Requesting Naltrexone - Any tips?

General health and lifestyle
1

I am planning to speak to my Gp tomorrow, requesting that he/she prescribes Naltrexone so that I can begin my road to recovery safley. Looking for some advice/tips on how to get my point across that I need something now whilst I remain highly motivated to tackle my addiction?

I a have been to my Gp several times in the last few months seeking support to come off alcohol. I was admitted to hospital for 3 months in 2008 as an inpatient pin order to detox. Have had a on/off relationship with alcohol since, but have been drinking half a litre of vodka in the evening for the past few years, I can't remember when I last had a dry day. The Gp has referred me to alcohol services but I am currently number 14 on their waiting list and don't feel I can wait that long. I have tried to cut down on several occasions since Xmas but my withdrawals symptoms have been severe enough for me to up my intake.

Any advice on how to get my needs met sooner by the Gp would be gratefully appreciated. I feel like I am fighting a losing battle to stop drinking due to lack of support, whilst fighting an equally losing battle with my addiction to alcohol.

Thanks x

2

I find it disgusting that you have to be on a waiting list just to see alcohol services.I got seen in a couple of weeks but I'm down south,not sure where you are.

I read up on my rights regarding Nalmefene and printed stuff off and also took onboard a lot of what RHGB,another poster said about getting your point across ect

3

Hello Vodka07.  I think you should be very open with G.P. about the whole situation.  Try to put the case forward about tapering down your alcohol consumption.  When it is high, it is dangerous to try to just stop.  I am taking Selincro/Nalmefene.  Have a read about it, online.  I am on week 4.  It is not a "magic pill", but... it is giving me hope, now.

I hope you find your road,

Alonangel 🎇

4

You will find it difficult. I'm not being defeatest, that is not in my nature, but you need to be clear in your mind what you're up against.

The general guidelines have pushed GPs away from dealing with this and the GMC/NHS are telling them to send you to an alcohol services rehab.

What I would do, is ask the alcohol services for a realistic date that you will be seen, be firm if they try to be evasive, just keeping coming back to the same question and tell them you are due for an update meeting with your GP and he will want to know of the progress, since he referred you.

If they don't give you a date, do what Joanna said the other day and contact DAAT and tell them the alcohol services won't give a date. Now I know you asked about your GP, but it is good to have more than one plan of action, so do pursue this.

Then see your GP, my own thoughts are that the alcohol services will be a bit fuzzy about a date, tell him this. Tell your GP the truth, tell him you are drinking half a litre a day and it is poisoning you (you will find that both GPs and alcohol services use the buzz word poison for alcohol these days). Tell him that you feel that you are not moving forward and in fact that you are increasing your drinking because of anxiety.

Tell him that you have done your research and that you feel that naltrexone or nalmefene is the right medication to help you and that you would like to be prescribed it, whilst you wait for your appointment to be confirmed at alcohol services. Also ask for an LFT test so that you have a recent one on record and the alcohol services can use that one and save time.

Write down bulletin points of what you are going to say, because as soon as the GP says why, all those well rehearsed lines that you had in your head will go out of the window. Remember, you drive the meeting, don't sit back like a passenger.

If you drink throughout the day, book a morning appointment.

Of course if the alcohol services come back with a reasonable date, your GP will probably ask you to wait. The reason I mentioned nalmefene is that for all intents and purposes it is the same as naltrexone, but without going long winded, it is easier to get nalmefene prescribed.

5

Google....

c three europe nhs selincro

The second entry should be entitled NHS Information and Resource Service for Nalmefene (Selincro).

This is an article I wrote about both naltrexone and nalmefene on the NHS in the UK.  It gives you background information and an understanding of how the NHS tackle AUD.  At the end is a section where you can put your town and county in and I will find the relevant info for your area but in all honesty, I doubt I would get a chance to look up your health authorities procedure before you doctors appointment if it is tomorrow.

Also on that website, in the left hand sidebar is a logo for C3 Europe counselling.  A problem getting either naltrexone or nalmefene is the providing of the additional support that is required.  If you doctor is willing to prescribe either, C3 Europe can provide you with the counselling support free of charge.  You can say that you have found your own 'private' counselling support and there is a pdf file that you can either print or email to your GP to show counselling qualifications etc.

Good luck!

Joanna

6

Hi vodka

i really do feel for you as you're stuck in a vicious circle.

youve been brave enough to admit you need help and have been referred to alcohol services by your GP.

its appalling that you're no 14 on a waiting list, unfortunately this seems to be the norm these days.

my understanding is that to get naltrexone or nalfemene or campral you need a detox before starting any tablets.

half a litre of vodka a night is bound to have taken its toll, and I can appreciate how hard, not to mention dangerous, it would be for you to try to stop on your own.

i think you ought to explain honestly to your GP how much you are drinking and need a detox urgently, whether that be at home with chlordiazepoxide (Librium) or diazapam (Valium). Inpatient detoxes take time. Am sure RHGB will come up with some help in how you could go about getting some urgent help.

i am amazed that you only drink at night. I certainly couldn't have lasted all day and just drink at night. So you can go without during the day.

good luck for tomorrow xx

7

Me either,if I'm off work the boredom sets in and I will drink if I don't have to drive anywhere

8

Getting a detox is probably the more likely option that the GP would go for, but in my experience, you are likely to return to alcohol soon after if there is not a follow up medication.

Detox helps to come off alcohol in a safe and pleasant way, but it does nothing to help you stay off it. The gap between detox and the follow up with nalmefene/naltrexone/acamprosate should be a small one.

9

Yes try to get urgent detox ASAP, then ideally the follow up drugs immediately would be ideal. The withdrawal controlled by either Librium or diazapam is the easy bit provided the dosage is high enough. The hard bit is abstainance and is when you're at the most vulnerable point.

was it six weeks you had to wait before you got campral? I've deliberately got a supply of diazapam and naltrexone stored away at home for emergencies. I know if I went to my GP in say several months, he wouldn't prescribe me any, he'd just tell me to go to ADS again, who will see me weekly with my drink diary for a month. Then they may suggest my GP prescribe the follow up drugs, or maybe try CBT or counselling first. Just depends on the GP in the end.

It winds me up that help is immediate for people coming off heroin, but the lack of consistent help for coming off alcoholic is apauling.

10

Yes, it was six weeks from detox to Campral and it should be instant. The doctor (at alcohol rehab) mocked diazepam and said that was not right, and proceeded to tell me how it should be done, at which point I said, like keeping me waiting for 2 - 3 months like your other branch? At that point he conceeded defeat.

I too have a supply of diazepam and 2 months supply of Campral. Plus I am looking at other supplies. Now, some of the new members will be reading this with horror, how we keep diazepam and naltrexone/Campral, but we've both been on the merry go round before and god forbid I ever have to use them, I'm not going through the same hoops as last time.

11

Exactly! I doubt I'd have been as strong willed as you. I felt like a bouncing ball, going from pillar to post back and forth. I hope I don't need them, but knowing I've got them makes me feel safer. Took three boxes of campral back to boots to destroy (or whatever they do with them) they were out of date.

I got a lecture on ordering expensive drugs and wasting them by not taking them from an assistant younger than my daughter. I just said "sorry. I thought I was being responsible, don't bother, I'll put them in the bin on my way out"

12

I imagine that if you store them in a cool place out of direct sunlight, kept in the blister packs and box, you will find that they last years and years.

13

Selincro/Nalmefene is expensive ... for G.P. to prescribe.  I don't know about the cost of Naltrexone.  

14

I'm funny about anything out of date, use before, or best before. Obviously it's a bit of ocd. They were 3 - 4 years out of date.

One of my Spanish friends has found out that if I take my repeat prescription form to a farmacia I will be able to buy diazapam, Librium and naltrexone over the counter for €3 per item.  I will be visiting several farmacias next week.