AMA VICDOC_Spring 2026_09.09.2026 - Flipbook - Page 23
OVER WEEKS AND MONTHS USING THE SINCL AIR METHOD,
AS PEOPLE GET LESS REWARD FROM DRINKING, THEY
DRINK NOTABLY LESS. EVENTUALLY, THEY REACH THE
POINT WHERE THEIR REL ATIONSHIP WITH ALCOHOL IS
NORMAL, OR NON-EXISTENT."
– Dr Dean Membrey
GP and Addiction Medicine Specialist, cohealth
Towards a model of
controlled consumption
for Australia
When naltrexone was first synthesised in
the US in 1963 and FDA-approved in 1984, it
wasn’t intended for the treatment of alcohol
use disorder at all, but for opioid addiction.
Then in the early 1990s, researchers worked
out it could also help with AUD. It received
FDA approval for AUD in 1994.
In Australia, Naltrexone has been available
on the PBS since 2001. At this time, the
protocol was one pill taken daily for three
months, to support abstinence. Then in
mid-2023, the Federal Government changed
prescription guidelines to allow doctors
to prescribe naltrexone for controlled
consumption – as in the Sinclair method.
Where naltrexone is not appropriate
or effective, there are several other
medications available that can assist
people to control their drinking.
as gabapentin, baclofen, topiramate and
increasingly the GLP1s,” says Paul, who
also points out that all the medications
work best as part of a broader treatment
plan that includes psychological support.
Prescribers can align treatment with a
person’s goals. Naltrexone can be initiated
with or without prior alcohol withdrawal,
and treatment can be daily or targeted
(non-daily) dosing, depending on what is
most suitable for the patient.
The pair are partnering with Uniting to
deliver an integrated community-based
alcohol program where people with AUD
have access to psychosocial supports and
pharmacotherapy prescribers. So far, the
clinic has seen more than 220 patients,
and work on outcomes data is underway.
They are expecting it to provide further
proof for a multidisciplinary model of care
for alcohol use disorder.
At around $1 per pill, naltrexone is relatively
affordable. Given alcohol consumption is the
fifth highest contributor to disease burden in
“These include acamprosate as first line
Australia, treatment clearly benefits patients
then off label but effective treatments such
and public health.
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