Why you should care

Because AA isn’t your only hope. 

The United States already boasts the world’s highest binge-drinking rates — drunken frat dudes are practically the country mascot abroad — and the problem is only getting worse. For the past 80 years, Alcoholics Anonymous has been the leading prescription for alcoholism, but, as evidenced by the growing problem, the 12-step program has a fairly dismal success rate. Still, contrary to almost any other ailment, the idea of relying on medicine rather than God to cure addiction just hasn’t been part of the vernacular. Until, perhaps, now.

It’s called the Sinclair Method. The now-deceased David Sinclair proposed that taking naltrexone at least one hour before drinking could curb the voracious appetite of the out-of-control drinker. Over the ensuing weeks, he argued, the urge to drink would diminish entirely. Sinclair published his theories in 1990 in the Annals of Medicine. Described as an opioid antagonist, which works by shutting off the pleasure centers of the brain triggered by alcohol, naltrexone received FDA approval in 1994. But it’s only recently that Americans have started opening up to this unconventional — or, when it comes to Western medicine, some might say more conventional — approach.

It blunts or kills the high that one feels when they drink or use.

Suzette Glasner-Edwards, UCLA Integrated Substance Abuse Programs

“For a lot of people, they have trouble understanding a very counterintuitive method,” says actress Claudia Christian, perhaps best known for her role on the cult sci-fi series Babylon 5. About half of the people who use naltrexone stop drinking forever, but many stay on it permanently, with some continuing to drink moderately. Since Sinclair’s death in April 2015, Christian has become the leading public advocate for his approach. She recently produced a film, One Little Pill, that documents the benefits of low doses of naltrexone, which she and others say can help dampen a number of impulsive habits.

So why would anyone have a problem with it? A recovering alcoholic, who chose to remain anonymous in accordance with the AA tradition, makes the case that taking a pill doesn’t address any of the underlying causes of alcoholism, leaving someone in recovery vulnerable to relapse. “As Dr. Drew himself has said, he can get anybody sobered up, but if I don’t have the willingness to work on my emotional, physical and financial recovery, I’m still the same asshole I was before,” the Big Book believer says. There can be side effects like nausea; and it doesn’t work for everyone, though its success rate is much higher than that of traditional treatments, according to Jenny Williamson, executive director of the C Three Foundation. “Naltrexone doesn’t make addicts feel good; it does the opposite — it blunts or kills the high that one feels when they drink or use,” says Suzette Glasner-Edwards with UCLA Integrated Substance Abuse Programs.

Even an advocate such as Christian says that what works will vary from person to person, and that a combination of approaches — therapy, diet, exercise, group therapy — may be most effective. What she, and a fast-growing number of proponents, is suggesting is that science has offered an alternative. Maybe not a cure, but a tool in the toolbox that’s worth talking to your doctor about.

Correction: An earlier version of this article contained factual errors regarding the Sinclair Method’s genesis and its use.

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