Drug recommended to help cut drink dependence | Hacker News Reader

Drug recommended to help cut drink dependence

bbc.co.uk

22 pointscolinramsay13 comments

It might be worth noting that there are other similar drugs already in widespread use for the same purpose.

https://en.wikipedia.org/wiki/Naltrexone

The submitted article doesn't seem to touch on what differentiates nalmefene from naltrexone, but the dubiously cited Wikipedia article for nalmefene mentions that advantages "include longer half-life, greater oral bioavailability and no observed dose-dependent liver toxicity." Both are recommended for use in conjunction with psychosocial support techniques.

The article was disappointingly short of a few bits of information. It didn't describe the class of drug (opioid receptor blocker), give examples of similar drugs or even give a pointer to more complete information.

Yeah, I know, I could look it up (and I will), but even in a brief announcement, I don't think a little more information is too much to ask for.

Naltrexone has shown benefit for alcohol dependence, and other addictive behaviors too. Probably too obvious to say, but no drug is a "magic bullet" and risk of side-effects remains an important consideration. For naltrexone, a particular concern is liver toxicity with higher doses.

The newer drug may be different, but a drug's bad effects may show up only after prolonged use. Registration trials may not be go on long enough, or involve enough subjects to reveal long-term or rare problems.

While on Naltrexone I felt a create decline in cravings, although for Marijuana and not alcohol. The noticeable side effects to me was irritated stomach and feeling very tired and fatigued, which was a plus, sleeping on cannabis withdrawal is a major bitch.

The WHO defines 3 drinks/day for men and 2 for women as "high intake." Meanwhile among those who recommend daily alcohol intake for health, the typical recommendation is 2 drinks/day for men and 1 for women - a difference of 1 drink.

Does anyone have any insight on this small apparent difference between "healthy person" and "drunkard"?

One impacts your lifestyle in a negative way and the other does not.

Someone can be consuming an unhealthy amount of alcohol by the WHO's standards which will cause things like weight gain and shorter lifespan, without being a alcoholic.

However conversely someone could drink, on average, below the recommended daily amount but have short periods of dangerously heavy drinking and thus be defined as an alcoholic over the longer term (e.g. some people with unmedicated bipolar disorders).

As I said at the start it really depends how much drinking impacts your life. If it doesn't in a negative way then you likely aren't an alcoholic (but yet still might want to look at your weight and fitness due to overconsumption).

I wasn't really asking a question about my health. I was more interested the methodological differences that result in very similar numbers of drinks per day (2 vs 3) being considered healthy (not just acceptable but desirable) or dangerously high, respectively.

But WHO's standards (2-3 drinks/day) won't make you gain weight if you live a healthy life otherwise (if you didn't, you'll gain that weight anyway, so hard to say if that was the alcohol doing that; sure if you drink 10 pints/night yes, but 2 normal sized drinks...) and that shorter lifespan is doubtful, but that's anecdotal from my side (the statistics WHO uses are not very convincing though; they just note everyone who drinks and has ailments and when they run their matlab algo's over it, they attribute all these which are known to be affected by alcohol to alcohol (ab)use, at least in the ones I read).

Btw. I think the WHO recommends no more than 2(3 for men) drinks per day and no more than 6-7 per week, so that would account for the periods of heavy drinking. You cannot really drink heavy and stay below that.

People suggesting two drinks per day for health are misreading the research. It's one drink per day for health, where a drink is something like 10 ml of alcohol. If you're drinking a 13.5% wine that's 75 ml - a teeny tiny glass.

If you believe the graph that's going around you can have up to six of those per day before the risks equal those from total abstinence from alchol. That's not saying that two drinks per day is healthy.

According to an article in the british medical journal ,nalmefene in alcohol misuse is bad medicine. I haven't got access but that's the replies to the article, by doctors:

http://www.bmj.com/content/348/bmj.g1531/rapid-responses

Another place is a the most recent review of alcohol dependency drugs:

http://www.ncbi.nlm.nih.gov/pubmed/24825644

There's only medium evidence for nalmefene use, and the results speak of an average reduction of 2 days of heavy drinking per month and average reduction of 1 drink per day. Not that big.

It's recommended for people who don't manage to cut down after two weeks of psycho-social intervention, who also drink more than 7.5 units per day (that's very roughly half a liter of 14% wine per day) but who also drink less than the amount needed for medically supervised detox.

Here's the priminary NICE information: http://www.nice.org.uk/advice/esnm29

The Cochrane summary is sparse for nalmefene.

http://summaries.cochrane.org/CD001867/ADDICTN_naltrexone-an...

The washington post had an article that basically said the 80/20 rule applied to drinkers (20% consmed 80% of alcohol).

http://www.washingtonpost.com/blogs/wonkblog/wp/2014/09/25/t...

Based on this article (3 pints @ 5% is considered high volume consumption for men) then 30% of the drinking age population falls into that category. If you eliminate non drinkers (less than 1 a week) then it's like 3/5th of drinkers.

3 pints a day of any high carbohydrate beverage is probably a bad idea. No alcohol required.

I think a few psychedelic sessions (ibogaine, ayahausca, mushrooms) and meditation/self reflection are a much better solution. Of course, they're also a lot less profitable, so no one besides a small subset of academics and journalists are pushing for more research into this line of treatment.

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