Hi Vicky, I have been on low dose Naltrexone for about 70 days. Last month I started on 3 mg at night instead of the 4 mg. It is the fast-ating kind. Slow release won't work. Neither will anything above 4.5 mg. I am still happy with the results. Chronic fatigue and all day pain is gone! I don't need Ultram, trazodone, or Neurontin at all anymore. I still take Restoril at night. I can take any other med such as Lotril for high blood pressure and my Synthroid. I can take Baclofen for mild muscle spasms but don't need to take that or Norflex very often. Sometimes I take a plain old 325 mg of aspirin or if I feel soreness. (I cannot take any opioids but don't even want to.) It does raise the immune systems ability to get back on tract. It also brings up the endorphine hormones for natural pain relief. In all of my twenty years of suffering with back and neck pain, DDD, and spinal spurs, this is the best and most natural pain relief I have ever had. I won't have to progress to Oxycontin or a morphine. I am able to walk more and longer every day. You wanted an update and this is it. How are you doing?