How is Say When different from most treatment programs?

   Alcohol use treatment in the US has historically been almost exclusively abstinence-based, while Say When incorporates a harm-reduction model that supports moderation.

Is Say When a substitute for 12-Step programs?

   While some people who have experienced drinking problems may benefit from a harm-reduction approach like Say When, abstinence-based resources are more appropriate for individuals who have suffered more severe and longstanding consequences from alcohol use.  

How do I know if I am a candidate for Say When?

   Say When is an option for people who may carry genetic risk for alcohol use disorder but have not experienced the most damaging consequences of excessive drinking, while maintaining resources that support moderation. 

Can I choose moderation or abstinence in Say When?

   Many people who use Naltrexone in response to their alcohol use disorder have the intention of learning moderation in their drinking, but it is also the case that some individuals have a different experience in the Say When program, leading them to choose abstinence as a long-term goal. 

What is Naltrexone?

Naltrexone is a prescription medication classified as an opioid antagonist, which attaches to and blocks the brain's opioid receptors, preventing opioids or natural endorphins released by alcohol use from binding.  By blocking these receptors, it diminishes the euphoric and rewarding sensations of alcohol, which helps reduce cravings. Naltrexone does not cause physical or mental dependence and will not produce any opioid-like effects.  (https://www.mayoclinic.org/drugs-supplements/naltrexone-oral-route/description/drg-20068408) 

What is harm reduction?

Harm reduction is an approach to education, prevention and treatment that acknowledges autonomy for adults in their decisions about substance use, while assisting them in reducing risk.

How is “moderation” defined?

While the National Institute for Alcohol Abuse and Alcoholism (NIAAA) has published suggested limits for healthy drinking, Say When utilizes a more individualized approach to moderation, emphasizing optimal functioning in the important areas of a person’s life, as they experience the positive aspects of limited alcohol use while avoiding the consequences of overindulgence.   

What does the Say When program include?

Following a thorough clinical assessment to determine appropriateness for moderation-based treatment, candidates are enrolled in the 90-day Say When program or referred to a different level of care, if needed.

During the first 30 days of Say When (known as the Reset Phase), clients are supported in abstinence from alcohol, to break old patterns of use and increase the likelihood of new ones.

Continuing through the Moderation Phase, participants learn to monitor and manage their physical and emotional relationship with alcohol, with weekly individual, group and family sessions combining education, practice and informed use of Naltrexone.     

At any time during the 90-day Say When program, a client or their individual therapist may realize that they are not well-suited for moderation-based treatment, and they will be refunded the balance of their fee and referred to a different level of care.