ReGen urges caution on disulfiram implants

ReGen urges caution on disulfiram implants

Melbourne, VIC, 5th May 2014 – UnitingCare ReGen, the lead alcohol and other drug treatment and education agency of UnitingCare Victoria & Tasmania, today urged members of the public to exercise caution over the potential use of disulfiram (known under the brand name ‘Antabuse’) implants to overcome dependent or other problematic patterns of alcohol consumption.

In responding to a feature article on one man’s decision to receive an implant to help him change an established pattern of heavy, episodic drinking (The Age, Desperate measures to beat the bottle, 02/05/14), Donna Ribton-Turner (ReGen’s Director of Clinical Services) said:

We all know the impacts that problematic alcohol consumption can have on the lives of individuals, families and the wider community. As we saw highlighted in the article, alcohol and other drug use can have a devastating impact on people’s physical and mental health, relationships and financial security.

Mr Byrnes’ case also emphasises how desperate those affected can be to find a solution. Sometimes that desperation can lead to choosing treatment options that offer a ‘last hope’. For some people, this is disulfiram. We know that it can play a successful role in supporting the establishment of new patterns of behaviour based on abstinence from alcohol. However, there are severe risks associated with its use. Some of these were addressed in the Age article, but not all.

Use of the drug can lead to some pretty severe consequences for individuals and their families. The ‘disulfiram reaction’ is potentially toxic and can occur through unintentional exposure to alcohol through products such as mouthwash, cosmetics, vinegars and salad dressings. It’s more complicated than avoiding black forest cake and punchbowls.

Usually, people take disulfiram in tablet form. This allows a quick response (i.e. ceasing its use) if problems develop. With an implant, this is much more difficult, making the potential risks that much greater. Apart from the health risks associated with using disulfiram, the feedback we consistently get from people who have made multiple attempts to overcome their alcohol dependence is that it is only effective with a small percentage of people.

We understand that it can appear to be an attractive option for people who are desperate for change, but the unfortunate reality is that overcoming dependence is a much more complicated process than popping a pill (or getting an implant). It’s about changing patterns of thinking and behaviour. This is the work of counselling and rehabilitation services, like our Catalyst program.

As anyone who has tried to give up smoking will know, you need more than just nicotine patches to quit.

As with any approach to alcohol and other drug treatment, medication should be seen as one part of a multipronged approach to supporting sustained behavioural change. Anyone considering including disulfiram in their treatment should be aware of the potential health risks and the additional medical monitoring that would be necessary as part of an integrated treatment plan, particularly if they have existing health problems. Anyone who is pregnant or breastfeeding, or has a mental illness or history of high blood pressure, liver, kidney or heart disease should seek expert medical advice about possible complications.

Occasionally, we see media coverage (such as the Age story) that asks why Antabuse isn’t more commonly prescribed in Australia. The simple reason is that it’s potentially dangerous and comparatively ineffective. Antabuse has been around since 1948. In the meantime, there are several other drugs that have been developed to support abstinence from alcohol, without the associated risks.

Anyone considering using medication to assist their recovery from alcohol (or any other drug) dependence should consult with experienced AOD services or an Addiction Medicine Specialist. With appropriate expert supervision, such medications can play an important role in achieving sustainable behavioural change, but they will be unlikely to produce any significant outcomes unless they are part of a more comprehensive response to the problem.