Since I have been in an online debate with someone who claims AA doesn't work and advocates the Sinclair Method, I should go over the newer medication assisted therapies.
The Sinclair Method is simply suggesting to use the medication Naltrexone along with engaging in moderate drinking. There have been studies showing that people can more easily moderately drink when taking Naltrexone, but the effect has also been described as being modest.
The Sinclair Method has the same problem all other moderation methods have: Yes, it shows some, albeit modest, level of short term success, but we do not have long term studies. Short-term studies advocating moderate drinking are unreliable; long term follow ups show the "moderate" drinkers drinking heavily again. Until we have a 10-year follow up study showing people still using Naltrexone to moderate their drinking, or being able to abstain from drinking altogether after using Naltrexone for a while, I am very skeptical. We have had too many people die deceiving themselves with "moderate drinking" approaches; I have not seen evidence that Naltrexone is a silver bullet that will change things.
Naltrexone is not an effective therapy for people who want to abstain; there are two studies showing this drug has little to no effect when the patient pursues abstinence.
Acamprosate, on the other hand, seems to work better when the goal is abstinence. The effect is "small but significant", but it may help alcoholics achieve abstinence when used with other therapies.
I think, when used with the 12 steps and regular Alcoholics Anonymous, Acamprosate may be a helpful drug for achieving long-term sobriety. Bill Wilson had no objection to the use of medications to successfully work the AA program. That said, while the effect for both drugs is there, it's small.
