Is there a cure for alcoholism? What the research says about The Sinclair Method
An honest look at the word "cure", what Dr Sinclair himself said, and what lasting change can look like.
The short answer: The Sinclair Method isn't a cure in the sense of a treatment you take once and are finished with.
Dr Sinclair himself said there should be no end to naltrexone treatment.1 What the research shows is that naltrexone, taken before drinking, can help people drink less for as long as they keep using it.1
On this page
Where does the idea of a "cure" come from?
Many people first hear about The Sinclair Method through a well-known book, The Cure for Alcoholism by Roy Eskapa.4
In health, a cure usually means a treatment that makes someone well again for good, so they no longer need it. That's a high bar, and it's worth being clear about whether The Sinclair Method meets it.
What did Dr Sinclair himself say?
Dr John David Sinclair, the researcher the method is named after, didn't describe it as a course you finish. In his own words:
His advice was to take the medicine only on occasions when drinking is likely, and to keep doing that. He reported that the benefits last for as long as naltrexone is used, and gradually weaken if it's stopped.1 In a trial of nalmefene, a medicine that works in a similar way, 57 people who had taken it for 28 weeks were then split at random: some carried on, and the rest were switched to a placebo without knowing. As a group, those switched to the placebo went back to heavier drinking.5
The longest follow-up comes from Dr Sinclair's own trial in Finland. Patients didn't have to stop drinking first, took naltrexone before drinking, and had no end date. His team contacted the first of them on average 31 months after they started (between 25 and 40 months). All 27 who replied and were still taking naltrexone before drinking said they were drinking less than before treatment, compared with 8 of the 30 who had stopped. Those still following the method also had fewer cravings, drank less per occasion, and had better results on blood tests linked to drinking. Patients knew they were taking naltrexone and there was no placebo group, so this can't prove cause and effect. Dr Sinclair's own conclusion was that continued targeted use is "safe and effective for at least 3 years".1
The long view
Drinking less than before treatment, around 31 months later
Patients who replied to Dr Sinclair's follow-up
Source: Sinclair JD, Alcohol and Alcoholism, 2001.1 Self-reported, with no placebo group.
As long as you drink, you take naltrexone first, and every drinking occasion becomes another step in unlearning the habit. On days you don't drink, you don't need a tablet at all. In Dr Sinclair's words, "If they never drink, it costs them nothing."1
If it isn't a cure, what is it?
The better word is remission, and the good news is that remission doesn't have to mean stopping drinking completely.
That isn't a fringe idea. In a large US survey of 4,422 adults whose alcohol dependence had started more than a year earlier, about as many had recovered while still drinking at low-risk levels as had recovered by stopping completely. Only about a quarter had ever had any treatment.8
Recovery in the real world
Where people with past alcohol dependence were a year or more later
4,422 US adults whose dependence began more than a year before the survey
Source: Dawson DA and colleagues, Addiction, 2005, from the US National Epidemiologic Survey on Alcohol and Related Conditions, 2001 to 2002.8 Scale runs from 0 to 40%. Only about a quarter had ever had treatment.
Cutting down counts, too. A US study that followed 22,005 drinkers for three years found that people who moved down the World Health Organization's drinking risk levels had much lower odds of alcohol dependence three years later. Among people who were dependent and drinking at very high risk, dropping two levels was linked with about 94% lower odds of dependence at follow-up.9
Once an alcoholic, always an alcoholic?
Not in the sense most people mean. The medical world recognises that drinking less, without problems, is a real and lasting outcome, not a failure to get "cured".
What that can look like in real life
For me, it looks like this: alcohol is a non-issue. I rarely even think about it. I don't call that a cure, and I don't call myself "in recovery" either. It's simply that drinking became my choice again.
That's what we mean when we say "control is the goal". For some people it's fewer drinks on the nights they do drink. For others it's more alcohol-free days. Some decide to stop altogether, and that's their call to make, now or later.
Why support matters when there's no finish line
If the method works for as long as you keep using it, the real question becomes how you keep going when life gets busy, stressful or celebratory.
The key Finnish trial
No return to heavy drinking over 32 weeks
People who also had coping-skills sessions
Source: Heinälä P and colleagues, Journal of Clinical Psychopharmacology, 2001.10 Scale runs from 0 to 40%. For people given general support only, naltrexone didn't beat placebo.
In the key Finnish trial, naltrexone made the biggest difference for people who also had coping-skills sessions.10 That's why coaching sits at the heart of what we do: planning ahead, staying consistent, and building the skills for the moments that decide whether change sticks. Our coaching itself hasn't been tested in a trial, and we won't pretend otherwise. But it's built around what those programmes worked on, and on our own experience, refined over thousands of coaching calls with our members.
Is The Sinclair Method right for you?
The Sinclair Method is one route, not the only one. Some people do best stopping altogether with support. There are other medicines, such as acamprosate, as well as talking therapies and free local alcohol services. The NHS sets out the options: alcohol-use disorder, treatment and support.6 The right choice is the one that fits you.
Whether naltrexone is suitable for you is a medical decision, made after a consultation. It usually isn't suitable, or needs extra care, if you:
- are dependent on opioids, or take or may need opioid medicines such as codeine, tramadol or morphine, including some cough and diarrhoea remedies.7
- have liver or kidney problems.7
- are pregnant or breastfeeding.7
If you drink heavily every day, please don't stop or cut down sharply without medical advice. As the NHS puts it, "It can be very dangerous to stop drinking suddenly if you're dependent on alcohol." Call 999 or go to A&E if you or someone else has severe withdrawal symptoms, such as shaking visibly, confusion, seeing or hearing things that aren't there, or a seizure.6
How to start The Sinclair Method in the UK
Frequently asked questions
What is The Cure for Alcoholism book?
The Cure for Alcoholism is a book by Dr Roy Eskapa, with a foreword by Dr John David Sinclair. It's how most people first hear about The Sinclair Method. Despite the title, Dr Sinclair said there should be no end to naltrexone treatment, so we talk about control rather than a cure.
Can alcoholism be cured?
Not in the sense of a treatment you take once and never need again. Medicine talks about remission instead: no longer meeting the criteria for alcohol use disorder. The World Health Organization and the US NIAAA both accept this can happen while someone still drinks, at lower-risk levels.
Can an alcoholic drink again in moderation?
For some people, yes. In a large US survey of people with past alcohol dependence, about as many had recovered while drinking at low-risk levels (17.7%) as had recovered by stopping (18.2%). It isn't right for everyone, and if your body depends on alcohol, speak to a doctor before you change how you drink.
Is "once an alcoholic, always an alcoholic" true?
Not in the way most people mean it. Drinking less, without problems, is recognised as a real and lasting outcome. Read our full answer to "once an alcoholic, always an alcoholic".
Does The Sinclair Method stop working if you stop naltrexone?
Dr Sinclair reported that the benefits last for as long as naltrexone is taken before drinking, and gradually weaken if it's stopped. That's why he said there should be no end to treatment. Any change to medication is a decision for your prescriber.
Sources
All 10 sources
- Sinclair JD. Evidence about the use of naltrexone and for different ways of using it in the treatment of alcoholism. Alcohol and Alcoholism, 2001. academic.oup.com
- Hagman BT and colleagues. Defining recovery from alcohol use disorder: development of an NIAAA research definition. American Journal of Psychiatry, 2022. psychiatryonline.org
- World Health Organization. ICD-11, 6C40.2 Alcohol dependence, including sustained partial remission. icd.who.int
- Eskapa R. The Cure for Alcoholism. BenBella Books, 2012 edition.
- Karhuvaara S and colleagues. Targeted nalmefene with simple medical management in the treatment of heavy drinkers. Alcoholism: Clinical and Experimental Research, 2007. PubMed 17451401
- NHS. Alcohol-use disorder. nhs.uk
- OpenPrescribing.net (Bennett Institute, University of Oxford). Naltrexone hydrochloride (0410030E0): NHS England prescribing data. openprescribing.net
- Dawson DA and colleagues. Recovery from DSM-IV alcohol dependence: United States, 2001 to 2002. Addiction, 2005. PubMed 15733237
- Hasin DS, Witkiewitz K and colleagues (Alcohol Clinical Trials Initiative Workgroup). Change in non-abstinent WHO drinking risk levels and alcohol dependence: a 3 year follow-up study in the US general population. The Lancet Psychiatry, 2017. doi.org
- Heinälä P and colleagues. Targeted use of naltrexone without prior detoxification in the treatment of alcohol dependence. Journal of Clinical Psychopharmacology, 2001. PubMed 11386491
This page was last updated on 4 November 2026 by Matt Brindley, co-founder of Rethink Drink.
