I tried TSM and I did not get the results that I was hoping for. At first my drinking levels went down, which seems to happen for many people at the beginning, but eventually mine plateaued and then went up again. I relapsed after about two months.
The concept of pharmacological extinction sounds logical, etc., but in my little corner of the world it was fantasy. I cannot reboot my brain to treat alcohol as I do a candy bar where I have one and don't even think twice about not having the second. I remember full well everything about alcohol especially what I enjoyed about it. Similar to noncompliance with antabuse users, I knew all along that all I needed to do was to stop taking nal and the buzz etc would come right back. After a couple of weeks on TSM, I started saying to myself, "I am drinking and not even enjoying it," but it wasnt because anything was being extinguished; it was because I was denying myself the fix.
I guess what I am saying is that I was too far down the road to go back. Maybe if I had tried a few years earlier, it would have been different, who knows.
Plus, I didnt want to drink anymore so being encouraged to drink and take the drug did not sit well with me. I did not want to take nal for the rest of my life and have to keep it on hand whenever I thought I was going to drink. Just get me off this merry-go-round already, ha. Abstinence is a better fit for me. The Sacred Flame Concept that keeps me steady is just knowing unequivocally that alcohol is simply something I cannot drink. I accept that; I dont debate it or judge it, etc. It's just how Nature designed me. I'm right handed too; I didnt have any say in that decision either, ha.
TSM has its proponents for sure and there's definitely evidence that suggests there's promise to it. I think it is oversold though as a quick and easy solution to a not so easy to solve problem. Regarding the rehab "industry" pushing back, like anything else there are two sides to every debate. TSM has its own rehab clinics called Contral which offer services similar to traditional rehab like counseling and behavior modification therapies so even they recognize that its not as simple as taking the pill an hour before drinking and voila.
I hope it works for you. The one piece of advice I offer is to simply be honest with yourself. Trust your instincts.