Ruminations on Nalmafene, a drug used to help alcoholics drink less, and the debate between harm reduction and abstinence

A new Finnish drug called Nalmafene, has shown good results in helping chronic alcoholics to drink less. The drug, which is used as a part of a harm reduction framework for the treatment of alcoholism, doesn’t call for complete abstinence as a goal, and only tries to reduce the amount and frequency of drinking; and under this philosophical framework, the new drug seems to be moderately successful.

Nalmafene is a drug that is taken only as needed. When an alcoholic feels a strong desire to drink, the drug is consumed, and the cravings are reduced. Clinical data shows that study participants taking the drug reduced their days of heavy drinking from an average of more than 15 to just over 9 days a month.

The study leader was previously employed by the pharmaceutical company now marketing the drug, and the study was funded by that company.

Harm Reduction?

Harm reduction proponents argue that any reduction in the quantity and frequency of consumption is a victory, and I can see their point; but when I succeeded in quitting treatment through abstinence, rehab and aftercare therapy, I can’t help but wonder why if I could do it, every one else couldn’t as well. While a 30% reduction in heavy drinking as reported by the drug study is noteworthy; the data still indicates that each of the participants was still drinking heavily almost once in every three days, and the social and physical costs of this abuse as a result remain terribly high.

Should we settle for a treatment that boasts that people using it are drunk only once in three days as opposed to once in two days…better to be sure, but is it good enough?

The drug has yet to be approved for use in the US, and if it is it will surely fuel the debate and controversy between proponents of abstinence and harm reduction, and this constructive and healthy debate is beneficial to all. I fall firmly in the abstinence category though, and I would argue that any alcoholic should at the very least strive for complete abstinence, and only if this proves completely impossible, settle for anything less.

Leave a Reply