Yuletide is nearly upon us: Welcome to the best time of year for problem drinkers. The easiest period in which to get blitzed as often as we wish without too much judgment. Those twinkling lights and jolly songs drown out all the rules against daytime drinking, and I, for one, used to spend the entirety of December hammered.
Not generally a social person, I would never turn down a festive party. Indeed, I would be nicely lubricated before turning up so as to have got a good head start on my peers. Even my mother couldn’t judge me for knocking back champagne first thing in the morning on Christmas Day, I reasoned: I was simply honouring tradition.
It helped (or really didn’t, depending on how you look at it) that the rest of my relatives, particularly on my father’s side, drink extra heavily around this time of year, too. And the truth is, it was always riotously fun, cheer-enhancing and a very merry bonding experience. Unlike a lot of families, we never quarrelled or partook in alcohol-induced drama. We just spent weeks on end giggling, pleasantly pickled. There was, in short, very little downside.
The problem would emerge when I then suddenly returned to the office come January, and a strong urge would start tapping my shoulder around midday, thirsty for a dose of wine.
It was one of the countless warning signs I ignored for so many years that indicated my relationship with alcohol was not a good one. Often, I’d surrender to the craving and buy one of those single-serve bottles of chardonnay from Marks & Spencer to wash down a sandwich on my lunch break.
This would go on for a week or so until I had sufficiently cut back to only popping the cork when I got home from work in the evening – the very first thing I’d do after closing the door behind me.
In retrospect, I was regularly weaning myself off to minimise withdrawals in the way doctors do with new patients at rehab, although they use tapering medication to replace the alcohol.
If I had continued swaying down that path, my tolerance to alcohol inching ever upwards, I would have ended up in a very bad place and been forced to give it up altogether. I got away with it most of the time because I was the sort of drinker you wouldn’t have clocked – always relatively composed, even mid-blackout – but the liver can only take so much.
One of my wake-up calls came two Christmases ago, when at 35, I had become a parent for the first time. Before then, the consequences of my drunken Decembers were limited to hangovers that I’d just chase away with the hair of the dog, and as I mentioned, tapering off in January on my lunch breaks.
This time, though, I had a six-month-old, and while I’d thus been almost teetotal that year in the run-up to the 25th, I gave in to my old habits on the big day itself and got so quietly hammered on Christmas morning that I spent the afternoon in bed while my mother took care of her grandson.
We were living in Iceland at the time, and a bitter storm left us snowed in over Twixmas, with all the booze shops closed. We ran out, therefore, and I’ll never forget the panic that gripped my brother (who has also long struggled with alcohol) and I, over the prospect of being dry that week.
Shortly after that, I decided that enough was enough and quit alcohol cold-turkey for several months, before falling off the wagon a few more times and then finally the following year adopting a programme that wound up curing me.
At the age of 37, I came across a medication called Naltrexone, and a plan – the Sinclair Method – that solved my alcohol problem almost with a snap of the fingers.
Together, they rewrote my brain’s neural pathways such that wine no longer triggered the same response, and allowed me to be what I always wanted to be: A moderate drinker. The sort of person who used to baffle me, who can leave a glass of wine on the table unfinished or go weeks without even thinking about it – even during December.
Naltrexone has a lot in common with Ozempic-type drugs in that it erases cravings and cures overconsumption to a staggering extent in a very short time frame. In a nutshell, it stops alcohol from being moreish.
When taken according to the Sinclair Method – developed in the 1980s by Dr John David Sinclair, an addiction specialist at the Finnish Foundation for Alcohol Studies – an hour before drinking, the drug, a dopamine inhibitor, kills off the reward loop for the next eight to 12 hours until it wears off.
In the simplest terms, it switches off the part of your brain that usually reacts to the sight of alcohol with that warm euphoria which keeps you coming back for more.
The first time I took it, last summer, I poured my usual glass of cold chardonnay and waited for the high that never came. I didn’t even finish the second glass – why would I? My trusty medicinal booze wasn’t ‘working’. I persevered, as per the Sinclair Method – which, unlike abstinence-based treatment programmes, actively requires you to keep drinking as you normally would – for the next few nights before giving up and becoming, for the most part, sober.
It was bizarrely swift and easy. The human brain very quickly learns to stop behaviour that isn’t rewarding, just as it quickly forms attachments to substances that make you feel good.
Naltrexone, and other similar brands that fall under the same umbrella, is in my view one of the greatest developments in modern medicine. Which makes it shocking that it isn’t widely prescribed by GPs, or even known about, thanks essentially to red tape.
While it is available in the UK, because of complex licensing reasons it has to be prescribed ‘off label’ – when a drug is issued for a condition it is not approved for – meaning it falls outside typical GP budgets. Dr Janey Merron, who left the NHS out of sheer frustration because she couldn’t prescribe Naltrexone to patients who desperately needed it, joined the Sinclair Method UK in its early days.
It’s where I got the medication, and packages start at £499 for a phone consultation and prescriptions (pills cost an extra £100 for 28 – equivalent to £3.57 a tablet) and three months of counselling.
Most of her patients, she tells me, are professionals between their 40s and 60s and are – as I was – very high-functioning. ‘A surprising number are within the top 1 per cent of earners,’ she says. ‘I have treated elite athletes, doctors and entrepreneurs.
‘They work hard and they drink hard at the end of the day, yet their colleagues would rarely guess it.’
The clinic generally sees a dip in patients during the Christmas holidays, when people are busy getting sozzled, but an uptick in January when children go back to school and parents find themselves at the grim end of a month-long, socially acceptable bender. ‘It’s always difficult during the Christmas season,’ Dr Merron says.
‘The problem is that the more we drink and the more frequently we drink, the more conditioned our brains come to need the dopamine reward, which itself drives us to keep the drinking up. The brain does not like to be deprived of its reward.
‘For those with enough willpower, you can employ habits like alternating alcoholic beverages with soft drinks, but it’s a bit like doing weights at the gym. It’s manageable for a certain number of reps before the fatigue sets in. Unless you take an opioid blocker like Naltrexone, which for the next eight to 12 hours eliminates the need for willpower because it prevents alcohol from being rewarding.’
I will confess, there have been occasions since first taking Naltrexone that I’ve consumed alcohol without taking the medication first – either because I didn’t have it with me or just because I was feeling rebellious – which is not recommended.
Even on those occasions, I drank far less than I otherwise would have. It was as if I’d been reset to my early teenage years, when booze tasted bitter and I couldn’t handle much.
If I started drinking again regularly without taking Naltrexone, however, it wouldn’t take long for those neural reward paths to be rewritten and for me to find my way back into problem-drinking. Which is why next time I wind up facing by far the greatest test – Christmas with my father and brother – I must resist.
It won’t be this year, I should add, given I’m pregnant again and spending it with my sober mother, but possibly next year. We all live in different countries, so it’s rare for us to get together. But when we do, as I’ve touched upon, it is customary for us to drink. A lot. Whisky at noon, wine with lunch, an afternoon nap, then more wine for dinner and another whisky nightcap. Rinse and repeat, every single day.
Obviously we wouldn’t be able to sustain such a drinking programme if we lived close by and saw each other regularly – we all have jobs, after all – but it’s such a treat when we do gather together, close our laptops and bask in the pleasure of good food and copious wine.
Some of my fondest memories are inextricably linked to these rituals, and to be honest, I still can’t imagine our Christmas spent any other way. It would be like summer with no sun, or Easter with no chocolate: Weird and underwhelming, surely.
I suspect a lot of people have scenarios or relationships like this, where it would feel like sacrilege to be the only sober one. And that is where merely taking a pill might not be enough – and why counselling is an important part of the Sinclair Method.
The drug did a stellar job in rewiring my brain’s response to alcohol, and destroying the desire. I don’t miss it at all; quite the opposite, my life is irrefutably better without it.
A good example is parties. I am socially awkward and autistic. I have never liked them. The only way I could ever tolerate them was by stupefying myself with booze.
These days, rather than having to endure them sober, I simply don’t go to them. Unless I have to, in which case I have one glass of wine and leave early.
If you have a problematic relationship with alcohol and don’t want to be unnecessarily plastered for most of the party season, I can highly recommend trying the Sinclair Method. You’ll lose your taste for alcohol and – revolutionary, I know – you don’t have to RSVP yes to the parties if you only ever enjoyed them because you were drunk.
Just be prepared for there to be at least one person or place that will feel utterly wrong without alcohol. And at that point, do what I plan to do next Christmas, and call a good therapist first.
