You may have heard of The Sinclair Method for alcohol addiction, an effective way of reducing alcohol dependency without giving up alcohol completely. Sound too good to be true? It might not be. We sat down with Dr Harpal Bains to find out more about how it works.
The UK Chief Medical Officer’s (CMOs) advice is that it is safest to drink no more than 14 units a week on a regular basis. According to The Drinkaware Trust, an independent UK-wide alcohol education charity In 2017 in England, 24% of men and 11% of women said that their average weekly alcohol consumption was more than 14 units.
Alcohol dependency can impact all aspects of life, from work to relationships, but taking steps to reduce drinking can be difficult. Many people will be drinking more than usual whilst stuck at home during this coronavirus pandemic. If you’re concerned about your alcohol intake but don’t consider yourself to be dependent, this is a good time to speak to us about how we can help you reduce your alcohol intake.
Here at the clinic we see patients at all stages of dependency, keen to stop drinking, but not everybody wants to give up drinking entirely. In fact, many of the patients we see just want to be able to go back to the days they were able to go out, have one or two drinks and be satisfied. The Sinclair Method for alcohol addiction allows patients to live a relatively normal life whilst reducing alcohol consumption.
Dr Bains: The Sinclair Method is an effective treatment for alcohol addiction and is suitable for anyone who is self motivated to make a change. Both binge drinkers and daily drinkers can be dependent without realising it. If you’re unsure if you are dependent on alcohol, the Drink Aware alcohol self-assessment test is a good starting point.
Generally speaking if you are starting to hide your drinking from people that’s usually a telltale sign of being alcohol dependent. Needing a drink in the morning to steady your nerves is another indicator we look for but this is usually quite a late sign. Multiple episodes of amnesia where you can’t remember what happened is also something we see in more established alcoholics.
Dr Bains: Naltrexone works by breaking the connection between the drinking and the pleasure you get from doing so. This can only happen when you do the action – when you have that drink. Naltrexone for alcohol dependence binds to the opioid receptors in the brain. This then blocks their function in the brain, and as a result, the feeling of pleasure that we get from having the drink.
Dr Bains: Yes, as long as they want it. We usually encourage the patient to involve friends and external support as we find it is more successful. If the drinking is not due to lifestyle and is a result of psychological issues, then it is preferable that the patient is seeking treatment for that simultaneously.
Quite a few people are functioning alcoholics but don’t realise it – they drink because of their lifestyle and before they know it the link (the addiction) has formed. Many people working in the City are expected to combine work and entertaining clients – which usually involves lots of drinking. Unfortunately, it’s possible to come across as antisocial or judgemental when you don’t drink. My advice? Never buy the first few rounds. Buy the third or fourth and by that point, nobody cares what you’re drinking and this enables you to order sparkling water – or gin and tonic as far as anyone else is concerned. We help people think outside the box. And it works.
Functioning alcoholics appear to function normally despite a dependency on alcohol. They drink in secret, and side effects might not catch up with them for some time.
There are certain criteria that one needs to meet to be considered to have a substance use disorder, and still be able to maintain work life, personal life and health. Amongst healthcare professionals the CAGE questionnaire is used to assess drinking and is extensively used. It asks:
Have you ever felt you needed to Cut down on your drinking?
Have people Annoyed you by criticising your drinking?
Have you ever felt Guilty about drinking?
Have you ever felt you needed a drink first thing in the morning (Eye-opener) to steady your nerves or to get rid of a hangover?
If the answer is ‘yes’ to two or more then this should be investigated further.
Dr Bains: We like to do things a little differently. We are not just a hormone based practice – we also specialise in functional and preventative healthcare. This allows us to take treatment one step further.
Addictive tendencies often occur in people with existing nutritional deficiencies (if you’d like to read more about this then I recommend the book Vitamin Cure for Alcoholism: How to Protect Against and Fight Alcoholism Using Nutrition and Vitamin Supplementation by Andrew Saul and Abraham Hoffer). And, once a person gets addictive qualities like drugs or alcohol in their system, their nutrition gets even more unbalanced, either because the body then has to detox it (which is very nutrient intensive), or because they are not eating as well – or both. Before you know it, you end up being in a vicious cycle of depletion. We step in and try to mitigate that.
Not only do we focus on nutrition to uncover and manage any deficiencies, but we also take the additional step of dealing with any potential liver issues right away. The liver is very powerful and has the incredible capacity to repair itself. When looking at the amount some of our patients drink, you’d think their liver function would be abnormal but many actually have normal liver function results and because of this, can get a false sense of safety. Here at the clinic we do not wait for liver function tests to show abnormal results, because at that point, the patient will be in a very late stage of alcohol addiction. We take a proactive approach and manage the liver alongside nutrition, and we do this by tailoring a program for liver support. Patients find very quickly that their energy levels go up, their general sense of wellbeing improves, and minor symptoms tend to disappear.
By putting all these different steps in place, our success rates with our patients are higher because of the support they have and because, overall, they just feel much healthier.
Dr Bains: We have a very good success rate with patients – around 70%. However, some patients get encouraged too quickly and think they can stop all together, which has the opposite effect, and they end up drinking more again.
Many patients who see us have very caring families who really want them to get better, but in order for treatment to be successful it’s really important to be motivated to make the change yourself. When a patient is motivated to start the journey themselves, we see a higher success rate.
There are also a small percentage of people for whom the medication just does not work, but in these cases we are able to prescribe alternative types of medication which may either do the same thing or work in different ways to naltrexone.
If you’d like to get a handle on your drinking, we can help. Call us on 020 7096 5475 to book in for a consultation or alternatively you can email us at email@example.com
Consider letting your friends and family know that you have a dependency and ask for support during treatment.
Ensure you’re committed to your treatment before starting.
Do not stop your treatment too quickly; even if you truly believe that motivation alone is enough.
Remember that addiction is a disease and should be treated as such. It is not an issue with motivation, personality or poor judgement.
Feed your body with top quality nutrition.
Care for your liver before it gives you a reason to be concerned.
Feed your soul with pleasurable hobbies or activities especially if they coincide with the timing of your first drink.
Kranzler, H. R., Tennen, H., Armeli, S., Chan, G., Covault, J., Arias, A., & Oncken, C. (2009). Targeted naltrexone for problem drinkers. Journal of Clinical Psychopharmacology, 29(4), 350–357. doi.org/10.1097/JCP.0b013e3181ac5213
Heinälä, P., H. Alho, K. Kiianmaa, J. Lönnqvist, K. Kuoppasalmi, and J. D. Sinclair. Targeted use of naltrexone without prior detoxification in the treatment of alcohol dependence: A factorial double-blind placebo-controlled trial. Journal of Clinical Psychopharmacology: 21(3): 287-292, 2001.