NICE pill for heavy drinkers

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A drug that helps to reduce the craving for alcohol in heavy drinkers has been recommended by the National Institute for Health and Care Excellence (NICE). 

Nalmefene has a UK marketing authorisation for the ‘reduction of alcohol consumption in adult patients with alcohol dependence’, but who do not have physical withdrawal symptoms or require immediate detoxification. The drug – also known by its trade name Selincro – is licensed for use alongside psychosocial support to help people reduce their alcohol intake and ‘give them the encouragement they need to continue with their treatment’. 

In a new draft guidance document, NICE says that the drug should be available ‘as an option’ to regular heavy drinkers, with almost 600,000 people eligible for the treatment. It should only be used with patients who still have a high drinking risk level two weeks after initial assessment, says NICE. Final guidance is expected towards the end of the year. 

‘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,’ said health technology evaluation centre director at NICE, Professor Carole Longson. ‘We are pleased to be able to recommend the use of nalmefene 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 Faculty of Public Health, however, said that while medication was ‘one route’, there were also ‘relatively simple alternatives’ such as tougher alcohol advertising restrictions and minimum unit pricing. ‘While it is up to each of us to look after our health, government has a responsibility to take action on everyone’s behalf when lives can be saved,’ said the faculty’s alcohol lead, Professor Mark Bellis. ‘That’s why public health professionals have long been calling for a minimum unit price for alcohol.

‘We need to think very carefully about how we use limited NHS resources,’ he continued. ‘Prescribing nalmefene will increase pressure on the NHS when there are alternatives that would reduce pressure on health services by cutting alcohol consumption. There are always side effects from medication and we don’t know yet what the long-term impact will be. That’s why we need a clear commitment from government to minimum unit pricing.’

Alcohol dependence – nalmefene, draft guidance document at www.nice.org.uk