4.10.4.3 Interventions for the reduction of alcohol consumption

Prescribing Notes

  • NICE CG 115 recommends that the first line treatment option in mild alcohol dependence is a psychological intervention.
  • Nalmefene is recommended by NICE as an option for reducing alcohol consumption. It is important that prescribers are aware of the prescribing requirements outlined by NICE and that nalmefene is only prescribed in line with these to avoid inappropriate prescribing. Refer to NICE TA325.
    • Nalmefene is an option for people with alcohol dependence who have a high drinking risk level (defined as alcohol consumption of more than 60g [or 7.5 units] per day for men and more than 40g [5 units] per day for women, according to the World Health Organization’s drinking risk levels) without physical withdrawal symptoms and who do not require immediate detoxification.
    • Nalmefene should:
      • only be prescribed in conjunction with continuous psychosocial support focused on treatment adherence and reducing alcohol consumption and
      • be initiated only in patients who continue to have a high drinking risk level two weeks after initial assessment