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One matter of minutae here: the link to the "78% get drinking below the level of increased risk of morbidity and mortality." I'd really love to see the original if you still have the link, Yvain. Thanks.
This post is timely. I'm an alcoholic who just began the Sinclair Method today. Subjectively, I don't notice any anhedonia or lack of happiness. On the other hand, I'm still getting a buzz from the alcohol so maybe something's gone wrong.
I actually asked the MD on staff in my rehab exactly the same question - "if it blocks dopamine, how am I ever supposed to feel happy ever again?" And he reassured me that it only blocked the reward from alcohol (and heroin) specifically. This feels too good to be true, but on the other hand the Sinclair Method works and anhedonia or depression aren't commonly known side effects of Naltrexone, so it looks empirically plausible.
It's worth noting that for many alcoholics, "start of a drinking session" means "waking up in the morning"