Scott DeLuzio: [00:00:00] Thanks for tuning in to the Drive On Podcast where we are focused on giving hope and strength to the entire military community. Whether you’re a veteran, active duty, guard, reserve, or a family member, this podcast will share inspirational stories and resources that are useful to you. I’m your host, Scott DeLuzio, and now let’s get on with the show.
Scott DeLuzio: Hey everybody. Welcome back to the Drive On Podcast. Today my guest is Brian Newnan. And Brian is here to dis discuss the Sinclair method and how it works to help those who are seeking help dealing with problematic drinking. So welcome to the show, Brian. I’m really glad to have you here. Yeah.
Brian Noonan: Yeah. Thanks Scott. It’s thanks for having me on and yeah, I’m gonna talk about the Sinclair method and how to drink less.
Scott DeLuzio: Yeah, absolutely. So, for the listeners out there who may not be familiar with you, just could you give us a little background on, on who you are and what you do?
Brian Noonan: Well, I am a psychiatric nurse [00:01:00] practitioner which means actually different things in different states. I think most states now it means that you’re capable of independent practice including prescribing privileges and in other states they’re they function more kind of like a physician assistant or something like that, where they’re.
Brian Noonan: Is some type of collaboration with a physician. In terms of diagnosing, in terms of prescribing medications I’m licensed in about 15 states. All of the states that I’m licensed in, I am independent practicing independently. So I provide psychiatric general psychiatric services to adults.
Brian Noonan: So, usually that is depression, anxiety A D H D sleep problems, those types of things. So that. Was kind of the foundation of my practice. After graduating from Vanderbilt to university in 2007 about five years ago five or six years ago I started practicing. I became aware of the Sinclair Method for alcohol use disorder.
Brian Noonan: [00:02:00] and it was so, impressive to me and so remarkable that it didn’t take very long to realize that this was really kind of a kind of a completely different way to think about the problem of drinking. And you know, and basically very quickly it became, Focus of my practice. And in fact kind of really formed the basis of telehealth which is really of course it’s common now because of the pandemic.
Brian Noonan: But back in 2017, 18 you really had to explain to people what it was. And, you know, there were kind of even concerns about having a healthcare delivered by video. But what kind of prompted it was. I was based in Seattle and kind of, I guess through word of mouth and so forth that people started actually driving up from Portland or from Spokane or from other places around the country.
Brian Noonan: And we were ha having inquiries from. Other places. And so that kind of prompted the idea that you know, I should have a license in Oregon and do telehealth so people don’t have to drive here. And then it was, you know, Idaho and Colorado and Arizona. And then most the states out west And and since [00:03:00] that time I’ve seen thousands of people.
Brian Noonan: I started the the company sinclair method.org. And we have a team of providers now. We serve about 80% of the United States. And it’s you know, it’s kind of every day we’re just kind of more and more convinced of kind of really the really tru, truly the amazing results over this medication to treat alcohol use disorders.
Brian Noonan: And it’s a completely different way to think about it. Versus something like Alcoholics Anonymous or
Scott DeLuzio: something like that. It really is amazing how far we’ve come since the 20 17, 20 18 time period that, that this started where you’re, you were saying people were still kind of hesitant with the telehealth and all that kind of stuff, but the pandemic really accelerated how quickly we accepted.
Scott DeLuzio: Telehealth, having a meeting over Zoom with somebody, you know, you’re on one side of the country, you got somebody else on the other side of the country, and you just sit down and you meet with them over Zoom or something along those lines. It really accelerated all of that stuff and it’s pretty amazing [00:04:00] to me how, yeah.
Scott DeLuzio: 2017 almost feels like the stone ages with, you know, how far back that was, you know, you know, as far as our thinking of you know, these types of things. But okay. Why don’t you describe what the Sinclair method is and how that works.
Brian Noonan: Yeah, what’s an interesting kind of history to it?
Brian Noonan: Actually the medication itself is that’s involved with Sinclair Methodist called Naltrexone n as in Nancy, a lexone. So Naltrexone and is actually was f d a approved for alcohol dependence in 1994. So it’s quite an old medication. It’s generic and now, and it’s quite in.
Brian Noonan: Maybe it’s about a dollar a pill or some, something like that. If you’re paying out pocket most insurance companies will actually pay for it. But what’s interesting about it is that it was the way the Sinclair Method uses the medication is not in the manner in which it was f d a approved which makes it you know, which is what makes it interesting about it.
Brian Noonan: Cause the me. Self. What we subsequently learned is that [00:05:00] the the method by which, or the approach that the f d a that granted at f D a approval turned out to be not very effective. And in fact the largest study using naltrexone. In the way that the f d a recommended was negative, it turned out that it did not help drinking and so, the f d a recommendation.
Brian Noonan: Was kind of based on a, kind of a traditional way of thinking about the problem. They would prescribe the medication and they would advise the patient to not drink alcohol, which kind of, you know, if you’re coming from a traditional framework that makes sense. So, the patient takes the medication like they would any other you know, the prescription medication and essentially they would go as long as they could without and in fact they required the early instructions required patients to have not had alcohol for seven days leading up to the initiation of the prescription.
Brian Noonan: And so this turned out to be not really effective treatment, but one of the interest. Things that they found about, and all the negative kind of subsequent negative studies for it was [00:06:00] that the people who did not follow the instructions the people who did drink what you saw was something different.
Brian Noonan: About their behavior versus the people who did follow the instructions. And what you saw is that when they would binge or when they would drink again there would be some type of limit on it. You know, in other words, the size of the binge drinking or the size of the relapse or the size of these types of things were were reduced in the people who combined the tablet.
Brian Noonan: With with the alcohol use. And this was kind of in concert. So this kind of information was developing and it was kind of in concert with the namesake of the approach Dr. Sinclair, who originally was doing studies with with rodents you know, like mice and rats and things like that.
Brian Noonan: And essentially creating mice who were alcohol dependent, you know, kind of alcoholic mice and kind of seeing and giving them naltrexone and seeing all these types of things. And so he developed a lot of his early theories based on this kind of. Seeing how naltrexone would work. And what he found was that only the the [00:07:00] mice who the only way to kind of extinguish the interest in drinking was to combine the the the tablet with the alcohol.
Brian Noonan: So, That kind of over time developed into kind of the Sinclair method, which is to combine the prescription medication with alcohol. You must continue drinking in order for it to work which is sort of a shocking kind of thing depending on, you know, how your understanding of.
Brian Noonan: Alcohol treatment goes. The way it works is the medication blocks the buzz, essentially the medication is a buzz blocker. It was kind of a shorthand way of thinking about it. What we don’t really appreciate when we drink, and it’s kinda like, well, why do we like drinking? Well, we like it because when we drink our brains release endorphins is kind of like the chemical is.
Brian Noonan: We associate with like runners high, something like that. Also, it’s involved with pain management. If you were to break your arm or something like that you would have endorphins released to kind of, help manage the pain. So they’re naturally occurring. Opioids they’re very similar in structure to morphine or Oxycodone or [00:08:00] something like that.
Brian Noonan: Vicodin these types of opiates. So when you drink, you have these naturally occurring endorphins, these naturally occurring opioids that are released and that’s what gives you the buzz. That’s why a drinking is enjoyable. But. , if you’ve taken the Naltrexone at least one hour prior to drinking the medication blocks these receptors so that when you drink you don’t get that reward, you don’t get the buzz.
Brian Noonan: So, what happens Is that really just like any other type of behavior, you know, all behaviors that we have. If they’re rewarded, you’re gonna see an increased frequency of those behaviors. It’s kind of, it’s called operant conditioning, which many people remember. From, you know, like a Psych 1 0 1 class, something like that.
Brian Noonan: So it’s just basic learning where we drink, we get a reward, we drink, we get a reward. And over time that association forms a pretty strong network in, in, in your brain. But with the Sinclair method, you drink, you don’t get the reward you drink, you don’t get the reward you drink and so on.
Brian Noonan: You do this over about four to six. And then what you see is a pretty predictable [00:09:00] what we call an extinction curve which is a gradual reduction in drinking and you start drinking less cause you’re not getting that reward. And it’s really a neurologically based uh, change in your behavior.
Brian Noonan: You’re not getting that reward, therefore you’re not having thoughts, you’re not having compulsions, you’re not having cravings, you’re not having all these types of things that kind of propelled the behavior in the first place.
Scott DeLuzio: Well, and it makes sense thinking about it now, and I understand the logic behind it, way back when the drug was first approved if you want people to stop drinking, then they should stop drinking.
Scott DeLuzio: And that kind of just makes sense that they would suggest, okay, well don’t drink while you’re taking this, but when you’re dealing with somebody who is used to drinking, Lots of alcohol you know, day after day after day. And then you just tell them, okay, well now all of a sudden just go cold Turkey and stop.
Scott DeLuzio: That’s easier said than done. They’re not going to be quite as likely to be successful when you ask them to do something like that. And so I can see why the medication wasn’t all that [00:10:00] effective way back when. Mm-hmm. . But now looking at it this way, Yeah, there, there’s that reward that you get.
Scott DeLuzio: I mean, anyone who’s ever had a drink of alcohol ever probably understands what we’re talking about. When you get that, that reward that you feel, it makes you feel good in a way. You know, obviously the next morning if you overdo it, you’re not gonna feel quite as good, but That’s right. But, but the immediate effect, you’re feeling good.
Scott DeLuzio: And so, like you said, You get that reward and you want more of that reward, so you do it more and more and more and more. Mm-hmm. . And that leads to the problems that we’re talking about here. Mm-hmm. . And so, yeah, blocking that reward is just like a logical next step. That’s
Brian Noonan: right. And of course, you know, for any behavior you know, or really any trait about US physical or mental, there’s always some type of genetic contribution to it.
Brian Noonan: And what we’re learning is that the people who develop a problematic drinking they really have kind of a hypersensitivity To this to the exposure to the alcohol. It really does [00:11:00] create kind of an exaggerated release or response in the form of these endorphins. So it really is a rewarding experience.
Brian Noonan: There. and a brain lights up an excitement in a different way than people who don’t develop these problems. And that was one of the, kind of the things with the original study when you can especially like in lab animals, you can really breed you know, kind of mice who are prone to alcohol to alcohol dependence.
Brian Noonan: And, but you, but what’s really interesting too is you can breed mice who, no matter how much they drink they don’t develop these behaviors. But one of the things that so there are many similarities. Even if you say, okay, well these are, these are lab animals but ultimately we find that there are lots of similarities.
Brian Noonan: Cause it really there’s an underlying neurology there with the kind of predisposition to the these the endorphin kind of the reward of this endorphin release. And then you know, and then also you know, kind of, kind of when you take away that reward you see a reduction in the behavior.
Brian Noonan: One of the things I’ll tell you too, it’s kind of interesting too when you think about like, because you were saying, well, [00:12:00] of course you would just give this medication and advise them not to drink, you know, one of the things that Alcoholics Anonymous is just kind of like, really kind of the go-to standard treatment and really kind of the standard way of thinking about the drinking problems.
Brian Noonan: And one of the things that they say that is definitely correct they say, well, you can be abstinent for. Five years, 10 years, you know, however long you cannot drink for some extended period of time. But if you start drinking again, you’re gonna pick up exactly where you left off, which is really a fascinating type of thing because.
Brian Noonan: because it kind of reveals that no matter how long you know, how much time has passed your brain is essentially the same. That nothing has really changed about the addictive part of the brain in question. You know, 10 years has passed. So it really kind of demonstrates that abstinence is not really a treatment if you can go 10 years without drinking and then something fundamental to the problem is completely the same.
Brian Noonan: It really shows you that just kind of, you really have to actively [00:13:00] reverse these associations. That time alone is not going to really have too much effect about the underlying neurological aspect of.
Scott DeLuzio: What about with the Sinclair method? So when you have somebody who let’s say they’ve been alcohol free or been using the the drug to kill that reward that they get from drinking.
Scott DeLuzio: So maybe not necessarily being alcohol free, just free of that reward. Mm-hmm. , if they were to, let’s say three, four or five years from now after they’ve. Kicked through the habit and the ritual of going out and drinking and for the sake of drinking and getting that reward.
Scott DeLuzio: If a few years from now, if they were to to drink without the medication is there risk of them relapsing? Obviously, you know, if you do anything in excess, you, yes, there’s gonna be that risk, but is it like a. What you’re talking about with the AA where they say you’re, you know, Drink once, or you’re gonna be right back to where you were?
Scott DeLuzio: Is it gonna be the same kind of situation or is it more of a [00:14:00] gradual kind of thing?
Brian Noonan: Yeah, well, first of all you know, most of the people that we work with just like most of people in society, most people in the world really do continue to drink. You know, abstinence is not required. And we don’t ask people To, to be abstinent because quite obviously it’s a normal part of our society.
Brian Noonan: You know, when people want to even just to fit in or kind of be part of the happy hour after work you know, people that don’t drink there is often a risk of being socially isolated or in some way kind of. Being the odd man out or something like that. So most of our people do continue to drink in a socially kind of, you know, appropriate way, in a way that they feel comfortable with so whatever that might be.
Brian Noonan: Once a month, once a year, once you know, whatever it might be. Most of our You know, the people we work with that do continue to drink. But it’s just a very matter of fact way. It’s not something that they have to spend too much time kind of, regulating. But you know, you kind of wanna think of the Naltrexone the way you would a seatbelt.
Brian Noonan: As far as the Sinclair method is concerned, you say, okay, well, am I gonna have to wear a [00:15:00] seatbelt for the rest of my life? Well, you’re gonna wanna wear a seatbelt. You know, every time you’re in the car for the rest of your life, that’s gonna be a smart safe thing to do. Of course you don’t drive every day, so you don’t wear your seatbelt every day.
Brian Noonan: And so that’s how Naltrexone is for people who for whatever reason they. You know, this kind of wiring that predisposes them to over drinking it’s gonna be a really smart idea for them to take the Naltrexone prior to drinking. So, it’s not a daily medicine, but you know, if you drink once a week, you’re gonna wanna take the Naltrexone prior to drinking.
Brian Noonan: So it’s not something that people would be taking. Daily. But there is sort of an, an indefinite aspect to it that you wanna take it before drinking? Now to answer your question about, well, okay. Let’s say you’ve reached this point of. You know, I kind of call it the point of indifference as far as alcohol’s concerned, you can take it or leave it, right, and it’s not a big deal.
Brian Noonan: So let’s say and and Dr. Sinclair called it pharmac pharmacological extinction, an extinction being that there’s no longer an association between this behavior and the reward. So let’s say you’ve reached that point and but for whatever reason you decide you’re gonna drink [00:16:00] without taking the naltrexone.
Brian Noonan: Therefore you’ll get the bus, you’ll get the endorphins, and it’ll be kind of a rewarding experience. Now you’re not gonna be back to where, say you left off, so to speak, because the association has been extinguished. However The same kind of underlying predisposition to develop and strengthen those associations will still be there.
Brian Noonan: You know, the kind of the foundation upon which the problem developed is still there. So if you continue to drink without it those pathways will just be strengthened. And then the person would eventually find themselves back up or back kind of in the same position now, which is not great.
Brian Noonan: I mean, the person kind of gradual. Finds himself back in the same kind of situation. But it’s definitely better than what happens when you see what typically happens with AA or kind of in response to, and use the word relapse. When someone relapses. One of the phenomenon that Dr.
Brian Noonan: Sinclair really kind of described really well is what he called the alcohol deprivation effect. And this [00:17:00] actually occurs in many types of things, especially like dieting or something like that. But the alcohol deprivation effect is this is that when you deprived yourself of something in this case, you know, drinking and getting that buzz for some period of time the deprivation of it actually increases interest.
Brian Noonan: It actually increases the frequency of thoughts. For that kind of denied reward. And then when you kind of inevitably do relapse and then drink, what you’re gonna see is kind of a gigantic binge at that point. And people see this with, you know, when they kind of restrict themselves from dieting as well.
Brian Noonan: But you definitely see this with drinking that people after a dry January or whatever, kind of the basis for their, you know, their abstinent period. When they finally do start drinking again it’s it’s not just kind of where they left off in some ways. And it’s often worse, you know, kind of the relapse is quite large.
Brian Noonan: So that’s kind of another kind of piece of the puzzle where abstinence actually increases your preoccupation in your brain’s kind of
Scott DeLuzio: pursuit of it. Yeah, that’s [00:18:00] interesting. Now the question about the drug itself, naltrexone are there any side effects to it?
Scott DeLuzio: You know, cuz you, you say, you know, you should take it before going drinking and if this is going to be a lifelong thing, obviously it’s not a daily thing every day for the rest of your life, but you know, I, if I was taking any kind of medication, the first thing I’d wanna know is what are the side effects?
Scott DeLuzio: And do those outweigh the benefits of it?
Brian Noonan: Yeah, I mean, well, one of the, kind of the, I guess, kind of a framework to really kind of think about, Question is to kind of, first kind of think about what are the side effects of the drug of alcohol that you’re you know, that, that kind of we’re also talking about.
Brian Noonan: And of course, that drug nearly every system in your body increases risk for cancer increases of course you know, hepatitis and cirrhosis, other liver diseases crazy risk for accident. Mood disorders, anxiety disorders, sleep disorders, you know, anything you can think of.
Brian Noonan: I mean, these are potential side effects from from the alcohol, which of course are. You know, causes opiates to be released. I mean, it’s very much a drug. So, so that’s kind of one way, kind of, when [00:19:00] you’re kind of deciding kind of, you know, weighing all these benefits and risk and those kinds of things, is that The alcohol itself is really if you think about things that are in a grocery store or really even pharmacies now you know, alcohol is very toxic.
Brian Noonan: It’s a toxic substance. So, so that’s kind of like the thing that we’re kind of weighing all of this against now, the medication. Is well tolerated. Most people don’t have any side effects at all, but of course, you know, any medication, you’re gonna have some potential side effects. The most common side effect really is gonna be some type of gastrointestinal side effects.
Brian Noonan: So that’s gonna be nausea, vomiting, diarrhea, something like that. And that’s sort of an interesting thing too because that’s really a common side effect for a lot of psychiatric medications. Medications in general, but, It’s specifically interesting in psychiatry because most of the neurotransmitters, the chemicals that we think of as brain chemicals like serotonin and dopamine and norepinephrine, and in this case opioid op opioids, you know, we think of them as brain chemicals.
Brian Noonan: But [00:20:00] really 80% of. Drugs that I just chemicals I just mentioned are manufactured in your gastrointestinal system. They’re, you know, they’re mostly gastrointestinal chemicals if you want to think of them that way. So, cause this medication affects opioid receptors, which are mostly in your GI tract, then it makes sense that most of the potential side effects would be nausea, vomiting, diarrhea.
Brian Noonan: It’s also interesting too you know, the drugs that we use for depression, anxiety, and those types of, The most common side effect of those nausea, vomiting, diarrhea, because of all the serotonin and receptors that we have in our GI tract. So, so that can be an issue. You know, usually we have, basically food is kind of like a good thing to take with any medicine when you’re first starting.
Brian Noonan: So we start people at low doses and then kind of, go up from there as tolerated kind of, Kind of, and then you can have kind of what we would think of as generic type of side effects or just be like, dizziness, dry mouth, you know, sleepiness, you know, something like that. Some interesting things about Naltrexone.
Brian Noonan: So, you know, kind of beyond stomach and beyond kind of like, just generic types of things. Any medicine might might cause it can actually cause [00:21:00] Something that some people don’t think of as a side effect, but a benefit really. It can cause appetite changes in regards to carbohydrates.
Brian Noonan: So people and there is actually a prescription drug on the market that’s a combination of naltrexone and another medication used for depression called Wellbutrin. This combination drug is called contrave, and it’s used for obesity. And binge eating, overeating types of things. So, naltrexone is also sometimes used for binge eating.
Brian Noonan: Cause it because of Xa opioid system, which is tied into our carbohydrate system or carbohydrates affect our opioid system, you know, like sugar is kind of viewed as our, by our brain as a drug. So, when you take Naltrexone, you’re gonna. Have a generalized, or often will have a generalized reduction in your brain’s interest in carbohydrates.
Brian Noonan: And of course, alcohol itself is a carbohydrate. So people often you know, people can take naltrexone for binge eating and other kind of eating disorders as they relate. To you know, especially as they relate to carbohydrates. So people do not notice appetite [00:22:00] changes or often notice appetite changes, of course, as they’re drinking less, you know, they’re, you have, you’re having fewer calories.
Brian Noonan: But there seems to be something on top of that as well that people. People kind of, you know, they’re to the extent they have a sweet tooth or something like that. And there is some interesting relationships between kind, kind of sweet tooths and and alcohol issues as well. Now there is sometimes some issues people, I guess a common question people ask is, you know, it’s like, well, you know, you’re blocking these endorphins.
Brian Noonan: And endorphins are as I mentioned they’re associated with runners high sex, chocolate eating exercise. You know, all these kinds of endorphins are used or kind of our body’s way of, kind of rewarding us as well for other types of often. Beneficial behaviors. So, so people sometimes wonder about that.
Brian Noonan: Well, if you’re blocking these receptors you know, am I gonna not enjoy running and sex and chocolate and all these other kind of things? And and that, that is it’s a good question because it really is a good it really does make sense that that would be the case. And we do sometimes see [00:23:00] that it’s not really a common thing though.
Brian Noonan: Usually if we have, if we see something in that department it would not be kind of a complete absence of reward. It would be that the magnitude of the reward is diminished somewhat. So if they went for, you know, if they were ran a marathon instead of runners high being an eight, you know, it would be a six or something like that.
Brian Noonan: So, sure. But again, it goes back to comparing that to alcohol. You know, course alcohol is a depressant and those types of things. So it’s always kind of, you know, compared to alcohol. You know, most people are feeling great. Most people feel wonderful that they’re drinking less.
Scott DeLuzio: Yeah. And that all makes perfect sense.
Scott DeLuzio: And I, I actually wonder how many of the side effects that you mentioned, like things like nausea, vomiting, drowsiness those types of things are. I mean, a lot of those you get from drinking alcohol anyways. And if you’re drinking the alcohol while you’re on that medication very likely it’s not the, I would think it’s not necessarily the medication.
Scott DeLuzio: It could be from the alcohol itself as well. So, you know, it really, to me, I don’t see any of those things [00:24:00] as like deal breaker side effects. If this was me evaluating this and looking at the pros and cons I’d be like, okay. Yeah, I’m, if I’m gonna go out drinking, I’m probably gonna end up feeling kind of nauseous maybe to the point where I’m vomiting.
Scott DeLuzio: I’m definitely gonna be drowsy. Anyways, and so what do I have to lose here? Like I may just be drinking less and where I won’t get to that point where I’m having nausea, vomiting, all that kind of stuff, so. Right. You know, I look at that as a actually as in a way kind of a positive because you know, I.
Scott DeLuzio: I’d be having those types of things anyways if I was binge drinking and that kind of stuff. Right. So, you
Brian Noonan: know, and although, yeah, I was gonna say even, but even that’s only like 10%. I mean, the vast majority of people don’t have any of those side effects, but if Sure. If they do, it’s most likely to be a gastrointestinal.
Scott DeLuzio: Yeah, exactly. And so, you know, since it’s such a small percentage of the people and I would imagine it’s likely the people who are just first starting to use it because over time your body gets used to it and then you’re not gonna have those kind of side effects quite as often I would imagine.
Scott DeLuzio: So, you know, Really for me you [00:25:00] know, as I’m doing my mental checklist of like, you know, pros and cons weighing the benefits versus the costs or the risks. You know, I don’t see any of that as a deal breaker in my book anyways. I mean, everyone obviously has to make their own judgment for themselves but to me, I don’t see any of that as being a, you know, a real negative.
Scott DeLuzio: You also mentioned how it has some other unintended benefits where, you know, people, their appetite is suppressed potentially and they don’t have that same you know, the highs that they get from you know, binging on a meal or whatever. Eating lots of food. And that was actually gonna be my next question is like, could this possibly be used for other things?
Scott DeLuzio: Cause I know you know, things like other drugs you know, whether it’s illegal substances or whatever, or you know, even. Eating foods you know, sweet tooth kind of things. Those release chemicals in your brain as well. And I would imagine that there has to be some similarities and some crossover between you know, not just the alcohol use but some of the other potential vices that people might have as
Brian Noonan: well.
Brian Noonan: Right? That’s exactly [00:26:00] right. One of the interesting uses for it. Now of course, I think as. As course as we go forward, we’re gonna know more and more and kind of, I think it’s application will be broad you know, broader to, to other behaviors. But one of the things that’s kind of well established is its usefulness for gambling disorders.
Brian Noonan: You know, when you gamble and you hit the jackpot and you know, you have this rush of endorphins and things like that. So, people who have gambling disorders if they take the Naltrexone prior to. Whatever, however they like to gamble you can see similar kind of reductions in, their gambling addiction.
Brian Noonan: And then kind of what you’re saying is I think this basic idea, I think the eventual success of the Sinclair Method, and by the way, if you kind of track the Sinclair method through like Google searches and these types of things, and a number of physicians and nurse practitioners who are providing the service that’s growing and growing and growing.
Brian Noonan: And I think this will kind of be it will really will change the way we think about this. So, so, yes. One day there will be something that blocks the Cannabinoid drug receptors and that will help [00:27:00] people to develop cannabis use disorders or what, or whatever it might be. But I think the basic idea is that we’re gonna kind of appreciate the fact that abstinence is really not necessarily or even often not the correct way to think about it.
Brian Noonan: They that. In accord with the basics of operant conditioning, which is just, you know, kind of foundational learning principles and psychology. You have to engage in the behavior without the reward to reverse it. You know, so this is just idea that just not. You know that not having it, I think just kind of freeing ourselves in that way to think about you know, that the person does not have to be abstinent in fact they should not be for this to work.
Scott DeLuzio: Yeah. And there are some benefits to drinking alcohol in some cases. I’ve read some things about you know, heart disease and stuff like that when you’re talking about you know, like red wine or something like that could potentially be a benefit. So, you know, completely eliminating altogether may not necessarily make a whole lot of sense you know, for people.
Scott DeLuzio: So, so yeah, I mean, this is. To [00:28:00] me just makes the most sense, right?
Brian Noonan: That’s right. Yeah. And really you know, the hard the studies, you know, some of these health and nutrition studies are often kind of contradictory, you know, it’s like, well, one study will say this, that, and the other. So it’s hard to kind of, say that You know, drink, drinking alcohol won’t would necessarily be a helpful thing for sure.
Brian Noonan: We know that it has negative social not drinking has negative social consequences. You know, it really, people really it’s such so embedded in our culture and especially our social social rituals to just meet someone and have a drink and, you know, it’s like if you. At that happy hour where some business deals being discussed or you’re not you know, and oftentimes it raises defenses in other people, you know, if you’re out socializing and you know, I’m not drinking what’s wrong with him or what’s wrong with, you know, or something like that.
Brian Noonan: So it really creates kind of an awkwardness, or it often can so kind of, people really just like the fact that they can take their naltrexone. Go out, and they may not even finish the drink, but just like, you know, they’re participating in the ritual, the social ritual and you know, then they just go home and they don’t think about it.
Brian Noonan: [00:29:00] So Right. So I definitely can have most people, A lot of the kind of barriers to, you know, to kind of solve or solving a drinking problem is that people, it is a social aspect. People don’t want to not go out with their friends or what have you,
Scott DeLuzio: right. When you think about the last few years with the pandemic and so many people were isolated, they were away from larger groups of people for.
Scott DeLuzio: Extended periods of time. People want to get back and socialize with people and like you said, it’s just part of our society, part of our culture is drinking, you know, meet, meeting up with somebody for a drink is a very common thing. I go into a happy hour after work. Very common. And if you’re avoiding all of those things, you’re just increasing that isolation even longer, which I gotta imagine is gonna have even more you know, mental.
Scott DeLuzio: Impacts going forward. Right? And you know, not to say that you necessarily need alcohol, but it’s just the way that people interact these days. And you know, it, it, [00:30:00] in a way it is somewhat necessary. And so, you know, having this Sinclair method available and being able to use naltrexone to manage this so that you don’t get that reward every time you drink. And like you said, you may not even finish your drink because you’re not getting that reward every sip you take. You know, so you’re just, Taking part in the ritual as opposed to seeking out
Brian Noonan: that reward. That’s right.
Brian Noonan: You know, and actually you know, people say that once they kind of reach this extinction phase, they actually kind of the ritual of drinking. They enjoy it more in some ways. Of course, they’re not getting the chemical reinforcement, but a person who over drinks there’s a certain anxiety there.
Brian Noonan: Because you are worried about overdrinking, you are worried about. Binging and maybe embarrassing yourself in some way. You know, ba probably for good reason based on history. You know, so people kind of, they develop a confidence in their drinking that they’re going to stop when it’s appropriate to stop.
Brian Noonan: So in some sense there’s a certain ease that develops around the [00:31:00] drinking because they feel confident. They just know they may not even finish the first one, but if it’s you know, a concert, maybe they’ll have a. Or whatever it is, but it’s not gonna be excessive. You know, and we always just kind of just say too that, you know, drinking is not a problem.
Brian Noonan: Problem drinking is a problem. So, so people use the Sinclair method just to move from problem drinking to drinking, and they’re doing it socially and they’re doing it in a way that they are comfortable with. And you know, and so we don’t we don’t really have ideas about how people should do that other than, you know, we just want people to have.
Brian Noonan: You know, and they can use that control to be abstinent, which most people aren’t most people aren’t pursuing that. But but then, or they can use it to drink once a week or whate, whatever, but you know, just that it just becomes kind of a non-issue
Scott DeLuzio: in their life. Right. And you brought up a point that I don’t think we touched on yet, but I, it’s something I think it’s important for the listeners to understand is that while the, this drug does block, that, that buzz that that high feeling that you might get, the good feeling [00:32:00] that you get from drinking, it doesn’t necessarily.
Scott DeLuzio: It doesn’t, not necessarily, it doesn’t prevent you from getting drunk. So there it is still possible for you to over drink and not be safe to drive a car, for example, or,
Brian Noonan: or whatever. Right? That’s right. And that’s what’s really interesting you know, kind of alcohol we kind of think of it as just kind of this uniform chemical or something like that.
Brian Noonan: But really alcohol. In and of itself is a cocktail, you know, I mean, you know that it has many effects on our brain and and our motor system and all kinds of things. So, what’s interesting for users of Naltrexone is that the medication only blocks. The endorphins, it only blocks the buzz aspect of it.
Brian Noonan: It’s not an alcohol blocker. And that really actually is important for kind of the mechanism because you’re still getting these other effects. You can still get a D U I you know, your blood alcohol level’s gonna be the same. All the impairments. That come when you drink slurred speech, loss of balance putting your foot in your mouth, all these kinds of things are still gonna be there.
Brian Noonan: So, you’re you know, you’re impaired. You might not be kind of, you’re not [00:33:00] intoxicated, but you’re impaired. And it’s really interesting because people find that being impaired is not all that great with, without. Without the buzz on top of it. So you’re just you know, you just can’t speak clearly or something like that.
Brian Noonan: So, so it’s interesting. So all the things that can go wrong when you drink alcohol can still occur when you even though you take a naltrexone. So that’s definitely something we encourage. It’s like still need to be a responsible,
Scott DeLuzio: a drinker. Right. And I, the reason why I wanted to just put that out there is because up until that point in the conversation, someone might be sitting there thinking to themselves, wow, this is great.
Scott DeLuzio: I can go out and drink as much as I want and I’m not gonna get drunk. But that’s not true. Don’t do that because you’re gonna get yourself in trouble or hurt or hurt somebody else. And that’s definitely not what we want to have happen with this. So That’s right. So I think that that’s an important point.
Brian Noonan: Yeah, that’s right. And it’s really an interesting kind of way you put that because what people find is that even if a part of their brain wanted. That seemed like a good idea. Like, I can drink as much as I want. I mean, that’s obviously kind of an addictive part of their brain. [00:34:00] Mm-hmm. , what they would find is, is that because they aren’t getting that reward they would just kind of quickly lose interest in it.
Brian Noonan: You know, that it would be because the brain was not lighting. This exciting way they would actually find that you know, that they would kind of lose steam, that there would be kind of no point to it. And they would simply get tired because all the other effects of alcohol would be there, like the depressant effect and all these other types of things.
Brian Noonan: They would, most of the time instead of kind of crossing some line and. Loss of control. If you’ve taken the Naltrexone, what we hear is that people just get sleepy. They just get tired. You know, it’s kind of like it is a depressant. So that, that depressant effect is more pronounced. So, yeah, but it is interesting.
Brian Noonan: There’s definitely, you kind of described it well, I mean, there’s one part of that addictive brain that just, there’s no limit to it. You know, the idea of just. Being able to drink without limit that would definitely appeal to that part of the person’s brain.
Scott DeLuzio: Yeah, exactly. And I think that’s why I [00:35:00] wanted to just emphasize that point that that’s not what this is designed for.
Scott DeLuzio: And not to, you know, overdo things still, you still have to be careful with that type of thing. So, for the listeners who are out there, who are here in this and saying, you know what I want to give this a try, I want to, I wanna see how this works. Where can people go to find out more and potentially even book an appointment with you or somebody on
Brian Noonan: your.
Brian Noonan: Yeah. Sinclair method.org. Dot org is our website. And it’s interesting you know, the laws of of medical practice are by state. And then this is why I have so many state licenses and the other providers have so many state licenses because it really depends on where the patient is.
Brian Noonan: So, you know, I can be in Australia, , but if I’m licensed in Washington, the then the patient has to be in Washington. Or if I’m licensed in Idaho, the patient needs to be in Idaho or vice versa. So, so, so it’s kind of, there’s as, as great as telehealth is, there’s still kind of these restrictions on where the patient can be.
Brian Noonan: And so we’re [00:36:00] licensed in about 35. And that covers about 80% of the population. We’re definitely licensed in all the large states, you know, Texas, Florida, New York, California, those places. And you know, we have a team of psychiatrists nurse practitioners. All of us have backgrounds and and addiction generally speaking.
Brian Noonan: And then and then of course, you know specifically here all we you know, really focus on is this Sinclair method. So it’s really, it’s easy. It’s all telehealth. Go there, pick your state. If you’re in Ohio, you pick Ohio on the map. You book your appointment you see your provider by video.
Brian Noonan: We send the prescription. Digitally directly to whatever pharmacy you want. And then you know, and you of course we will have instructions for the medicine, but you take like a half tablet for a few days and those types of things and you come back and, you know, the basic ideas that given quantity is gonna last a person a longer and longer.
Brian Noonan: You know, often I’d say the most typical person we see is drinking every day. They’re drinking. Bottle of wine, two bottles of wine. I’ve had, you know, a case of beer these kind of things really, you know, heavy drinker, daily drinkers. And so for the first month they’re [00:37:00] gonna be drinking every day still, but instead of drinking 24, Beers, we’ll say you know, we estimate about 25% reduction you know, the first month.
Brian Noonan: So, you know, it’s like they could come back and they’re they’re down to 18, which is still how, you know, really a lot of beer per day. So 18. And the next day they’re, you know, the next time we see ’em, they’re down, they’re down, they’re down. And so it kind of works like that over. About four to six months, you’re just gonna see kind of steady reductions.
Brian Noonan: Some people faster, some people a little bit slower. But that’s basically how it works is and then at some point you know, a quantity of 30 tablets might last you a month at the beginning, within a quantity of 30 at some point might last you a whole year. , depending on what your girls are, it might last you the whole, your whole life if you never want to drink again which is great.
Brian Noonan: So, it’s very simple. No detox. One of the great things that is the fact that you don’t have to detox, it’s because it’s a gradual reduction in your drinking. So, right, so you just drink less and less and less. So it’s very safe in that front. I mean, there should not, in fact, we encourage people, if you’re drinking heavily, please do not stop abruptly because there is a risk of [00:38:00] seizures and.
Brian Noonan: Even just your own physical discomfort. So, but that’s basically how it works. It’s all by video and you can even have your meds delivered to you, that kind of thing. So it’s very private, very convenient, and and even if you travel you know, if you’re in Ohio and then you go to California we have a provider in most states as well.
Brian Noonan: So even people who are out and about you know, we have ways to kind of, you know, continuity and treatment in that
Scott DeLuzio: regard. Well, that’s great. And I think that’s, again, going back to the point in the beginning of this conversation about how far we’ve come as far as telehealth goes because you know, who wants to take time off of work to go go to an appointment and sit in an office and meet with somebody and then have to explain why you’re taking time off of work and you know, that.
Scott DeLuzio: Could be rather embarrassing for some people who are in that situation. So having this available where you can you know, you can close your office door potentially or you know, maybe even just go out to your car and have the appointment there. , you know, it’s someplace where it’s a little more private,
Brian Noonan: right.
Brian Noonan: I’ve [00:39:00] had many appointments in a car. I’ve had people at the bottom of ski slopes where they just took off, or, you know, you can see the thing in the background. People I mean, it’s just kind of like, you know, wherever you are, as long as you feel comfortable you know, in terms of.
Brian Noonan: You know, who might see, you know, it’s like, you know, I, I’m happy to see the only thing is if they’re driving the car, of course if they’re driving, you know, I’ll ask people to pull over cuz I don’t, you know Sure. You see the tree zooming by. But, you know, but otherwise, yeah, wherever had people, all kinds of places just because it’s very casual thing and You know, and most of the time it’s good news.
Brian Noonan: It’s not, it’s like a really exciting happy type of mental health practice. You know, for prior to doing the, working with the Sinclair Method I was actually trained at Vanderbilt in their addiction. Institute, Vanderbilt Institute of for the Treatment of Addiction. So that was kind of like my original kind of a specialty, but addiction is generally thought of as a really kind of, the outcomes aren’t great.
Brian Noonan: A lot of the treatments, you know, it’s kind of this chronically relapsing type of thing. [00:40:00] So it can often be just kind of a you know, the stats are not great but now. The Sinclair method is really such an amazing treatment. It really is in terms of kind of effectiveness I think of it as being more effective.
Brian Noonan: Than just kind of common treatments for life depression and these other things. So it’s not just gone from kind of the, the kind of, the lowest kind of successful outcomes of the issues I was helping people with. It’s actually become the most commonly, you know, just successful. It’s the most common successful treatment.
Brian Noonan: It’s really is amazing you know, for people to be, to really be liberated from this. You know, one of the things with drinking if you develop a drinking problem and you do some type of abstinence program, Almost all of the metrics that you know, a scientific study would use would just be how long did the person maintain their sobriety?
Brian Noonan: You know, if they went six months or, you know, how whatever the measurement was. The kind of the concern, the chief concern of the study is how long did the person go without drinking? But it really doesn’t talk [00:41:00] about. You know, how many times did they have to fend off a craving? How much mental energy was expended?
Brian Noonan: Kind of, you know, This battle in their brain. How much time do they spend at a meeting? How much time you know, these types of things. So it doesn’t really tell you it doesn’t really kind of capture the aspect that you’re kind you’re kind of a prisoner to this in some way to this.
Brian Noonan: You know, your brain really is not gonna let you go. It’s not gonna let this issue go. It’s gonna keep right kind of pursuing this this reward. So what we really hear and see is just this. Really, it really is a liberation that the yes, the people are not drinking, or maybe they’re drinking, you know, in a casual way, but what they’re free from is this incessant kind of monitoring and regulating, am I drinking enough or I’m only gonna drink on Monday, Tuesday.
Brian Noonan: We, you know, it’s like this rulemaking around, you know, it’s like the whole issue. They’re free from it. So I think that’s what’s really great about it is that people are just kind of, it doesn’t alcohol. The alcohol problem, the alcohol solution, none of it is [00:42:00] occupying the person.
Brian Noonan: I mean, they truly are free from it, from the issue.
Scott DeLuzio: Well, that, that is great. And I think it’s great news actually for some of the listeners who might be out there who are struggling with this or maybe know somebody who is struggling. And they’ve tried a whole bunch of different things.
Scott DeLuzio: They’ve tried AA, they’ve tried other things, and they just don’t seem to be sticking with them. As far as I’m concerned, just it’s one more option out there that gives hope. Mm-hmm. to the people who are. Are struggling, don’t know what else to do, where else to turn. So again, the website is sinclair method.org and I will have a link to that in the show notes for listeners who are interested in finding out more about the Sinclair method and where they can book an appointment.
Scott DeLuzio: You can do that all on their website. Brian, it’s been a pleasure speaking with you in, in learning more about the Sinclair method and how it works to. You know, not just not just beating this but you know, being able to live with it and not feel like you’re isolated from, you know, other groups that may still be you know, involved in drinking alcohol and things like that.
Scott DeLuzio: So, [00:43:00] so thank you for taking the time to come on and share this with us.
Brian Noonan: Oh yeah, it’s my pleasure. I mean, it’s such a, a really alcohol. Of course we, you know, the opioid epidemic is a big issue. But really in terms of financial cost to society in terms of health costs, mortality, all those things alcohol.
Brian Noonan: Really it’s an alcohol epidemic is actually exceeds the societal cost of the opioid epidemic. So it’s a really big problem and is a really amazing solution and I hope you know, if you, you know, if you’re a listener specifically doesn’t have a drinking problem, almost certainly they know someone who does.
Brian Noonan: I mean, it’s really that widespread. So, right. So, it’s my pleasure to share it with you and hopefully you know, someone will check it out.
Scott DeLuzio: Thanks for listening to the Drive On Podcast. If you want to support the show, please check out Scott’s book, Surviving Son on Amazon. All of the sales from that book go directly back into this podcast and work to help veterans in need. You can also follow the Drive On Podcast on Instagram, Facebook, Twitter, LinkedIn, YouTube, and wherever you listen to podcasts.[00:44:00]