Are you drinking more than you should? Not in a way that’s destroying your relationships or career – or that involves reaching for a drink as soon as you wake up.
But maybe you find yourself having almost an entire bottle of wine at night. Perhaps you don’t consider this much of a problem, but as a consultant liver surgeon for more than 30 years, I believe it is.
There is a very real danger of becoming an increasingly heavy drinker: what once seemed a perfectly normal, enjoyable habit ends up seriously compromising your life and your health.
I know that many patients enjoy years of drinking heavily at the weekend, as well as a bottle of wine a night in the week, with little more than a few headaches and hangovers to trouble their routine or make them realise they’re problem drinkers.
It’s only decades later that some find themselves suffering from the symptoms of liver cirrhosis – scarring within the liver which can cause fatigue, weight loss, anaemia and jaundice – that the reality hits home.
Of course, education plays a significant role in highlighting the dangers of excess alcohol. But there’s something else I believe could help many more people cut down – a little-known medication that’s been called the ‘Ozempic for drinking’, comparing it with the weight-loss drug for its ability to dull the urge to drink alcohol.
I would argue far more people who are regular heavy drinkers should be offered this treatment than currently are.
Professor David Lloyd believes a little-known medication that’s been called the ‘Ozempic for drinking’ can help more people cut down on their alcohol intake
The drug, which is called naltrexone and comes in tablet form, works by blocking brain receptors where alcohol attaches so that the pleasurable buzz of drinking is reduced
The drug, which is called naltrexone and comes in tablet form, has been available on the NHS since the 1980s. It works by blocking brain receptors where alcohol attaches so that the pleasurable buzz of drinking is reduced.
By reducing the pleasurable effects of alcohol, the brain ‘unlearns’ the link between alcohol and the production of feel-good chemicals that spark addiction – and the urge to reach for a drink – in the first place.
The drug is taken an hour before drinking and should be used in a targeted way to reduce drinking over time. It is usually only prescribed on the NHS for serious alcohol dependency.
But in my view we should consider prescribing it much more widely. Almost a third of men (32 per cent) and one in six women (15 per cent) regularly drink more than the recommended 14-unit limit a week, according to the latest data.
Certainly, if you feel you consume too much alcohol, even if you don’t think you are a binge drinker, you should talk to your GP about going on this drug. Especially if you’re regularly drinking the best part of a bottle of wine every night.
And the point about naltrexone is that it works, with several randomised trials proving its benefits in helping people overcome their addiction.
In 2011, psychologist Helen Pettinati, who specialises in addiction, published a study confirming that those taking naltrexone reduced their drinking by nearly 40 per cent.
In 2022 a review of research by Dr Charles Murphy concluded that people taking the drug had fewer drinking days compared with those taking a placebo. Indeed, those who benefited from taking naltrexone maintained abstinence for up to two years – even after they had stopped. It is relatively cost effective at around £80 for 28 tablets.
As with any drug there are side-effects – usually minor (e.g. nausea), but occasionally more serious (e.g. depression and suicidal thoughts).
Naltrexone must be taken with the advice of your GP or liver specialist, and you should be monitored closely for a six-month trial period. This means regular blood tests to check your liver function – because you need a normally functioning liver for the drug to work effectively.
Naltrexone is available off-licence in the private sector – but again you should be monitored by a specialist. Clearly, if you have a poorly functioning liver, you cannot receive this drug because it is metabolised in the liver and its side-effects will be exaggerated in liver failure patients.
That’s why we can and should act pre-emptively before alcohol does too much damage, which is why naltrexone should have a major role in our health service for people who want to drink less.
I believe most sensible people really don’t want to drink a bottle or two every night. They’ve just got into a habit and don’t know how to break it. I have seen lives devastated by too much drink.
Yet there’s something in our arsenal to stop this happening: something simple and relatively cheap. The time has come to use this unsung drug to help drinkers kick the habit while they still have time to do so.
Professor David Lloyd is a consultant liver surgeon at University Hospitals of Leicester and is on the Clinical Advisory Group for the British Liver Trust.
Interview by Angela Epstein
