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Scotland approves drug to help cut alcohol use

The first drug to help dependent drinkers cut down on their alcohol use has been approved in Scotland.

The Scottish Medicines Consortium has approved the use of nalmefene in patients with alcohol dependence who have a high drinking risk level, without physical withdrawal symptoms.

The drug should only be prescribed in conjunction with continuous psychosocial support focused on treatment adherence and reducing alcohol consumption, the SMC stressed.

The drug – an opioid receptor antagonist – dampens the ‘buzz’ alcohol-dependent people get from drinking, helping them cut down their alcohol intake.

It is the first to be specifically licensed for reducing alcohol consumption, other medicines such as acamprosate and naltrexone are licensed for maintainence of abstinence after alcohol withdrawal.

The judgement was based on studies which showed nalmefene enabled patients to cut down both on their heavy drinking and the total amount of alcohol they consumed.

In two separate 24-week studies, patients who used nalmefene as well as receiving psychosocial support had on average 3.7 and 2.7 fewer heavy drinking days a month at the six-month follow-up, relative to patients receiving psychosocial support only, and 18 g/day and 10.3 g/day greater reductions in total alcohol intake.

Withdrawal rates were high relatively high with nalmefene, but the SMC ruled that a further, cost-effectiveness analysis made the case for approving its use on the NHS.

Nalmefene is taken in tablet form, with one tablet taken on each day the patient feels they are at risk of drinking, preferably an hour or two before they anticipate starting to drink.

NICE is currently scoping out nalmefene for potential ‘technology appraisal’.

Scottish Medicines Consortium – advice on nalmefene