U.K. Addiction Treatment Plan For 'Mild Alcoholics' Sparks Debate

By McCarton Ackerman 10/03/14

Almost a million people in the UK will be eligible for nalmefene.

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A new addiction treatment drug designed for “mild alcoholics” will be available under plans from one of Britain’s national health watchdogs, but it has raised concerns from some health experts about whether medicating large numbers of people is the correct approach.

The National Institute for Health and Care Excellence will make roughly 750,000 people in the UK eligible to be prescribed nalmefene in order to reduce their alcohol consumption. Mild alcoholism, in this case, is being defined as those who drink a half bottle of wine or three pints of beer per night. Funding for this new plan will be available in the next three months. It’s expected to cost roughly $460 million per year, but is estimated to save around 370 lives each year and prevent 8,600 alcohol-related diseases and injuries over the same period.

Nalmefene costs just under $5 per tablet and is designed to be used when people feel the urge to drink, ultimately stopping them from wanting more than one beverage. However, qualifying for treatment with the drug does carry some restrictions. Severe alcoholics or those who are deemed able to either reduce their alcohol consumption or remove it completely will not be eligible for treatment.

"Although for many people dependent on alcohol, abstinence is the preferred and optimal goal, nalmefene represents an alternative step, helping people to cut down drinking to less harmful levels when they are not ready and have no medical need to give up alcohol altogether,” said Professor Jonathan Chick, a consultant psychiatrist and honorary professor at Queen Margaret University Hospital Edinburgh. "This may help us to engage many alcohol dependent patients that we know are not currently receiving help.”

In clinical trials the drug helped people to cut their alcohol consumption by about 60%, from the equivalent of 5.5 pints of beer per day to just two pints. But Professor Mark Bellis, alcohol lead for the Faculty of Public Health, said the reductions were modest when compared with counseling alone and it’s still unclear whether the reduced alcohol consumption is maintained over time. He believes that the government funding to treat alcoholism could be used more effectively.

"There are plenty of ways that don't require prescribing and the additional pressures on the NHS that could reduce harmful drinking,” said Bellis. "We need to think very carefully about how we use limited resources and prescribe for people who with relatively simple population interventions such as reducing advertising and minimum unit price could quite easily reduce alcohol consumption to safer levels."

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McCarton Ackerman is a freelance writer and editor living in Portland, Oregon. He has been a contributor for The Fix since October 2011, writing on a wide range of topics ranging from medical marijuana in Colorado to the world's sexiest drug smugglers. Follow him on Linkedin and Twitter.