The “Messer Method” for Alcohol Abuse Disorder
Richard was a master of the universe-type. He went to Wharton, had 3 children at Ivy League Schools, ran a large hedge fund and lived in Greenwich. He played golf on the weekends and ate 3 healthy meals per day. There was just one issue. He had gained 90 pounds since the 1990s in the setting of drinking 6-7 drinks per day. He already had 1 DUI under his belt, and his marriage was on shaky ground. He had tried to address his alcohol abuse disorder on multiple occasions: he went to a yearlong class on alcoholism, saw a psychologist for cognitive behavioral therapy and joined AA. All to no avail. When I met him in March 2023, he had hit rock bottom and was willing to try anything.
At our first visit, I started him on a combination of weekly Mounjaro and daily naltrexone ( ~ 30 minutes prior to starting to drink each evening).
Here is feedback after two weeks:
Hi …some feedback after week two..the naltrexone works great and is strong ….small dose for me effective ...I haven't wanted to drink and when I do I cant finish a glass over 2 hours …went from 25 drinks a week to about 4 ...don't notice other side affects ...sleeping better too
Here is feedback after 6 weeks:
Hi doctor ...some more feedback ..on week 6-7 and all going well...drinking very little alcohol and still on half tab of Naltrexone ...that works well and have no side effects ...the Mounjaro works well too. I do get hungry after a few days pass of shot but still don't crave sugar or bad snacks ...weight down 21 pounds since started …292 to 271
And finally, after 8 weeks:
Hi, looking at my last text to you I see the progress ...been incredible ...now down 35 pounds and at 254 …continue to feel excellent with plenty of energy …want to exercise more ...and no temptation to eat or drink unhealthy stuff ...I think the half dose of naltrexone still fine as it works very well. I'm very happy this has surprised my expectations on how fast it's worked and I don't feel any side affects
Mounjaro is a medication that contains two hormones, GLP-1 and GIP, that are naturally produced by our bodies after meals. Scientists have recently learned that the GLP-1 system contributes to the feedback loop of addictive behaviors. Increasing synthetic GLP-1 appears, through medications like Mounjaro, to minimize drinking by limiting alcohol’s ability to upregulate the brain’s production of dopamine. Similarly, naltrexone blocks opioid receptors in the brain, which leads to a reduction of dopamine levels. This reduces the feeling of pleasure associated with alcoholic drinks and decreases cravings for alcohol during times of abstinence. While neither medication is currently FDA approved for alcohol abuse disorder, in my own practice, to date I have achieved a 100% success rate with this combination. While there is a clear role for counseling and support groups, I believe that medications should become standard of care of alcohol abuse disorders.
