Can you drink your way sober?

US journalist and podcaster Katie Herzog tried everything to address her alcohol use disorder: quitting cold turkey, 12-step programmes, sheer willpower. But nothing stuck.

Then she discovered a science-backed approach that didn't demand total abstinence from alcohol but used medication to quiet cravings and restore control.

Her new book explores how this unconventional path helped her finally make peace with drinking - Drink Your Way Sober: The Science-Based Method to Break Free from Alcohol.

"At its worst it was bad," Herzog told RNZ's Afternoons.

"It vacillated though, over the years, so sometimes it really interfered with my life and I had all the typical drunken debauchery stories. I was in the hospital twice. I lost jobs, relationships.

"I was broke, spent what little money I had on alcohol - all that kind of stuff."

And other times, Herzog managed to function around the drinking.

"Some periods I had good relationships and was able to work and things like that and some periods I dove head first into it and let drinking really take over my life."

For Herzog, the defining feature of her addiction was the effect on her mental health.

"It was this all-consuming obsession with alcohol, this compulsion to drink. And so even in periods of sobriety, which were relatively short throughout my life until I finally found what worked for me, I never stopped thinking about drinking."

That was the hardest part, she says.

"I think that the obsession was rooted in the drinking itself.

"A lot of people have this belief that alcoholics and drug addicts have some sort of spiritual hole inside of them - something that they were trying to fill. I just don't think that that was my experience."

Instead, Herzog - with a genetic pre-disposition to alcohol abuse - began drinking as a young teenager and drank a lot.

"So for me really I think my addiction was a learned behaviour, perhaps a maladaptive coping mechanism.

"I drank, I loved it and I did it so much I drank myself into addiction."

Before Herzog figured this out, her attempts to establish why her life was such a mess led to a misdiagnosis of bipolar disorder for which she took mood-stabilising medication.

"At the time I would rather have been bipolar than to be an alcoholic because if I was an alcoholic then I would have to quit drinking.

"I found every excuse. I blamed everything but the drinking."

She blamed her Irish heritage, that she is a Gemini - even though she’s a Taurus - and anything she could so that she wouldn't have to admit to being an alcoholic.

"I wanted anything to be the problem besides just the fact that I drank too much."

When friends quit drinking Herzog took it personally because it was a reminder being sober was achievable, something she didn't think was possible for her.

For years she woke up every morning telling herself she wouldn't drink that day, only to drink later that day.

Herzog said she hit many "rock bottoms".

Once, after riding her bike home drunk from a bar and crashing, she gave a false name in hospital because she didn't have health insurance, and then discharged herself when no-one was looking.

Later, her story was validated by other heavy drinkers as being funny when she told them she woken up at home wearing a hospital wrist-band in someone else’s name.

She judged sober people harshly: "I didn't understand how anybody could have a life worth living if they didn't drink".

One of the biggest barriers to quitting drinking for Herzog was the thought of abstaining from alcohol for the rest of her life.

"I could not imagine my life without alcohol. It was such an integral part of my life it would be like not having food or water - but worse."

Part of the reason for Herzog's inability to view life without alcohol was because of her complete love of drinking and the euphoria that came with it.

"For me alcohol is an energising drug. It doesn't chill me out, it brings me up. It peps me up, it makes me talkative, more fun than I ever am sober - it's a fun high.

"In the first or second drink I get this high, euphoria, rush, that would slowly dissipate, so I would drink more to recapture that buzz."

It made the Sinclair Method perfect for Herzog.

A technique attributed to researcher Dr John Sinclair, the method uses opioid blocker naltrexone in a pill form taken an hour before drinking alcohol.

The idea is that the medication blocks the typical buzz a person can get from drinking and thereby limits their desire to drink.

"And so, Dr Sinclair's theory was that after repeated use if every time that you drink alcohol the brain is blocked from getting that euphoric high, people will stop craving alcohol and that's what I did."

It took about seven months of actively taking the drug every time she drank.

"It cut out that immediate desire for more and also made me feel down, low energy, little depressed.

"I didn't just stop craving alcohol, I stopped thinking about alcohol. It's been three years since I last had a drink."

She said naltrexone cut out the "booze noise" and now she can go to bars, or events with people drinking around her and she never craves it.

Herzog began taking naltrexone in her late 30s and admits life was "boring" after it but she says she wouldn't swap the superficial highs for the genuine joy she experiences now.

She says it doesn’t work for about a quarter of the population, who might drink for relief or sedation rather than binge drinkers who consumed alcohol to get energy.

These days Herzog has a happy life.

"My life is fantastic now. I live out in the woods. I have land. I spend a lot of time chopping wood now. I have a very good dog. I have a good marriage. I have a really good job.

"I don't have the high highs I got from drinking but I also don't have the low lows."

But she says naltrexone is only half the answer and there are other changes that need to be made such as to habits and lifestyle.

"That's why I wrote the book."

Herzog says writing the book was hard because she'd kept her alcoholism hidden for so long due to shame and stigma.

"I didn't want to attach my name to it. I was really ashamed of my addiction. It took me a couple years to tell anybody about this, friends, family even my spouse."

In the end she knew she had to help others, because the method was so life-changing for her, she couldn't not tell people.

"I'm sure this saved my life."