Drug recommended to help cut drink dependence

The pill reduces the urge to drink alcohol

A pill designed to reduce alcohol consumption among problem drinkers looks set to be made available to NHS patients in England and Wales.

Nalmefene should be made available to people who regularly drink high amounts of alcohol, the National Institute for Health and Care Excellence (NICE) said.

Costing just over £3 a tablet, it is already prescribed in Scotland.

Final guidance is set to be published next month and NICE says 600,000 people would be eligible for the drug.

Serious issue

Nalmefene, which is also called Selincro, is taken as a tablet once a day and reduces the urge to drink alcohol. The drug is licensed for use along with psychosocial support.

If it receives final approval, it will be made available on the NHS in England and Wales. Northern Ireland will review this final guidance before making a decision.

Prof Carole Longson, NICE Health Technology Evaluation Centre director, said alcohol dependence was a serious issue for many people.

"Those who could be prescribed nalmefene have already taken the first big steps by visiting their doctor, engaging with support services and taking part in therapy programmes," she said.

"We are pleased to be able to recommend the use of namelfene to support people further in their efforts to fight alcohol dependence.

"When used alongside psychosocial support nalmefene is clinically and cost effective for the NHS compared with psychosocial support alone."

The World Health Organization defines high alcohol consumption as drinking more than 7.5 units per day for men and more than 5 units per day for women.

For men, that is three pints of beer or cider at 5% strength. For women, two pints of similar strength alcohol would put them into the high consumption category.

'Motivated to change'

However, Dr Niamh Fitzgerald, Lecturer in Alcohol Studies at the University of Stirling, said there were reasons to be concerned about what the introduction of nalmefene would mean in practice.

"The fact that alcohol problems are widespread in society is an important principle for effective policy options such as minimum unit pricing and restrictions on marketing of alcohol," she said.

"It would be unfortunate if the availability of nalmefene led to a sense that the appropriate response to these widespread problems was for the NHS to medicate large numbers of people, rather than initiating these other more effective and less costly approaches to reduce consumption."

Prof Matt Field, Professor of Addiction at Liverpool University, said the effectiveness of nalmefene was controversial.

"All of the clinical trial data are from people who were motivated to reduce their drinking," he said.

"It simply hasn't been tested on people who are not interested in reducing their alcohol consumption and most clinicians believe that no treatment can be effective unless people are motivated to change."