so much better for it.
There's a subreddit with lots of info and support if you're interested. https://www.reddit.com/r/Alcoholism_Medication/
All the best.