The goal of The Sinclair Method of alcohol abuse or alcoholism treatment is to enable heavy drinkers to drink in moderation. The technique uses naltrexone or a similar substance to prevent the patient’s brain from experiencing the pleasure of a high. This mechanism of pharmacological extinction (operant conditioning) reduces craving for the otherwise positive reinforcement caused by consuming alcohol (or drugs such as heroin).

Although naltrexone has been approved by the U.S. Food and Drug Administration (FDA) for decades, other pleasure blockers are now available and may be used.

The Sinclair Method treatment period lasts from a period of three to 15 months. After that, the patient needs to continue taking naltrexone before drinking to prevent positive conditioning from occurring. Otherwise, the pharmacological extinction will reverse itself.

Because there are no withdrawal symptoms, there is no need for hospitalization or rehab attendance. The program can be followed with a person’s own physician.

Named after the doctor who developed it, John David Sinclair, the method is the standard protocol used in Finland and widely used elsewhere. Its limited use in the United States may result from the very strong influence of Alcoholics Anonymous, which claims that alcoholics can never learn to drink in moderation. The difference between A.A.'s ideology and science is that the latter is modified by empirical evidence. Much scientific research for decades, some of it conducted by the U.S. government, has clearly demonstrated that a large proportion of alcoholics can and do learn to drink in moderation.1

The majority of clinical trials have found the method to be effective and it appears that it may have a success rate of about 80%.2 That’s much higher than the apparent 5% success rate of AA.

On the Psychology Today website, addictions expert Kenneth Anderson wrote that “It remains difficult to understand why so few American physicians, therapists, and addiction counselors are familiar with The Sinclair Method.”3 Anonymous persons have asserted on Wikipedia without any evidence on that conspiracies and blatant self-interest operate to prevent the wider acceptance of the Sinclair Method, which is clearly based on well-established scientific principles:

"Dissemination of information of the treatment has been blocked by all of the existing treatment organizations largely because their existence depends upon the continued use of the treatments that they provide. The "give 'em a pill and send 'em home" simplicity of the system is anathema to our current alcoholism treatment industry. Most treatment centers rely upon inpatient treatment for funding, and would cease to exist if widespread adoption were to occur. Alcoholics Anonymous opposes the treatment on two fronts - the use of drugs and the continuation of drinking...

The medical community has been largely unconvinced of the effectiveness of this cure because of the extreme shift in mindset necessary to accept a treatment for alcoholism that involves continued consumption. To further cloud the matter, many studies have been done involving using naltrexone to help enforce abstinence - a purpose for which it is poorly suited at best. Although their "failure due to relapse rate" has no bearing on the Sinclair Method, most doctors see a "this drug failed" result and don't look to see how it was used....

Other obstacles are more mysterious and tentative. It is guessed that the pharmaceutical company that makes the antagonist does not wish to pursue advertising this treatment because its use would decrease the sales of other more profitable drugs. Although insurance companies would benefit from the decrease in inpatient alcoholism treatments, it is suggested that they would lose money in the long run from former alcoholics who no longer let their health slide until they lose their jobs and their insurance."4

Whatever the reasons for the general lack of awareness of The Sinclair Method, the process is based on sound brain and behavioral science and and clinical research supports its effectiveness.

I. Popular Readings about The Sinclair Method.

Christian, Claudia.  (2012) Babylon Confidential, Dallas, TX, BenBella Books.

Eskapa, R. (2012) The Cure for Alcoholism, Dallas, TX: BenBella Books.

II. Podcast by Dr. John David Sinclair

Sinclair, J.D. The Sinclair Method for Treating Addiction. Shrink Rap Radio

III. Selected Scholarly Publications about The Sinclair Method

Heinälä, P., H. Alho, K. Kiianmaa, J. Lönnqvist, K. Kuoppasalmi, and J. D. Sinclair. (2001). Targeted use of naltrexone without prior detoxification in the treatment of alcohol dependence: a factorial double-blind, placebo-controlled trial, Journal of Clinical Pharmacology 21(3): 287–292.

Sinclair, J. D., Sinclair, K. and Alho, H. (2000) Long-term follow up of continued naltrexone treatment. Alcoholism: Clinical and Experimental Research 24 (Suppl. to No. 5), 182A. Sinclair, J.D. (2000). Evidence about the use naltrexone and for different ways of using it in the treatment of alcoholism. Alcohol and Alcoholism 36(1): 2–10.

Sinclair, J. D., Kymäläinen, O. and Jakobson, B. (1998) Extinction of the association between stimuli and drinking in the clinical treatment of alcoholism with naltrexone. Alcoholism: Clinical and Experimental Research 22 (Suppl.), 144A.

Sinclair, J. D. (1998) From optimal complexity to the naltrexone extinction of alcoholism. In Viewing Psychology as a Whole: The Integrative Science of William N. Dember. Hoffman, R., Sherrick, M. F. and Warm, J. S. eds, pp. 491– 508. American Psychological Association, Washington, D.C. Sinclair, J. D. (1998) New treatment options for substance abuse from a public health viewpoint. Annals of Medicine 30, 406–411.

Sinclair, J. D. (1998) Pharmacological extinction of alcohol drinking with opioid antagonists. Arqivos de Medicina 12 (Suppl. 1), 95–98.

Sinclair, J. D., Kymäläinen, O., Hernesniemi, M., Shinderman, M. S. and Maxwell, S. (1998) Treatment of alcohol dependence with naltrexone utilizing an extinction protocol. Abstracts: 38th Annual Meeting, National Institute of Mental Health (NIMH)-sponsored New Clinical Drug Evaluation Unit (NCDEU) Program, Boca Raton, Florida, June 10–13, 1998.

Sinclair, J. D. (1997) Development in Finland of the extinction treatment for alcoholism with naltrexone. Psychiatria Fennica 28, 76–97.

Sinclair, J. D. (1996) Laboratory animal research in the discovery and development of the new alcoholism treatment using opioid antagonists. Scandinavian Journal of Laboratory Animal Science 23 (Suppl. 1), 379–390.

*Sinclair, J. D. (1996) Alcoholism: Pharmacological extinction and the P-word. Työterveyslääkari 2/1996, 170–173.

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