Nalmefene as an intermittent treatment for alcohol abuse triggering cocaine and sex consumption

Abstract

Nalmefene modulates the motivational system by blocking the opioids receptors. Nalmefene indication is the alcohol consumption reduction in alcoho dependent patients. We describe the case of a patient with weekend alcohol abuse that was followed by cocaine use and sex. After being treated with nalmefene, the patient decreased alcohol consumption and did not engage cocaine use and sex. The patient is a 36-year-old man with a previous history of cocaine, cannabis and alcohol abuse. After detoxification the patient became a weekend drinker. Two months later he started complaining that after drinking he needed to consume cocaine and this led him to having sex with prostitutes. These behaviours had a serious impact on his finances that lead him to asking for help. Nalmefene, 18 mg at dinner before going out, was prescribed. Taking one pill of nalmefene “allowed me to drink several shots without feeling a need to continue drinking and, most importantly, I didn’t feel the need to consume cocaine and have sex”. In an attempt to ascertain if what had happened the previous weekend was “psychological” the patient went out without taking nalmefene. The pattern of alcohol use, control loss, and consumption of cocaine and sex repeated itself. During the following two months, the patient took nalmefene during dinner before going out every weekend and the results were the same as when he first took the treatment.

Conclusion

Nalmefene may be helpful in the treatment of several other addictions by blocking the positive reinforcements of the drugs.

Disclosure of interest

The authors have not supplied their declaration of competing interest.