As with the vast majority (85 percent) of the 18 million Americans who have drinking problems, Claudia’s attempts at recovery had failed. However hard she tried to control her drinking, she inevitably relapsed back to heavy, dangerous drinking bouts.
Claudia was determined not to become another statistic—one of the 105,000 Americans who, according to the American Medical Association, die from alcoholism each year. She did not want to join the World Health Organization’s figure of 1.8 million worldwide deaths from alcohol—double the number of deaths from malaria and equal to the death rate from lung cancer.
Fortunately, fate intervened when she discovered TSM in the nick of time. She was able to reclaim her life. Babylon Confidential demonstrates how resilience, determination, and luck led Claudia to discover The Sinclair Method—a safe and cost-effective cure for her addiction.
No one walks into a bar at eighteen or twenty-one, has a beer, and immediately loses control over his or her drinking. The addiction takes time—many drinking sessions over months and years—to learn through a process known as reinforcement. Some people are faster learners than others, but once the addiction has taken root in the brain it remains incurable for life. Or at least it had been incurable. In the past, Alcoholics Anonymous was right: once an alcoholic, always an alcoholic. Today, however, the situation has changed, thanks to the research of Dr. David Sinclair. Today most cases of alcoholism can be cured.
Dr. Sinclair began his research with the groundbreaking discovery—now widely accepted by alcohol and addiction researchers—of the alcohol deprivation effect (ADE).
The most common treatment for alcoholism has been alcohol deprivation: detoxifying patients and then keeping them for several weeks in a place where they cannot get alcohol. This treatment does remove the physiological dependence on alcohol which the theories previously said was the reason for craving and drinking alcohol. But Dr. Sinclair discovered that alcohol deprivation actually causes the craving and drinking to be increased. This was a revolutionary discovery. First, it contradicted the standard treatment of detox and rehab. Second, it meant the existing theory was wrong: something other than physiological dependence was causing alcoholism.
The discovery of the alcohol deprivation effect was followed by many years of research with hundreds of experiments aimed at determining what that “something” really is. The studies first showed that the human body’s opioid system was involved. Next, they showed that alcohol drinking is a learned behavior reinforced by the opioid system.
Naltrexone and its relatives nalmefene and naloxone are in a class of medications known as “opioid antagonists.” These medications are highly effective at blocking the effects of both opiate drugs (morphine, heroin, oxycodone) and the body’s own morphine-like substances known as endorphins. When we drink alcohol our brains secrete endorphins, and, like morphine, these endorphins bind to opioid receptors on nerve cells in the brain, causing reinforcement. As a result, the person is more likely to drink alcohol again in the future, releasing more endorphins, causing more reinforcement, and making drinking still more likely to occur. While the majority of people are born with “normal” opioid systems, it is thought that about 15 percent of the population inherit a particularly sensitive opioid system. This engenders a genetic predisposition to alcoholism. For these people, the vicious cycle of drinking, endorphin release, and reinforcement of further alcohol drinking is likely to proceed to the point where the person can no longer control the drinking.
It is now clear that this learning to crave and drink alcohol takes place unconsciously in the primitive parts of the brain. For most people the conscious higher brain can dominate the primitive parts and block excessive drinking. Alcoholics, however, have had so much reinforcement from drinking so often that the primitive brain’s demands can no longer be blocked. The primitive brain demands that the conscious brain think about alcohol, and the alcoholic thinks about it nearly all the time. The primitive brain, especially after alcohol deprivation, demands that alcohol be consumed, and so the alcoholic drinks.
The primitive brain is powerful. Once addicted, few of us—perhaps less than 10 percent—have the ability to use our higher cortical brain, our “willpower,” to overcome the biological cravings for food and water. The systems in the primitive brain that drive impulsive and compulsive heavy drinking in the alcoholic have become as powerful as those for the basic drives. For those individuals who can override the impulse to drink and can remain abstinent there is no need for The Sinclair Method.
It is often very difficult for non-addicts to understand addiction. One way of illustrating the overwhelming power of biology driving addiction is to imagine being out in the desert for forty-eight hours without water. The forty-eight hours now become seventy-two hours. In the distance you see a truck driving toward you. All you can think about is your thirst—a drink of water. As the truck approaches, you see that it is refrigerated and surely contains some cool, nourishing liquid. Indeed, when it arrives two people hop out and set up a table on which they place a bucket of ice and water and several types of juices and soft drinks. They now instruct you to resist: “Don’t drink,” they say. But the biological impulse to drink, to survive, overwhelms you, and of course you cannot resist the deprivation effect. This is what it is like to be an alcoholic—or an amphetamine addict, a cocaine addict, or even someone suffering from non-substance addictions like gambling.7 The primitive brain takes over and you relapse.
Until the discovery of “pharmacological extinction,” which has come to be known as The Sinclair Method, alcoholism and many other substance and non-substance addictions were indeed incurable. The best you could hope for was that you would remain on the wagon as long as possible between relapses. While it is true that around 10 to 15 percent of those addicted to alcohol do manage many years of abstinence, they can never touch a single drink again. Indeed, many traditional detox and rehab centers actually inform their patients that their chances of remaining abstinent are less than 15 percent at one year.
Naltrexone changes that situation, but only when used correctly. Claudia read about TSM and the correct way in which to use the medication in The Cure for Alcoholism. The book describes the origins of Dr. David Sinclair’s thirty years of alcohol research for the National Public Health Institute in Finland and how pharmacological extinction represents a major breakthrough in addiction science.
Instead of the 85 percent failure rates associated with traditional treatments,8 TSM achieves success rates of around 80 percent. Success in TSM terms means that after treatment, individuals are biologically de-addicted. Their craving is dramatically reduced, and they are able to drink within World Health Organization safety limits—or they are able to abstain without craving alcohol.
In most cases the benefits of the treatment take about three to four months to appear. Babylon Confidential demonstrates that Claudia was a “fast responder.” But, depending on the individual, benefits may take some people up to ten or twelve months. Once patients have successfully reversed the addiction they must follow one golden rule. The Cure for Alcoholism constantly reminds them never to drink alcohol without first having taken their naltrexone (or nalmefene); otherwise they remain at risk of relearning the addiction.9
Despite more than ninety clinical trials—many of them conducted to the gold standard of clinical research (double-blind and placebo-controlled)—most doctors have not yet heard about naltrexone and its efficacy in treating alcohol addiction. Unless a medication is covered by a patent, there is no financial incentive to spend the hundreds of millions required to market a new medication. Unfortunately, when a doctor has heard about naltrexone but prescribes it according to the manufacturer’s implied directions—take a 50 mg naltrexone tablet and abstain from drinking—the result is always failure.10 Fortunately, Claudia’s search led her to my book The Cure for Alcoholism, and she learned how to treat her alcoholism effectively with naltrexone by following the golden rule and not abstaining from drinking.
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br /> Alcoholism remains a stigma. Physicians, patients, and their families often mistakenly conclude that the individual is “weak” or “immoral.” Babylon Confidential bravely describes how Claudia Christian was rescued by TSM from the “monster” unconsciously arising from the super-strengthened opioid system in her primitive brain—and how after years of unnecessary suffering she has been freed of the tormenting, unrelenting imprisonment of the addiction that had become hardwired into her brain.
Tragically there are millions of people like Claudia confined to this biological prison. Since they do not know about The Sinclair Method, they remain addicted despite battling the craving and addiction as hard as they can. While their intentions may be noble, mere conscious knowledge of the dangers of compulsive, uncontrolled drinking makes no difference, and most unwillingly relapse back to heavy drinking.
One study conducted at the Karolinska Institute in Sweden confirmed that naltrexone also attenuates amphetamine addiction. This is a most convincing and groundbreaking study, proving that naltrexone cuts craving and significantly reduces amphetamine abuse by blocking the reinforcement coming from the amphetamine. It was conducted by Nitya Jayaram-Lindström and a team headed by Johan Franck in the Department of Clinical Neuroscience at the Karolinska Institute in Stockholm.1112,13 Jayaram-Lindström points out that there are an estimated 35 million amphetamine abusers worldwide—more than the total number of heroin and cocaine abusers combined. In its final phase the study used a double-blind, placebo-controlled design and obtained results showing that naltrexone was effective in treating amphetamine addiction. Just think about the wonderful implications of pharmacological extinction for the millions in the grip of amphetamine and methamphetamine addiction.
Now think about the World Health Organization figure of 76.3 million people addicted to alcohol. We know from the science that taking naltrexone or nalmefene one hour before a drinking session (the Sinclair way) can help around 80 percent of people. Unlike many other approaches TSM is firmly grounded on evidence-based medicine. Dignified, safe, and kind, this alcoholism treatment is by far the most effective now known. Unfortunately, it does not produce the kind of profits associated with the $6.2 billion rehab industry in the United States. The main ingredients—a prescription from a physician in any general medical setting, according to the American Medical Association, and taking the inexpensive generic medication one hour before drinking in a twenty-four-hour period—are not profitable propositions.
Dr. David Sinclair’s discoveries are now being tested in a promising phase-two double-blind clinical trial for binge-eating disorder (BED) under the auspices of Lightlake Therapeutics Inc. BED appears to be caused by addiction to foods that, like alcohol, release endorphins; therefore, it should be possible to treat BED with a method similar to TSM. It also should be an effective treatment for bulimia. In this instance the treatment uses a short-acting opioid antagonist called naloxone administered as a nasal spray. Naloxone remains in the brain for only a couple of hours, which is the usual duration for an eating binge.
Finally, there is real hope that a sister medication, nalmefene, which is very similar to naltrexone and especially safe, will receive final approval for the treatment of alcoholism after a large European phase-three trial concludes at the end of 2011. Nalmefene would engender enormous hope for problem drinkers, binge drinkers, and alcoholics in the UK, Europe, and eventually the United States.
Claudia Christian’s Babylon Confidential is a courageous contribution to the world. It will inform others who have no idea that a scientifically proven medical treatment for alcohol addiction actually exists for moderate, severe, and end-stage alcoholics. Alcoholism and other addictive behaviors need no longer destroy so many lives. Despite the widespread misconception that alcoholism is an incurable lifelong condition, science informs us that now there really is a cure—that for 80 percent of those who try it, the treatment allows for gradual detoxification and de-addiction.
ACKNOWLEDGMENTS
Claudia Christian
FROM CLAUDIA CHRISTIAN: Thank you to my family and friends for sticking by me in the tough times; I love and appreciate all of you very much. Holly, you’ve gone through it all with me and I can never say “thank you” enough.
To Drs. David Sinclair and Roy Eskapa—you saved my life. How do you thank someone for that? I am forever grateful for your research and dedication in developing and spreading the word about The Sinclair Method.
Thanks also to Neil Gaiman, Kevin Anderson, Rebecca Moesta, Shari Shattuck, and Walter Koenig for reading this book and offering their kind words of support, and to David Honl for his love, friendship, and massive talent.
And to Morgan . . . here’s to many more years of collaboration. You are a huge talent with an enormous heart. I don’t know how we found each other but I am utterly chuffed that the universe managed to arrange it.
Morgan Grant Buchanan
FROM MORGAN GRANT BUCHANAN: Love and thanks to my wife, Catherine, and sons, Calum and Liam, for their patience and support while I scheduled interviews and phone conferences at all hours from Australia to work on this book.
Sincere thanks to my writing collaborator and friend, Claudia Christian, for asking me to help share her amazing life story.
We’d both like to thank our agent David Fugate at LaunchBooks and the team at BenBella Books for their support and professionalism.
NOTES
1 “Nearly one-fifth of women (18 percent) reported experiencing a completed or attempted rape at some time in their lives.” (National Institute of Justice and Centers for Disease Control and Prevention, “Prevalence, Incidence, and Consequences of Violence Against Women: Findings from the National Violence Against Women Survey,” November 1998.)
2 Babylon 5, Season 4, Episode 19, “Between the Darkness and the Light.”
3 EXTRA Online’s live interview with J. Michael Straczynski, executive producer and creator of Babylon 5, and actress Claudia Christian, who plays Lt. Commander Susan Ivanova on the show. Copyright 1995 America Online, Inc., all rights reserved.
4 Computer-generated imagery, the technique used by filmmakers to produce lifelike digital animation.
5 http://www.orange-papers.org/orange-effectiveness.html.
6 www.28weekrecovery.com/index_files/Page389.htm.
7 Gambling, high-risk compulsive behavior, and several other destructive behaviors are thought to be mediated via the opioid or endorphinergic system.
8 National Institute on Alcohol Abuse and Alcoholism, National Institute on Drug Abuse, World Health Organization.
9 50 mg is standard, but sometimes, according to reports from readers of The Cure for Alcoholism on their Internet forum www.thesinclairmethod.com, a dose of 75 mg one hour before a drinking session in a twenty-four-hour period is required.
10 John H. Krystal, MD, et al., “Naltrexone in the Treatment of Alcohol Dependence,” New England Journal of Medicine, December 13, 2001. This study of 627 alcoholics in Veterans Affairs hospitals proved that naltrexone is ineffective when combined with abstinence.
11 Nitya Jayaram-Lindström et al., “An Open Clinical Trial of Naltrexone for Amphetamine Dependence: Compliance and Tolerability,” Nordic Journal of Psychiatry (59 (3): 167–171, 2005).
12 Nitya Jayaram-Lindström et al., “Naltrexone for the Treatment of Amphetamine Dependence: A Randomized, Placebo-Controlled Trial” (2007, submitted).
13 Nitya Jayaram-Lindström, “Evaluation of Naltrexone as a Treatment for Amphetamine Dependence,” a dissertation from Karolinska University Hospital, presented Dec. 18, 2007. After tests with volunteers and a compliance test with amphetamine addicts, a twelve-week randomized double-blind, placebo-controlled clinical trial showed that naltrexone eventually reduced addicts’ craving and produced fewer urine positives for amphetamine.
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