Medication for alcohol dependency
The UK has a worldwide reputation as a nation of drinkers. Millions of UK citizens are classed as ‘alcohol dependent’.
Cutting back on the booze can be hard, especially when alcohol feels so integral to social life. Modern clinical treatments can help you find the discipline needed to drink in moderation, or to give up alcohol altogether.
So if you are worried about your drinking we offer a short consultation session which lasts about 5 to 10 minutes, and covers risks associated with your pattern of drinking, advice about reducing the amount you drink, alcohol support networks available to you, and any emotional issues around your drinking.
Health Plus Pharmacy make clinical alcohol treatments convenient and accessible. The treatment options for alcohol misuse depend on the extent of your drinking and whether you’re trying to drink less (moderation) or give up drinking completely (abstinence).
We can prescribe a number of medications for alcohol dependency which are recommended by the National Institute for Health and Care Excellence (NICE) to treat alcohol misuse.
Tablet Treatments Available
Acamprosate calcium
Disulfiram
Nalmefene hydrochloride dihydrate (Selincro®)
Naltrexone Hydrochloride
Treatments for alcohol misuse include:
Acamprosate Calcium
Acamprosate (brand name Campral) is used to help prevent a relapse in people who have successfully achieved abstinence from alcohol. It’s usually used in combination with counselling to reduce alcohol craving.
Acamprosate works by affecting levels of a chemical in the brain called gamma-amino-butyric acid (GABA). GABA is thought to be partly responsible for inducing a craving for alcohol.
If you’re prescribed acamprosate, the course usually starts as soon as you begin withdrawal from alcohol and can last for up to 6 months.
Disulfiram
Disulfiram (brand name Antabuse) can be used if you’re trying to achieve abstinence but are concerned you may relapse, or if you’ve had previous relapses.
Disulfiram works by deterring you from drinking by causing unpleasant physical reactions if you drink alcohol. These can include:
- nausea
- chest pain
- vomiting
- dizziness
In addition to alcoholic drinks, it’s important to avoid all sources of alcohol as they could also induce an unpleasant reaction. Products that may contain alcohol include:
- aftershave
- mouthwash
- some types of vinegar
- perfume
You should also try to avoid substances that give off alcoholic fumes, such as paint thinners and solvents.
You’ll continue to experience unpleasant reactions if you come into contact with alcohol for a week after you finish taking disulfiram, so it’s important to maintain your abstinence during this time.
When taking disulfiram, you’ll be seen by your healthcare team about once every 2 weeks for the first 2 months, and then every month for the following 4 months.
Nalmefene Hydrochloride Dihydrate (Selincro®)
Nalmefene (brand name Selincro) may be used to prevent a relapse or limit the amount of alcohol someone drinks.
It works by blocking opioid receptors in the brain, which reduces cravings for alcohol.
Nalmefene may be recommended as a possible treatment for alcohol dependence if you’ve had an initial assessment and:
- you’re still drinking more than 7.5 units a day (for men) or more than 5 units a day (for women)
- you don’t have any physical withdrawal symptoms
- you don’t need to stop drinking immediately or achieve total abstinence
Nalmefene should only be taken if you’re receiving support to help you reduce your alcohol intake and continue treatment.
Naltrexone Hydrochloride
Naltrexone can be used to prevent a relapse or limit the amount of alcohol someone drinks.
It works by blocking opioid receptors in the body, stopping the effects of alcohol. It’s usually used in combination with other medicine or counselling.
If naltrexone is recommended, you should be made aware it also stops painkillers that contain opioids working, including morphine and codeine.
If you feel unwell while taking naltrexone, stop taking it immediately and seek advice from your GP or care team.
A course of naltrexone can last up to 6 months, although it may sometimes be longer.
Before being prescribed any of these medications, you’ll have a full medical assessment, including blood tests.
What are the benefits of cutting down alcohol?
The immediate effects of cutting down include:
- feeling better in the mornings
- being less tired during the day
- better looking skin
- feeling more energetic
- better weight management
Mood
There’s a strong link between heavy drinking and depression, and hangovers often make you feel anxious and low. If you already feel anxious or sad, drinking can make this worse, so cutting down may put you in a better mood generally.
Sleep
Drinking can affect your sleep. Although it can help some people fall asleep quickly, it can disrupt your sleep patterns and stop you sleeping deeply. So cutting down on alcohol should help you feel more rested when you wake up.
Behaviour
Drinking can affect your judgement and behaviour. You may behave irrationally or aggressively when you’re drunk. Memory loss can be a problem during drinking and in the long term for regular heavy drinkers.
Heart
Long-term heavy drinking can lead to your heart becoming enlarged. This is a serious condition that can’t be completely reversed, but stopping drinking can stop it getting worse.
Immune system
Regular drinking can affect your body’s ability to fight infections. Heavy drinkers tend to catch more infectious diseases.
What is the best tips on cutting down on alcohol?
If you regularly drink more than 14 units of alcohol a week, try these simple tips to help you cut down.
14 units is equivalent to 6 pints of average-strength beer or 10 small glasses of low-strength wine.
Make a plan
Before you start drinking, set a limit on how much you’re going to drink.
Set a budget
Only take a fixed amount of money to spend on alcohol.
Let them know
If you let your friends and family know you’re cutting down and it’s important to you, you could get support from them.
Take it a day at a time
Cut back a little each day. That way, every day you do is a success.
Make it a smaller one
You can still enjoy a drink, but go for smaller sizes. Try bottled beer instead of pints, or a small glass of wine instead of a large one.
Have a lower-strength drink
Cut down the alcohol by swapping strong beers or wines for ones with a lower strength (ABV in %). You’ll find this information on the bottle.
Stay hydrated
Have a glass of water before you have alcohol and alternate alcoholic drinks with water or other non-alcoholic drinks.
Take a break
Have several drink-free days each week.
Am I better off moderating or cutting alcohol out completely?
Moderation or abstinence are treatment options if you’re:
- regularly drinking more than 14 units a week
- experiencing health problems directly related to alcohol
- unable to function without alcohol (alcohol dependency)
Cutting alcohol out completely will have a greater health benefit. However, moderation is often a more realistic goal, or at least a first step on the way to abstinence.
Ultimately, the choice is yours, but there are circumstances where abstinence is strongly recommended, including if you:
- have liver damage, such as liver disease or cirrhosis
- have other medical problems, such as heart disease, that can be made worse by drinking
- are taking medication that can react badly with alcohol, such as antipsychotics
- are pregnant or planning to become pregnant
Abstinence may also be recommended if you’ve previously been unsuccessful with moderation.
If you choose moderation, you’ll probably be asked to attend further counselling sessions so your progress can be assessed, and further treatment and advice can be provided if needed.
You may also have regular blood tests so the health of your liver can be carefully monitored.
Is it worth keeping a drinking diary?
If you’re aiming to moderate your drinking, then keeping a drinking diary will most certainly help!
On a daily basis, make a note of:
- all the alcoholic drinks you’ve had
- what time you had them
- where you were
- how many units you drank – you can use the Alcohol Change UK unit calculator to work this out
This will give you a good idea of how much alcohol you’re drinking, the situations in which you drink, and how you could start to cut down.
How do I calculate alcohol units manually?
Units are a simple way of expressing the quantity of pure alcohol in a drink. One unit equals 10ml or 8g of pure alcohol, which is around the amount of alcohol the average adult can process in an hour. This means that within an hour there should be, in theory, little or no alcohol left in the blood of an adult, although this will vary from person to person.
The number of units in a drink is based on the size of the drink, as well as its alcohol strength.
For example, a pint of strong lager contains 3 units of alcohol, whereas the same volume of lower-strength lager has just over 2 units.
Knowing your units will help you stay in control of your drinking.
To keep health risks from alcohol to a low level if you drink most weeks:
- men and women are advised not to drink more than 14 units a week on a regular basis
- spread your drinking over 3 or more days if you regularly drink as much as 14 units a week
- if you want to cut down, try to have several drink-free days each week
14 units is equivalent to 6 pints of average-strength beer or 10 small glasses of lower-strength wine.
A 750ml bottle of red, white or rosé wine (ABV 13.5%) contains 10 units.
See the guide below to find out how many units are in your favourite tipple.
| Type of drink | Measurement (ml) |
Percentage (ABV) |
Number of alcohol units |
|---|---|---|---|
| Single small shot of spirits* | 25ml | 40% | 1 unit |
| Alcopop | 275ml | 5.5% | 1.5 units |
| Small glass of red/white/rosé wine | 125ml | 12% | 1.5 units |
| Bottle of lager/beer/cider | 330ml | 5% | 1.7 units |
| Can of lager/beer/cider | 440ml | 5.5% | 2.4 units |
| Pint of lower-strength lager/beer/cider | 568ml | 3.6% | 2 units |
| Standard glass of red/white/rosé wine | 175ml | 12% | 2.1 units |
| Pint of higher-strength lager/beer/cider | 568ml | 5.2% | 3 units |
| Large glass of red/white/rosé wine | 250ml | 12% | 3 units |
*Gin, rum, vodka, whisky, tequila and sambuca.Large (35ml) single measures of spirits are 1.4 units.
How do I calculate alcohol units?
Use the Alcohol Change UK’s unit calculator to find out how many units are in a particular drink, or to check how much you’re drinking.