The Sinclair Method of alcohol abuse or alcoholism treatment is unique. It enables most alcoholics to drink in moderation. The technique uses naltrexone or a similar substance.
Taking a pleasure blocker prevents the brain from having the pleasure of a high. Pharmacological extinction (operant conditioning) then reduces craving for alcohol. Surprisingly, few people in the U.S. have heard of the Sinclair Method.
The U.S. Food and Drug Administration (FDA) first approved naltrexone decades ago. Now other pleasure blockers are approved and can also be used.
The Sinclair Method treatment lasts for three to 15 months. After that, the patient needs to continue taking naltrexone before drinking. This prevents positive conditioning from occurring. Otherwise, the pharmacological extinction will reverse itself.
Some Advantages of The Sinclair Method
- Simple and easy.
- No withdrawal symptoms.
- Detoxification unnecessary.
- Rehab facility unnecessary.
- No disruption of employment or family life.
- Can be followed with a person’s own doctor.
Avoiding a rehab is a major advantage. There is no travel, high expenses, safety concerns, or anxiety about living with strangers.
Dr. John David Sinclair developed the method. It is the one used throughout Finland and widely used elsewhere. The reason it’s not widely used in the U.S. is unclear. It may be the very strong influence of Alcoholics Anonymous. A.A. insists that alcoholics can never learn to drink in moderation. However, much scientific research for decades has proven that most alcoholics can and do learn to drink in moderation.
Most clinical trial evidence suggests that The Sinclair Methodit may have a success rate of about 80%.1 That’s much higher than the apparent 5% success rate of A.A.
Why Isn’t the Method More Widely Used?
On the Psychology Today website, addictions expert Kenneth Anderson raised an important point. “It remains difficult to understand why so few American physicians, therapists, and addiction counselors are familiar with The Sinclair Method.”2
Another observer wrote that it will take some time for the Sinclair approach
“to gain wider acceptance, especially in the US, where the treatment industry seems dominated by 12-step ideology. The Sinclair Method is becoming popular in other countries. It’s now available on the National Health Service in the UK. It’s also being used extensively in Scandinavian countries such as Finland, with great success. It is gaining popularity in underdeveloped countries that don’t have a pre-existing 12-step recovery treatment industry, too. It is a much cheaper solution compared to inpatient rehab and this will be attractive to countries without the infrastructure to support hospitalization for many people.”3
A third suggested that
“The medical community has been largely unconvinced of the effectiveness of this cure because of the extreme shift in mindset necessary to accept a treatment for alcoholism that involves continued consumption. To further cloud the matter, many studies have been done involving using naltrexone to help enforce abstinence – a purpose for which it is poorly suited at best. Although their “failure due to relapse rate” has no bearing on the Sinclair Method, most doctors see a “this drug failed” result and don’t look to see how it was used….”4
The reasons for the general lack of awareness of The Sinclair Method are unclear. But sound science is the basis for the process. More important, clinical research proves its effectiveness.
I. Popular Readings about The Sinclair Method.
Christian, C. Babylon Confidential. Dallas: BenBella, 2016.
Eskapa, R. The Cure for Alcoholism. Dallas: BenBella, 2012.
II. Podcast by Dr. John David Sinclair
Sinclair, J. The Sinclair Method for Treating Addiction. Shrink Rap Radio
III. Selected Scholarly Publications about The Sinclair Method
Heinälä, P., et al. Targeted use of naltrexone without prior detoxification in the treatment of alcohol dependence. J Clin Pharmacol, 2001, 21(3), 287–292.
Sinclair, J., et al. Long-term follow up of continued naltrexone treatment. Alco Clin Exper Res, 2000, 24 (Suppl. to No. 5), 182A.
________. Evidence about the use naltrexone and for different ways of using it in the treatment of alcoholism. Alco Alco, 2000, 36(1), 2–10.
________., et al. Extinction of the association between stimuli and drinking in the clinical treatment of alcoholism with naltrexone. Alco Clin Exper Res, 1998, 22 (Suppl.), 144A.
________. From optimal complexity to the naltrexone extinction of alcoholism. In Hoffman, R., et al. (Eds.). Viewing Psychology as a Whole. Washington: Am Psych Assn., 1998. Pp. 491–508.
________. New treatment options for substance abuse from a public health viewpoint. Ann Med, 1998, 30, 406–411.
________. Pharmacological extinction of alcohol drinking with opioid antagonists. Arqivos de Med, 1998, 12 (Suppl. 1), 95–98.
________., et al. Treatment of alcohol dependence with naltrexone utilizing an extinction protocol. Abstracts: 38th Ann Mtg, NIMH-sponsored New Clinical Drug Evaluation Unit (NCDEU) Program, Boca Raton, FL, June 10–13, 1998.
________. Development in Finland of the extinction treatment for alcoholism with naltrexone. Psychiatria Fennica, 1997, 28, 76–97.
________. Laboratory animal research in the discovery and development of the new alcoholism treatment using opioid antagonists. Scan J Lab Animal Sci, 1996, 23 (Suppl. 1), 379–390.
________. Alcoholism: Pharmacological extinction and the P-word. Työterveyslääkari, 1996, 2, 170–173.
2. Anderson, K. Naltrexone and the Sinclair method of pharmacological extinction. http://hams.cc/naltrexone/
3. D., M. Why Isn’t The Sinclair Method Used More Often? https://www.addiction.com/expert-blogs/why-isnt-the-sinclair-method-used-more-often/
4. Dombeck, M. The Paradoxical Sinclair Method For Treating Alcohol Dependence. centersite.net
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