A Buzz-Killing Pill Won't Stop Young People from Binge Drinking
Nalmefene is being reported as some sort of wonder drug for alcohol abuse and a way of combatting binge drinking. But are young people ready to kill their buzz?
Photo by Jason Meredith via Flickr
I often exceed the recommended daily allowance of alcohol. Am I one of the 1.6 million people who are dependant on drink? I wouldn't say so, but I'm definitely among the nine million probably doing some damage to my health.
Maybe I need nalmefene, the latest tactic in the battle against booze and a hot topic of the pharmaceutical world. The drug is said to be effective at combating alcohol addiction, reducing cravings by suppressing the "buzz" that booze bring by blocking the part of the brain that gives drinkers pleasure. Five pints could become three. Livers could be spared. Oil-slick kebabs eaten while staggering off the kerb could be avoided.
Nalmefene has been around in Scotland a while now, after being given the go-ahead by the Scottish Medicines Consortium. The country became the first in Europe to take it on, hopeful that spending £3-a-day on a pill will help fight our inherent drinking culture.
Professor Jonathan Chick, consultant psychiatrist at Queen Margaret University Hospital Edinburgh, is all for it, telling the BBC when it was introduced that he was "pleased that Scottish patients will have access to nalmefene, which represents a new option for treating some people with alcohol dependence by helping them to cut down their drinking when they may not be ready, or have no medical need, to give up alcohol altogether."
Others remain unconvinced. A Glasgow GP, Dr. Des Spence, calls it a "bad medicine". He questions a supporting study—perhaps understandably given it was conducted by the producer of the drug—and has aired concerns regarding cost and approval. "Even among these problem drinkers, the benefit of nalmefene was a reduction of just one or two units of alcohol a day, three heavy drinking days, and one additional dry day a month," he wrote in the British Medical Journal. "Changes in liver function test results were minimal.Are these gains clinically significant?"
Dr. Spence feels resources might be better spent on human intervention, that "the drugs in alcohol addiction have tiny benefits and are a distraction from the real challenges of limiting the availability and increasing the cost of alcohol. This bad medicine is all too familiar."
Meanwhile, Dr. James Nicholls, director of research at Alcohol Research UK, is anticipating nalmefene's arrival across the border. He stressed he's yet to delve as deep as he'd like, but said he's watchful of what's been reported so far. "I've been concerned by lots of the coverage," he says. "Some seem to present it as a wonder drug and might not be the answer some people think it is."
There's no doubt nalmefene is achieving notoriety after it hit the news last week following the National Institute for Health and Care Excellence (NICE) came out in support and published its draft guidance.
"Alcohol addiction is a serious issue for so many," says Health Technology Evaluation Centre director for NICE, Professor Carole Longson, who appears to be a fan of the idea. "Those who could be prescribed nalmefene have already taken the first big steps in their fight against their addiction by visiting their doctor and taking part in therapy programmes. We are pleased to be able to make draft recommendations which can support people in their fight."
The organisation has stipulated that the drug is to be taken with other preventative tools, to be viewed as only one cog in a sobering machine. "When used alongside psychosocial interventions nalmefene is clinically and cost effective for the NHS compared with psychosocial interventions alone," she says.
The thing is, the NHS reported that over 100,000 people had alcohol-related treatment in 2012-13. In the same year, the bill for drink-induced harm cost an estimated £3.5 billion. The situation's pretty desperate. But is there a danger that nalmefene could become too easy a go-to? For both those savvy enough to get it online (yes, you can already do that) and wearied doctors keen to see results? Is treating a dependency on booze with another drug really the way forward? You can't imagine that those who advocate abstinence-based recovery—the Russell Brands of this world—would be a fan of the idea.
The danger, too, is the way it's being marketed. The angle the Metro took was presenting nalmefene as the latest technique in addressing our binge drinking problem, a way of muffling our passion for getting absolutely shit faced at the weekend, undoubtedly pointing a finger at the young, sweaty booze hounds projectile vomiting outside Wetherspoons on a Friday night and taking themselves on booze cruises in the summer months.
You only have to look at things like PoundPubs to see how endemic binge drinking is, so often leading to a place where pleasure becomes curdled with calamity and despair, and it's worryingly common in young people. But would the woman involved in the now notorious Magaluf incident, for example, be keen to try nalmefene in the future? Would a red-nosed, booze-loving stoke broker lad be quick to bay a batch of the stuff online to numb the potency of that eighth or ninth pint before heading home? I'm not so sure.
People (discounting those with serious, debilitating addictions) largely drink because they want to feel somewhere on the shit faced spectrum. That's the point. I can't imagine any of my twenty-something peers who binge drink contemplating taking something to curb the effects of alcohol, but you can also see how it's an attractive proposition—drink as much as you like! Taking this will make your body tell you when to stop!
The fighting-fire-with-fire approach of the drug—which will be made widely available on the NHS soon enough—has thrown up all sorts of debate. It doesn't seem like anything has really made a dent in Britain's alcohol dependency so far, though, and we do need some kind of intervention. But if the drug continues to be sold as something to curb binge-drinking, it's opening itself up to abuse. We are nothing if not a generation of quick-fix seekers, but I'd wager that young people aren't quite ready to swallow the idea of taking something to dilute the buzz of alcohol.