Naltrexone: the wonder drug for alcoholism

Although it's been used since the 1980s, naltrexone remains a relatively unknown treatment for alcohol dependency.

Costing around £3 per pill, the drug blocks the "euphoric and sedative effects" of alcohol which helps "reduce cravings" and cut down consumption, said London's The Standard. Naltrexone reportedly has a claimed 80% success rate in clinical trials and can be prescribed by the NHS but is more commonly accessible privately.

However, some argue that the drug could be used for heavy drinkers who do not meet the "criteria for alcohol addiction" and help stop them from "mindlessly" drinking, which can lead to dependency, said Esther Walker in The Times.

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An 'off-switch' for drinkers

Naltrexone is an opioid antagonist, meaning it blocks opioid receptors in the brain that cause a "dopamine high" and subsequently lead to craving, said The i Paper. People can "still get drunk", but the lack of a "euphoric effect" should reduce the appetite to drink more and more.

Naltrexone is not the only drug used to treat alcoholism, but its high success rate and lack of substantial side effects are what led it to go "viral on social media" and be "praised for helping those struggling with alcohol overconsumption", said Metro.

There are some common side effects, including headache, nervousness, nausea, dizziness, decreased appetite, and stomach upset, while more serious uncommon side effects include depression and hallucinations. Users also need to be aware that it "stops painkillers that contain opioids working", according to the NHS.

The drug is taken an hour before drinking alcohol and can act as an "off-switch" for problem drinkers, "drastically" reducing how much they drink, said The Standard.

Naltrexone is used as part of the Sinclair Method, a treatment for alcohol addiction devised by Dr David Sinclair at the Finnish Foundation for Alcohol Studies. The method works by trying to "reset the neural pathways" that have been "created by regular drinking", said Walker. The user keeps drinking while taking naltrexone, but when there is "no buzz", eventually your "brain will stop insisting that you do it".

'Tangled up in red tape'

In a first-person account of trialling the drug, Walker said it had been "staggeringly effective" and "within four weeks" she was able to regain a "functioning relationship with alcohol". It still "requires willpower and a readiness to address bad habits", she added, but not "superhuman levels".

In a similar account of using naltrexone, Annabel Fenwick Elliot in The Telegraph said it had been "game-changing" and "severed" the "neurological bond" that she had with alcohol. Why, then, is it not more readily available to people wanting to reduce alcohol intake? The answer is "tangled up in red tape". The drug is "out of patent" and therefore there is "no real money to be made by Big Pharma", while in the UK it is "tricky for GPs to prescribe thanks to licensing".

There is also a sense that the government doesn't want to "prioritise alcohol reduction", said Walker. At the same time, National Institute for Health and Care Excellence guidelines advise prescribing naltrexone only "alongside a programme of abstinence" which will not "sever the link in the mind between the alcohol and the dopamine reward".