New wonder drug?

A pill which is claimed to prevent people drinking to excess has made its appearance on the market.

It is claimed that the development should be able to help a condition which normally responds to drugs only in extreme cases. Alcoholism is usually treated with counselling. Unlike other drug treatments, such as antabuse, which make people physically ill if they drink, the new drug, naltrexone, helps people to control their alcohol habits yet still allows them to imbibe socially.

According to Roger Thomas, a consultant psychiatrist who is promoting the treatment, the pill removes any pleasure in drinking and so destroys craving. The removal of pleasure, of course, is not crucial to the substantial proportion of dependent drinkers who say that they do not actually enjoy the taste of alcohol. It could, on the other hand, be used by binge drinkers to reduce the amount they drink. In the case of dependent drinkers, it could act as a tool in the process of rehabilitation, allowing them time to begin the process of recovery without having to fight a constant craving. Other drugs such as librium are already used in this way. Many experts are cautious about a drug-based approach to addiction. Robert Lefever, the director of the Promis Recovery Centre, said he preferred a non-drug approach. He pointed out that drugs such as antabuse and naltrexone create "dry drunks" who "still have all the behavioural characteristics of an addict. We can prescribe valium and librium to help with withdrawal symptoms but apart from that we do not use drugs."

Naltrexone, for which an 80 per cent success rate is claimed, works by blocking the effects of alcohol on pleasure receptors in the brain so cravings for it are weakened. Up to now, a small number of people in the United Kingdom have used it at the ContrAl clinics in Cardiff, Bristol, and London.

The drug is not yet licensed in this country, which means that doctors need Home Office permission to prescribe it, and can do so only for named patients. However, the manufacturers hope that naltrexone will soon be available to National Health Service patients. It costs £1,500 for a five-month course which includes 10 counselling sessions. The cost of a course of rehabilitation at a private hospital, such as The Priory, is considerably higher.

Dr Thomas, of Cardiff Community Healthcare Trust, who also works for the ContrAl clinic, said that the drug had to be combined with a psychological approach to deal with the underlying cause of the drinking problem. He said: "This is not a magic treatment. It's a new approach which has a lot of possibilities. It is not a pill which allows you to drink." He said it was useful for people who were drinking 50 or more units a week.

Professor Brian McAvoy, of the Department of Primary Care at Newcastle University Medical School, agreed that naltrexone "was not a wonder drug but that it benefits dependent drinkers as long as it is used along with social and psychological support." Professor McAvoy, who has observed the use of naltrexone in Australia where it is a licensed drug, said that it would be interesting to see the results of its use with dependent drinkers recruited through General Practice rather than specialist addiction units.

A study of the drug's use in America, which looked at more than 3,000 patients, showed that naltrexone was a safe and effective treatment for alcohol dependence as part of a counselling programme. The average number of drinks per week fell from 57 to four and the main side effect was nausea. The considerable press interest in the drug is an echo of previous sensational stories of wonder drugs which were heralded as the answer to dependent drinking and so it is important to keep in mind the fact that naltrexone's benefit comes when it is used alongside counselling and other forms of psychological therapy.

The writer Catherine Grace was the first person to take the drug in this country. She began drinking as much as three bottles of wine a night after the breakdown of her marriage. She tried Alcoholics Anonymous but relapsed after three months.

After taking the drug for a few weeks she gradually started to lose the desire to drink. She now only drinks at social functions and does not enjoy more than two drinks. She said: "Now when I drink I do not get the buzz. Instead I get a buzz from salsa dancing and keeping fit."