How the Sinclair Method for Alcohol Addiction Recovery Works

Table of ContentsView AllTable of ContentsOverviewHow It WorksPros and ConsSide EffectsIs It Right for You?

Table of ContentsView All

View All

Table of Contents

Overview

How It Works

Pros and Cons

Side Effects

Is It Right for You?

This article discusses how the Sinclair Method for alcohol addiction recovery works, the potential pros and cons, and some things you should consider before deciding if this approach is right for you.

Overview of the Sinclair Method

Unlike many traditional approaches to alcohol recovery, the Sinclair Method is a medication-based approach. By administering naltrexone prior to consuming alcohol, the pleasurable feelings that drinking usually produces are blocked.

Because people feel less pleasure when they drink, they find it much easier to drink less. In some cases, they completely lose the urge to drink at all. While this approach is less common in the United States, it has become much more widely used in Europe.

Naltrexoneis a synthetic drug that blocks opiate receptors in the brain. It is used for treating opioid addiction as well as alcoholism. Nalmefene is similar drug that is available in Europe.

The Sinclair Method is not the only medication-based approach to alcohol recovery.

While naltrexone is also taken prior to drinking alcohol, it does not cause illness. Instead, it simply makes it so drinking no longer produces an endorphin rush or “buzz”. Without those pleasant feelings, the brain eventually stops associating drinking with pleasure.

This is known as pharmacological extinction. Inoperant conditioning, rewards increase the likelihood that a behavior will occur again. When it comes to addictions such asalcohol use disorder, consuming alcohol is the behavior and the release ofendorphinsis the reward. When the brain unlearns this association, pharmacological extinction occurs.

History of the Sinclair Method

Sinclair first observed the effects of naltrexone on drinking behavior in his animal research. In animals that had been trained to drink alcohol, they would press a lever repeatedly to obtain it. Sinclair found that if the longer they were deprived of alcohol, the more they would press the lever. He termed this phenomenon the alcohol deprivation effect, likening it to the increasedalcohol cravingsthat make it hard for people with AUD to stay abstinent and avoid a binge.

He also discovered that administering naltrexone before drinking would eventually extinguish the drinking behavior. Later research also demonstrated that naltrexone had a similar effect on humans with alcohol use disorder who wanted to drink less.

Naltrexone is effective because it blocks the pleasurable feelings people have when consuming alcohol. Because drinking is less rewarding and reinforcing, it becomes easier for people to limit their alcohol consumption and reduce their alcohol cravings. If someone uses naltrexone consistently whenever they drink, over time, they can stop their excessive thoughts about alcohol and free themselves from the symptoms of their addiction.

The actual process for using the Sinclair Method includes the following steps:

Researchers do not fully understand how naltrexone reduces alcohol cravings. It blocks certain opioid receptors in the brain and influencesdopamine, aneurotransmitter, which is believed to help block alcohol’s reinforcing effects.

Pros and Cons of the Sinclair Method

The Sinclair Method has advantages and disadvantages that you should consider before you decide if this approach is right for you.

Pros

The Sinclair Method can help people reduce their drinking without quitting drinking entirely. This can be a useful option for people who want to drink socially on occasion but want to cut back and gain greater control over their alcohol consumption. By helping people drink less, it reduces the harm they experience from alcohol.

It can also serve as a step toward sobriety while minimizing the need for medically-supervised detox in residential alcohol treatment. Unlike some other more expensive treatment options, the Sinclair Method is cost-effective and can be done at home.

Research also suggests that it can be very effective in helping people reduce their drinking. According to Sinclair’s research, the use of naltrexone in the treatment of alcohol use disorder can have a 78% efficacy rate.

Other potential benefits of the Sinclair Method:

RecapThe Sinclair Method is an affordable, realistic, and flexible treatment option that has a high rate of success.

Recap

The Sinclair Method is an affordable, realistic, and flexible treatment option that has a high rate of success.

Cons

Extinctiontakes time, and even occasional reinforcement can serve to maintain a behavior. In order for the Sinclair Method to be successful, it is important to always, without fail, take naltrexone before consuming any alcohol.

Some other possible downsides of the Sinclair Method:

As Verywell Review Board MemberDr. John Umhaunotes in an article published inAdvances in Addiction & Recovery, the Sinclair Method requires a lifetime commitment. While it minimizes cravings, it is important to remember that people also drink for other purposes, including social reasons, boredom, habit, and as a way to dampen emotional pain.

Naltrexone is not simple or easy “cure” for alcohol use disorders. It needs to be used correctly and consistently in order for it to be effective.

Regular naltrexone use can also increase the sensitivity of opioid receptors, a process known as upregulation.As a result, drinking alcohol can feel much more rewarding if naltrexone use is suddenly stopped. This can cause excessive drinking, which is why consistently using naltrexone before every drink is critical for success.

Side Effects of Naltrexone

More rarely, severe side effects can include blurry vision, diarrhea, confusion, drowsiness, stomach pain, and vomiting.

Liver toxicity is another serious risk of naltrexone. Symptoms include unusual bleeding or bruising, dark urine, yellowing of the skin or eyes, and pain in the upper right part of the abdomen. If you experience such symptoms after taking naltrexone, you should contact your doctor immediately.

Is the Sinclair Method Right for You?

The Sinclair Method might be a good option for you if you:

In some cases, the Sinclair Method can be a great start toward recovery. Because it engages people with alcohol-treatment professionals, it may help lead people to better recognize the extent of their problem while also giving them the hope and motivation to keep working toward giving up alcohol.

The Sinclair Method is not the onlymedication-based treatment approach. Depending on your own situation, you may find that another type of medication might work better for your needs.

If you are trying to reduce your alcohol consumption orquit drinkingaltogether, the Sinclair Method is one approach you might want to consider. Talk to your doctor about whether taking naltrexone every time before you drink might be an option for you.

While it requires consistent use of the medication, naltrexone may help you reduce your drinking over time. For some people, it can also be a positive step toward abstinence and connect them with treatment professionals who can support them as they work toward sobriety.

10 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sinclair JD.Method for treating alcohol-drinking response. U.S. Patents.Kranzler HR, Tennen H, Armeli S, Chan G, Covault J, Arias A, Oncken C.Targeted naltrexone for problem drinkers. J Clin Psychopharmacol. 2009 Aug;29(4):350-7. doi: 10.1097/JCP.0b013e3181ac5213. PMID: 19593174; PMCID: PMC3184851.Center for Substance Abuse Treatment.Chapter 3—Disulfiram. In:Incorporating Alcohol Pharmacotherapies Into Medical Practice. Substance Abuse and Mental Health Services Administration.Sinclair JD.Evidence about the use of naltrexone and for different ways of using it in the treatment of alcoholism.Alcohol and Alcoholism. 2001;36(1):2-10. doi:10.1093/alcalc/36.1.2Umhau JC.Therapeutic Drug Monitoring and the Clinical Significance of Naltrexone Blood Levels at the Time of a First Drink: Relevance to the Sinclair Method. Alcohol Alcohol. 2019 Mar 1;54(2):192. doi: 10.1093/alcalc/agz014. PMID: 30861062.Anton RF.Naltrexone for the management of alcohol dependence.N Engl J Med. 2008;359(7):715-21. doi:10.1056/NEJMct0801733Sinclair JD.Evidence about the use of naltrexone and for different ways of using it in the treatment of alcoholism.Alcohol and Alcoholism. 2001;36(1):2-10. doi:10.1093/alcalc/36.1.2Umhau JC.How the Sinclair Method changed my mind about naltrexone and alcohol recovery.Advances in Addiction and Recovery. Spring 2020.Yoburn BC, Duttaroy A, Shah S, Davis T.Opioid antagonist-induced receptor upregulation: effects of concurrent agonist administration.Brain Res Bull. 1994;33(2):237-240. doi:10.1016/0361-9230(94)90259-3Substance Abuse and Mental Health Services Administration.Naltrexone.

10 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sinclair JD.Method for treating alcohol-drinking response. U.S. Patents.Kranzler HR, Tennen H, Armeli S, Chan G, Covault J, Arias A, Oncken C.Targeted naltrexone for problem drinkers. J Clin Psychopharmacol. 2009 Aug;29(4):350-7. doi: 10.1097/JCP.0b013e3181ac5213. PMID: 19593174; PMCID: PMC3184851.Center for Substance Abuse Treatment.Chapter 3—Disulfiram. In:Incorporating Alcohol Pharmacotherapies Into Medical Practice. Substance Abuse and Mental Health Services Administration.Sinclair JD.Evidence about the use of naltrexone and for different ways of using it in the treatment of alcoholism.Alcohol and Alcoholism. 2001;36(1):2-10. doi:10.1093/alcalc/36.1.2Umhau JC.Therapeutic Drug Monitoring and the Clinical Significance of Naltrexone Blood Levels at the Time of a First Drink: Relevance to the Sinclair Method. Alcohol Alcohol. 2019 Mar 1;54(2):192. doi: 10.1093/alcalc/agz014. PMID: 30861062.Anton RF.Naltrexone for the management of alcohol dependence.N Engl J Med. 2008;359(7):715-21. doi:10.1056/NEJMct0801733Sinclair JD.Evidence about the use of naltrexone and for different ways of using it in the treatment of alcoholism.Alcohol and Alcoholism. 2001;36(1):2-10. doi:10.1093/alcalc/36.1.2Umhau JC.How the Sinclair Method changed my mind about naltrexone and alcohol recovery.Advances in Addiction and Recovery. Spring 2020.Yoburn BC, Duttaroy A, Shah S, Davis T.Opioid antagonist-induced receptor upregulation: effects of concurrent agonist administration.Brain Res Bull. 1994;33(2):237-240. doi:10.1016/0361-9230(94)90259-3Substance Abuse and Mental Health Services Administration.Naltrexone.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Sinclair JD.Method for treating alcohol-drinking response. U.S. Patents.Kranzler HR, Tennen H, Armeli S, Chan G, Covault J, Arias A, Oncken C.Targeted naltrexone for problem drinkers. J Clin Psychopharmacol. 2009 Aug;29(4):350-7. doi: 10.1097/JCP.0b013e3181ac5213. PMID: 19593174; PMCID: PMC3184851.Center for Substance Abuse Treatment.Chapter 3—Disulfiram. In:Incorporating Alcohol Pharmacotherapies Into Medical Practice. Substance Abuse and Mental Health Services Administration.Sinclair JD.Evidence about the use of naltrexone and for different ways of using it in the treatment of alcoholism.Alcohol and Alcoholism. 2001;36(1):2-10. doi:10.1093/alcalc/36.1.2Umhau JC.Therapeutic Drug Monitoring and the Clinical Significance of Naltrexone Blood Levels at the Time of a First Drink: Relevance to the Sinclair Method. Alcohol Alcohol. 2019 Mar 1;54(2):192. doi: 10.1093/alcalc/agz014. PMID: 30861062.Anton RF.Naltrexone for the management of alcohol dependence.N Engl J Med. 2008;359(7):715-21. doi:10.1056/NEJMct0801733Sinclair JD.Evidence about the use of naltrexone and for different ways of using it in the treatment of alcoholism.Alcohol and Alcoholism. 2001;36(1):2-10. doi:10.1093/alcalc/36.1.2Umhau JC.How the Sinclair Method changed my mind about naltrexone and alcohol recovery.Advances in Addiction and Recovery. Spring 2020.Yoburn BC, Duttaroy A, Shah S, Davis T.Opioid antagonist-induced receptor upregulation: effects of concurrent agonist administration.Brain Res Bull. 1994;33(2):237-240. doi:10.1016/0361-9230(94)90259-3Substance Abuse and Mental Health Services Administration.Naltrexone.

Sinclair JD.Method for treating alcohol-drinking response. U.S. Patents.

Kranzler HR, Tennen H, Armeli S, Chan G, Covault J, Arias A, Oncken C.Targeted naltrexone for problem drinkers. J Clin Psychopharmacol. 2009 Aug;29(4):350-7. doi: 10.1097/JCP.0b013e3181ac5213. PMID: 19593174; PMCID: PMC3184851.

Center for Substance Abuse Treatment.Chapter 3—Disulfiram. In:Incorporating Alcohol Pharmacotherapies Into Medical Practice. Substance Abuse and Mental Health Services Administration.

Sinclair JD.Evidence about the use of naltrexone and for different ways of using it in the treatment of alcoholism.Alcohol and Alcoholism. 2001;36(1):2-10. doi:10.1093/alcalc/36.1.2

Umhau JC.Therapeutic Drug Monitoring and the Clinical Significance of Naltrexone Blood Levels at the Time of a First Drink: Relevance to the Sinclair Method. Alcohol Alcohol. 2019 Mar 1;54(2):192. doi: 10.1093/alcalc/agz014. PMID: 30861062.

Anton RF.Naltrexone for the management of alcohol dependence.N Engl J Med. 2008;359(7):715-21. doi:10.1056/NEJMct0801733

Umhau JC.How the Sinclair Method changed my mind about naltrexone and alcohol recovery.Advances in Addiction and Recovery. Spring 2020.

Yoburn BC, Duttaroy A, Shah S, Davis T.Opioid antagonist-induced receptor upregulation: effects of concurrent agonist administration.Brain Res Bull. 1994;33(2):237-240. doi:10.1016/0361-9230(94)90259-3

Substance Abuse and Mental Health Services Administration.Naltrexone.

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