Our program

Satzuma is a program designed to help people who have struggled with alcohol addiction for years and have not yet been able to manage their intake.

Addiction to alcohol usually has multiple simultaneous causes and each one will need to be treated individually. Because of this, we combine The Sinclair Method with a multi-pronged therapy in order to empower you with skills that will help you beat the addiction. When we have been relying on alcohol for many years, we need to retrain our brains so we don't continue drinking purely to keep dark feelings at bay.

Addiction is not a choice

We often hear that people suffering from AUD chose to drink and just like to get drunk and all they have to do is want to control or stop altogether. We assume that people drinking alcohol like the euphoric feelings of partying and the warmth they feel when they drink. Unfortunately, there is a critical difference between liking and craving. Even though we know full well we shouldn't give in, we do it against our better judgement. This has a name: Cognitive dissonance.

As we tend to prioritise immediate reward over long term goals, we find all kind of reasons why we could just have one drink now. But it's never just one. We delude ourselves with thoughts like "I'll stop tomorrow", or "this was a very stressful day, I really need a drink". And many other reasons. Cognitive dissonance is an important part of the Satzuma program and we explore it in more depth in the program. Cognitive dissonance is a complex brain mechanism and it takes time to rewire the brain and change neural pathways responsible for these maladaptive processes.

Instead of having a choice, sufferers of alcohol addiction become controlled by the alcohol and form unconscious habits linked to over consumption. It is an automated reaction, and in time the happiness and pleasurable emotions cease to exist. Yet the misuse continues.

AUD is not a choice and people quickly become controlled by alcohol and form unconscious habits linked to over consumption. It is an automated reaction, and in time the happiness and pleasurable emotions cease to exist. Yet the misuse continues...

The science of addiction

To understand the science of addiction, we first must understand (to some extent) the neurochemistry underpinning it. Emotions, learning, and memory are all rooted within the hippocampus which is a complex brain structure embedded deep in the temporal lobe and has a major role in learning and memory. Another part of the brain responsible for addiction is the amygdala (a region of the brain primarily associated with emotional processes).

The amygdala is involved in both the making and storing of memories, and even though it is a tiny part of the brain, it plays an important part in determining behaviour. Behaviour is a culmination of decisions that take form in the hippocampus and has a direct neural pathway to the nucleus accumbens. The nucleus accumbens is a crucial part of the reward circuit and works closely with mechanisms of pleasure within the ventral tegmental area. It connects the reasoning and planning processes with the seat of emotions through the control of dopamine.

What is TSM

The Satzuma program is primarily (but not only) based on TSM (The Sinclair Method) and offers an alternative to residential rehab, Alcoholics Anonymous and other methods based on the idea of total abstinence. We will not ask you to stop drinking alcohol during the program. In fact, TSM is based on the idea that it is only to be used when you drink alcohol.

The way alcohol interacts with the brain's neurochemistry is very complex. There are three main pathways that are used by alcohol which science has been able to establish, and those pathways directly relate to addiction.

The first pathway is the one targeted by the drug Naltrexone and it relates to the opioid receptors. In a nutshell, this is the group of receptors responsible (to some extent) of the euphoria we experience when we drink alcohol.

There are also two other main pathways used by alcohol that are also involved in alcohol dependency. The first one uses GABA receptors and the other one uses the Glutamate receptors. It is beyond the scope of the website to go into detail about this, but if you're interested, have a look at this simply explained Youtube video.

We also examine those pathways in the Satzuma program, and even though all of this is fairly complex, we will explore it in more detail when talking to you. Don't worry, the actual mechanism is simple to understand.

Jean-Charles Crave

The Satzuma program is run by Jean-Charles Crave. Jean-Charles is a specialist Social Worker who has been working in drug and alcohol for many years and was until recently a senior counsellor at the Alcohol and Drug Service of Tasmania and is currently working in Primary Health at THS.

Jean-Charles has been involved in mindfulness therapy for some time, working in the OPALL program with fellow clinician Michelle Nicholson. Mindfulness is one of the key co-treatments of TSM.

Satzuma is a program designed to help people who have struggled with alcohol addiction for years and have not yet been able to manage their intake.

For a very long time now, various methods have been designed to help us control our alcohol intake. The more traditional approach has been to offer people with an alcohol dependence, detox followed by a rehab program. This approach implies that they have to be totally abstinent, if not for ever, at least for the foreseeable future. Some medical alternatives have also been tried.

Antabuse

A famous one is Disulfiram (Antabuse). Disulfiram works by inhibiting an enzyme in the brain (acetaldehyde dehydrogenase), causing many of the effects of a bad hangover, but with the effect to be felt immediately after drinking alcohol. Disulfiram is not a cure for alcoholism per se, but the idea behind it to discourage you from drinking alcohol by making you feel sick. WE DO NOT support this idea, at all. Apart from bad side effects and some unwanted drug interaction, Disulfiram has not proved to be effective at all. We believe it could even be dangerous in some instance. (Feel free to check it for yourself. There is a great deal of information about Disulfiram on the internet from trusted medical websites).

Campral

Another one is Acamprosate (Campral) which must be taken three times a day. The way Campral seems to work is still unclear and more research is needed to understand how the medication can help with alcohol dependence. Campral seems to help reduce cravings by reducing the positive response to drinking alcohol and by reducing cravings. However, Campral does not help relieve symptoms of alcohol withdrawal, and ongoing medical reviews are, as for any medication, very important.

Naltrexone

Finally, Naltrexone. Naltrexone is an opioid antagonist and works by blocking some of the receptors in the brain from responding to endorphins created by the consumption of alcohol. Traditionally, Naltrexone was given to patients as a medication that needed to be taken once a day.

The idea behind it was that Naltrexone would help people reduce their cravings for alcohol. The efficacy was never great. Eventually Doctor Sinclair’s research in Finland and in the US helped changed the way Naltrexone could be used. In TSM, instead of one a day, Naltrexone is to be taken one hour before a first drink. The way the medication works is by preventing receptors in the brain from receiving messages from endorphins created by alcohol. This results in stopping the feelings of euphoria associated with alcohol. And if no alcohol is to be drunk, then the medication would also not be used.

Satzuma is a Medication-assisted therapy (MAT) program

Medication Assisted Treatment (MAT) is a holistic treatment that uses medication in combination with counseling and education based therapies, which is the most effective treatment of Alcohol Use Disorder (AUD). Not only will MAT help people recover from AUD, it will also help them sustain their recovery into the future.

Even though many experts in addiction believe that people with moderate or severe alcohol related problems would benefit from a Medication Assisted Treatment on a routine basis, some resistance to the use of MAT persists in the medical community, mainly due to the fact that most GPs have so little time to work with a client suffering from addiction. They often think that a psychologist is better placed to help.

A diagnosis of Alcohol Use Disorder carries significant social exclusion, which affects both the individual who receives the diagnosis and the health care professionals to whom that individual may turn for care. In part, the social exclusion continues because of a lack of understanding of AUD as a treatable medical disorder.

The Sinclair Method is the most common, evidence based MAT for AUD there is and has been used very successfully in Europe and the US for well over ten years.

Need more info?

If you have any questions regarding our program, please email Jean-Charles