The Sinclair Method

 

The Sinclair Method (TSM) is a treatment approach for alcohol addiction that purports to use "pharmacological extinction" by use of the opiate blocker Naltrexone to reduce alcohol cravings.

People take Naltrexone prior to drinking, and must continue to do so on a life-long basis. The program is aimed at turning obsessive drinkers - alcoholics - into "responsible" drinkers.

The TSM website claims that in a few months, most people can cut down their alcohol consumption to safe levels and many stop drinking alcohol for good.

How it works

The program involves taking a Naltrexone tablet one to two hours before drinking before your first drink of the day for the rest of your life as long as you continue to drink. The tablets are purported to chemically disrupt the body’s behavior/reward cycle causing you to want to drink less instead of more.

If you stop taking the medication before drinking, you can undo the progress and go back to drinking how you did before the treatment.

Success rates

The TSM website claims that the method "has a 78% long-term success rate." However, this statistic is meaningless because it is not given in context. It does not define what constitutes a "success:" Is it abstinence? Reduction in drinking amounts? Reduced health problems? Less dysfunctional behavior? Over what period of time? Also, no source for this very high-sounding statistic is given.

I have done a comprehensive search of the medical research literature, and I have found nothing hat would support this "78% success" statistic. By far the most trusted source of unbiased medical data for doctors and researchers is the Cochrane Review, which is an independent organization that collates all available data from studies done all around the world and analyzes the overall results. The Cochrane review is "bullet-proof" in terms of being free from any commercial bias.

There is no Cochrane review for TSM, but there is a lot of data for Naltrexone use in alcohol treatment, which is the basis of the TSM. The overall data indicates that it will help one out of nine (11%) people to reduce or stop their alcohol use over the short-term. All of the studies were short-term, 3 months on average.

Background of the program

Dr. Sinclair started his research in America during the 1960s. He established what he called the “alcohol deprivation effect” as a driving force in alcohol addiction. He later moved to Helsinki, Finland, to take his research forward using specially bred rats genetically predisposed to becoming alcoholic. The conclusion of Sinclair’s experiments? That alcoholism is a learned behavior. When a response or emotion has been “reinforced” with alcohol over a period of time it is learned. Some people (and some rats) have genetic traits that lead them to feel a lot of “reinforcement” from consuming alcohol, which eventually creates uncontrollable cravings.

Sinclair was influenced by the work of the Nobel Prize-winning Russian physiologist, Ivan Pavlov, famous for making dogs salivate when a bell was sounded. Once conditioned, dogs rewarded with food after a bell had been rung would salivate at the sound of the bell itself. Over time, Pavlov would ring the bell, but he stopped rewarding the dogs with food; the salivating tapered off. This is called “extinction” and Sinclair thought the learned behavior of an addiction to alcohol could be removed by extinction, too.

Impression of the program

As an addictions researcher, I have to say that Dr. Sinclair's conclusions, based on questionable research about half a century old, are unfounded. There have been no studies that I have been able to find that reproduced any of his data or conclusions, other than the research that he conducted himself.

I am for anything that helps someone to get sober, so I encourage anyone to go with what works for them. However, I find that the Sinclair Method gives unreferenced and unfounded data on its website, and its basis has not held up well in clinical trials. Calling TSM or Naltrexone a "cure" for alcoholism is far from the truth.

However, I am for anything that helps people. If you decide to give the Sinclair Method a try, I strongly recommend that you do so under the supervision of your doctor. I also strongly recommend using TSM in conjunction with a recovery program that addresses the real basis of obsessive drinking, such as the Twelve Step program (Click Here) or SMART recovery (Click Here).

  Cochrane Review Reference:
Rösner S, Hackl-Herrwerth A, Leucht S, Vecchi S, Srisurapanont M, Soyka M. Opioid antagonists for alcohol dependence. Cochrane Database of Systematic Reviews 2010, Issue 12. Art. No.: CD001867. DOI: 10.1002/14651858.CD001867.pub3