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Pill That Reduces Desire to Drink Approved in U.K.

Posted in Relapse Prevention

Pill That Reduces Desire to Drink Approved in U.K.A medication has recently been approved in the U.K. that aims to help problem drinkers cut down on their alcohol use. However, the medicine—called nalmefene—is approved only for moderate drinking problems (rather than extreme issues) and is recommend by its backers for men who drink three pints of beer on a daily basis and women who drink two large glasses of wine each day. 

Nalmefene is a drug that acts on opioid receptors, preventing the activation of two types of receptors and mildly activating another type. The drug is designed to be taken “as needed,” but only once a day at most. It costs about $5 per pill, and has been likened to nicotine patches for smokers. The drug is also designed to be used alongside psychological support.

Formal Guidance on Nalmefene

The British National Institute for Health and Care Excellence (NICE) has recommended the use of nalmefene as a possible treatment for alcohol dependence in specific circumstances.

An example of the sort of person the drug would benefit is described by Lundbeck, the drug’s manufacturer, as a 39-year-old woman who “looks forward to a glass of wine after work when the kids go to bed but always finishes the bottle while cooking and eating with her husband, and opens a second bottle a few days each week.”

Evidence for the Effectiveness of Nalmefene

There are three randomized controlled trials that have been conducted to investigate the impact of the drug in adults with alcohol dependence. These compared the outcomes of those who used the drug (on an as-needed basis) alongside psychological support compared to those who used a placebo combined with the same support. The results showed a reduction in both heavy drinking days and total alcohol consumption for those taking the drug, but the size of the changes was fairly limited (13 percent and 11 percent, respectively), indicating that the psychological support may be the crucial factor.

The differences between groups were judged to be clinically significant, but the NICE committee noted that the studies didn’t compare the drug with naltrexone, a similar medicine. In effect, the studies showed that the treatment is better than nothing (a sugar pill), but this is obviously a limited benefit since other available medications are also better than a placebo. Additionally, a couple of the studies excluded people who had severe psychiatric conditions, so there is a chance that the drug is less effective in these circumstances.

A New Vital Tool in Reducing Alcoholism?

Although any medication that may help people reduce the amount they drink has the potential to be a valuable tool in reducing the number of alcohol-related deaths, there is more than enough reason to be skeptical about the impact nalmefene is going to have. The evidence for its effectiveness is limited and may be largely dependent on the sort of psychological support that has been the mainstay of addiction treatment for decades. Considering this in combination with the low uptake in initial prescribing areas and the fact that the most extreme cases aren’t in the drug’s target user group, it’s clear the potential of this drug—if it exists—is far from being realized.