What is the Sinclair Method?

The Sinclair Method (TSM) is a medical approach to reducing problem drinking. You take one tablet of naltrexone (or sometimes nalmefene) one hour before you plan to drink. Over three to four months of consistent use, the medication blocks the brain's reward response to alcohol. Your urge to drink quietens. Your drinking reduces, often substantially, often to a level the patient is happy with.

It is unusual in two ways. First, you don't have to stop drinking to do it. The method only works while you are drinking with the medication in your system, which means it sits oddly with the abstinence-based approaches most people associate with alcohol treatment. Second, it is built on a specific neuroscience insight rather than psychology or willpower.

Where it comes from

The method was developed by Dr John David Sinclair, a US-born neuroscientist who spent his career at the Finnish state alcohol research institute (Alko) in Helsinki. He published the foundations of the method in 1992. Since then, more than ninety clinical trials have examined naltrexone in alcohol use disorder, and a 2023 JAMA systematic review of 118 trials and nearly 21,000 participants confirmed it significantly reduces heavy drinking compared with placebo.

How it works (briefly)

When you drink, the brain releases endorphins, which bind to opioid receptors and trigger a dopamine reward. That reward is what teaches the brain that drinking is worth doing. Naltrexone blocks the opioid receptors. With the receptor blocked, the dopamine reward doesn't happen. Every drinking episode on naltrexone is, in brain-learning terms, an unlearning trial. Over months, the learned association between alcohol and reward fades.

This is called pharmacological extinction, and it's what makes TSM different from medications like Antabuse (which makes you ill if you drink) or acamprosate (which is for people who have already stopped drinking).

Who it's for

It works best for people whose drinking is reward-driven — they drink because it feels good in the moment. It works less well for habit-driven or socially-driven drinking. About 78-80% of patients who stick with the method see meaningful reduction. About one in five don't, often because of genetic variation in opioid receptors, untreated mental health issues, or poor compliance with the timing of the tablet.

It is not appropriate for people in physical alcohol dependence who need a medically-supervised detox first, or for people taking opioid pain medication.

How LoveMyLife runs it

We offer four tiers, from a £99 form-reviewed prescription up to a £499 90-day doctor-led, nurse-delivered programme. Patients can also roll into an Ongoing subscription at £39/month for continued support after the programme. See our pricing or read about the science in more depth.

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