What Is the Sinclair Method?

The Short Answer

The Sinclair Method (TSM) is a medication-assisted approach to alcohol use disorder that uses naltrexone — taken before drinking — to gradually reduce the brain's reward response to alcohol over time. The goal is pharmacological extinction: the systematic weakening of the learned association between drinking and reward.

Unlike abstinence-based approaches, TSM does not require you to stop drinking immediately. Instead, you take naltrexone before drinking, and over weeks and months, the rewarding effect of alcohol is gradually reduced — which typically leads to reduced cravings, reduced consumption, and for many people, eventual control or abstinence.

The Fourth Option Framework

Most people who struggle with alcohol are presented with three options:

1. Willpower / quitting alone — trying to moderate or stop through self-control.
2. AA or peer support — abstinence-focused community recovery.
3. Rehab or intensive treatment — structured inpatient or outpatient programs.

The Sinclair Method is a fourth option — one that many people never hear about, despite being supported by decades of clinical research and FDA-approved medication.

Who Developed the Sinclair Method?

The Sinclair Method was developed by Dr. John David Sinclair, a Finnish neuroscientist who spent decades researching alcohol dependence and the opioid system. His work demonstrated that naltrexone, when taken specifically before drinking (rather than as a daily abstinence aid), could produce pharmacological extinction of alcohol-seeking behavior.

How Is TSM Different from Traditional Naltrexone Use?

Naltrexone has been FDA-approved for alcohol use disorder since 1994. But it is most commonly prescribed as a daily medication to support abstinence. The Sinclair Method uses naltrexone differently — taken only before drinking, so that the medication is active during the drinking experience. This targeted use is what produces the extinction effect over time.

Who May Benefit?

The Sinclair Method may be relevant for:

• People who want to reduce drinking rather than immediately commit to lifelong abstinence
• Gray-area drinkers and high-functioning drinkers
• People who have tried AA or rehab and did not connect with those approaches
• People who want a science-based, medication-assisted option
• People who experience strong alcohol cravings

TSM is not appropriate for everyone. See Is the Sinclair Method Right for Me? for a fuller discussion.

Important Safety Notes