Nalmefene

The latest weapon in the battle against alcohol dependence

To neuroscience, the brain’s complicated reward and addiction pathways are of intense interest. Understanding these systems seems to be essential in battling addiction of every stripe. From gambling to drugs & alcohol, a key set of pathways and receptors in the brain deliver that pleasure jolt we associate with our favorite vices.

The hunt for effective therapies that can help a person recover from physical and psychological dependence has spawned several industries, some based on fact and others based on quackery.

The latest drug to find wider acceptance in this arena is a molecule generically called Nalmefene (AKA Nalmetrene, Selincro).

The drug is by no means new. It has been used since the 1970’s in the treatment of Opioid dependence (Heroin, etc). In October 2013 though, the European Medicines Agency finally approved the drug to be used in alcohol de-addiction therapies. The drug has been used in an off label manner for this problem for awhile now. Formal approvals will help those who depend on insurance and National Health Service (NHS) for medical reimbursement.

Nalmefene is a close cousin to another Opioid de-addiction molecule known as Naltrexone. A small change in the molecular structure separates the two which gives Nalmefene some advantages. Nalmefene lasts longer in the blood, has fewer side effects and is not as rough on the liver as Naltrexone. It still has to be used under the supervision of a doctor, more so during the initial stage of treatment. Prescribing Naltrexone or Nalmefene to an alcoholic or Opioid user can precipitate quite sudden and severe withdrawal symptoms that are best managed under medical supervision.

Nalmefene is also seen more commonly in the operating room and the intensive care unit (ICU). Small doses have been used to counteract strong Opioids given during surgeries and help wake people up from that medically induced slumber more effectively and safely.

Nalmefene usage was first pioneered by John David Sinclair, PhD. His research began as an undergraduate in the 70’s, where he showed that forced abstinence from alcohol actually worsened cravings! Therefore, for those of you who are worried about yourselves or your loved ones, talk to your doctor about Nalmefene use and if it’s right for you.