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Saturday, 4 October 2014

Anti-booze pill? Nice

I see in yesterday's Guardian that drinkers who have half a bottle of wine or three or four pints a night are to be offered a pill which helps reduce their alcohol consumption. It is estimated that nearly 600,000 people will be eligible to receive the nalmefene tablet which works by blocking the part of the brain which gives drinkers pleasure from alcohol, stopping them from wanting more than one drink. 

Predictably, "experts" claim the drug could save as many as 1,854 lives over five years and prevent 43,074 alcohol-related diseases and injuries. I'd like to know the rigour of the methodology that produces such precise figures. There's nothing wrong with treating people who have problems with alcohol, and if this pill helps some people, all well and good. I do think, though, that a threshold of 3 pints or half a bottle of wine is rather low.

What irritates me is the mea culpa attitude of certain people who, having lacked any self control themselves in the past and frequently ended up in a mess, then seem to think that makes them an expert with a special insight into drinking. The comedian Frank Skinner is one such, and another was Guardian columnist Hugh Muir who wrote in an article about the new pill:

"When you’ve suffered ulcers at 21, principally because you drank too much on a regular basis and didn’t make time to eat, you tend to take an unmoralised stance on those who drink too much alcohol. When you’ve tried and failed to get off the Central Line before being sick after a night’s boozing, you see the issue in a certain way. When you’ve woken in strange places, strange beds, travelled comatose around the entire Circle Line for a couple of hours, thrown up from taxi windows … you have the sense that the human capacity for self-control is sometimes superceded by the craving for our national stimulant of choice. These are my war stories as a young journalist in the hard drinking days of our profession in the 1980s and 1990s."

I've been drinking for quite a lot longer than Hugh Muir, but I have never ended up in the kinds of scrapes he describes. No matter how much I've had, and there have been times when I've had a lot, I've always got myself home or to where I was supposed to be, taken my contact lenses out and put them in their storage case, got undressed and gone to bed. The fact that he drank himself into such ludicrous states means he is not a typical drinker.

He does make the point that you can't expect a pill to resolve all the country's problems with drink, but do we need a journalist to state the obvious? It is worth pointing out that the original article stated that NICE (the National Institute for Health and Care Excellence) recommended the use of the drug because trials showed "it cut drinking by 61% over six months when used with counselling" (my emphasis). So, how much of the pill's success can be attributed to the chemicals, and how much to the one-to-one attention the patients received in counselling sessions? No way of knowing.

3 comments:

  1. "No way of knowing" Yes there is!
    Have a read of Christopher Snowdon's blog entry at http://velvetgloveironfist.blogspot.com/2014/10/the-drug-for-mild-alcoholics-possibly.html
    Very enlightening - His conclusion "In any case, the widely reported claim that nalmefene can "cut alcohol consumption by 61%" needs to be seen in the context of the placebo which "cut" alcohol consumption by 50%. And that's only if confine yourself to the more optimistic evidence."

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  2. I'm not surprised by that at all, and it's what I was trying to imply. Thanks for the info.

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  3. A well argued post Nev, and one I wholeheartedly agree with. Like you, I've always managed to get myself home and into bed, no matter how much I've had! I've also never missed administering my nightly eyedrops - designed to keep my Glaucoma under control. There are certainly none so righteous as reformed heavy drinkers, smokers, excessive eaters etc.

    On a much more serious note I would be extremely wary of any drug which interferes with brain chemistry, by blocking those pathways which give pleasure. The drug Champix was lauded as helping people quit smoking, by acting in the same way. It ended up leaving many users feeling suicidal, as it not only blocked the pathways which associated pleasure with nicotine, but it also ended up blocking all "pleasure" pathways in the brain. With nothing pleasurable left to them, no wonder many users of this "poison" felt life was no longer worth living.

    If I wanted to be really cynical I would say this whole exercise is just another ploy by the pharmaceutical industry to get people hooked on a drug which they may well then find very hard to get off.

    Final point, Xopher's re-posting of the flawed statistical evidence used to justify the use of nalmefene, shows just how far these so-called "health experts" will go in their pursuit of their twisted aims.

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