naltrexone

Why do we keeping throwing back those cocktails?

Or popping those pills?

Or eating a whole cheesecake or bag o’ big macs in a single sitting?

(“Why choose?”)

Deep down, we believed at some point that one (or all) could solve inner pain.

And it may have – for a moment. But let’s fast-forward to the point where it mowed through our life goals, gasolined our dreams, and spat a match on the whole mess. Does it still feel like a solution? (Assuming you’ve recognized your use of it is responsible for that aforementioned destruction?) And, if you (rightly) answered no – then why would another substance be the answer to that inner turmoil you never addressed at the start? You cannot solve an internal problem with an external solution, as we all know. And that’s why I was kinda curious as I was reading up on the drug called Naltrexone. A life saver, quite literally, for those going through the worst of alcohol addiction, this stuff essentially competes with your pleasure receptors, rendering that rum you love unpalatable and joyless. And does it work? Well, it gets the job done – as far as stealing the appeal from adult beverages.

But at what cost?

The trick with this med is that you’ve got to keep using. Sounds counterintuitive, but the way in which is works is to “extinguish” that Pavlovian association you have between a substance and the sensation of euphoria that follows. Studies showed that attempting the pharmaceutical without the substance failed to eradicate cravings all but one time (36 out of 37) trials. Contrarily, in those subjects ingesting alcohol alongside the pill, all but one case eradicated craving. After that, it’s simple. You take the med an hour before partaking. And, in so doing, you tweak the link between your brain and beer bottle from glorious angel choirs streaming through stained glass to monochrome indifference slathered in apathy.

So, what’s wrong with suddenly feeling indifferent to the spirits that’re killing you?

That sounds like a pretty good plan to me.

The issue, unfortunately, is that this sentiment tends to follow all the feel good stuff. See, when I decided to quit all external toxins for a bit, it was tough. I thought I needed something to stay afloat socially. (Like Valium.) Something to endure work. (Like Valium.) To survive life’s clearly malevolent plans against me. (Say it with me now…) Once I decided benzos were no longer an option, however, something was indeed there to catch me; natural highs were my saving grace. Jogging. Yoga. Meditation. Writing. Socializing with like minded survivors of their own minds, who were also trying to navigate life in their flesh vessels, minus plying them with chemicals of any kind. (That – positive human connection – is so underrated as a “high”.) Yes, those organic endorphin pumpers were necessary not only to help me re-associate my source of joy to something healthier; but they were also crucial in giving me a reason to stay the course. They made sobriety sustainable. They made exhuming that deep sense of doom more doable – so I could see why I was reaching for chemical comfort in the first place and fix it. If I could find my joy by other means, I didn’t need to be under the thumb of rum or go on benzo benders. But Naltrexone doesn’t really allow that. In clinical trials, it thwarted many sources of euphoria – however natural. From working out to visits with friends or fam, the enjoyment’s extracted from everything:

“Furthermore, a single 50 mg dose of naltrexone (versus placebo) inhibits participants’ experience of the calm, peaceful, relaxed and pleasant mood states following exercise (Daniel et al. 1992). A recent double-blind naltrexone-placebo crossover study demonstrated that ingestion of naltrexone for four days (25 mg for the first two days, and 50 mg for the last two days) significantly reduced participants’ feelings of social connectedness towards friends and family compared to a placebo control period”

And that’s not a long term way to manage an issue like this.

It takes three months to work – for the pill to rid the desire to drink. And, the whole time you’re on it, you’re joyless and drinking. Can you imagine going that long without any enjoyment in life? Problems I’d foresee would be prematurely quitting the stuff, overdosing in a desperate attempt to get high, or suicide in the absence of any positive feelings. And, the thing is, it would be good for people who need to quit drinking pronto because they’re at death’s door – if you could take it without drinking or using your drug’ve choice. You cannot. You have to keep using so your brain can associate total boredom with your tried and true brain soother. And what’s a better solution? Working from the inside out. For someone wanting to get clean or sober in a sustainable way, finding an alternative means of fulfillment is imperative. If you can’t find the joy or fun in life sans a substance, then what’s the point? If you can’t feel good from something like socializing, exercising, creating, learning, or any of the other top notch natural highs, then why bother?

Now, this may raise the whole “get real, Ashley” statement. (Eyeroll and all.) I mean, sure, programs work for plenty of people. But for plenty of others, programs get left by the edge of the road in favor of old habits. So, perhaps, the best bet would be to use this pharmaceutical as a backup plan. In other words, go ahead and get a prescription. Don’t take it until you’ve gone to a few meetings sober and connected with some members. Then, if you feel a craving, try plan A first: calling your sponsor or trusted sober mentor. If that fails, go for Plan B: pop this med you’ve been prescribed, as directed, and then ingest your libation. And then keep taking the med from then on (again – as directed).

So where do you find these “groups”? Well, it depends on what you’re looking for. Some people become dependent but don’t identify as addicts. If that’s you – if you’re looking to manage your drinking this year (versus quitting altogether) – then maybe consider a group like Moderation Management. Or, even if you’re on the fence about whether you need total sobriety or not, any of the “Anonymous” groups are helpful. Even if you’re not subscribing to all the dogma, some of it’s pretty stellar advice to live by. In addition, some people find respite in religion. Or a dojo. Or a sewing circle. Supplement with whatever you need. Just find a group of people who’ve managed to get sober or moderate. Find people who have a map of how to get there. And let them help you on your quest to do the same. Remain open – not only to change, but to assessing what it is that fuels you to feed this fruitless desire in the first place so that you can change it. Seek the reason for your drug seeking. Because even if you end up using this pill as “Plan B”, it can never solve the underlying problem. And, as a wise man once said, you cannot solve a problem with the line of thinking that got you there.

So, why not assume a new one?