Worried about my best friend drinking 24/7
Posted , 15 users are following.
For you that know me I started taking Nalmefene 8weeks ago I've gone from drinking a bottle of wine a day to one a week I feel great. I gave my pills to my friend as he was good at hiding the amount he was drinking He stayed here for the weekend just drank the whole time other than sleeping. He's been taking Nalmefene for two weeks why is it not having any effect? I'm worried as he had seizures. Really hard to watch. Any advice, how can I help him. The doctor wouldn't give him pills he's on a waiting list for an addiction clinic.
1 like, 27 replies
Joanna-SMUKLtd Cisorium
Posted
First of all, please do not give nalmefene or naltrexone to anyone else. It is prescribed for you, and your particular set of circumstances.
For this treatment to work, it can take some time - for some, a number of months. During that time, a person needs to know that they are going to be able to receive the prescription for however long it takes. When these tablets are taken, the brain tries to overide the blockage by producing more sensitive opioid receptors. Of course, when the tablets are taken compliantly, then this isn't an issue. But if someone is either intermittent with compliance - either with the tablets or the timing - or takes them and then runs out, they are left in the position that they are gaining even more of a hit from the alcohol than before, since the endorphins are hitting much more sensitive opioid receptors. This is called up-regulation. In effect, each drink taken when the opioid receptors are more sensitive, create even more re-inforcement of the alcohol drinking and makes the pathway in the brain much, much stronger.
There can be a number of reasons why it isn't showing an effect for your friend, the most likely being:
1. There is an element of actually working to reduce drinking in the beginning, if early progress is to be seen. If someone takes the tablet, but doesn't try to work alongside it, then the science will still (eventually) work if they remain 100% compliant, but the pill will not stop someone pouring alcohol down their neck if that is what they are set on doing - or being driven to do because of alcohol withdrawal symptoms. It's the equivalent of taking a pill to help someone lose weight, but then continuing to eat fast food every day - any progress can be patchy or non-existent. It certainly will not be smooth. It's not a magic pill, as you know.
2. If your friend is drinking 24/7 then the chances are that they are not remaining compliant, and perhaps the pills are wearing off. Selincro is expected to last around 8-10 hours, so if drinking is continuing and another tablet is not taken at that point, then the person is drinking with no protection AND with super sensitive opioid receptors, as explained in the top paragraph.
With a 24/7 drinker, I am not surprised that the GP will not prescribe. He does not meet the criteria for Selincro, it's as simple as that. A doctor is not going to risk his/her career for someone who could/probably would be at risk of alcohol withdrawal and seizures if they prescribe medications outside of the NICE guidelines. Your friend sounds like he needs a proper medical detox, so that he is not in danger, and then evaluate with a specialist doctor which treatment is correct for him.
It is hard to watch, I know. I've been on that side of the fence, too. But when someone is so engrained in around the clock drinking, safety has to come first in terms of medically removing the alcohol from his system before seeking other treatment.
Cisorium Joanna-SMUKLtd
Posted
I know is wrong for me to give him my medication I just couldn't watch him I was trying to help. I hope he's seen soon by the addiction clinic and they prescribe. I had intended giving him Nalmefene until he got his own as I'm not drinking more than once a week. I will take him to the clinic to make sure he tells them everything.
nicole36330 Cisorium
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Cisorium nicole36330
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I felt it was wrong for him to be turned away when he was asking for help. You hear it all the time ( go to AA) I didn't think it causes any harm. But Joanne has pointed out how it will affect him if he drinks now without the pill. He means so much to me.
Breaks my heart to watch.
Joanna-SMUKLtd Cisorium
Posted
Yes, I see where your intentions are coming from, but the fact is that he is very, very unlikely to be able to get his own prescription for nalmefene on the NHS. The guidelines for prescribing nalmefene are: for a man, around 7.5 units a day, not in danger of withdrawal, and unable to reduce consumption on his own.
Although this treatment works with all kinds of drinkers, it was approved by NICE as a treatment to be used 'at home' for mild to moderate dependency issues, which is basically those not at a severe enough stage to need alcohol recovery services input. It was intended as an early intervention treatment for GPs to prescribe. Of course, we all know that it didn't work out that way in practise and many people are still having to go to the ARCs to get it because GPs didn't receive a budget to provide the additional support that is also required, but your friend is simply not likely to ever be prescribed nalmefene on the NHS (as far as I can see from what you are telling us).
If he does end up having an NHS medical detox at around £2000+ cost to the NHS, then afterwards, the doctor is not about to say 'ok, go drink again, but take nalmefene first'. It just won't happen.
He will be able to discuss medications with them, but is more likely to be encouraged to remain abstinent with perhaps Campral, or maybe naltrexone (which can be used for The Sinclair Method). But let's be honest here - there is no way a severe 24/7 drinker is going to be encouraged to drink again by the NHS and prescribed nalmefene.
Cisorium Joanna-SMUKLtd
Posted
He has been to rehab in the past they put him on baclofen which did control his drinking. He has just spiralled as hr last his job got depressed. So I have seen him in control. Can he not do that again? I haven't read The Cure for Alcoholism yet, I will to better understand. Claudia Christian was in rehab she drank for days on end when she relapsed. So why can't it work for him? I read the book this week.
Joanna-SMUKLtd Cisorium
Posted
The issue remains whether a doctor will be willing to prescribe it to him, which I seriously, seriously doubt an NHS-based doctor will be. He may be more likely to get naltrexone when he has been detoxed but it will be on the basis of helping him remain abstinent. What he does from then on, is his decision, but there is zero chance that (after a detox) the NHS will give him nalmefene so that he can drink again.
Cisorium Joanna-SMUKLtd
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Cisorium harriet67221
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AA would be no good he's done it before he's very intelligent it drove him crazy. Im reading Roy Eskapa The Cure for Alcoholism I just know he needs Naltrexone. Im gong to contact clinic tomorrow to see if they can see him soon. I still have wine glass in hand but its flavoured water all because I've taken Nalmafene I feel free want him to be aswell or anybody who's addicted.
Nat666 Cisorium
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So glad the Nalmefene is working for you . TSM is one amazing journey providing we remain compliant.Love the fact you are now down to 1 bottle of wine a week. Well done you
Cisorium Nat666
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Thank you so much, as ivr said I know it's wrong to give my meds buy as long as he takes them and willing to he can get addicted so what the harm. He has to wsiy 6 weeks for clinic...
I love him dearly I'd do anything to help him even if some people don't agree.
Cisorium harriet67221
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I understand what your saying the waiting list is so long I'm terrified GP just referred so he's just waiting for help. As you well know me taking drink away from him is dangerous.
Cisorium Joanna-SMUKLtd
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I'm not a doctor I'm not saying I have the answer I'm just stating what TSM states I'm just trying to understand myself if Claudia Christian tired everything until she found naltrexone
Now shes cured. I don't understand why it can't work for my friend who has tried everything else. I'm taking onboard what your saying its just all very confuseing.
Cisorium Joanna-SMUKLtd
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Joanna thank you, I'm getting upset as i feeling like a bad person. I've told my GP what's going on and I rand the addiction clinic he's just editing to be seen.
Cisorium
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Cisorium
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Joanna-SMUKLtd Cisorium
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Don't worry, you are doing your best - especially when being faced with a system that is basically stuck in the 1930's! You are a good person for wanting to extend your knowledge and experience to your friend and help him, too.
The situation will be that (as it stands today) your friend is likely to be steered towards a medical detox, which it certainly seems to be needed for his own safety, and then we can take things from there. The NHS is a massive layer-upon-layer bureaucracy that has a guideline in place for each medication. It won't be until he is medically assessed by a consultant that specialises in treating alcohol dependency that anyone will know his full medical condition and whether he is then suitable for any of the treatments that are available.
We shall help you cross one bridge at a time.......