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The Cure for Alcoholism -- The Medically Proven Way to Eliminate Alcohol Addiction
by Roy Eskapa, Ph.D. in Clinical Psychology
(BenBella Books: Dallas, TX) [quiz based on the first 208 pages]
[Answer 18 of 25 questions to receive 11 hours of Continuing Education credit]

SECTION ONE -- Alcoholism: Who Says It's Incurable?
Chapter 1: Introducing Yourself to the Cure (p. 3-12)

1. Which is NOT true?
a. Based upon clinics in both Finland and Florida, success rates for The Sinclair Method are 78 % or higher.
b. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the World Health Organization (WHO), current non-Sinclair Methods of alcohol rehabilitation are about 10-15% successful
c. Naltrexone only works when the person takes it and does NOT drink.
d. Antabuse, a drug which causes a severe and unpleasant reaction when someone drinks alcohol, does NOT reduce one's craving for alcohol.

Chapter 2: The Genesis of the Cure for Alcoholism (p. 13-41)
2. What is the Alcohol Deprivation Effect (ADE)?
a. The symptoms of withdrawal when one does not drink alcohol.
b. The increase in one's craving for alcohol when one abstains from alcohol.
c. One's ability to drink more alcohol after developing tolerance to its effects.
d. One's realization that the pain and suffering their drinking caused was greater than any pleasure they derived from drinking.

3. David Sinclair discovered a way to use medications such as Naloxone, Naltrexone, and Nalmefene to ________________ each time alcohol was consumed, thus reducing one's craving to drink.
This process was called the extinction of alcohol addiction.
a. block reinforcement from the endorphins
b. cause nausea
c. cause pleasure
d. limit one's consumption of alcohol to 2 drinks

4. Certain external triggers, like seeing a bottle of wine, and internal triggers, such as being in a party mood, can create an urge to drink. When a person drinks, endorphins are released. These endorphins bind to opiod receptors in one's brain. Now this pathway for neurons has just been reinforced, the pathway that caused the craving for alcohol. After many drinking sessions, this pathway becomes permanently hard-wired into one's brain. At this point, people have little or no control over drinking. They are addicted to alcohol. Alcoholism is a permanent condition unless
a. the person commits to regular attendance at Alcoholics Anonymous meetings and completes the 12-Step Program.
b. the person stops drinking one-day-at-a-time and remains abstinent for a minimum of 90 days.
c. the person undergoes detoxification before taking medication.
d. the addictive neural pathways controlling it can be removed by blocking endorphins with drugs such as Naltrexone.

5. Which formula is supported by this book and The Sinclair Method?
a. Taking Naltrexone + Not Drinking = Cure
b. Taking Naltrexone and then Drinking = Cure
c. Detoxification + then taking Naltrexone = Cure
d. Drinking first, then taking Naltrexone = Cure

Chapter 3: The Hard Evidence Behind the Cure (p. 43-55)

6. Which one of these is NOT true?
a. If a person is going to drink, he must take Naltrexone 1 hour before drinking.
b. If a person is NOT going to drink that day, he should NOT take Naltrexone that day.
c. When doctors prescribe Naltrexone, they should tell their patients to take it, and then NOT drink.
d. When doctors prescribe Antabuse, they should tell their patients to NOT drink.
e. With the Sinclair Method (Naltrexone + Drinking), a person's drinking is gradually reduced. Withdrawal symptoms are significantly reduced as well.
f. Naltrexone is not addictive.
g. 72 clinical trials consistently show that Naltrexone and Nalmefene, when used according to the Sinclair Method, are effective in treating addictions.
h. Project COMBINE (2006), the largest clinical trial in the history of alcoholism research, found Naltrexone to be effective.
i. Naltrexone works without counseling.
j. In Finland, the Sinclair Method is effective in 78% of the patients.
k. In Florida, the Sinclair Method is effective in 85% of the patients.
l. About 10% of the patients who take Naltrexone and drink do not benefit from it.
m. The more often people drink while on Naltrexone, the less they will want to drink.
n. The Sinclair Method fulfills the cost effective requirements of evidence-based medicine.

Chapter 4: Why Haven't I Already Heard of the Sinclair Method? (p. 57-73)

7. Which one of these is NOT a reason why the Sinclair Method is not more well-known?
a. Not enough successful clinical trials have been performed.
b. Most primary care physicians are not aware of the largest multi-center study in addiction research ever conducted, Project COMBINE, which was published in the Journal of the American Medical Association in 2006. The AMA said that Naltrexone could serve alcohol-dependent patients.
c. Our society is used to the standard treatment for alcohol addiction to be "abstinence only", and "not taking any drugs for addiction."
d. Naltrexone quickly became a generic medication which would not be profitable for large pharmaceutical companies to promote.
e. When DuPont launched Naltrexone (as ReVia) in 1995, inserts accompanying this drug warned that it could case liver damage, even though this was at doses greater than 300mg, 6 times the recommended safe dose of 50mg.
f. When doctors first prescribed Naltrexone, they told their patients to NOT drink alcohol, which is the opposite of what they should do, in order for Naltrexone to be effective.
g. Insurance companies often don't allow Naltrexone to be covered as a primary treatment for alcoholism.
h. Many alcohol treatments are based upon the assumption that drinking is a rational behavior that occurs in order to maximize pleasure and minimize pain. So if the consequences of drinking are made sufficiently horrible, alcoholics should learn to abstain from drinking. But alcohol abuse is not rational because most alcoholics say they get little or no pleasure from drinking, yet they continue to drink, even when faced with hangovers, car accidents, divorce, job loss, cirrhosis of the liver, and legal problems. Naltrexone is a rational way to stop the irrational behavior of drinking.

SECTION TWO: Five Steps to Curing Alcoholism
Chapter 5: An Introduction to the Five Steps -- How to Drink Your Way Sober (p. 77-78)

Chapter 6: Step One -- Understanding the Cure (p. 79-92)

8. Which is NOT true?
a. 85 to 90% of recovering alcoholics will relapse within the 1st year following non-Sinclair methods.
b. Some people are just born alcoholics.
c. The Sinclair Method removes the hard-wired neural circuitry that produces the desire for alcohol.
d. The Sinclair Method is intended for those who are currently drinking excessively, whether frequently or infrequently, or wish to prevent an escalation of the drinking.
e. The Sinclair Method works by blocking reinforcement.

Chapter 7: Step Two --Self-Assessment -- Do I Need Help? (p. 93-99)
9. The most important sign of alcoholism is
a. the amount people drink.
b. how often people drink.
c. how good alcohol tastes.
d. the inability to remain abstinent.

10. Which one of these was NOT a self-assessment question?
a. Do you have a blood relative who has had a drinking problem?
b. Has anyone ever told you that you drink too much?
c. Do other people have different opinions about your drinking style than you do?
d. Do you sometimes think that drinking causes problems in your life?
e. Can you stop drinking after 2 drinks
f. Ever felt you ought to Cut down on your drinking?
g. Have people Annoyed you by criticizing your drinking?
h. Ever felt bad or Guilty about your drinking?
i. Ever had an Eye-opener to steady your nerves first thing in the morning?

Chapter 8: Step Three -- Your Prescription for Naltrexone (p. 101-110)

11. Which is NOT a result of taking Naltrexone + Drinking?
a. decreased craving for alcohol.
b. a reduction in drinking to safe levels.
c. the ability to choose either total abstinence or drinking within safe limits.
d. the person never drinks again after 3-4 months

12. Which is NOT true?
a. Most alcoholics do not drink because they get pleasure from drinking. They drink because they have become hard-wired to drink.
b. Drinking after taking Naltrexone incrementally weakens the neural circuitry in your brain that causes you to drink. The circuitry is weakened because one's brain is no longer being reinforced by endorphins that are released by the alcohol.
c. Research on opioid antagonist medications (Naltrexone, Nalmefene, Naloxone) proves that the addictive wiring acquired over many years of drinking is restored functionally to the state it was in before the addiction took root.
d. Taking a dosage of Naltrexone higher than the usual 50mg will speed up the 3-4 month de-addiction process.

Chapter 9: Step Four -- Charting Reduced Craving and Drinking (p. 111-123)
13. All of the following servings of alcohol constitute 1 drink unit EXCEPT
a. 10-12 oz. of beer (4-5% alcohol)
b. 8-12 oz. of wine cooler (4-6% alcohol)
c. 8 oz of table wine (9-12% alcohol)
d. 2.5 oz of fortified wine (20% alcohol)
e. 1.25 oz of 80 proof distilled spirits (40% alcohol)
f. 1 oz of 100 proof distilled spirits (50% alcohol)

14. Which violates the "Upper Limits of Moderate Drinking"?
a. A man who drinks a 6-pack of beer after work one night.
b. A woman who has 2 glasses of wine at dinner one night.
c. A man who drinks 3 beers every night.
d. A woman who has one glass of wine every evening.

15. After 3-4 months, the Sinclair method reduces drinking to an average of fewer than ___ drinks per week.
a. 5
b. 7
c. 9
d. 11

16. Opioid receptor sensitivity occurs when Naltrexone is not taken and drinking does not occur for a period of days. The receptors then become more sensitive to reinforcement from endorphin release.
On these days, it would be wise for a drinker to
a. take Naltrexone anyway, even if he does not drink.
b. replace the "bad" endorphin activity of drinking with a "good" endorphin activity such as exercise, or enjoying a meal with a friend
c. do nothing out of the ordinary.
d. none of the above.

Chapter 10: Step Five -- The Golden Step -- Staying Cured (p. 125-128)

17. Which one of these was NOT an indication of success for those using the Sinclair method?
a. You are drinking within the safety limits or not drinking at all.
b. Your craving levels are way down or nonexistent.
c. You no longer need to take Naltrexone.
d. Your mood has improved and you feel better physically and emotionally.
e. Hangovers are history.
f. Others notice you are drinking less.
g. Alcohol no longer dominates your thoughts or rules your life and you have stopped obsessing about the next drink.
h. You have simply lost interest in drinking -- you can take it or leave it.
i. Your confidence and self-esteem have improved.
j. Your relationships no longer suffer as a result of your drinking.
k. Your psychological and physical health has improved. Your depression has lifted. Your liver function is improved.

18. What is the Golden Rule of the Sinclair method?
a. Tale Naltrexone until your desire to drink goes away. Then you can stop taking it.
b. Take Naltrexone every day for the rest of your life even on the days you do not drink.
c. Take Naltrexone for 3-4 months. Then remain abstinent for life.
d. Take Naltrexone 1 hour before drinking, for the rest of your life.

SECTION THREE: Real Stories of Real Cures
Chapter 11: Julia's Story -- Sinclair "Deluxe" Treatment (p. 131-141)

19. When Julia began the Sinclair method, her Drinking Diary showed her consuming over 60 drinks per week (p. 135). By the end of her 8th week, she already had dropped to ___ drinks per week.
a. 52
b. 46
c. 38
d. 23

Chapter 12: Richard's Story -- The Sinclair "Lite" method -- Same Great Success, Less Intensive (p. 143-153)

20. At the beginning of the Sinclair method, Richard was drinking more than 100 drinks per week, the equivalent of 3 bottles of 12.5% wine every evening. His consumption decreased to less than 24 drinks per week.
He accomplished this
a. without any conventional therapy.
b. by not taking Naltrexone before his drinking episodes.
c. after he quit his job in the pub.
d. 6 months after beginning the Sinclair method.

Chapter 13: David's Story -- A Relapsing Patient Is Successful (p. 151-153)

21. Which was NOT true about David?
a. He was a weekend binge drinker.
b. He could go weeks without drinking.
c. A boating accident in which he almost drowned made him seek help.
d. His personality dampened after doing the Sinclair method. He became less fun.

Chapter 14: Pete's Story -- A Troubled, Relapsed Alcohol and Cocaine Addict Until He Got a Prescription for Naltrexone (p. 155-162)

22. What happened to Pete 4 months after using the Sinclair method?

a. His craving was way down and he was hardly drinking at all
b. He relapsed and stopped taking Naltrexone.
c. His government subsidy for Naltrexone ran out.
d. He was still drinking over the safe limit.

Chapter 15: The Sinclair Method as a Blueprint for Treating Other Addictions (Heroin, Cocaine, Amphetamine, Sex, Gambling, Chocolates, Smoking, Computer Hacking, and Pathological Thrill-Seeking) (p.165-190)

23. So far there is NO convincing evidence that Naltrexone is helpful for ___ addiction.
a. cocaine
b. sexual compulsions
c. gambling
d. nicotine and smoking

Chapter 16: The Human Costs of Alcoholism (p. 191-201)
24. Which is TRUE?
a. The majority of people who drink do not go on to become alcoholics.
b. Research shows that people who seek standard alcohol treatments like A.A.'s Twelve Steps have a failure rate of 85 percent.
c. Two-thirds of Americans consume alcohol.
d. All of the above.

Chapter 17: For Medical Professionals (p. 203-231)

25. What do doctors need to know when prescribing Naltrexone?
a. Patients who are actively drinking are better candidates for Naltrexone than ones who have been abstinent for more than a week.
b. The standard dose of Naltrexone has been 50mg daily, beginning at 35mg for the first day or two. Naltrexone can begin as soon as the liver function results are known.
c. Naltrexone must be taken 1 hour before the patient drinks, for the rest of his life.
d. All of the above.