#993 - Katie Herzog - A Controversial New Cure for Alcohol Dependence
In this Modern Wisdom episode, Katie Herzog shares her personal experience with alcohol addiction, from its beginnings in middle school through her attempts at recovery using traditional methods like AA and therapy. She describes how drinking shifted from a euphoric, social activity to a solitary habit, while explaining how the normalization of heavy drinking in her social circles made it difficult to recognize and address the problem.
Herzog introduces the Sinclair Method, an alternative treatment approach that uses naltrexone to reduce alcohol cravings by blocking the pleasurable effects of drinking. She discusses why this treatment remains underutilized despite its effectiveness, pointing to factors such as limited addiction medicine education among doctors and pharmaceutical economics. The episode explores both personal and systemic aspects of alcohol addiction and treatment.
This is a preview of the Shortform summary of the Sep 13, 2025 episode of the Modern Wisdom
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Katie Herzog's Personal History With Alcohol Addiction
Katie Herzog shares her journey with alcohol addiction, which began in middle school and evolved throughout her life. She describes how drinking initially provided euphoric, energizing effects but gradually transformed into a solitary, depressive habit as she entered her late 30s and early 40s.
Despite recognizing her problematic drinking patterns in her early 20s, Herzog attempted various solutions, including AA and therapy, but couldn't maintain sobriety for more than 30 days. Her addiction led to serious consequences, including medical emergencies and nearly burning down an apartment, while also disrupting her education and employment.
The Culture and Social Dynamics Around Heavy Drinking
Herzog explains how drinking was deeply embedded in her social life, where it was celebrated and normalized within her friend groups. Her heavy drinking was often treated as humorous by her community, which made it harder to recognize its severity. When friends chose sobriety, Herzog felt personally betrayed, highlighting how integral drinking was to her social connections.
Treating Alcohol Addiction: The Sinclair Method
After traditional approaches failed, Herzog discovered the Sinclair Method, which involves taking [restricted term], an opioid antagonist, one hour before drinking. This method gradually decreased her alcohol cravings through pharmacological extinction by blocking alcohol's pleasurable effects.
Despite its effectiveness, Herzog notes that the Sinclair Method remains underutilized in medical practice. She attributes this to limited addiction medicine education for doctors, legal and ethical concerns, and economic factors, as [restricted term] is an inexpensive generic drug with little marketing incentive for pharmaceutical companies. Through her experience, Herzog advocates for more diverse and personalized treatment approaches beyond traditional abstinence-only methods.
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Actionables
- You can start a journal to track your drinking habits and their consequences to gain a clearer perspective on your relationship with alcohol. By documenting each drinking session, the emotions involved, and the aftermath, you'll create a personal record that can help you identify patterns and triggers. For example, if you notice that social events are a major trigger, you might decide to seek out alternative social activities that don't involve alcohol.
- Develop a support network of friends or online communities that encourage healthy habits. Connect with people who have similar goals of reducing alcohol consumption or maintaining sobriety. You could join forums, attend local meetups, or even start a small group with friends who are also interested in healthier lifestyles. This network can provide accountability, share strategies, and celebrate milestones together.
- Explore new hobbies or activities that provide a sense of fulfillment and joy without involving alcohol. This could be anything from sports, arts, volunteering, or learning a new skill. By filling your time with engaging and rewarding experiences, you reduce the void that might be filled by drinking. For instance, if you've always wanted to learn an instrument, schedule regular practice sessions during times you would typically drink.
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Katie Herzog's Personal History With Alcohol Addiction
Katie Herzog candidly shares her personal struggle with alcohol addiction, detailing its progression from her teenage years into adulthood and the disruptive impact it had on her life.
Herzog's Drinking in Teens, 20s, and 30s
Herzog began drinking in middle school and found the effects of alcohol pleasurable from the onset, before she even acquired a taste for wine or beer. As she progressed through high school and college, her drinking escalated. Post-college, Herzog viewed herself as a barfly, typically seen in bars socializing, often with older men.
Herzog's Drinking: From Euphoric and Social To Depressing and Isolating
Initially, her drinking experiences gave her a euphoric buzz, reminiscent of the effects of caffeine or cocaine, making her feel energized and talkative. During her earlier party days, she remembers making fun but questionable decisions like performing on stage while wearing a horsehead mask and pasties. However, the euphoria Herzog sought between her first and third drinks eventually turned into slowness and sloppiness by the fourth and fifth drink. Despite this, she continued chasing that initial high.
As she entered her late 30s and early 40s, Herzog found most of her drinking to be done alone and in secret. She narrates that alcohol had an increasingly domineering role over her life. Her friends either settled their lives or passed away, which led her drinking to evolve from a social activity into a depressive and solitary habit—finalizing in Herzog drinking alone at home.
Herzog Struggled With Drinking From a Young Age Despite Trying Aa and Therapy
Despite understanding from her early 20s that something was amiss with her drinking habits, Herzog tried to attribute her behaviors to anything but alcoholism. She sought explanations ranging from being bipolar, which a psychiatrist suggested, to astrology.
Herzog's Drinking Caused Incidents Like Burning a Porch, Isolating Her and Disrupting Her Life
Throughout the years, Herzog tried various approaches to manage her problematic relationship with alcohol, such as Alcoholics Anonymous (AA), therapy—both individual and group—and cognitive beh ...
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Katie Herzog's Personal History With Alcohol Addiction
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Actionables
- Create a personal timeline of your relationship with alcohol to identify patterns and triggers. Start by jotting down when you first started drinking and note any significant changes in your consumption over time. This can help you recognize when and why your drinking may have escalated, similar to how Herzog's did, and can be a tool for self-reflection or to discuss with a healthcare professional.
- Develop a "sobriety resume" to document your journey and accomplishments without alcohol. This can include personal achievements, improved relationships, or career stability that you've experienced during periods without drinking. It serves as a motivational record that highlights the positive aspects of sobriety, countering the euphoric recall that often accompanies addiction.
- Experiment with a "habit swap" strategy where you replace the ritual of drin ...
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The Culture and Social Dynamics Around Heavy Drinking
The social dynamics around heavy drinking reveal a complex relationship between alcohol consumption, friendship, and identity. Herzog and Williamson discuss the imbrication of these elements in one's social life.
Drinking Was a Rite of Passage and Badge of Honor in Herzog's Social Circles
Herzog examines how she was perceived as the life of the party, reflecting that her drinking was celebrated amongst her friends. Drinking and spending time in bars were standard practices among Herzog's friends and peers, and preventing fatal drinking incidents was seen by her peers as rites of passage and badges of honor. These behaviors were normalized within her social circles, with Herzog indicating that her lifestyle while drinking was considered standard in her upbringing.
Friends and Community Normalized and Laughed At Her Drinking, Masking Its Severity
Herzog's social circles found humor in her heavy drinking, including an instance where Herzog accidentally set her porch on fire while intoxicated. The normalization and hilarity found in such stories by Herzog's community helped mask the seriousness of her addiction and made it challenging for her to recognize the abnormality of such behavior.
For Herzog, Socializing and Bonding Over Drinks Made a Fulfilling Alcohol-Free Life Hard to Envision
Herzog discusses her judgmental attitude toward those who didn’t engage in heavy drinking, highlighting how deeply integrated into her social life drinking had become. It was a significant part of making and maintaining friendships and was seen as necessary for social interaction. Katie Herzog additionally emphasizes the loss of something valuable when socializing that typically involves drinki ...
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The Culture and Social Dynamics Around Heavy Drinking
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Counterarguments
- While drinking may have been normalized in Herzog's social circles, this is not the case in all social groups, and many people find healthy ways to socialize without alcohol.
- The perception of heavy drinking as a rite of passage or badge of honor is not universal and can be seen as a harmful stereotype that overlooks the negative consequences of alcohol abuse.
- Friends and community laughing at dangerous drinking behaviors might mask the severity of addiction, but it also reflects a potential lack of awareness or denial about the risks associated with heavy drinking.
- It is possible to have a fulfilling social life without alcohol, and many communities and social groups actively promote sober lifestyles.
- Drinking is not necessary for social interaction in all contexts, and there are diverse social circles where alcohol is not central to social ...
Actionables
- You can create a mocktail menu for your next social gathering to offer non-alcoholic options that still feel festive. By crafting a variety of appealing non-alcoholic drinks, you provide an inclusive environment for those who don't drink and subtly shift the focus from alcohol to the quality of the beverages. For example, serve a "Nojito" (a mojito without rum) or a "Berry Fizz" (mixed berries with sparkling water) to keep the party spirit alive without the need for alcohol.
- Start a new tradition with your friends that revolves around a shared interest or hobby rather than drinking. This could be a monthly book club, a hiking group, or a cooking club. By establishing a regular event that doesn't involve alcohol, you create new opportunities for bonding and socializing that don't rely on drinking culture. For instance, if you and your friends enjoy cooking, host a potluck where everyone brings a dish to share and the focus is on culinary creativity.
- Develop a personal reward system for social situations where you choose not to drink. Set goals for yourself, suc ...
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Treating Alcohol Addiction: The Sinclair Method
Katie Herzog discusses her journey with alcohol addiction and the unconventional path she took for treatment, utilizing what is known as the Sinclair Method, rather than traditional approaches like Alcoholics Anonymous (AA).
Traditional Approaches Like AA Didn't Work for Herzog Due to Spiritual Focus and Ignoring Her Desire to Drink
Herzog Attempted AA, Therapy, and Abstinence but Couldn't Achieve Sobriety
Herzog delves into her experience with AA, therapy, moderation management, and other traditional recovery methods, including attempting to quit drinking entirely. However, none of these methods worked for her, as they did not address her enjoyment of alcohol and the physical and emotional addiction associated with it. She found the spiritual aspect of AA and the focus on group dynamics challenging due to her skepticism and reluctance toward introspection.
Herzog explains that the only option she saw for herself was to quit drinking forever, which created a mental barrier for her. She knew she had to either face going to rehab and attending AA meetings or find another solution.
Sinclair Method: [restricted term] Before Drinking Extinguished Herzog's Alcohol Desire Over Months
Sinclair Method Blocks Opioid Receptors, Preventing Alcohol Addiction High
The Sinclair Method, which Herzog discovered after reading about it, involves taking [restricted term], an opioid antagonist, one hour before consuming alcohol. Over time, this practice helped Herzog gradually decrease her craving and consumption of alcohol through a process known as pharmacological extinction. The opioid antagonist blocks the pleasurable effects of alcohol, thus reducing the desire to drink. This method is based on experiments by John David Sinclair, which showed that it could reduce the tendency to drink alcohol in lab rats.
Herzog carefully followed the procedure, always taking her medication before her scheduled drinking days. She explains the importance of adhering strictly to the protocol for the method to work. She also touches on genetic factors, such as the presence of the allele ASP40 in the Mu opioid receptor, which may predict the efficacy of [restricted term] for individuals.
Sinclair Method: Effective yet Underutilized Treatment for Alcohol Use Disorder
Doctors Hesitate With Sinclair Method Due to Education, Legal, and Economic Concerns
Despite the Sinclair Method's efficacy for Herzog and others, it remains underutilized in medical practice. Historically, addiction medicine has receive ...
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Treating Alcohol Addiction: The Sinclair Method
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Counterarguments
- The efficacy of the Sinclair Method may not be as high in broader populations as it was for Herzog, given that individual responses to addiction treatments can vary widely.
- While the Sinclair Method worked for Herzog, it might not be suitable for everyone, especially those who cannot drink safely in any capacity.
- The spiritual aspect of AA, although not helpful for Herzog, can be a critical component of recovery for many individuals, providing a sense of community and support.
- Abstinence-based programs like AA have a long history of success for many individuals and can lead to long-term recovery.
- The idea that the Sinclair Method is underutilized due to economic concerns may overlook the complexity of addiction treatment and the multifaceted reasons why certain treatments are preferred over others.
- The criticism of the medical community's unfamiliarity with the Sinclair Method may not account for the growing interest in and adoption of medication-assisted treatments in recent years.
- The suggestion that genetic factors like the ASP40 allele may predict the efficacy of [restricted term] could oversimplify the complex nature of addiction and its treatment, which often involves a combination of genetic, environmental, and psychologi ...
Actionables
- You can explore your personal relationship with alcohol by keeping a journal that tracks your drinking habits and emotional states. Write down what you drink, when, and how you feel before, during, and after drinking to identify patterns and triggers. This self-awareness can be a first step in recognizing the role alcohol plays in your life and may help you understand your own enjoyment and emotional connections to drinking.
- Consider creating a support network that aligns with your beliefs and needs by reaching out to friends or online communities who share your approach to managing alcohol use. This network can offer a space to discuss your experiences with others who might be using or considering methods like the Sinclair Method, or who are open to non-traditional paths to sobriety.
- Educate yourself ...
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