The Sinclair Method: Everything You Need to Know

the sinclair methodThis article provides an overview of the practices for alcohol addiction. Unlike abstinence-based treatment, the practice uses a prescription medicine called Naltrexone to extinguish alcohol cravings.

Like many people with life-threatening alcohol disorders, I sought professional help for alcohol detox.

I gradually got my life together by actively changing my body and mind through fitness and holistic techniques.

These are the main topics of this site, and they can enrich your life regardless of your recovery practice.

It wasn’t until several months after I quit for good that I learned about a little-known but highly effective treatment option. I was astounded that no one I’d consulted – including numerous mental health professionals – mentioned this practice to me when I was still actively trying to control my drinking.

[Please note that I’m not a doctor, and none of the following constitutes medical advice. As always, consult your physician before starting any program to treat your addiction.]

What Is the Sinclair Method?

This practice uses Naltrexone, an opioid antagonist, to prevent opioids and endorphins from binding receptors in the brain. Naltrexone is not addictive.

the sinclair method
Dr. John David Sinclair

The practice is named after the late Dr. John David Sinclair, a Finnish doctor who found that 80% of people he treated with Naltrexone either quit drinking or reduced their alcohol consumption to moderate after several months.

There have been 82 clinical trials that demonstrate the effectiveness of the practice.

Since alcoholics experience an abnormal rush of endorphins upon consuming alcohol – leading them to drink more and more – taking Naltrexone before drinking rewires their brains to stop associating alcohol with pleasurable endorphin release.

This process is called pharmacological extinction.

A person with a drinking problem simply takes the pill (usually 50 mg) an hour before drinking every time he or she plans to drink. The pill must be taken before every drinking session, or the process will not work.

Although Naltrexone goes to work immediately, drinking levels usually taper off gradually. There is no need for professional detox with this method.

The Sinclair Method – Why Do AA and Treatment Centers Ignore It?

the sinclair method
Naltrexone Tablets

The Sinclair Method is controversial because in order for it to work, a person must continue to drink. There can be no blocking of endogenous opioids – and therefore no pharmacological extinction – if alcohol is not present along with the Naltrexone.

Studies in which Naltrexone was used to promote abstinence only found that it worked no better than a placebo. The 80% success rate was only for people who continued to drink, although about a quarter of people quit drinking for good after several months.

While I’m not in the business of trashing AA – I think it’s great that there’s a free support group for people with alcohol addiction – many of its members oppose the Sinclair Method because it bypasses the spiritual changes they champion.

(At the same time, I honestly see no conflict in principle between AA and the Sinclair Method. Both share the same stated goal – saving lives from alcohol addiction.)

The Sinclair Method treats physical addiction to alcohol; it doesn’t automatically make you a better person. Of course, for a lot of people (including myself) without underlying psychiatric disorders, treating physical addiction is kind of the point of recovering. I would have liked to know before I sought expensive help that the Sinclair Method has an 80% success rate, compared to 5-10% for AA.

As for treatment centers, it’s easy to see how a method that solves the problem of withdrawals and puts people back in charge of their lives might threaten the enormous addiction treatment industry. Most treatment centers utilize 12 step programs, and employ people in recovery who used these programs themselves to get sober.

To put it bluntly, human nature often causes us to avoid new things that threaten our sentimental, personalized attachments and narratives. In all things related to addiction, the 12 Step worldview is deeply ingrained in the American psyche.

The Sinclair Method – How To Get Naltrexone Prescribed

Since many addiction experts in the U.S. aren’t aware of the Sinclair Method, it can be difficult to get Naltrexone prescribed.

Ironically, it’s relatively easy to get it prescribed as part of an abstinence plan, despite the fact that studies show no benefits for doing this.

Some people get it prescribed to support abstinence, and then continue to drink. I think a better option is to find a doctor who is familiar with the Sinclair Method and supports its use.

The C Three Foundation provides a database that can be used to find a doctor willing to help patients who want to try the Sinclair Method.

“Did I Miss Out on Continuing to Drink?”

I’m not promoting the Sinclair Method for anyone who has already quit drinking without it.

To those of us who quit without his method, Sinclair had this to say: “Congratulations! Keep it up. You do not need our help, and we have nothing to offer you.”

If someday I find myself relapsing into active addiction – say, because of a bad accident that leaves me paralyzed after a divorce amidst a nuclear World War III that wipes out my entire family – it’s nice to know that there’s a method I could probably use to help me regain my footing.

Until then, I’ll savor being mentally sharper and more clear-minded than 99% of people I know who still drink.

I don’t judge anyone who drinks. But in my humble opinion, alcohol is a sham. It’s a toxic, stupefying, dirty drug that I can afford to live happily without.

I’ve gone out to bars and had club soda while watching allegedly “normal” people get absolutely hammered. I can’t judge them because I used to do it too. But it’s very surreal to behold while stone cold sober.

I’d rather read a book, get quality sleep, get up feeling refreshed and get a lift in the next morning.

And then meet non-hungover friends for lunch and drink beverages that actually taste good.

Grown adults habitually incapacitating themselves is weird for me to watch these days (and I don’t unless I’m at a wedding, friend’s birthday, etc.). People think they’re so smooth while doing the most cringeworthy things. Far from feeling like the odd guy out, I’m actually amused that I was once part of that.

The Sinclair Method – Further Resources:

Claudia Christian is a celebrity proponent of the Sinclair Method, which helped her control her drinking after other recovery methods failed. The video below contains segments from a film called “One Little Pill” that she appears in.

UPDATE – June 2021

I’m pleased to have gotten so many kind emails about this article. Since I wrote it 6 years ago, I’ve done a lot of research on medical and holistic alternatives for alcohol addiction. In my opinion, the Sinclair Method is still one of the most ignored and underrated treatments for alcoholism out there.

You can listen to my interview with Claudia Christian here.

When it comes to alcohol addiction, there is no one size fits all solution.

If one method doesn’t work for you, there is another one out there that will if you give it a chance.

An overarching theme of Fit Recovery is this: People deserve to be armed with knowledge rather than dogma.

If you enjoyed this article on the Sinclair Method, be sure to check out this comprehensive review of naltrexone and alcohol. Also check out these articles about alternative methods for alcohol detox and recovery:

the sinclair method


What is the success rate of the Sinclair Method?

Research shows that TSM works for around 78% of people within 3-4 months. A 12-week study found that 86% of people were able to reduce their level of drinking with naltrexone.

Does naltrexone work for everyone?

Studies show that naltrexone helps the majority of people quit or reduce drinking. Crucially, the Sinclair Method does not work for people who are already abstinent. It works only if subjects keep drinking for a period of time after taking naltrexone, thereby helping them to achieve “pharmacological extinction.”

Is naltrexone bad for your liver?

In high doses, naltrexone can possibly cause liver damage. Most people who use The Sinclair Method do not take doses large enough to harm the liver. Typical dosage is 25-50 mg per day, or before each drinking session, until the desire to drink is permanently resolved.

How does naltrexone make you feel?

Since naltrexone is an opioid antagonist, it prevents stimulation of the endorphin centers in the brain. It blocks natural endorphins as well as opiate drugs, resulting in an inability to feel intense pleasure. Side effects from naltrexone can include nausea, headache, dizziness, nervousness, lack of energy, and insomnia.

Does naltrexone affect mood?

Naltrexone blocks opioid receptors in the brain, causing an inability to feel intense pleasure. This can be useful for people who are using naltrexone in a targeted manner to extinguish the desire to drink. Naltrexone taken daily can result in a reduced zest for life.

Do side effects of naltrexone go away?

Side effects from naltrexone can include nausea, headache, dizziness, nervousness, lack of energy, and insomnia. They typically go away over time, and can go away quicker if a doctor decides to reduce the dosage.

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The information we provide while responding to comments is not intended to provide and does not constitute medical, legal, or other professional advice. The responses to comments on are designed to support, not replace, medical or psychiatric treatment. Please seek professional care if you believe you may have a condition.

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Michael Baron
Michael Baron
6 years ago

Hi there, I was looking for something about the length of time that one would have to use Naltrexone. Is this more of a potential “life-time” preventative or did Dr Sinclair find that some people simply lost cravings after a few months, years, etc,

Currently examining all options on our site and keep excellent notes 🙂

Chris Scott
6 years ago
Reply to  Michael Baron

Hi Michael, TSM requires naltrexone before every drinking session for the rest of a person’s life. However, pharmacological extinction – in which the naltrexone extinguishes the desire to drink excessively – can take up to several months, with the timeline of voluntary drinking reduction depending on the person. Some people with severe alcohol addiction may have to detox before starting TSM. It’s not uncommon for people to get to the point where they have one or two drinks infrequently, but they will always have to take naltrexone first.

5 years ago
Reply to  Michael Baron

Hi Michael, I might be a truly exceptional case, but I have been a weekly binge drinker for well over 20 years and have tried all manner of distractions to avoid starting my weekend binge during this time. Always failed eventually – I’d last a fortnight at the most. Well, got to talking to my GP a couple of months back and five weeks ago decided to give TSM a shot. Guess what? I got through two standard drinks the first and second weekends, drank nothing the third and coundn’t stomach the smell of it last weekend or the one… Read more »

6 years ago

Thank you. I had to forward this article to my dad and sister (both MDs) and to a reporter friend at the Washington Post.

7 years ago

I picked up this documentary randomly after seeing it at the my local library. My mom (who is a cancer nurse) came in at the tale end of my watching it and her biggest criticism was that the focus seemed to be on decreasing alcohol consumption and not on eliminating it completely. She compared it to smoking and how many professionals in the cancer field want people to stop smoking completely and not just partially. I think this is a valid criticism, but (at least in the documentary) Naltrexone really seemed to help people improve their quality of life and… Read more »

6 years ago
Reply to  Kay

I think that criticism is valid, however, most nurses would agree that it is acceptable for a person to drink at low levels. In fact, according to the Nurses Health Study, most nurses engage in some level of alcohol consumption. If someone with AUD drinks at the same levels of the low-alcohol consumer, their condition should be viewed as equally as healthy. Additionally, this person no longer suffers the various aspects of addiction that once set them apart from those without addiction; namely the obsessive thoughts and a life focus on alcohol. I think it is as much harm-reduction as… Read more »

Joanna - C3 Foundation Europe

Thank you for a very factual and balanced article about The Sinclair Method. I started this method back in October 2013 and now operate C3 Europe to help others with resources and support. It is worth noting the following small points; Firstly, there are times when a detox first is a suitable option prior to starting The Sinclair Method. In rare cases, the method can work a little too well and actually dramatically reduce someone’s drinking very rapidly. For those who are at great risk of withdrawal, or who have previously experienced seizures etc, then it may be beneficial to… Read more »