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Moderation Management members' experiences with naltrexone (ReVia) as an aid to controlled drinking

Compiled by Alex DeLuca, M.D., 2000, 2001. Originally posted: 2001. Most recent minor revisions: 6/25/2004.
Attention naltrexone shoppers! -- In search of the best prices we could find for naltrexone, we called local pharmacies and surfed online drug stores. Here are  the results of our haphazard investigation. -- MM members, 10/26/01
Dr. Alex  - Naltrexone, car wrecks, and clean underwear -- Common questions about starting naltrexone therapy.
Sandra 1 - "Only 5 beers were left in the refrigerator, and ... seven days later, they're still there!"
Sandra 2 - further reflections -- "One of the things naltrexone can do for you is that you learn to drink like a moderate drinker again." 
Mary Sid -- "It's now been 38 days with no desire what so ever for a drink, ...  it doesn't get any better than this." 
Sophia 1 -- "It all went like a charm, I stayed within my limits... I had no problem turning wine down. I just didn't crave it, but I did enjoy the glasses that I had."
Sophia 2 -- "[Since] starting naltrexone I have not lost the 'urge to merge' ..."
Serena 1 -- "...Craving is almost a physical/visceral sensation for me - a feeling ... of uneasiness / anxiety. I still think about having a drink ...  however, (with NAL) the craving  is not there - gone - period."
Serena 2 -- testing naltrexone --"I conducted this experiment...I suspect I drank about 3.5 glasses of wine that evening and I had no difficult in resuming my course of abstinence the next day. I suspect what I experienced, is what "normal" folks experience, no sudden burst of endorphin activity to reinforce to continued drinking."  
Madame  Bozo -- "But for me, (naltrexone) wasn't practical. I personally only had a psychological craving ....  So why couldn't I [control] that without taking a pill?" 
Netty1 -- June 19, 2001  --  "The awesome part about the NAL is the feeling that I have complete control over my choice to drink (without beating myself up about my lack of self-control) in a manner which is not detrimental to my physical or mental health."
Netty2 -- September 9, 2001 -- "I've always loved the taste of a good beer, or an occasional glass of dry wine with dinner. That is why I still have a beer or a glass of wine with a meal. I can only assume this is how "normal" people feel when they drink and why they don't continue to excess."
Netty3 --  August 6, 2001 -- "The increase to 100 mg dose does have the desired effect (eliminating any physical/mental craving whatsoever from the start), especially in combination with my deliberate intent to work the MM steps."
Netty4 -- August 8, 2001 -- "As I read the e-mail my friend sent (about all the breweries and brew pubs they were going to hit), I was astonished to realize I don't want to take part in the event. The thought of drinking beer all day does nothing for me...WOW!!! So, I'm planning to be a great hostess and baby-sit all the girls so my friends can enjoy their grown-up day in sunny Tucson."
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Diana1 -- March 24, 2001 -- " Within a week (of starting naltrexone), I just wasn't drinking. I still had that idea (to drink)
pop into my head... but without the first drink sending a signal to my brain that says 'Hey... that felt good - let's have another!' I drank less and less, until now there's no point. So I don't."
Diana 2 -- June 25, 2001 -- "I'm still down the 26 pounds I lost since starting the Naltrexone so it's not my imagination. I'm off 3 of the 5 medications I was taking, I'm probably the happiest I've ever been - really. I'm not paranoid, depressed, confused or delusion. Or terrified. And I do believe it's because of the decreased alcohol intake. I'm present, available, sociable. Too much to ascribe to Naltrexone? Not if you ask me."
Diana 3 -- October 10, 2001 --
Having taken naltrexone for some 4-5 months, Diana is now stable, drinking moderately, and enjoying life (to say the least!) to the fullest now off the medication.
J. J. -- "I have actually tried and I just get no buzz so get tired and give up. I think I have cut the drinking to half or less of what was for me normal. " Added: J. J. replies to another MM'ers negative experience."
Tom Anon -- "So [the doc] suggested I try Naltrexone to help cut back on my drinking. He said it would reduce the cravings... but it had no noticeable effect, either positive or negative. I concluded that I drank not because of any physical craving. Also Revia had no effect on the way alcohol felt or the amount I consumed. So I stopped taking it."
The Adventures of Aloha Dave:

1) The Grand Experiment begins - 7/12
2) Counselor: "I don't agree with moderate drinking so  when you're ready to try abstinence,  come on back and see me."
3) One week of successful moderation. What does it signify?
4) Naltrexone seems to pull me down --> moderate drinking sans naltrexone

Slow & Pokey -- "I have been tracking my drinking (on naltrexone) since March and I've noticed that the number of times that I have been over limits per week has dropped from 3 to about 1 or 2 times in the past 3 weeks... and I am drinking slower."

Rere -- July 10 & 25, 2001 --  "Well day 2 of taking NAL. The craving seems to be gone but the thoughts are still in my mind." ... "I know the NAL is working...I no longer have the urge to guzzle. The craving is no longer there at all"

Clyde, 30 y/o -- The Bang & Reflections on Naltrexone -- "That first "bang" in the frontal lobes is orgasmic, full of a dizzying excitement and naughtiness that encourages me to drink more." ... "I CAN say that I'm not only drinking less and less, I'm finding that my interest in drinking has changed considerably."
Clyde2 -- two months on naltrexone -- So the idea is that if I feel I must drink I'll drink something "light" in alcohol and "heavy" as an inebriation obstacle. My tolerance is/was ungodly. Now I have two beers and I feel woozy! :-)  And after two beers I'm ready to take it easy.
A doctor in recovery is put to the test and tries naltrexone with good results -- Suddenly exposed to available opiates, this recovering MD was having a rough time until he started on naltrexone. "Within days, I was no longer irritable around the office. I knew the morphine was still there, and I knew I still couldn't have it, but it no longer bothered me AT ALL."
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Dr. DeLuca's Addiction, Pain, and Public Health Website

Alexander DeLuca, M.D., FASAM.

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Originally posted:  6/22/2004

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