26.11.14
One too many?
How many people who drink too much and want to cut down will actually be prescribed nalmefene, the drug that dulls any pleasure people get from drinking?
One estimate is 35,000 people – three-fifths of those getting psychosocial interventions. Considering the potential public health benefits, we have to hope it is widely prescribed, and takes off more than it has in Scotland, where just 53 people were prescribed it in 2013-14.
NICE’s new guidance published today means health bodies in England and Wales have a legal duty to begin funding the treatment for eligible patients within the next three months.
The drug is for people who drink too much and have a mild dependency, such as more than half a bottle of wine or a few pints of beer every day (7.5 units a day for men and five units a day for women). It is not for those with more serious alcoholism.
Professor Carole Longson, Nice health technology evaluation centre director, said: “Many people have a difficult relationship with alcohol even though they have a very stable lifestyle, maintain jobs and a social life and would not automatically assume they have a problem.”
The estimated number of people with an alcohol dependency is anything up to 2.5 million, based on surveys.
Dr Niamh Fitzgerald, Lecturer in Alcohol Studies, Institute for Social Marketing (ISM), School of Health Sciences, University of Stirling, is among those concerned by the decision to fund nalmefene, saying the published trials show it working only in very specific settings and that there is now "nothing to stop nalmefene being prescribed in other settings or for other patients, or with inadequate or no counselling",
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.”
Professor Matt Field, professor of addiction at University of Liverpool’s Department of Psychological Sciences, said: “Most clinicians believe that no treatment can be effective unless people are motivated to change.”