Does the Sinclair Method Work?
Origins on the Effectiveness of the Sinclair Method
Contrary to what others may say, we at Origins Recovery Centers are actually not very rigid in our thinking. We do teach 12-step principles with intensity, and we do believe that these principles have saved many, many lives. We do not veer off the course of the original idea and intents behind the 12-step program (hence our name, “Origins”), as we do not believe it benefits the health and well-being of our clients for us to do so.
With that said, however, if a method were discovered tomorrow that was clinically, empirically and anecdotally proven to be superior to the 12-step program, we would change our name and adopt a completely new philosophy. Our business is not about branding or ideology; our business is about helping people get well. We do not adhere to the 12-step program simply to the end of loyalty; we adhere to the program because we believe it works, and much more so than any other method that currently exists.
A Treatment Method that is Hard to Believe
It may not come as a surprise that Origins Recovery Centers does not condone the Sinclair Method. However, it is not simply because the method does not incorporate a 12-step approach, or because it is not an abstinence-model of recovery. In fact, it’s quite the opposite. The Sinclair Method requires you to drink in order to be effective. Proponents of this method would have you believe that, over time, your use of alcohol will diminish until your level of drinking has reached normal to below normal amounts. We oppose this method because it simply does not work.
However, we will admit that on the outset, we were quite intrigued at the prospect this method presented. While we love the lives we are afforded by the 12-step program, it would be wonderful to have that and also be transformed to a point where we could once again drink like normal people. That would be excellent, in fact.
We at Origins Recovery Centers are not so entrenched with our own beliefs that we are unable or unwilling to consider those of those. Furthermore, we are very open about the fact that we have “no monopoly on recovery”, as it is mentioned in the Big Book of Alcoholics Anonymous. For these reason, we did examine the information available on the Sinclair Method, casting aside any contempt prior to our research. We have thoroughly examined the efficacy of this approach, and we have determined that, well, the method is just entirely too problematic, and it is based upon a distorted view of what alcoholism is. In our process, we recognized that our dissection of this method and why it cannot work, is a great tool for teaching precisely what alcoholism is.
What is the Sinclair Method?
The Sinclair Method is a treatment for alcoholism which is gaining some degree of popularity, likely due to the increasing number of people who look online for health information. It is not a new concept, in fact most of the research on the Sinclair Method was conducted in the 1980s. It is named for the researcher who developed it and who helped the method gain prominence, primarily in Europe. The premise of the method is very simple, which probably is part of the appeal.
A Bit of Background
The Sinclair Method involves the ingestion of an opiate antagonist — Naltroxene, in most cases — prior to drinking alcohol. Opiate antagonists, like Naltroxene, are used to block the action of synthetic opiods like heroin, opium, oxycodone, and so on within the body. That way, if a person were to ingest both substances (i.e. Naltroxene and Heroin) the opiod would be rendered useless in terms of the analgesic and euphoric effects. Opiate antagonists also work on edogenous morphine or “endorphins”, which are released when someone drinks. Endorphins are, in part, responsible for the feeling of euphoria associated with alcohol ingestion. Theoretically, a person who drinks alcohol while on this medication will not experience the same chemically-fulfilling experience as a person who drinks without it.
The Theory Behind the Sinclair Method
From this point, the Sinclair Method appeals to the theory of Pavlovian conditioning referred to as “extinction” or, more specifically, “pharmacological extinction”. Overtime, the alcoholic becomes conditioned to no longer obsess or crave alcohol because his or her neurochemistry is now set to believe that the ingestion of alcohol leads to no great euphoric benefit. Without the reward of euphoria, the alcoholic should no longer crave alcohol. As long as the alcoholic takes Naltroxene, the addiction patterns of the alcoholic will wane and eventually dissipate to the point where they no longer drink to a dangerous degree — or even at all.
A Critical Analysis of the Sinclair Method
The problem with the Sinclair Method is that it is based upon the assumption that alcoholism is purely a physical affliction, and it can be treated by changing addictive brain chemistry. We will expound upon why this is incorrect later. However, for now, we will simply assume that this basis is valid so that we may touch upon other issues with the Sinclair Method that exists even if the method rested upon solid assumptions (which, again, it does not).
The Issue of Desire or Willpower
Will an Alcoholic Take a Medication Which Reduces the Effects of Alcohol?
It seems impractical, to believe that an alcoholic — who is addicted to the feeling afforded by alcohol consumption — would be able to continually take a medication that prevents the feeling they crave? In other words, why should we assume that an alcoholic would or could voluntarily comply with the proper medication regimen required of the Sinclair Method? Ask an addiction medicine specialist who has routinely prescribed Antabuse (a medication that creates an unpleasant reaction when taken with alcohol) what the biggest issue with Antabuse is. More often than not, the specialist will cite the failure of patients to comply with the dosing schedule. Patients complain, “I get sick when I take my Antabuse and drink. So, I decided not to take it.”
This fault seems intuitively obvious to us. Taking a alcoholic who is addicted to feeling produced while drinking alcohol, then asking them to take a medication that will block that feeling sounds absurd. If they can manage that much, why do they not just stop drinking altogether? That way they would not have to deal with the cost of alcohol, or the toll it takes on their body, or the hangovers, and so on. Alcoholics will not stop drinking for the reasons they will not be able to comply with Naltroxene, or a similar drug: they are addicted, and by definition, they are unable to neglect themselves of the feelings they are addicted to.
The Issue of Regular Dosage and Up-Regulation
Will an Alcoholic Take the Medication as Directed?
Let us ignore this previous point and continue down this path supposing that, miraculously, a person who has lost all power, choice and control over their drinking can convince themselves to regularly ingest a medication that diminishes the joys of drinking. Can we reasonably expect such a person to ALWAYS take their medication as directed? Surely not.
The Dangers of Up-Regulation
What is even more problematic is the well-documented phenomena, known as up-regulation, that occurs within one’s brain when there is a large presence of opiod antagonists. Up-regulation is a natural response by the brain when it is being flooded by opiod antagonists, like Natroxene. After sensing an increase of opiod antagonists, the brain will make cells more responsive to the stimuli (Natroxene, in this case) by increasing the amount of opiod receptors. This is a way for the brain to maintain normalcy.
In the presence of Natroxene, an increase in opiod receptor is not a problem. However, if a person practicing the Sinclair Method misses even one dose of Natroxene and proceeds to drink, that person will be drinking with a brain which is now hyper-sensitive to the effects of alcohol. The alcoholic will likely engage in binge-drinking, and potentially forego the Sinclair Method entirely now that their brain has once again experienced the pleasurable effects of alcohol sans Naltroxene. Plus, the experience will be more intense than the addict had ever experienced before due to the increase in opoid receptors in his or her brain.
Evidence of this phenomena has been observed in those practicing the Sinclair Method. In fact, the greatest proponents of the Sinclair Method even caution against ever missing even one dose. Is this realistic? We believe the answer is obvious, but again, let us continue with this thinking and find where else it can lead us. Suppose an alcoholic could adhere to taking Naltroxene regularly, without fail, for the rest of time. What possible other consequences could this method hold?
Will an Alcoholic Search for a New High?
An alcoholic substituting an old addiction with a new addiction is not a new concept. And this concept is particularly likely when employing the Sinclair Method, which really does not address the true issues of alcoholism (but, more about that later).
Once an alcoholic has chemically reduced the effects of alcohol on their brain, there is a high chance that the alcoholic will find a new drug of choice that will mimic the effects. For instance, while opiods would not work (due to the opiate antagonist medication), barbiturates (e.g. Phenobarbital) and benzodiazepines (e.g. Xanax) are commonly known to offer the same euphoric effects as alcohol. The dangers of this switch are great. Barbiturates are known to be some of the easiest substances to overdose on (relative to alcohol). Not to mention, severe barbiturate and benzodiazepine addictions entail even worse withdrawal symptoms than that of alcohol. For this reason, the Sinclair Method seems to be a poor treatment method since it opens up an incentive for the alcoholic to self-medicate through other sources.
The Issue of Urgency
Should an Alcoholic Continue to Poison the Body with Alcohol? Will They Survive It?
We have yet to touch on this point yet, since it seems to be such an obvious argument against the Sinclair Method that is almost goes without saying, but it still needs to be mentioned. A large percentage of alcoholics are unable to admit they have a problem at all until it is absolutely and undeniably glaring. Sometimes the problem reveals itself after the 3rd DWI; sometimes the problem reveals itself when an alcoholic loses their job because of their addiction; sometimes the problem reveals itself after the alcoholic experiences liver or other organ failure caused by excessive alcohol consumption.
Do we really want this type of person experimenting with their neurochemistry over the course of several months in attempt to induce pharmacological extinction? Are we sure this type of person has the strength to continue to poison their bodies to death while they wait for the Naltroxene to work? They very well may not have that long.
The Sinclair Method Simply Does Not Work
The point we are really trying to drive home in this article is that the Sinclair Method, even when assuming its faulty logic to be correct, is still quite problematic. Even if alcoholism is simply a physical affliction of unfortunate brain chemistry, it still seems highly unlikely that this method will be successful for any significant percentage of recovering alcoholics. Is it logical to think a true alcoholic will regularly take this medication without fail? Is an bender brought about by up-regulation worth the risk? Is it not likely that the alcoholic will not turn to other drugs to get high? Is jeopardizing their physical health worth it?
What is Alcoholism?
The true fact of the matter, however, is that alcoholism is not simply a physical affliction. Obviously, there is that component of physical affliction. The body of an alcoholic does, in fact, experience a craving once alcohol has been consumed. And this physical craving does cause the alcoholic to lose control over the amount of alcohol they intake.
However, the physical affliction is just one piece of a complex puzzle. Plus, as we have demonstrated, it is unlikely that the Sinclair Method even addresses the physical aspect, although proponents claim it does.
Alcoholism is often referred to as a “bio-psycho-social” affliction which attempts to indicate that it is a disease of the body, mind and spirit. The alcoholic has a mind that obsesses over alcohol constantly whenever the alcoholic is still in active addiction but is not physically drinking, a body that craves it once the substance has been introduced to the body and a spiritual malady that promotes substantial “inward unmanageability,” the symptoms of which are restlessness, irritability and discontentedness, which will always work toward getting the alcoholic to anesthetize these feelings with alcohol.
It’s this third component of alcoholism – the spiritual malady – that really defines why the Sinclair Method ultimately fails. While we don’t believe the following to be actually true, for the sake of discussion, we will concede that if the Sinclair Method did in fact remedy the physical aspect of alcoholism, then it could logically also eliminate the mental obsession. Again, this is the unproven theory behind the method, but if craving could be lessened and the mind taught to believe alcohol did not posses euphoric traits, then conceivably over time the mental obsession around alcohol would also lessen.
Unfortunately, that still leaves the most prominent and troublesome component of alcoholism – the spiritual component – and no amount of Naltroxene is going to remedy substantial and personally handicapping long-term inward unmanageability so severe it can really only be aptly described as a malady that is spiritual in nature. The only thing that has ever been observed to relieve such an ailment, and this was stated in no uncertain terms by the preeminent Carl Jung, is a truly transformative spiritual experience which is precisely what a properly executed 12-step program will recreate and precisely what a lot of Naltroxene and booze will completely neglect.
Has it Been Successful?
Yes, there are stories of “success” popping up on the internet of Sinclair Method individuals being “cured” of alcoholism. There is little clinical evidence of this, but rather a fair number of blog postings and videos on YouTube. We’d like to first suggest that most likely those individuals whom were supposedly “cured” by Sinclair Method intervention were possibly not true alcoholics in the first place; perhaps just really heavy drinkers.
And of those who have had supposed success who are in fact true alcoholics, we would contend that they aren’t “recovered” in the sense a person in long-term sobriety living the 12-step way of life are, but rather these Sinclair “success” stories are really the equivalent of what we call “dry drunks” or they are “white knuckling” it as we put it.
You see, alcoholics who can forcefully separate themselves from alcohol absent a spiritual solution, while rare, aren’t in fact unheard of. These poor souls take the brute-force method of recovery (which is not recovery at all but really deprivation) and the term “white knuckling” refers to the lack of blood in their knuckles as they clench a chair and greet their teeth fighting off the urge to drink.
Anyone who has been in the recovery community long enough has observed individuals like this; those alcoholics who don’t find solution through the spiritual experience afforded by the 12-steps and in fact just physically separate themselves from alcohol and live painfully through the spiritual malady or “bedevilments” that still remains in full-force constantly compelling the “dry drunk” to want to self-medicate. This is what the Sinclair Method alcoholics have done, in effect. While they haven’t separated themselves from alcohol like the dry drunk has, they have separated themselves form the euphoric effects of alcohol that act to temporarily alleviate the spiritual malady, which to us is in effect the same thing.
If there’s any question as to the veracity of our point here, please just look to the Sinclair Method drunks themselves. They seem to really like to post on the internet and most of the time they’re not delivering experience, strength and hope of an inspirational nature like that of many 12-step enthusiasts in long-term sobriety. No, most of them are besmirching 12-step fellowships as evil and weak-minded, in addition to a bunch of other poison they are spreading. We have even seen a few by one gentleman who self-designates as a doctor of some sort and his video which is supposed to be in support of the Sinclair Method is actually just him chain-smoking, drinking beer and slurring an ugly cacophony of nonsensical hate of various types. But really, can you blame him? He’s slurping down booze that no longer works.
Yes, it is a novel concept and theoretically quite attractive, but upon further review we find that this level of attraction is quite speciously so. The Sinclair Method represents just another easier, softer way, as referenced in the Big Book, that the alcoholic uses to try and control his drinking rather than looking to a spiritual solution to cease drinking altogether.
We would encourage anyone who has either experimented with the Sinclair Method or thinking about it to contact us as 888-U-GET-WELL or by clicking the contact button below.