It’s the magic drug for hard drinkers that has an 80 per cent success rate, so why is this treatment so under-prescribed?
Already a subscriber?Am I an alcoholic? It’s a question I’ve asked myself many times over more than a decade. That alone is enough for most addiction counsellors to confirm that yes, I probably fulfil the criteria – along with an estimated 10 million adults in England who regularly exceed government guidelines on alcohol consumption and a further 600,000 who are dependent on it.
Because it requires at least a bottle of wine to unlock that cave , anything less felt akin to having an itchy nose but not quite being able to follow through on a sneeze. Torment. It is not a new drug – it was first approved in 1984. It’s not expensive, costing between £1 to £3 a pill. There are few side effects . It works on people who would simply like to cut down a little, all the way across the spectrum to full-blown addicts.
“I practised in a very deprived area with a high rate of alcohol misuse and was so fed up with not being able to treat people with this simple drug. It was incredibly disempowering,” she tells me.Dr Merron was the first doctor to join Sinclair Method UK, a clinic formed in 2019 that prescribes opioid blockers alongside counselling to those who wish to reduce or eliminate their drinking.
I kept taking another sip, waiting for the chain reaction to fire off – the one that usually takes me to the end of the bottle – but it never did. I took a larger gulp, then half an hour later, did something I hadn’t done in as long as I can remember – I tipped the rest down the sink.A small part of me felt sad that I no longer had the key to my cosy cave that evening. But mostly, it felt like a miracle had occurred, and an overwhelming relief took over.
I’m an introvert. I despise small talk. I find socialising boring, scary and pointless. If it were up to me, I’d never go to another wedding or festival or dinner with strangers ever again, but alas, I have a very outgoing husband, and sometimes it’s expected of me. I spoke to several friends who are in AA – the program, developed in 1935, which argues there is no cure for alcoholics but lifelong abstinence – and most were sceptical. AA had worked for them, after all.
Of course, actually swallowing the pill before you drink alcohol requires willpower, especially in the early stages of treatment, just as abstinence does. But I have found that popping a tablet while I still have good intentions, thus removing any opportunity to get hammered for the rest of the night, is a whole lot easier than having to resist on a minute-by-minute basis.
All cards on the table, am I going to allow myself the occasional debauched, naltrexone-free knees-up? Yes. Those are one of life’s great pleasures, are few and far between, and have never been a problem for me. It’s the insidious, bottle-a-night spell that needed breaking. Like in the UK, it is “woefully” under prescribed, experts say, because addiction is woefully under-treated in Australia. Only 3 per cent of people with an alcohol problem are prescribed medications like naltrexone.
“The fact you can’t control your drinking means you might have a low-level dependence, and harm may just be hangovers or being grumpy with the kids; they are relevant harms, you don’t need to have a sclerotic liver.” Professor Dan Lubman, director of leading addiction centre Turning Point, agrees drugs like naltrexone are hugely under prescribed, a fact that is not surprising given it takes a median 18 years for someone with an alcohol problem to seek help.
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