Chapter 14: Microdosing

A little-known treatment that may curb the side-effects of Naltrexone.

Photo by danilo.alvesd on Unsplash

This is the 14th installment in an ongoing series and it’ll make a lot more sense if you read them in order. Catch up on earlier posts here.

Last week I wrote about my struggles with the side-effects of Naltrexone, which make me feel like I’ve just eaten bad clams. Again, I don’t want to let my own weak constitution dissuade anyone from trying TSM, so let me emphasize: I’m in the minority on this. Most people, if they have side-effects at all, get over them quickly as their body habituates to the medication. Most people, unlike me, also don’t get insomnia from walking by a coffee shop, so really don’t take my experience as any indication of your own. It seems as though the only substance I have a tolerance for is booze.

That said, I’m definitely not alone with it comes to side-effects. For TSM practitioner and coach Samara Ibanez, Naltrexone was a god-send. Except for one thing: those damn side-effects, which, for her, included nausea, headache, fatigue, upset stomach, itchiness, and, she says, feeling “kinda stoned.” (That’s similar to mine experience, along with ennui, sweaty feet, and the sensation that’ve just chugged a quart of soda and need to burp.)

Samara spent 25 years in the throes of addiction and her path was a common one. She tried to get sober over and over, and had periods of abstinence and endless AA meetings followed by periods of binging. It was classic Alcohol-Deprivation Effect: the longer she went without a drink, the more she wanted one. Eventually, she always gave in to her cravings.

“I would tell myself every day I wasn’t going to drink and then it was like I had no control over my body,” she told me. “I would be in my car driving to the liquor store and it was like the car was driving itself.”

Samara was sneaking around, stashing bottles in her closet, and drinking and driving just so she could be away from her family and drink in peace. “There were a couple nights when I ran out of booze at 3 AM and panicked because I couldn’t get more and actually drank mouthwash,” she said. “I did this more than once. It made me so sick.” 

Even when Samara was going through periods of sobriety, she wasn’t happy. She couldn’t enjoy being sober when she was she was consumed by desire to drink—and the knowledge that she couldn’t. It just made her angry.

Then she found TSM.

“I read the book [Roy Eskapa’s Cure for Alcoholism], I joined the Facebook groups, and in January 2021, I sat my mom down and I said, ‘Ok, this is what I’m doing. I’m going to put all my other life goals on the back-burner and focus 100 percent on TSM. Whatever I have to do to make it work.’”

There was, however, a problem. “I’m very very sensitive to the medication,” she said. “I was a binger rather than drinking every day so I would go four or five days without it and then get sick all over again. It wore me completely down.”

Samara scoured the TSM groups for advice and read all the articles on Naltrexone she could find, and through this, she developed what she calls “a hack.”

It’s a four-step process. The first two steps are well-known: Take Naltrexone with a full meal and drink a lot of water. Stay hydrated. She also, Step Three, takes non-drowsy dramamine to cut the nausea, also common advice for people on Naltrexone. But the fourth step was something I hadn’t heard much about: taking low-dose Naltrexone, or LDN, at night, whether or not you are drinking.  

LDN is basically what it sounds like: a microdose of Natlrexone. You can either get LDN from a compound pharmacy, or, like Samara, you can make it yourself by dissolving a 50 mg pill of Naltrexone in distilled water and using a syringe to extract a few milligrams. Samara would take 3 to 4 milliliters as part of her bedtime routine, which kept her body habituated to the medication so that when she did take a full dose, she didn’t get sick.

It worked. Not only did this reduce the side-effects to nothing, Samara hit extinction in just five months. After 25 years of struggle, she was free. She’s now a coach at Thrive Recovery, where she tries to help her clients find similar success.

On the rare occasions Samara does drink now, she’s mindful about it. And she prepares. “If I have an event like a wedding or something coming up and I know I’m going to drink, I’ll take LDN every night for about two weeks leading up to it,” she told me.

She says there are no negative side-effects from LDN, but, she adds, there are some positive ones, including immune support, cancer prevention, increased fertility, decreased inflammation, and help with sleep. 

Could this be legit? It sounded too good be true so I looked at a website that promotes LDN and along with some studies, and, unfortunately, the data is basically non-existent. While proponents of LDN have claimed it can treat everything from MS to AIDS, none of this has been demonstrated, or even studied, in clinical trials. What studies do exist are pilot studies, which are meant to demonstrate the feasibility and safety of a potential clinical trial. They make no claims about a drug’s ability to heal.

Interest in using LDN for various ailments seems to be increasing, but there are some barriers to studying it. The main one is profit: Naltrexone is a cheap generic drug. Pharmaceutical companies don’t typically invest in trials for drugs they won’t profit on. There is one clinical trial in process on using LDN to treat fibromyalgia, but it won’t be published for a few years. So I’m not saying LDN can’t cure what ails you, but without more evidence, I’m not betting on LDN to treat any latent cancers that may be brewing inside me. Still, if it takes care of the side-effects of the full dose, that’s plenty useful for me.

After speaking with Samara, and hearing how she had to hack together this treatment herself—and how she DIYs her own low-dose Naltrexone—I realized how underground this whole treatment is. I get more information from people like Samara and TSM Facebook groups than I could ever get from my doctor. She’s never even heard of it. In a way, there’s a beauty to that, I guess—people figuring things out for themselves after conventional wisdom has failed them—but it’s also a shame because it shows just how unknown this whole process is, despite so many success stories like Samara’s.  

People shouldn’t have to read Facebook groups and watch YouTube videos to get good information on Naltrexone. But that’s where we’re at, and so I’m soon going to be another data point for Samara’s four-step protocol to beat the side-effects: full stomach, lots of water, over-the-counter nausea pills, and a microdose of Naltrexone, taken every night before sleep. 

I’ll keep you posted.