Britain is turning to pills for help in what is the most drastic measure yet in the effort to curb this country’s significant drinking problem.
The drug, called nalmefene (marketed as Selincro), simply takes the fun out of drinking by blocking the area in the brain that registers pleasure derived from it. Proponents believe it could save hundreds of lives a year under a proposed, nationally funded scheme that critics counter will unnecessarily "medicate the middle class."
On Saturday, the National Institute for Health and Care Excellence, or NICE, recommended nalmefene be prescribed in conjunction with counselling to help heavy drinkers reduce their intake.
“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,” Prof. Carole Longson, NICE Health Technology Evaluation Centre director, said in a statement.
“When used alongside psycho-social support nalmefene is clinically and cost effective for the [National Health System] compared with psycho-social support alone.”
Tens of thousands of people qualify for the handout — one pill a day — that targets not the worst alcoholics, but those who drink enough to risk serious health consequences.
Those include women who drink the equivalent of half a bottle of wine a day and men who drink in excess of three or four pints of beer each day.
And for those people among them who would like to cut back, there is a "frightening lack of provision out there," says Dr. David Collier, a proponent of the plan who conducted a clinical trial on the drug at the William Harvey Research Institute of the Barts Queen Mary University.
Trials suggest Nalmefene can reduce the number of "heavy drinking days and total alcohol consumed by more than half," according to the National Health System.
In an interview, Collier said after his trial, he is convinced the drug works. But because it will be administered only with counselling, it may be that in some cases the counselling alone will be enough — meaning not everyone who qualifies for the drug will need to take it.
Many have long insisted Britain needed something far stiffer than its existing policy of advocating abstinence to tackle a problem that’s bad and growing worse.
'Epidemic' of alcohol-related deaths
According to one NHS count, more than a quarter of the population "consume alcohol in a way that is potentially or actually harmful to their health or well-being."
The U.K.’s Faculty of Public Health believes there is a growing "epidemic" of alcohol-related deaths. It also says more than 2.5 million children live with parents who "drink hazardously."
Part of the problem, says the faculty, is alcohol’s affordability. In a manifesto released ahead of the upcoming election, it advocated setting national minimum pricing for alcohol. That alone "would save over 3,000 lives every year, reduce chronic illnesses by as much as 41,000, and cut violent crime by 11,000."
The faculty believes the cost of providing the drug nationally— at £3 a pill, or just over $5 Cdn — also outweighs the benefits.
Dr. John Middleton, vice president for health policy at the faculty, said nalmefene can only be one tool in a range of them necessary to fight the problem.
"The level of harms that are being talked about" could be dealt with through setting minimum prices, reducing advertising for alcohol and better policing of alcohol licensing, he said in an interview.
"The middle class is being medicated instead of going through a counselling process and simply being helped to stop their drinking at harmful levels."
'I just want to shout it from the rooftops because it’s given me my life back.' - Joanna Duyvenvoorde
NICE disagrees, pointing out today that “alcohol-related harm costs the NHS £3.5 billion a year.”
Joanna Duyvenvoorde, 44, once an extremely heavy drinker, says she’s living proof pills can be appropriate in treating dependence on alcohol. She has been sober now for more than a year after taking a drug similar to nalmefene.
Duyvenvoorde was so determined to quit drinking she tried every method available, including Alcoholics Anonymous, but nothing worked. When she finally learned there was a drug, she travelled all the way to a clinic in Scotland just to get a prescription.
"I don’t think it’s lazy at all," she says about the NHS plan. "Unfortunately in the nation, we’ve had 50 years of ‘this is the only way to do it’ and that isn’t the case now.
She says her life has been transformed, and hopes NHS moves forward with the proposal so others might have the same experience.
"I just want to shout it from the rooftops because it’s given me my life back," she said. "Medical science moves forward and I think we should embrace medical science moving forward."
Nalmefene is made by Lundbeck, a publicly traded Danish company which last week made new shares available for purchase. A day later, its stock rose.
Even with the drug, patients have to want to quit for it to work. But there’s no pill yet for that.