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The pill that promises to help problematic drinkers, who consume half a bottle of wine or have a couple of pints of beer a day, to drink less is a hard one to swallow.

Nalmefene, which costs £3 per tablet, may soon be offered by the NHS in England and Wales to around 750,000 habitual drinkers who are regularly drinking more than the NICE (National Institute for Health and Care Excellence) guidelines. It will not be available to severe alcohol-dependent people or those deemed able to stop by themselves without the help of medical intervention.

Over 5 years it is estimated that the treatment could save around 2,000 lives and help prevent more than 40,000 alcohol-related illnesses.

Nalmefene works by blocking the part of the brain that gives drinkers gratification from alcohol and stops them wanting more. But does it only inhibit the feelings derived from using alcohol? The problem may be that it could also reduce pleasure across the whole enjoyment/feel-good spectrum?

There is some evidence to suggest the latter, and tests have also shown it to work with gambling and eating addictions.

The pill may take away the craving, but the root cause of why a person feels the need to have that one extra drink in the first place will still exist; perhaps this may be a contributing factor to the circa 40 per cent drop out of participants during the clinical trials.

And, if it doesn’t have the side-effects of making people sick or ill, as with prescribed medication such as Antabuse, will we have drunk, unrewarded people in our communities, who couldn’t care less about themselves or others; who may also cross-use other, stronger substances to try and feel good, and escape from reality?

Will medicating people solve what seems to be an intrinsic problem?

It might help but it is imperative that the bigger issues are addressed through the best psychosocial interventions.

A final decision to issue the drug, at a cost of £288m a year, on the NHS will be made in November


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