The Sinclair Method is a medical treatment for drinking problems that grew out of research by Dr. John David Sinclair starting in the late 1970s. It involves taking the medication, naltrexone (an opioid blocker), that alters how alcohol affects the brain.
Alcohol problems are often characterized by a vicious cycle in which drinking tends to promote more drinking. Although the pleasurable effects of alcohol reach a plateau after the first few drinks, the desire or compulsion to drink beyond that point may continue to the point of serious intoxication and blackouts. The brain of chronic heavy drinkers becomes tolerant to alcohol; the highs become less intense while the lows become increasingly deep. But the heavy drinker responds by increasing the dose, which further intensifies the process. Naltrexone can break this cycle by blocking certain neurochemical effects of alcohol in the brain. While taking naltrexone, alcohol loses some of its luster and the drive to drink to the point of severe intoxication may be markedly reduced.
What makes the Sinclair Method different?
In the U.S., the standard naltrexone regimen is to take it every day (usually in the morning) while trying to completely abstain from alcohol. When used in this way, naltrexone can make abstinence easier to maintain by reducing the desire to drink. Dr. Sinclair developed a different method. He discovered that giving up alcohol “cold turkey” was counter-productive because of what he termed the ‘alcohol deprivation effect’ which leads to intensified cravings and actually promotes rather than prevents heavy binge drinking. Instead, he recommended taking naltrexone only on drinking occasions, approximately an hour before taking the first drink.
It might seem counter-intuitive to say that the way to beat a drinking problem is to keep drinking. However, according to Sinclair, it is precisely by drinking alcohol while taking naltrexone that the brain learns to respond to alcohol in a different way. In fact, many people who use the Sinclair Method go on to quit drinking altogether, presumably because naltrexone changed their brain’s relationship with alcohol.
Does the Sinclair Method work?
Evidence shows that it can be very effective, although it apparently does not work for everyone. Studies conducted in countries where naltrexone is most widely used, such as Finland, report success rates as high as 78%– far greater than any other method of alcoholism treatment, including the standard method of taking naltrexone every day regardless of drinking. The Sinclair Method is not a magic cure, but it can help increase a person’s chances of reducing or stopping harmful heavy drinking. The Sinclair method can be an important harm reduction strategy and as a way to help facilitate abstinence.
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In Dr. Washton’s experience, success rates using naltrexone treatment by the Sinclair Method are markedly improved by combining it with participation in a behavioral counseling program that teaches moderate drinking and harm reduction skills, as we do in our Alcohol Moderation Program. This program provides participants with immediately actionable strategies and moderate drinking skills to enhance their ability to reduce their alcohol consumption, drink more safely, and avoid negative consequences. For more information about the Alcohol Moderation Program and other treatment options available in New York and New Jersey, just fill out the contact form and click Send.