A new book contends that our approach to alcohol addiction can be irrational and unhelpful
An early American doctor called Benjamin Rush signed the Declaration of Independence. He also wrote down an idea that would become almost equally hallowed in the American ethos: “‘Taste not, handle not, touch not’ should be inscribed upon every vessel that contains spirits of a man who wishes to be cured of the habits of intemperance.”
A couple of centuries later, Rush’s message remains the central tenet of Alcoholics Anonymous, the leading recovery programme for alcoholics worldwide. AA purports that alcoholism’s grip over its victims never loosens; only total sobriety can stave off the demons. The goal of AA’s 12 Step Program is complete, indefinite abstinence.
In Drink Your Way Sober: The Science-Based Method to Break Free from Alcohol (BenBella, 2025), journalist Katie Herzog turns this entrenched wisdom on its head. The sceptre of total abstinence prevents many problem drinkers from seeking help in the first place, and shames them when they slip up. For Herzog, there is an easier, less extreme way to kick the habit and far too few sufferers know about it.
Part memoir, part practical manual, Herzog tells the story of her own recovery from alcoholism through something called the Sinclair Method. American researcher John David Sinclair discovered the process while working with lab rats in the 1970s: if a patient takes an opioid blocking pill — usually a drug called naltrexone — one hour before drinking, the seductive and euphoric effects of the alcohol are removed. One patient described drinking on naltrexone as like “eating cake on day four. It’s just less exciting, less pleasurable.”
Over time, deprived of the buzz they once craved, drinkers lose interest in drinking. Sinclair called this “extinction” which is effectively the opposite of addiction: “a state of indifference.” This allows former boozers to enter a new era of either no drinking at all, or occasional, moderate drinking, something deemed impossible in the recovery world of AA.
In the age of Ozempic and Wegovy — new injectable revolutionary weight loss drugs that deaden the delight of food —- you might think that a pill that interrupts the addictive properties of drinking and short circuits recovery would be booming. But Herzog explains that the medical establishment is largely still in the dark about the potential of pill-based alcohol recovery, and the method has simply failed to launch. “It’s bizarre,” writes Herzog. “This is America. There’s almost no problem that’s not treated with some kind of pill, from baldness to obesity to fidgety kids.” Yet only 2 per cent of drinkers are prescribed any medication to try to reduce their drinking.
The Sinclair Method disrupts the idea that alcoholism is not just a physical condition but a deeper spiritual malaise
Part of the reason for this is the dominance of AA in American culture. AA’s total sobriety model appeals to a kind of insuppressible Protestant zeal for the drama of the redemption story: salvation is to be achieved only through gruelling moral labour and complete surrender. A pill that bypasses all of that simply doesn’t satisfy the American psyche.
The Sinclair Method disrupts the idea that alcoholism is not just a physical condition but a deeper spiritual malaise. As Herzog puts it, “what if fearless moral inventory isn’t necessary for everyone? What if we don’t all have underlying issues or trauma that made us drink in the first place? What if some of us simply drink because we’re drunks?”
She describes her own drinking problem as pretty much genetic and biochemical, rather than rooted in a deeper childhood trauma or depressive disposition. This may explain why she was able and willing to seek help when it got out of hand. The Sinclair Method requires buy-in from the patient: you’ve got to get your hands on naltrexone — which many doctors don’t prescribe — and make sure to take it an hour before you have a drink, every time.
This lack of education and training around naltrexone lead many doctors to assume that it’s unproven or unsafe
Flying in the face of the deep-seated AA message — “that even a single drink could lead to devastating relapse” — the Sinclair Method strikes many as counterintuitive. How can you get sober by continuing to drink? One doctor that Herzog interviews points out that the Sinclair Method “relies on continuing the bad habit for it to work, and that’s just a very unusual paradigm. It’s not a way that physicians think about disease and so it’s a significant barrier to widespread adoption.”
This lack of education and training around naltrexone lead many doctors to assume that it’s unproven or unsafe. Herzog quips, “this is one of the rare situations where you may be more likely to get good information from the internet than from your own family doctor.” Many of the subjects in the book learned about the treatment online, got a prescription using telemedicine, and began the process — as Herzog did — with support only from Facebook groups and other online communities.
Because her own experience was less a dark night of the soul, and more the slow creep of chemical dependency while having fun at the bar, Herzog sometimes makes light of the disastrous effects of alcoholism. Her benders involved finding herself “somehow able to belt out ‘Jolene’ at karaoke on a Thursday night” or the time when she “broke into a construction site, climbed up a crane, and then walked out onto the limb.” In her words, “Sure, I could have died or been arrested, but it made for a great story.”
Part of Herzog’s point is to destigmatise these misadventures and to show that she was like a frog in heating water: not noticing that her drinking was out of control until her life was boiling around her. Herzog includes many humorous refrains: blackouts are being unaware of your surroundings, “or the person drawing a penis on your forehead as you drool on the couch” and a bad binge ends with the line, “I also burned down a porch.” While they lend the book humour and affability, they may feel callous or beside the point to those for whom drinking has had far more sinister consequences.
Nevertheless Herzog’s text itself performs what it describes as the Sinclair Method’s appeal: it’s approachable, non-judgemental, and doesn’t overcomplicate alcoholism by freighting it with moral or spiritual panic. Herzog’s story is more prosaic and pragmatic, and she contends that this was part of her success in quitting the booze.
A recoverer in the book called Susie describes a process that lacks the atonement drama of an AA narrative, but instead is one that any of us will recognise as deeply familiar in life: “In the first year, it was ten steps forward, three steps back. In the second year, it was ten steps forward, two steps back. Now, it’s ten steps forward, one step back.”
No Damascene moment, just a winding road of mistakes, corrections, trial and error. And yet Herzog reaches the destination: “It was over. I was free.”
