May 2021 - Monument

I had been binge drinking for most of my life before I quit alcohol for good. By the time I was 32 I found myself stuck in a cycle of drinking too much on weekends, and then suffering from hangovers that lasted several days. Married with an 18 month old son, I was struggling to keep up. Once I realized that I didn’t need alcohol like I had thought, my life was forever changed. My husband and I had been together for seven years when I quit drinking. We both had to figure out what our lives, and relationship, looked like without alcohol.

Even in the case of positive change, the people in your life may need time to adapt to the new you. Hopefully your loved ones will be there to support you through your sobriety, even if they aren’t sure what that looks like at first. Here are five ways that my husband supported me that may help you on your own journey, or while supporting someone else on theirs.

1. Accepted me without judgment

When I decided to quit drinking, I didn’t tell anyone at first. I was afraid that people wouldn’t believe me and to be honest, I didn’t believe in myself quite yet. After a week without alcohol, I told my husband what I was up to. In the past after particularly rough nights, I’d joke that I was “never drinking again.” There were many rough nights, so I couldn’t expect him to think anything would be different this time. Despite this, he accepted my decision without judgement or apprehension. His support then helped me believe in myself.

Once my confidence grew, that’s when the real work started. I had to figure out who I was without alcohol, and some days were better than others. My husband was learning about the person I was becoming, and he started to fully trust me when I said I wasn’t drinking anymore.

2. Showed interest in what I was doing

If you’ve never had an unhealthy relationship with alcohol, it can be challenging to truly empathize with what a sober person is navigating.

My husband falls in that category, so he didn’t pretend to know what I was going through. He was there for me, without judgement or assumptions, and that’s what I needed. I was having major realizations about myself and my relationship with alcohol. Although he couldn’t relate, he showed interest in my journey. He gave me advice if I asked for it. He asked questions, and some days he just listened. Currently, I am very active in the online sober community. I write about being alcohol-free and I give support to others. I ask him to read my writing and I talk about projects I’m working on. He still doesn’t entirely “get it,” but he knows that this is a passion of mine, so he continues to actively learn and support me.

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3. Helped me create a safe environment

As soon as I decided to quit drinking, I removed all of the physical things that could trigger me from my home. I got rid of the alcohol, the fancy glasses, and the bottle openers. My husband doesn’t drink, so it didn’t bother him. If you live with a person who still drinks, ask them if you can put those things away for a short time. The beginning of your sobriety journey can be the most challenging and the most pivotal. The more alcohol-free days you string together, the easier it gets.

For some people, it’s helpful to have something to replace their alcoholic beverages. If this is you, keep those fancy glasses around. You can create a new celebratory ritual. Find some non-alcoholic drink recipes and have fun with them (start with Monument’s Delish AF drinkbook!) Being sober doesn’t have to be boring!

4. Gave me time and space

My husband supported me by letting me take my time. He let me do things on my terms, however long that was going to take. At first, I immersed myself in everything alcohol-free. That often meant spending more time on my phone. It meant listening to a podcast or reading a book instead of hanging out with him. This didn’t last forever. As time went on, I didn’t need to focus on not drinking nearly as much. It became second nature. While I still may spend a little too much time on my phone, I can now balance my energy on other activities I enjoy, and time with my family.

5. Let me lead

Removing alcohol from my life was a personal choice and I wasn’t forced into making the decision. My husband was supportive and helpful, but he didn’t try to run the show. He asked me how I was and if I needed anything. If I wanted to leave an event early or not go at all, he understood. He let me call the shots when it came to our social life. As I got more comfortable being a non-drinker, I felt like I needed his support less. It was as if I was standing on my own two feet and I was confident in my own choice. He’d say I still call the shots. He’s mostly right.

If you’re beginning this journey and not sure how to engage your partner, here’s more information from a therapist about how to ask your partner for support in your recovery. If your partner is already aware of your choice to get more out of life by drinking less, you can also attend a Monument support group together. In Making progress together: For family, friends, and those in recovery they discuss how to better understand one another and support each other throughout this journey.

But wait! What if my partner isn’t supportive of my decision?

When sharing my story, this is a common follow-up question. It’s possible your partner isn’t ready to support you, or doesn’t know how to yet. If they have an unhealthy relationship with alcohol themselves, perhaps your decision has caused them to confront their own habits in a way that’s uncomfortable for them. To ease into the journey together, see if they’ll cut back or stop drinking for a short time with you as a challenge. Or, have a conversation about if moderation might be a better place to start. If they aren’t receptive, you can start by demonstrating all of the benefits from not drinking through your actions, and encourage them to join you at their own pace.

It’s a balance of communicating your needs while making room for them to share and work through their own discomforts too. With time, your partner should begin to understand why this decision is important to you, and how they can be there for you.

It’s also helpful to find outside support, such as specialized alcohol therapy or therapist-moderated alcohol support groups (check out Monument’s support group dedicated to navigating relationship challenges and sobriety or moderation).

These resources can help support you in both reaching your goals of sobriety or moderation, and navigating any relationship challenges that may arise in the process (like changes in love languages).

My relationship with my husband is much different now than it was when I was drinking. Not only have I grown as a person, but we’ve grown closer as a couple too. Honesty and communication are at the forefront of our relationship. We’re partners and we confront issues head on. We no longer argue about trivial things. Being together and happy is important to us and we try to not take life too seriously. Since I’m no longer numbing myself with alcohol, he gets the real me all the time, good and bad. And I wouldn’t want it any other way.

Disclaimer: Our articles and resources do not constitute clinical or licensed therapy or other health care services. If you need counseling or therapy services please contact a licensed provider. If this is a medical emergency, call 911.

Naltrexone is approved by the FDA for the treatment of opioid dependence and alcohol use disorder, among other conditions. In the context of this article, I’ll specifically be discussing alcohol use disorder, and how naltrexone helps people who want to stop drinking, cut down on drinking, or only drink on special occasions. While medication to stop drinking was once lesser-known, it’s now instrumental in many recovery journeys. As a physician at Monument, I get to see the transformative qualities of this treatment every day.

What are the benefits of naltrexone?

Naltrexone is an opioid antagonist that is commonly used for those looking to reduce alcohol consumption or achieve sobriety. What it does is reduce cravings for alcohol and the likelihood of unhealthy drinking. When you drink alcohol, your brain produces “feel-good chemicals” called endorphins. For endorphins to give you the pleasurable effects of alcohol, they need to bind to the endorphin receptors that are responsible for feelings of euphoria in your brain.

Naltrexone works by blocking these receptors so that you get less pleasure from drinking alcohol. Blocking these receptors also indirectly decreases the release of dopamine, a pleasure neurotransmitter. As you continue to take naltrexone, your brain will no longer associate alcohol with pleasure, and you will have less desire to drink.

Naltrexone therapy is especially helpful for a patient in the beginning phase of recovery when you have intense cravings for alcohol. Fighting against cravings all day takes up a lot of energy and can make you both mentally and physically tired. By having fewer and less intense cravings, you get more headspace to work on other aspects of recovery, such as processing emotions and developing coping mechanisms in alcohol therapy.

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One of the most important naltrexone benefits is that it’s not habit-forming (or ‘addictive’). Naltrexone is generally well-tolerated, with very few interactions with other medications. You can read more about potential side effects in this Naltrexone 101 overview, and discuss in detail with your physician in the context of your own medical history and goals.

Does naltrexone actually work?

The FDA approved naltrexone in 1994 for alcohol dependence, and since then, many studies and clinical trials have supported its effectiveness. A meta-analysis of 19 studies with a total of 3205 participants showed that naltrexone reduced the likelihood of relapse by 38%.¹ Another meta-analysis of 50 randomized clinical trials with 7793 participants concluded that naltrexone was effective at reducing the amount and frequency of drinking.²

It’s important to note that naltrexone is not a ‘miracle drug’ that will completely take away a patient’s desire to drink. (There is no such thing!) Though it’s not a miracle drug, for some people, it works so well for them that they immediately change their relationship with alcohol.

However, for most people, naltrexone reduces the pleasure of and cravings for alcohol to a certain degree and is best supported by other tools to control or stop drinking such as alcohol support groups and alcohol therapy. Alcohol use disorder is a biopsychosocial condition, which means it’s influenced by biological, psychological, and socio-environmental factors. Tools like online therapy and treatment can be especially effective in addressing the social and psychological influences, and managing co-occurring conditions such as anxiety or depression.

What factors may affect naltrexone’s effectiveness?

While naltrexone treatment is well tolerated and effective for many people, as with all components of the recovery journey, your experience will be unique to you. At Monument, you’re connected to a Care Team to personalize your online alcohol treatment plan in a way that will be most effective for you. Here are several factors to be aware of as you discuss medication to stop drinking with your physician.

Genetics

Research suggests that people with a certain type of endorphin receptor gene respond better to naltrexone therapy.³ While this is random based on your own genetics, it can play a small role in its effectiveness.

Dosage

If they deem it safe and appropriate, your physician will prescribe oral naltrexone in accordance with the FDA recommended daily dose of 50 mg. As with many other medications, if you and your physician agree a different dosage may better suit your needs and goals, your physician will work with you to prescribe the optimal dosage for you.

Timing & adherence

Naltrexone’s duration of action is approximately 24 hours. Therefore, with consistent adherence, you will have a therapeutic dose throughout the day. To integrate taking naltrexone into your daily routine, your physician will encourage you to take your oral naltrexone tablet at a time most convenient for your schedule. With consistent adherence, time of day doesn’t play a significant role in medication effectiveness. However, like with many other medications, the best results will come with consistency.

Co-occurring conditions

While naltrexone treatment can help you have less urge to drink, it’s important to simultaneously treat the underlying causes of heavy drinking. As referenced previously, mental health conditions like depression and anxiety are commonly experienced alongside alcohol use disorder. The alcohol recovery timeline is often non-linear and can bring about uncomfortable mental, physical, and emotional changes. These challenges and more can be worked through in specialized alcohol therapy. It’s important to remember that growth happens through discomfort and that these changes are most likely an indication of recovery, healing, and progress.

Is naltrexone right for me?

Multiple factors need to be considered before starting naltrexone, all of which should be discussed with a licensed physician via a Monument treatment plan or elsewhere. First, if you believe you are experiencing acute withdrawal symptoms, you should contact your provider immediately and visit https://findtreatment.gov/ to find a location to get supervised detox near you. Quitting cold turkey can be life-threatening, and proper withdrawal management is critical for your safety.

Moreover, naltrexone can cause side effects that could make the withdrawal symptoms worse. A physician will review your medical history and determine whether it’s safe and recommended for you to take naltrexone.

As mentioned, naltrexone is generally well tolerated. Like any medication, there are some potential side effects, the most common being headache and nausea. It’s recommended to connect with your physician about managing side effects, which can subside after a few weeks. Everybody is different, and your physician can help you weigh the side effects and benefits.

Alcohol use disorder is a medical condition and can be treated with science-backed solutions. For most people who have an unhealthy relationship with alcohol, naltrexone can be an incredibly effective tool for building healthier habits and unlocking the benefits that come with sobriety or moderation. Interested in seeing if naltrexone is right for you? Sign up for an online treatment plan to get the personalized, evidence-based care you deserve.

¹Carmen, B., Angeles, M., Ana, M., & María, A. J. (2004). Efficacy and safety of naltrexone and acamprosate in the treatment of alcohol dependence: a systematic review. Addiction, 99(7), 811-828.

²Rösner S, Hackl-Herrwerth A, Leucht S, Vecchi S, Srisurapanont M, Soyka M. Opioid antagonists for alcohol dependence. Cochrane Database of Systematic Reviews 2010, Issue 12. Art. No.: CD001867. DOI: 10.1002/14651858.CD001867.pub3

³Vuoristo-Myllys, S. (2014). Predictors of Alcohol Treatment Outcome: Prognostic factors in cognitive behavioral therapy for problem drinking including Targeted Use of Naltrexone.

Naltrexone has the capacity to cause hepatocellular injury (liver injury) when given in excessive doses. Naltrexone is contraindicated in acute hepatitis or liver failure, and its use for a patient with active liver disease must be carefully considered in light of its hepatotoxic effects.

In the treatment of alcohol dependence, adverse reactions include difficulty sleeping, anxiety, nervousness, abdominal pain/cramps, nausea and/or vomiting, low energy, joint and muscle pain, headache, dizziness, and somnolence. This is not a complete list of potential adverse events associated with naltrexone hydrochloride. Please see Full Prescribing Information for a complete list

Month: May 2021

5 Ways My Partner Supported Me When I Decided To Quit Drinking