

Drug recommended to help cut drink dependence - colinramsay
http://www.bbc.co.uk/news/uk-29468885

======
rmxt
It might be worth noting that there are other similar drugs already in
widespread use for the same purpose.

[https://en.wikipedia.org/wiki/Naltrexone](https://en.wikipedia.org/wiki/Naltrexone)

The submitted article doesn't seem to touch on what differentiates nalmefene
from naltrexone, but the dubiously cited Wikipedia article for nalmefene
mentions that advantages "include longer half-life, greater oral
bioavailability and no observed dose-dependent liver toxicity." Both are
recommended for use in conjunction with psychosocial support techniques.

~~~
jrapdx3
The article was disappointingly short of a few bits of information. It didn't
describe the class of drug (opioid receptor blocker), give examples of similar
drugs or even give a pointer to more complete information.

Yeah, I know, I could look it up (and I will), but even in a brief
announcement, I don't think a _little_ more information is too much to ask
for.

Naltrexone has shown benefit for alcohol dependence, and other addictive
behaviors too. Probably too obvious to say, but no drug is a "magic bullet"
and risk of side-effects remains an important consideration. For naltrexone, a
particular concern is liver toxicity with higher doses.

The newer drug may be different, but a drug's bad effects may show up only
after prolonged use. Registration trials may not be go on long enough, or
involve enough subjects to reveal long-term or rare problems.

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mga226
The WHO defines 3 drinks/day for men and 2 for women as "high intake."
Meanwhile among those who recommend daily alcohol intake for health, the
typical recommendation is 2 drinks/day for men and 1 for women - a difference
of 1 drink.

Does anyone have any insight on this small apparent difference between
"healthy person" and "drunkard"?

~~~
Someone1234
One impacts your lifestyle in a negative way and the other does not.

Someone can be consuming an unhealthy amount of alcohol by the WHO's standards
which will cause things like weight gain and shorter lifespan, without being a
alcoholic.

However conversely someone could drink, on average, below the recommended
daily amount but have short periods of dangerously heavy drinking and thus be
defined as an alcoholic over the longer term (e.g. some people with
unmedicated bipolar disorders).

As I said at the start it really depends how much drinking impacts your life.
If it doesn't in a negative way then you likely aren't an alcoholic (but yet
still might want to look at your weight and fitness due to overconsumption).

~~~
tluyben2
But WHO's standards (2-3 drinks/day) won't make you gain weight if you live a
healthy life otherwise (if you didn't, you'll gain that weight anyway, so hard
to say if that was the alcohol doing that; sure if you drink 10 pints/night
yes, but 2 normal sized drinks...) and that shorter lifespan is doubtful, but
that's anecdotal from my side (the statistics WHO uses are not very convincing
though; they just note everyone who drinks and has ailments and when they run
their matlab algo's over it, they attribute all these which are known to be
affected by alcohol to alcohol (ab)use, at least in the ones I read).

Btw. I think the WHO recommends no more than 2(3 for men) drinks per day and
no more than 6-7 per week, so that would account for the periods of heavy
drinking. You cannot really drink heavy and stay below that.

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pinkyand
According to an article in the british medical journal ,nalmefene in alcohol
misuse is bad medicine. I haven't got access but that's the replies to the
article, by doctors:

[http://www.bmj.com/content/348/bmj.g1531/rapid-
responses](http://www.bmj.com/content/348/bmj.g1531/rapid-responses)

Another place is a the most recent review of alcohol dependency drugs:

[http://www.ncbi.nlm.nih.gov/pubmed/24825644](http://www.ncbi.nlm.nih.gov/pubmed/24825644)

There's only medium evidence for nalmefene use, and the results speak of an
average reduction of 2 days of heavy drinking per month and average reduction
of 1 drink per day. Not that big.

~~~
DanBC
It's recommended for people who don't manage to cut down after two weeks of
psycho-social intervention, who also drink more than 7.5 units per day (that's
very roughly half a liter of 14% wine per day) but who also drink less than
the amount needed for medically supervised detox.

Here's the priminary NICE information:
[http://www.nice.org.uk/advice/esnm29](http://www.nice.org.uk/advice/esnm29)

The Cochrane summary is sparse for nalmefene.

[http://summaries.cochrane.org/CD001867/ADDICTN_naltrexone-
an...](http://summaries.cochrane.org/CD001867/ADDICTN_naltrexone-and-
nalmefene-for-alcohol-dependent-patients)

------
hoopism
The washington post had an article that basically said the 80/20 rule applied
to drinkers (20% consmed 80% of alcohol).

[http://www.washingtonpost.com/blogs/wonkblog/wp/2014/09/25/t...](http://www.washingtonpost.com/blogs/wonkblog/wp/2014/09/25/think-
you-drink-a-lot-this-chart-will-tell-you/)

Based on this article (3 pints @ 5% is considered high volume consumption for
men) then 30% of the drinking age population falls into that category. If you
eliminate non drinkers (less than 1 a week) then it's like 3/5th of drinkers.

~~~
rch
3 pints a day of any high carbohydrate beverage is probably a bad idea. No
alcohol required.

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ZeroFries
I think a few psychedelic sessions (ibogaine, ayahausca, mushrooms) and
meditation/self reflection are a much better solution. Of course, they're also
a lot less profitable, so no one besides a small subset of academics and
journalists are pushing for more research into this line of treatment.

