Nalmefene is a drug that is used to help treat those with alcohol dependence. Furthermore, it is begin tested to determine its efficacy in the treatment of other addictions such as gambling addiction. It is approved for use in the UK, with NICE (National Institute for Health and Care Excellence) recommending its use for the ‘reduction of alcohol consumption in patients with alcohol dependence who have a high drinking risk level without physical withdrawal symptoms, and who do not require immediate detoxification’.
Going by the above recommendation from NICE then, it is a suitable treatment for those who are not addicted to alcohol but who could benefit from reducing the amount of alcohol that they are drinking. The drug works by reducing the pleasurable effects normally associated with alcohol. Those who want to curb the amount of alcohol they consume will take a pill around an hour or two before having their first drink. Nalmefene makes the act of alcohol consumption less enjoyable so that the person partaking will have no desire to have more than one or two drinks.
What Addictions is Nalmefene Used to Treat
Medications for Abuse and Addiction
Certain substance use disorders can be treated with specific medications. However, these medications tend to work best when used as part of an alcohol detoxification and rehabilitation programme. In other words, it is not sufficient for medication to be used as a standalone treatment for abuse and addiction.
When used correctly, medication can help to curb cravings for certain substances and many will also help to lessen the impact of withdrawal symptoms during the detox process. It may also be appropriate for some individuals for medication to be prescribed as part of an ongoing sobriety maintenance programme.
For example, there are some medications that when taken can cause unpleasant symptoms when certain mood-altering substances are used. Such medications are common in the treatment of alcohol dependence and addiction as they react to ethanol and therefore make the consumption of alcohol a very unpleasant experience.
How to Choose the Right Medication
Overcoming any substance addiction will require a determination to succeed and a willingness to accept a life of abstinence on the part of the affected person. This will typically necessitate the completion of a programme of detoxification to break the cycle of abuse, and then rehabilitation to learn how to live a substance-free life. To make it easier and more comfortable for you, if you are the sufferer, medication may be prescribed during either the detox or rehab process.
If medication is deemed an appropriate treatment option during an alcohol rehab, your doctor will consider your health, age, and the severity of your addiction to find the right medication.
What is Nalmefene?
Nalmefene is an opioid antagonist that acts on the same area of the brain that opioid drugs do. It binds to these receptors but does not activate them, the result of which is that it prevents the body from responding to the effects of opioids and endorphins.
As well as being a drug to combat alcohol abuse and dependency, Nalmefene can be, and has been, used to treat the symptoms of an opioid overdose. It counteracts the respiratory depression caused by opioid overdose. Nevertheless, the usual treatment for such an overdose would be the similar but less expensive drug naloxone.
Brand Names for Nalmefene
History of Nalmefene
Nalmefene was first approved in the US in 1995 as an injectable solution for use as an antidote for opioid overdose, sold under the brand name Revex. However, it was discontinued in 2008 due to poor sales.
Although the pill form of the medication used to treat alcohol dependence has never been sold or approved for use in the US, it is regularly used in Europe. Clinical trials on the use of Nalmefene for alcohol dependence were carried out by Lundbeck after it licenced the drug from Biotie Therapies.
In March 2013, Nalmefene was approved for use in the EU while in October that same year, Scotland became the first country to prescribe it for use in alcohol dependence. The following year, Nalmefene was offered for use in England and in November 2014 became an approved drug for use on the NHS with the aim of reducing alcohol consumption in problem drinkers.
Is Nalmefene Addictive?
Nalmefene is not an addictive drug and there are no withdrawal symptoms with sudden cessation.
What is the Mechanism of Action?
Nalmefene works by antagonising those receptors in the brain responsible for producing the body’s feel-good chemical, dopamine. This prevents the alcohol-induced release of this chemical, resulting in the reduced desire to continue drinking.
Studies on Nalmefene
Research by PLOS Medicine into the risks and benefits of Nalmefene in the treatment of adult alcohol dependence was conducted and consequently published in December 2015. The aim of the study was to ‘compare the harm/benefit of Nalmefene versus placebo or active comparator in this indication’.
It was concluded that there was no evidence to establish the value of Nalmefene as a treatment for alcohol addiction, but that there was limited efficacy in reducing the amount of alcohol consumed.
A further study by PLOS One that was published in 2017 looked to assess the harm that Nalmefene caused when administered to those with substance use or impulse control disorders. A review of randomised controlled trials was conducted, and it was found that ‘overall, serious adverse events did not occur more often in the Nalmefene group than in the placebo group’.