This seems like a bit of a tricky one. The trial comparators don’t seem to match what is recommended practice in the UK. And recommended practice in the UK is not widely provided. Which seems to mean that in order to offer nalmefene in combination with a psychosocial intervention, a service to provide the psychosocial intervention needs to be developed. And these services are to be commissioned by local authorities, not the NHS?
Whilst implementation could be a nightmare, the ERG report was a dream. Because it was produced by ScHARR-TAG. The authors were Stevenson M, Pandor A, Stevens J, Rawdin A, Wong R, Morgan MY, Rice P, Thompson J. I can’t tell who they all work for, because their affiliations are blanked out; I know that ERG work was secretive, but……
