The Sinclair Method

The Sinclair Method (TSM) is a medication-assisted approach to treating alcohol use disorder that is based on the science of pharmacological extinction. It was developed by Dr. John David Sinclair, a researcher in Finland, and has been used in Europe since the 1990s, later spreading to the U.S. and other countries. 

www.sinclairmethod.org 

Alcohol

Secular (Non-Meeting)

The Sinclair Method was developed from Dr. John David Sinclair’s research in Finland starting in the 1970s–80s, based on the discovery that alcohol reinforces behavior through endorphins. By blocking opioid receptors with naltrexone before drinking, the “reward” could be extinguished, gradually reducing alcohol use. Though proven effective in trials, TSM spread slowly outside Europe. It gained more visibility in the 2000s–2010s thanks to advocates, books, and documentaries, and today it stands as a respected, science-backed alternative to traditional abstinence-only recovery.

In the 1950s, Dr. John David Sinclair, an American neuroscientist, began studying the biology of addiction. He was particularly interested in how alcohol reinforced behavior in the brain. While working in Finland at the National Public Health Institute during the 1970s and 1980s, Sinclair studied the role of endorphins (the brain’s natural opioids) in alcohol use. His research showed that drinking releases endorphins, which reinforce alcohol consumption through the brain’s reward system.

Sinclair discovered that blocking opioid receptors with medications like naltrexone could disrupt the brain’s learned association between alcohol and pleasure. This led to the concept of “pharmacological extinction”: Every time a person drinks with naltrexone in their system, the brain fails to receive the expected reward. Over time, the conditioned response (pleasure from alcohol) is extinguished.

Beginning in 1989, Sinclair and colleagues ran clinical trials in Finland using naltrexone. They found that participants who took naltrexone before drinking experienced reduced craving and drinking levels compared to control groups. This was groundbreaking, as it contrasted with abstinence-only treatment models and showed that drinking behavior could be extinguished rather than suppressed by willpower.

In 1994 the U.S. FDA approved naltrexone for treating alcohol dependence, but under a daily-use model, not Sinclair’s targeted approach. In Finland and parts of Europe, Sinclair’s method (using nalmefene as well as naltrexone) became more widely studied and applied during the 1990s and 2000s. More clinical research supported the effectiveness of targeted opioid antagonists for reducing alcohol consumption.

During the 2010s books like The Cure for Alcoholism (by Roy Eskapa, co-written with Sinclair’s input) helped popularize TSM. Documentaries and advocacy groups raised awareness, especially in the U.S., where the method was relatively unknown compared to Europe. In 2013 the European Medicines Agency approved nalmefene (a similar opioid blocker) specifically for targeted use in alcohol dependence, reinforcing Sinclair’s model.

The Sinclair Method is now recognized as a science-based, harm-reduction approach to alcohol use disorder. It’s used in multiple countries, with stronger adoption in Finland and parts of Europe than in the U.S., where abstinence-based models (like 12-step programs) remain dominant. Advocacy groups (like the C3 Foundation) continue to work on increasing awareness among doctors, treatment centers, and people struggling with alcohol.

The Cure for Alcoholism: The Medically Proven Way to Eliminate Alcohol Addiction by Dr. Roy Eskapa    

• Naltrexone is at the heart of the Sinclair Method (TSM) for Alcoholism. When you take Naltrexone prior to drinking, it blocks endorphins, the naturally occurring opiates in the brain, from being released when alcohol is consumed.
• When the endorphins are blocked, there is no “buzz” or rewarding experience, and the alcohol doesn’t make you feel the pleasure that drives you to drink excessively.
• Over time, your brain learns not to associate alcohol with pleasure, resulting in reduced cravings and improved control over alcohol use.

• Unlike abstinence-based programs, TSM allows people to keep drinking at first.
• Over time, many people naturally lose interest in alcohol because it no longer provides the same reinforcement.
• Some achieve moderation, others naturally transition to abstinence—depending on personal goals.

The Sinclair Method does not offer meetings.