Targeted dosing of medication is also called “as-needed” dosing and contrasts with “constant dosing.” An example of constant dosing is to take a pill once a day, or sometimes several times a day, but consistently on a daily cycle.
The idea with constant dosing is to keep a steady amount of medication in your system 24 hours a day so it can constantly be working its action on your body or brain.
Sometimes constant dosing is an ineffective use of medication and can be harmful because you have more medication in your system than you need producing an unintended effect, including taxing your body’s system in eliminating the excess medication.
The Sinclair Method employs targeted or as-needed dosing, and in that way the medication is simply a tool to assist your body in readjusting its dependency on alcohol.
While the Sinclair Method employs naltrexone, a safe FDA medication to attack the physiological changes to brain chemistry caused by repeated consumption of alcohol, it’s primarily a behavioral modification model, only not in the traditional sense where you start with talk-therapy or apply conscious, deliberate willpower to suppress cravings for alcohol, or work hard on other changes to behavior.
Instead, naltrexone works at the brain neuron level by blocking the action of endorphins that are released in response to drinking alcohol. Endorphins are basic neurochemicals that reinforce behavior in all animals including humans. By blocking them, patients slowly breakdown the physiological craving sensation for alcohol over time. That’s called “extinction” in medical science and originated with studies done in the field of Behavioral Science over one hundred years ago.
Since alcohol use disorder involves an acquired learned response at the physiological level that involves core, reflexive neurological and biological processes in the human body, it’s not something you can always consciously “will away” or control once it takes hold.
The classic sign of alcohol use disorder having taken over is when your body begins to crave alcohol if it’s deprived of it for too long, often coupled with a difficult time stopping drinking once you start. Craving is simply an uncomfortable, strong desire for alcohol. It’s the body’s way of signaling it wants more alcohol, all caused by the unintended effect of alcohol repeatedly releasing endorphin with each sip. The body, in effect, is “tricked” over time by that unintended release of endorphin each time you drink.
By blocking that endorphin release in a targeted fashion with naltrexone, you begin the process of extinction of that acquired response and cravings begin to dissipate and control over drinking begins to come back. That’s how targeted or as-needed dosing works. It’s targeted, or timed to coincide, with the act of drinking.