Institute recommends brief counselling and as-needed nalmefene to help people with alcohol dependence

October 6, 2014

The drug nalmefene, which can help people dependent on alcohol cut down on the amount they drink, has been recommended in final draft guidance by the National Institute for Health and Care Excellence (NICE).

Over 1.5 million people in the UK have alcohol dependence and over 600,000 people are at risk of liver disease haemorrhagic stroke and as a result of their drinking. It is this higher risk group (more than 7.5 units per day for men and 5 units a day for women) who will be eligible for the treatment with basic counselling and drug treatment if needed.

This recommendation follows results of three large clinical trials; ESENSE 1, ESENSE 2 and SENSE (Safety and Efficacy of Nalmefene in Patients With Alcohol Dependence). The first two studies took place over 6 months and SENSE involved 13 months of follow-up. Queen Mary University of London's William Harvey Research Institute, in partnership with Barts Health NHS Trust, was the biggest UK centre involved in the trial, with 31 patients under the care of Dr David Collier, Dr Manish and Dr Julian Shiel.

Dr David Collier, who led the study at Queen Mary University of London, comments: "We wholeheartedly welcome the new guidelines from NICE. The SENSE trial was challenging but we saw great rewards from treatment through use of nalmefene as needed by the patient, and simple counselling. Patients began to improve quickly, looking noticeably healthier and happier."

Nalmefene is taken as a tablet once a day on an as-needed basis and reduces the urge to drink. The drug is licensed for use alongside counselling to help people reduce their and help them stay motivated to continue with their treatment.

Nalmefene is believed to work by altering the 'reward' mechanisms in the brain, and unlike other drugs for alcohol dependence, it does not make you sick if you drink, or stop you getting intoxicated. Patients reduced their by 61% in the trials at 6 months – an average of 28 bottles of wine a month each.

NICE believes prescribing nalmefene alongside counselling is clinically and cost effective for the NHS compared with counselling alone. It is hoped the new guidelines will prevent over 300 deaths per 100,000 patients treated over a 5 year period. Patients usually only need the drug for a few months and keep a few in reserve once they, and their doctor, are happier with their drinking level.

Dr Collier concludes: "Alcohol dependence is a serious issue, and sadly it remains stigmatised which can discourage people from seeking help. Over time, consistent unhealthy drinking may lead to physiological changes in parts of the brain that control what is called 'reward reinforcing behaviour'.

"People without alcohol dependence can naturally control the potential negative consequences of drinking too much- once they think about it and try. In people with alcohol dependence, the system is unbalanced and they are unable to control the urge to continue drinking. Many people will not need medication and with basic counselling can cut down on their drinking over a couple of weeks and often sustain this. For those who still cannot cut down, nalmefene works by helping to restore balance to these systems, and alongside counselling, can have a huge impact in the lives of those affected by ."

Explore further: A new treatment option for alcohol dependence: Reduced consumption rather than abstinence

Related Stories

A new treatment option for alcohol dependence: Reduced consumption rather than abstinence

April 11, 2013
A potential new treatment for alcoholism called nalmefene is effective and safe for reducing alcohol consumption in alcohol dependent individuals, says a new study published this week in Biological Psychiatry.

Counselling has limited benefit on young people drinking alcohol

August 20, 2014
Counselling techniques used to help young people with drinking problems may be of limited benefit, a new study suggests. In a systematic review published in The Cochrane Library, researchers found that an approach known as ...

EU approves medication that quenches urge to drink alcohol

February 28, 2013
The European Union has given the green light for the sale of a medication that will help quench the urge for alcoholics to drink, the companies behind the new treatment said Thursday.

Self-medicating with alcohol linked to later dependence

May 5, 2013
(HealthDay)—Use of alcohol to self-medicate mood symptoms correlates with increased odds of subsequent alcohol dependence and persistence of dependence, according to a study published online May 1 in JAMA Psychiatry.

Hazardous drinking in UK athletes linked with alcohol industry sponsorship

July 2, 2014
New research from the University of Manchester (UK) and Monash University (Australia) shows a link between alcohol sponsorship and hazardous drinking in UK athletes.

Anti-smoking medication shows promise for treating alcohol dependence

June 4, 2013
A smoking-cessation medication may be a viable option for the treatment of alcohol dependence, according to a study by scientists at the National Institutes of Health. The study found that varenicline (marketed under the ...

Recommended for you

Amber-tinted glasses may provide relief for insomnia

December 15, 2017
How do you unwind before bedtime? If your answer involves Facebook and Netflix, you are actively reducing your chance of a good night's sleep. And you are not alone: 90 percent of Americans use light-emitting electronic devices, ...

Warning labels can help reduce soda consumption and obesity, new study suggests

December 15, 2017
Labels that warn people about the risks of drinking soda and other sugar-sweetened beverages can lower obesity and overweight prevalence, suggests a new Johns Hopkins Bloomberg School of Public Health study.

Office work can be a pain in the neck

December 15, 2017
Neck pain is a common condition among office workers, but regular workplace exercises can prevent and reduce it, a University of Queensland study has found.

Regular takeaways linked to kids' heart disease and diabetes risk factors

December 14, 2017
Kids who regularly eat take-away meals may be boosting their risk factors for heart disease and diabetes, suggests research published online in the Archives of Disease in Childhood.

Simulation model finds Cure Violence program and targeted policing curb urban violence

December 14, 2017
When communities and police work together to deter urban violence, they can achieve better outcomes with fewer resources than when each works in isolation, a simulation model created by researchers at the UC Davis Violence ...

One in five patients report discrimination in health care

December 14, 2017
Almost one in five older patients with a chronic disease reported experiencing health care discrimination of one type or another in a large national survey that asked about their daily experiences of discrimination between ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.