Editor’s note: Earlier this week, Jon Hamm quietly checked out of rehab. Well, as quietly as a celebrity can; word was soon all over the place. We’re big fans of Hamm, and the news got us thinking about a couple things. First, good for Hamm for seeking treatment, we wish him all the best. And second, didn’t we run a piece last year that explored the topic of alcohol excess in an interesting way? Ah yes, here it is. Worth a look if you haven’t read it before…
New York is New York. Work is work and people are people. In this city, we drink. A lot. I once told my therapist (conservatively) that I was having four to six drinks a day, every day.
“You know where I live, you know what I do. Four drinks a day, six drinks a day, seven days a week. On a big night, ten,” I said. “Problem?”
Well, it really wasn’t a problem. Things were fine at work, fine at home, fine with my family. I didn’t get hangovers, I didn’t black out, my physicals were clear, my liver was healthy, my doctor told me to just keep on doing what I was doing. The drinks I had were often very productive and more or less part of the job (the magazine business). I was a guy who worked a lot, was out a lot and drank a lot, period. The same way that you have friends who run a lot, or tinker with model airplanes a lot, or rescue dogs a lot. I drank a lot, or was out having drinks a lot, or out having lots of drinks with dinner — a lot.
And then, swear to God, on a whim, a goof, a lark, I asked my psychiatrist (another New York necessity) about a pill I had heard about in polite conversation that eliminates the urge to drink. He knew exactly what I was talking about: 50mg daily of naltrexone, an “opioid receptor antagonist” originally built to wean heroin addicts off smack, with an off-label use to make people drink less.
My drinking has been cut by fifty — if not seventy-five — percent. Without unwanted urges, without willpower struggles.
It’s supposed to work like this: Pop a pill daily before your first drink and then (this is important) drink normally. Keep doing that day after day, and next thing you know, sometime soon you’ll be drinking less. And that’s precisely what happened.
I filled my prescription and followed the directions to the letter: Day one, I popped the first pill and went on drinking as usual — martinis after work, wine with dinner, etc. Day two, I did the same, as well as for day three, four, five, six … pill, drink, pill, drink, pill, drink. Day in, day out.
Fast forward, nine months later, I still drink every day. But my drinking has been cut by fifty — if not seventy-five — percent. Remarkable. Without unwanted urges, without willpower struggles, without any effort beyond popping the pill once a day.
Pill, drink. Pill, drink. Pill, drink a little less. Pill, drink a good bit less.
Anyone who finds this interesting should do some reading up on something called the Sinclair Method. And naltrexone. In combination, the medicine (naltrexone) and the methodology (Sinclair) pull off a bit of a magic trick with your body’s feedback loop with regard to alcohol intake.
It works something like this : When you take that first big gulp of a martini, your body rewards your bloodstream with a big gulp of endorphins, and that feels good. This positive feedback and the resulting quest for more endorphins is what makes one drink taste so good, and the urge for another so great. It’s this positive feedback loop that makes shots follow beer, the third martini follow the second, and the scotch follow the wine.
Naltrexone, however, puts a stop to all that. By way of pharmacology, it stops that feedback loop — it blocks the endorphin rush. You don’t get the same rush of sheer pleasure from drink. The reward goes away, the feedback loop is severed, and after a few months (if you keep taking the pill and if you keep drinking) something called “extinction” occurs: The body completely forgets that alcohol and big rushes of endorphins are related at all. And thus, the compelling urge to drink — and drink and drink and drink more — evaporates.
Sometimes I’ll realize it’s ten o’clock and it’s just occurred to me that a glass of wine might be nice . That used to happen at five o’clock.
And with no compelling urge, no feedback loop, no positive reinforcement, no rushes of endorphins, you are free to sit down, relax, and have a big glass of wine. Or a gorgeous glass of scotch. You can savor your drink, enjoy its relaxing properties, marvel at how great it tastes, enjoy the lively conversation it brings. Without rushing it, being driven by it or urged on by it. It’s no longer a demon, it’s merely a drink.
All of a sudden, you drink like a normal person. Not like someone who’s training for a gold medal in the sport. Weirdest part of the naltrexone Sinclair Method? It only works if you keep drinking. Pill, drink, pill, drink … and then nine months later …
The difference in consumption manifests in a few different ways. Sometimes I’ll realize it’s ten o’clock and it’s just occurred to me that a glass of wine might be nice . That used to happen at five o’clock. Or sometimes, I’ll realize it’s eleven o’clock and I’m only halfway through a bottle of wine that I opened at four in the afternoon — unheard of a year ago. I’ll find myself going out for drinks with friends after work, having two or three or four, and then walking right past the liquor store on the way home perfectly content without having anything else to drink that night — before, I used to love nightcaps at home.
I used to worry that I might become a full-blown, card-carrying alcoholic in that most 1950s sense of the word.
On all fronts, I am drinking less alcohol and spending less of my time drinking, here and there, and it all adds up to fifty to seventy-five percent fewer drinks. Painlessly and without want.
I’ve always been open about this. For years, I used to worry about my drinking. I used to worry that it would get out of hand. That it would lead to problems in my life — my work, my friends, or my family. I used to worry that it might get ahold of me and take over. That, basically, I might someday, years from now, become a full-blown, card-carrying alcoholic in that most 1950s sense of the word. Blake Edwards’ and Jack Lemmon’s Days of Wine and Roses, seven seasons of Rescue Me and Don Draper’s firing certainly had me scared stiff of the life of a recovering, abstaining “AA Alcoholic.”
Not anymore. I have no worries. I have no guilt, reservations or concerns. I drink what I want, when I want, as much as I want, without a care in the world.
I’m sharing this because I know a lot of people who drink a lot. People who drink a lot tend to know others who drink a lot, and I’ve noticed something with a lot of my drink-a-lot friends: A lot of them (sometimes privately, sometimes publicly) wish they drank a lot less.
When I hear this, I tell them about my experience with naltrexone and the Sinclair Method. I urge them to look it up and talk about it with their doctors. And a few of them have.
If it’s something you’re interested in, I’d urge you to check into it. It’s a painless process, and naltrexone is pretty much free of side effects, well-understood, widely available in generic form and covered by most insurers. There’s not much downside to be considered. I mean, the worst that’s going to happen is that you keep drinking what you already drink.
At best, you’ll be able to drink as much as you like — or as little.
You can read more about the Sinclair Method on Wikipedia.