nhs

There seems to a total lack of information regarding the drug. Some GPS prescribe it, others say they've never heard of it. People are given different guidelines on how to take it, how long for etc.

having said that I thought NICE had agreed to it being prescribed by GPS if you meet the required criteria. I do feel really sorry for you, after doing so well and then to be told you won't be able to get it.

I know it's been said on this forum that it's a waste of space and a waste of tax payers money but to many it's a lifeline that could be taken away.

I hope someone somewhere can help you. Good luck

I am new to this site but I saw your post and as I work in substance misuse I thought I would reply. Firstly - do not worry! The idea with nalmefene is that it allows you to begin to gain control of your alcohol consumption. Usually 6 months is enough time to do this but I understand that it is not always that simple so my advice to you would be to try one or two days of not taking it and see how that affects you. You can stockpile the tablets (I know that's not really allowed so don't tell!!) so that you have some in reserve in the future if you start to slip again. Sometimes having that psychological crutch there can help but ultimately, the tablet can only do so much. YOU are doing all the hard work so don't underestimate your own contribution to how well you are doing.

It is because of the cost that the NHS are putting limits on it. There is another medication called naltrexone that is very similar and much cheaper so maybe ask your GP if you can try that when your 6 months is up. It is not licenced to be used like nalmefene, it is licenced to maintain abstinence rather than controlled drinking, so the GP may not agree.

Remember to keep a drink diary and pat yourself on the back when you have good days. Keep reminding yourself how well you are doing and make a note of the improvements in your life (e.g. more money in your pocket, feeling better in the mornings, any physical improvements etc.) Support groups are good too.

I hope this helps and good luck! Also, well done you for addressing your alcohol issues - many people don't until it is too late.

Most Primary Care Trust's drug committees don't approve the prescribing of Nalmefene due to its cost. It is possible that your GP sought permission to make you an exception and that they agreed to 6 months only, and have now contacted your GP to say 'time's up.'

This is scandalous if it is working for you. The price of the complications of excessive drinking is far higher than continuing to give you a treatment that appears to be working well.

I would get some more information from your GP about exactly who this letter is from and what it says. Then I would send in a complaint about them withdrawing treatment which is working.

An alternative is to offer to pay for the pills yourself. Your GP could then give you a private prescription but you would have to pay full price at the pharmacy which is about £100 for 28 pills, currently. If you did that, I would suggest that you made those pills last a long time. For example, if you drank only one day a week, you could make them last 28 weeks.

Good luck, don't give up trying to get what you need.

There is a better chance you can drink and not get plastered - like me.

So what about the cost if you will feel better within yourself?

How do you feel you are progressing with the treatment?  Did you log what you are drinking and how often?

I would suggest that you gather this information together, perhaps in a simple graph form to show how much your drinking is improving and then discuss it with your GP, saying that the medication is working but you are not quite at the stage where you feel secure drinking without it.  Can you show him/her whereabouts you are compared to where you would like your drinking levels to be?  If he/she can see a continuing reduction in your drinking, it would be very unethical of him/her to say that they are discontinuing the medication.  Their overall concern should be your wellbeing and if you are continuing to get well but need a little longer to reach successful treatment.....

Another question to ask your doctor is that if you have your prescription removed so close to reaching your goals, what will happen if your drinking increases again.  Will you receive a new prescription again at that point?  In which case, it will cost the NHS more to prescribe to you again if you end up back at square one.

To answer your question, without the medication blocking the endorphins released by drinking, if you drink without the medication you will get a full 'hit' of the endorphins and (over time or even very quickly) your brain will 'relearn' that the drinking is creating the previous sensations in you that it did prior to the medication.

So, if your cravings haven't quite been extinguished by the medication, which it sounds like they haven't, the cravings will likely begin again and you MIGHT end up back at the beginning.  This may happen, but you may find that you have more control over drinking than you realise.

Selincro isn't like an antibiotic that after so many tablets the problem is gone - everyone is different.  For some people that might be 3 months to get things sorted, for others 6 and for other still 12 months.  I've known people go beyond this 6 month mark and still be prescribed so it must just be your NHS area cutting costs.

It seems very unfair to withdraw a medication from you if you can show that it is working and that you are reaching the point when another couple of months prescription now will save the NHS more money in the long run.

Naltrexone IS a potential option, but as mentioned in other comments it is only licensed in this country to help reduce cravings in those people when they have already stopped drinking.  It costs approx half the price of Selincro for the NHS to prescribe, but it is usually only prescribed in secondary care (alcohol treatment specialists) rather than GP care.

Another option is if you are already under the care of and alcohol counselling service in your area, the prescribing physican can often 'overule' a GP and issue a prescription for either Selincro or naltrexone as either medication does the same blocking mechanism.  (overule may be the wrong word there, but right now I can't think of another word to use).

Lastly, when you speak to your GP you can ask if he would prescribe the tablets and you arrange your additional counselling.  This might help if the issue is really the cost of providing you with the aftercare.

Good luck!