The announcement today by NICE guidelines regarding the use of Nalmefene in mild to moderate alcohol dependence cements the place of opiate antagonists, of which naltrexone is another example, in the challenging treatment of addictions. Nalmefene and naltrexone act in very similar ways, blocking naturally occurring opioid receptors in the brain, attenuating the reward systems associated with consumption of alcohol and blocking the effects of opiates such as heroin, morphine and methadone. When taken as prescribed, opiate antagonists, licensed only in tablet form in the UK, are effective in a significant group of these patients.

As Dr Vince Gradillas, Consultant Psychiatrist and Medical Director of The Naltrexone Clinic explains, “Addictions, however, are complex disorders, often accompanied by mental ill health, social, vocational or other problems caused by or predisposing to misuse of substances that also need addressing. Furthermore, opiate antagonists only block and do not actively provide addicts with any form of immediate reward or resolution to their distress. Voluntarily taking a tablet, therefore, which does not achieve a reward or reduce psychological pain is often a poor option even for motivated addicts, which partly explains the rather low compliance and relapse rates with this form of treatment, and hence use, of already licensed naltrexone, despite opiate antagonists being available to clinicians and patients for 40 years. Often, particularly for opiate addiction, the process of detoxing itself can prove too difficult a step for many.”

Abbeycare and The Naltrexone Clinic are collaborating to provide services that help overcome some of these difficulties. Abbeycare specialises in rapid opiate detoxes, a five day treatment that increases opiate detox completion rates, and provides motivational and 12-step therapies that continue to play a key role in the treatment of  problems associated with addictions.  The Naltrexone Clinic, located in London, Birmingham and Newmarket, helps to overcome opiate and alcohol addiction with medical treatments.

About the author

Laura Morris

Laura Morris is an experienced clinical practitioner and CQC Registered Manager with over twenty years experience, over ten of which have been as an Independent Nurse Prescriber.

She has held a number of senior leadership roles in the substance use and mental health sector in the NHS, the prison service and in leading social enterprises in the field.