Tag: Addiction Medicine

Where can I find The Sinclair Method Doctors?


24 April 2020

Hi, thank you for coming back for the latest edition of Beyond Primary Cares blog; where can I find The Sinclair Method Doctors. In my blogs I highlight healthy and fun recipes, healthcare news, advice for medical conditions, as well as how membership for care works! Dr. Jeff O’Boyle is the owner of Beyond Primary Care, which is an insurance free, membership based family medicine and addiction medicine clinic. Beyond Primary Care is the only Direct Primary Care clinic serving patients in Ann Arbor, Ypsilanti, Saline, Dexter and the rest of Washtenaw county that offers virtually unlimited office visits, wholesale medications dispensed from the clinic, and wholesale blood work completed at the time of visit.

The primary purpose of the blog is to introduce healthy lifestyle concepts and answer common questions I receive from patients that I believe are important. I want to start discussions that will help educate, benefit, and improve your well-being. 

In this blog post, I wanted to answer a common question, where can I find The Sinclair Method Doctors?

What is The Sinclair Method?

According to the C3 foundation, the Sinclair Method (TSM) is a treatment for alcohol addiction that use a technique called pharmacological extinction- the use of an opiate blocker to ‘turn habit-forming behaviors into habit-erasing behaviors.’ The effect returns a person’s cravings for alcohol to its pre-addiction state. The Sinclair Method is named for the researcher, John Sinclair, Ph.D, who first developed it and helped it gain momentum, most notably in Europe. The Sinclair Method utilizes taking a medication,  Naltrexone, prior to drinking alcohol- which for some people may be everyday.

In America, many physicians have a very narrow ‘one size fits all’ approach to substance abuse, in that a person needs to totally quit the drug in order to be considered successful. While good natured and in some cases necessary, this maxim is dangerous when applied to every person. Instead, the American term for what The Sinclair Method accomplishes is better known as ‘harm reduction.’ As comparison, the idea being 5 cigarettes is better than 20 cigarettes if you refuse to quit smoking. Still not a great habit, but long term there is less harm from a quarter pack than a full pack. 

How does Naltrexone Work?

Naltrexone competes with other drugs for opioid receptors in the brain. 

Wait right there! 

This is a blog about alcohol treatment, why would we consider a medication that is meant for pain pills? 

Multiple bodies of evidence such as this, this, here too, suggest alcohol reinforcement mechanisms – what we call cravings- involve activation of our endogenous opioid system. Alcohol binds to and alters functioning of opioid signaling receptors. Originally use to treat opioid dependence, Naltrexone is also FDA approved for the treatment of alcohol dependence. 

Will Naltrexone Work For You?

As a board certified addiction doctor, I see hear the different stories all the time. As example:

  • The young executive who drinks too much at the end of the day
  • The liquor distribution salesman where drinks are a part of the job
  • The 67 year old grandmother drinking a case of beer a day and her family has no idea

You may of scoured every internet article for information that looked informed and accessible. In fringe support groups there are people enthusing about elixirs and ‘ten-day’ fixes. In ‘recovery’ websites you may feel like a marketing person’s dream- marginally desperate: open to attempt anything.

When you feel vulnerable trying to make sense of the treatments, take some confidence that Naltrexone is a very real possibility for changing your life for the better. 

Naltrexone is a great medication for a lot of reasons. It’s a generic medication- so it is affordable. It is not habit forming nor a drug of abuse. It’s side effect profile is comparable to many other medications, and are typically mild and short in duration. As long a you start it under the guidance of a trained physician, you will likely not discontinue for tolerance reasons. It has little impact on other medications. 

It is also important to know that taking Naltrexone alone does not guarantee success nor any successes will be long term. What improves the chances of success and duration of success? Follow-up with an addiction-trained physician and counseling with a certified therapist who has a substance abuse background are huge starts. From there, we can guide you on sleep health, journaling, support group meetings, exercise, diet, dealing with set-backs, and importantly- recognizing successes. 

Where to find The Sinclair Method Doctors

You can always click through TSM website and look for providers that way. In addition to being a board certified family medicine doctor, I am also a board certified addiction doctor and have been utilizing The Sinclair Method for years. At my clinic Beyond Primary Care in Ann Arbor, Michigan, I use an eclectic and personalized approach- not a ‘cookie cutter’ conversation- towards accessing and resolving your life changes and stressors. In addition to a thorough health history, I am  going to ask about your family, where your quality of life is being most affected, and—most importantly—what you want to do.


If you think some of what you may be experiencing may be due to excessive alcohol consumption, or if you notice any coworkers, friends, or family members silently struggling, send them a link to this post so that they can join the conversation!

You can also contact Dr. O’Boyle directly. I look forward to hearing from you!

Tortellini Pasta Salad


15 June 2019

Hi, thank you for coming back for the latest edition of Beyond Primary Cares blog; where I highlight healthy and fun recipes, healthcare news, advice for medical conditions, as well as how membership for care works! Dr. Jeff O’Boyle is the owner of Beyond Primary Care, which is a new approach to family medicine and addiction medicine that creates the time and space your healthcare deserves. Beyond Primary Care serves patients in Ann Arbor and throughout Washtenaw, Livingston, and Wayne County.

The primary purpose of the blog is to introduce healthy lifestyle concepts and answer common questions I receive from patients that I believe are important. I want to start discussions that will help educate, benefit, and improve your well-being. 

This featured recipe is Tortellini Pasta Salad. These recipes are my attempt, in a way, to bridge that Doctor’s adage of “Eat Better & Exercise More.” In this post, I will showcase a healthy meal made on a budget, my pictures are pretty decent, and that is how I got into this food endeavor.

Tortellini Pasta Salad

Prep Time: 20 minutes
Total Time: 1 hr
Serves: 4


– 1 package tortellini, cooked per package instructions
– 4 carrots, sliced thin
– 2 cups Edamame
– 1 (6 oz) jar, Roasted Red Peppers
– 12 oz thick cut salami, diced
– 2 tbsp apple cider vinegar
– 3 oz honey goat cheese, crumbled


1) Add all ingredients to a bowl and allow to sit for at least 30 minutes before dividing and serving.

Neurontin, Gabapentin, Controlled Substance

Gabapentin as a Controlled Substance


10 January 2019

This past Monday, 1/7/18, the state of Michigan classified Gabapentin (brand name Neurontin) as a controlled substance (C V) as it has been increasingly been reported abused by some patients.

Gabapentin is approved by the Food and Drug Administration (FDA) to treat epilepsy and neuropathic pain caused by shingles. That is it! However, as many people already recognize it is prescribed ‘off label’ by health care providers for various reasons including including depression, anxiety, migraine, fibromyalgia, muscle and joint pain, and bipolar disorder. According to some estimates, over 90% of Neurontin sales are for off-label uses. A report by IMS health found that 57 million prescriptions for Gabapentin were written in the U.S. in 2015, a 42% increase since 2011.

Many providers, including myself, have never screened for Gabapentin abuse in the past as this medication is not tracked by the state’s controlled substance tracking system nor is it typically detectable in most office-based urine drug screens. When Gabapentin is taken alone there is little potential for abuse. Yet, when taken with other drugs, such as opioids, muscle relaxants, and other anxiety medications, there are reports that Gabapentin can have a euphoric effect.

While I see the concern for making Gabapentin a controlled substance in Michigan, it is going to be a tremendous headache for everyone. The community, hospitals, treatment facilities, and doctor offices.

Isn’t it ironic that Michigan is locking up Gabapentin (which IS affordable and has good application when used appropriately) but legalizing marijuana?

It will eventually be easier for people to smoke a joint then get Gabapentin.

Currently, a month supply at Beyond Primary Care for 300 mg (90 pills) is $4.59. The street value for Gabapentin just went up because of this classification and that makes me concerned. Hell, the CDC lists Gabapentin as a non-opioid alternative treatment for pain control. This move by the State of Michigan makes my job as a physician, patient advocate, and provider certified in chronic pain management increasingly harder to deliver affordable and effective treatment to my patients.

Avoiding Resignation with Addiction


30 October 2018

As an addiction specialist offering addiction services, I have yet to meet a patient who enjoys being addicted to drugs. Addiction is a chronic illness around which is a great deal of confusion, few people know what to do. Faced with someone who appears to be driving heedlessly into the abyss, families often fight, freeze or flee, unable to figure out how to help.


Consider the opioid epidemic. This month, this news organization estimated that more than 300,000 Americans will die of drug overdoses in the next five years. Why are health professionals and the government not acting on this knowledge? Tradition? Prejudice? Utmost stupidity? The answer is sometimes all three.


Often times we scroll the sidebar reading about the passing of great actors and celebrities, such as Philip Seymour Hoffman, Heath Ledger, Michael Jackson, and Prince. But what about those who stray off course closer to home, who don’t get the huge publicity? The suburban middle-aged man, who is a credible business man and decorated community leader but passed from pancreatitis due to chronic alcohol use. Or the aspiring young woman who quietly finished her first marathon and worked unglamorously towards saving for her first house, but OD’d on heroin.


I can assure you that there is no as yet undiscovered riddle to these people, the disease of addiction recognizes none of these distinctions. It is indiscriminate, it is sad, it is irrational, and it is hard to understand. But what we should articulate, as I have outlined in this youtube video explaining my treatment of addiction, is that these deaths are unnecessary and something should be done. Fortunately, our brains are remarkably plastic. I know it is far easier said than done, but there is a way to find control and life without drugs. For those brave enough to share, recovery stories such as this are incredible and worth every effort.