- have a high drinking risk (defined as alcohol consumption of more than 60g (7.5 units) per day for men and more than 40g (5 units) per day for women, according to the World Health Organization's drinking risk levels) without physical withdrawal symptoms, and
- who do not require immediate detoxification.
Nalmefene must be prescribed in conjunction with continuous psychosocial support focused on treatment adherence and reducing alcohol consumption. It should only be started in patients who continue to have a high drinking risk 2 weeks after their initial assessment.
Nalmefene is an opioid receptor modulator which acts by reducing the urge to drink. One 18mg tablet is taken daily as needed, 1–2 hours before the patient believes he or she will be at risk of drinking.