How the Sinclair Method Works

The Core Principle

The Sinclair Method works by using naltrexone to block the opioid receptors that mediate alcohol's rewarding effects in the brain. When you drink while naltrexone is active, the brain does not receive the usual reward signal. Over time, through a process called pharmacological extinction, the learned association between drinking and reward is gradually weakened.

The Steps

1. Speak with a licensed clinician. Naltrexone is a prescription medication. The first step is a medical evaluation to determine whether naltrexone is appropriate for you.
2. Take naltrexone 1–2 hours before drinking. On days when you plan to drink, you take naltrexone approximately one to two hours before your first drink.
3. Drink as you normally would. This is counterintuitive but important: you continue drinking while the medication is active. The goal is not immediate abstinence — it is extinction.
4. Do not take naltrexone on days you do not drink. The medication is taken specifically before drinking, not as a daily medication.
5. Repeat over weeks and months. Over time, the rewarding effect of alcohol is reduced. Most people experience a gradual decrease in cravings and consumption.

What Pharmacological Extinction Means

Pharmacological extinction is the process by which a learned behavior is weakened when the expected reward is repeatedly absent. In the context of TSM, each time you drink while naltrexone is active, the brain's reward system receives a weaker signal. Over dozens or hundreds of drinking occasions, the association between drinking and reward is gradually extinguished.

This is different from willpower. You are not fighting the urge to drink — you are allowing the brain to unlearn the reward association through repeated experience.

What to Expect

Results vary. Many people begin to notice reduced cravings and reduced consumption within weeks. The full extinction process typically takes several months. Some people achieve controlled drinking; others eventually choose abstinence. The goal is not a specific outcome — it is reduced harm and improved quality of life.