Sinclair Method: Using Medication to Reduce Alcohol Use

The Sinclair method is a form of treatment for alcohol use disorder that focuses on reducing use rather than maintaining complete abstinence. This may be an option to consider if your loved one is struggling with alcohol use.

What is the Sinclair Method?

The Sinclair Method[1] is meant for individuals who may not want to or are not ready to cut out alcohol entirely, but want to drink less. This technique is largely attributed to researcher John Sinclair.

In this method, patients take the opioid blocker naltrexone in pill form an hour before drinking alcohol. This is meant to limit their desire to drink, because the naltrexone blocks the typical “buzz” or good feelings one might get from drinking. As a result, the person does not feel the need to continue drinking, which can prevent them from consuming a much more harmful amount of alcohol.

If naltrexone is taken consistently before drinking over the course of several months, it might cause “extinction,” which means that over time, an individual could lose the desire to drink entirely. When a patient reaches extinction, they may drink very infrequently or stop altogether. For many, this is the ultimate purpose of the Sinclair method.

Nalmefene, known by the brand name Selincro, is more similar in makeup to naloxone (Narcan), but can be used as a medication to help reduce drinking as well. It is more commonly used outside the United States.

Does it work?

There is evidence that the Sinclair method can be effective in reducing and stopping alcohol use. Naltrexone itself is proven to be very effective in treating alcohol use disorder.

In his 2001 clinical studies, John Sinclair found that 78% of the individuals observed were able to reach extinction after several months. Patients who have done this therapy have reported only having one or two drinks at a time or event when they might usually drink much more, and it has helped them maintain longer periods of sobriety.

However, naltrexone’s effects can wear off after several hours. Additionally, if someone chooses to continue drinking while on naltrexone, they can drink enough to break the protective “wall” that naltrexone provides. As a result, the enjoyment or “buzz” that alcohol provides can come back, which can lead to a return of previous levels of use.

It is important to note that medications for alcohol use disorder are the gold standard of addiction care and proven to be incredibly effective. However, there has also been relatively limited research on the use of this specific method.

While your ultimate goal may be for your loved one to stop drinking entirely, remember that any steps to reduce use and lower the risks associated with alcohol are steps in the right direction.