4.10. Drugs used in substance dependence
4.10.1. Alcohol dependence
Restrictions:
Restricted to specialist initiation only.
Prescribing Notes:
- Continue for up to one year, although can be continued when relapse prevention benefit is demonstrated
- Discontinue if lack of efficacy or full relapse occurs
- Recommended: Review of alcohol consumption and psychosocial wellbeing every 6 months
Restrictions:
Restricted to specialist use only.
Prescribing Notes:
Consult with your local Alcohol and Drug Recovery Service (ADRS) for details of local arrangements relating to ongoing supply of disulfiram. ADRS will retain responsibility for ongoing clinical review.
Prescribing Notes:
Nalmefene is licensed for the reduction of alcohol consumption in adult patients with alcohol dependence who have a high drinking risk level (DRL), without physical withdrawal symptoms and who do not require immediate detoxification.
Nalmefene should only be initiated if DRL remains high two weeks after an initial assessment and should only be prescribed as part of a full package of care including the provision of continuous psychosocial support by appropriate NHS personnel. It should also be reviewed regularly.
Restrictions:
Restricted to specialist use (Addiction Services) according to local treatment guidelines
Prescribing Notes:
- Treatment should continue for 6 months, or longer for those benefiting from treatment who are motivated to continue.
- Treatment with naltrexone should be discontinued after 4 to 6 weeks if drinking persist
4.10.2. Nicotine dependence
Prescribing Notes:
Nicotinell® products (24-hour patch, lozenge or gum) are the nicotine replacement treatments of choice. If dual nicotine replacement is appropriate then a 2nd product should be added to Nicotinell® patches. If a mini lozenge is required, the first choice is Niquitin Mini®.
4.10.3. Opioid dependence
Restrictions:
Restricted to use on advice of specialist from the GGC Alcohol and Drug Services.
Restrictions:
Restricted to use on advice of specialist from the GGC Alcohol and Drug Services.
Restrictions:
Restricted to use on advice of specialist from the GGC Alcohol and Drug Services. Excludes Eptadone®.
Prescribing Notes:
The solution strength is 1mg/ ml.