The Sinclair Method success rate: what the research shows, and what success can look like

Does The Sinclair Method work?

Yes, the controlled trials show it can help people drink less, especially with support alongside.

In these trials, some people take naltrexone and others take a placebo, so you can see what the medicine itself adds.^3,4,7,8

The Sinclair Method means taking naltrexone, a prescription medicine, before drinking. The idea is that, over time, drinking becomes less rewarding, so the desire to drink gradually eases. Here's what the trials found.

What brain scans show

Brain scans let researchers see what alcohol does inside the brain, rather than relying on how people say they feel. In 2012, a team in California used PET scans to show that a drink releases the brain's own feel-good chemicals, endorphins, in two reward areas. The more endorphins released, the better people felt. That is the system naltrexone blocks.¹⁶

Other studies scanned people while they were shown drinks. On naltrexone, a reward area called the ventral striatum reacted less.^17,18 In a 2017 US trial of 152 people, those whose response dropped most went on to drink heavily the least.¹⁹ Two German studies found naltrexone helped most in people whose brains reacted strongly to drink cues.^20,21 Most of these studies were small, but they all point the same way.

The bigger picture

A Cochrane review of 50 trials and 7,793 people found naltrexone lowered the risk of heavy drinking to 83% of the risk on a dummy pill, and concluded it appears effective and safe.⁹ A 2023 review of 118 trials concluded that naltrexone is a first-line medicine for alcohol problems, alongside support.¹⁰ Most of these trials used a daily dose, rather than the "targeted" approach Dr Sinclair championed of taking it before drinking.

In 2023, the World Health Organization added naltrexone to its list of essential medicines. Its expert committee noted that naltrexone's benefits may be greater in people whose drinking is driven by reward, which is what The Sinclair Method is designed to work on.¹ WHO guidance also recommends medicine and psychosocial support together for alcohol dependence.¹¹ UK clinical guidelines describe naltrexone, taken daily, as a first-line treatment to prevent relapse, as part of a psychosocial treatment plan.² NICE also recommends a related medicine, nalmefene, taken on days when drinking is likely, for some adults with alcohol dependence who want to cut down, always with ongoing support. It's a different medicine, and NICE's guidance isn't about The Sinclair Method itself.¹²

Sinclair Method success stories: real-life experience

Trials only tell part of the story. Alongside them, a growing number of people are sharing their own experience of The Sinclair Method, in books, on podcasts, in online communities and on social media. Awareness is growing, and so is the number of people who say it helped them change their relationship with alcohol.

Personal stories aren't clinical evidence. They're known as anecdotal evidence, and they can't tell you what will happen for you. But they matter, in the same way you'd read other people's reviews before any big decision. They show what change can look like in real life, from people who've lived it.

From Matt, our co-founder

I'm one of those real-life stories. The Sinclair Method is how I got my choice back around drinking. Today alcohol is a non-issue for me: I rarely even think about it. It changed my life enough that I wanted to share this option with the world, and that's why I started Rethink Drink. You can see the early part of my journey on my YouTube channel.

Where does the 78% come from?

You'll often see The Sinclair Method described as having a 78% success rate. It comes from Dr Sinclair's own clinics in Finland in the 1990s, where people took naltrexone before drinking, alongside counselling, for around 110 days. Over that time, their craving for alcohol steadily went down. He first reported the figure in 1998 and described it again in 2001.^5,6 In his words:

On average, those 115 people had cut down to about nine drinks a week. And 38 of the 147 (26%) had stopped drinking altogether, even though only 3% had set that as their goal.⁶

That's an encouraging result from real patients, and it's a big part of why the method spread. It just isn't the kind of figure that can promise you a result:

• It only counts the people who stayed in treatment long enough to be assessed. The paper doesn't say how many started.⁶
• There was no placebo group to compare with, so we can't tell how much of the change came from the naltrexone itself.
• The paper doesn't set out how "successful" was defined, and we haven't found any independent check of the clinic records.⁶

Dr Sinclair's team also followed up some of these patients around two and a half years later. Of those who replied, all 27 who were still taking naltrexone before drinking said they were drinking less than before treatment, compared with 8 of the 30 who had stopped taking it. It's a small, self-reported follow-up with no comparison group, but it's the longest look at the approach we have.⁶

Where we stand on the 78%

What does success look like?

Success looks different for everyone. For some people it's fewer drinks on the nights they do drink. For others it's more alcohol-free days, or less alcohol noise in their head about the next one. Some people decide to stop altogether, and that's their call to make, now or later.

That fits the evidence too. The World Health Organization counts reducing drinking, not only stopping, as a goal of treatment,¹³ and Dr Sinclair wrote that success should be judged by "the health and satisfaction of the patients".⁶

What to expect

The Sinclair Method isn't a quick fix, and naltrexone isn't a magic pill. It's gradual by design, and anyone who gives you an exact timeline is guessing. It depends on taking the medication as your prescriber directs, having patience, trusting the process, and knowing what you want to get out of it. Progress, not perfection.

Support makes a real difference. Naltrexone is studied and recommended as part of a package with support, not on its own.

In the key Finnish trial, naltrexone helped most for people who also had coping-skills sessions.³ 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. Clinical decisions are made by Professor Jonathan Chick, consultant psychiatrist and our clinical lead, or by an independent prescriber.

Is The Sinclair Method right for 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.¹⁵
• have liver or kidney problems.¹⁵
• are pregnant or breastfeeding.¹⁵

How to start The Sinclair Method in the UK

Frequently asked questions

Sources

This page was last updated on 3 November 2026 by Matt Brindley, co-founder of Rethink Drink.