An alcohol substitute that mimics its pleasant buzz without leading to drunkenness is being developed by scientists.

The new substance could have the added bonus of being “switched off” instantaneously with a pill, to allow drinkers to drive home or return to work.

The synthetic alcohol, being developed from chemicals related to Valium, works like alcohol on nerves in the brain that provide a feeling of wellbeing and relaxation.

But unlike alcohol its does not affect other parts of the brain that control mood swings and lead to addiction. It is also much easier to flush out of the body.

Finally because it is much more focused in its effects, it can also be switched off with an antidote, leaving the drinker immediately sober.

The new alcohol is being developed by a team at Imperial College London, led by Professor David Nutt, Britain’s top drugs expert who was recently sacked as a government adviser for his comments about cannabis and ecstasy.

He envisions a world in which people could drink without getting drunk, he said.

No matter how many glasses they had, they would remain in that pleasant state of mild inebriation and at the end of an evening out, revellers could pop a sober-up pill that would let them drive home.

Prof Nutt and his team are concentrating their efforts on benzodiazepines, of which diazepam, the chief ingredient of Valium is one.

Thousands of candidate benzos are already known to science. He said it is just a matter of identifying the closest match and then, if necessary, tailoring it to fit society’s needs.

Ideally, like alcohol, it should be tasteless and colourless, leaving those characteristics to the drink it’s in.

Eventually it would be used to replace the alcohol content in beer, wine and spirits and the recovered ethanol (the chemical name for alcohol) could be sold as fuel.

Professor Nutt believes that the new drug, which would need licensing, could have a dramatic effect on society and improve the nation’s health.

The NHS report Statistics on Alcohol: England, 2009 found more than 800,000 alcohol-related admissions to hospitals in 2007-08 – and more than 6,500 deaths – at a cost to the service of £2.7bn a year.

Some charities estimate that the toll could be up to five times higher. Drink is, for example, a factor in 40 per cent of fatal fires, 15 per cent of drownings, 65 per cent of suicides and 40 per cent of domestic abuse. It also has other costs, including 17 million lost working days a year, worth about £20bn to the economy.

“I’ve been in experiments where I’ve taken benzos,” said Professor Nutt. “One minute I was sedated and nearly asleep, five minutes later I was giving a lecture.

“No one’s ever tried targeting this before, possibly because it will be so hard to get it past the regulators.

“Most of the benzos are controlled under the Medicines Act. The law gives a privileged position to alcohol, which has been around for 3,000 years. But why not use advances in pharmacology to find something safer and better?”

Getting the drug approved could be hard for the team as clinical trials are expensive, and it is not clear who would pay for them, according to Professor Nutt.

He said that the traditional drinks industry has not shown any interest, however some countries might be persuaded to sponsor the team.

Some countries have more liberal regimes than others, though, and Professor Nutt thinks Greece or Spain, within the EU, could lead the way.

The latest Home Office performance figures showed that more than one in four people believe that alcohol is blighting their community.

A survey of every police force area in England and Wales found that 26 per cent of those polled “perceived people being drunk or rowdy in public placed to be a problem in their area” – a slight increase from last year.

The fears over the affects of alcohol range from urban to rural communities, with the worst hit being Manchester, South Wales, London, Northumbria and Gwent.

By Paul Rodgers and Smitha Mundasad

Sunday, 16 May 2010

The spectre of plague stalked the world last year with its constant companion, fear. Schools and stadiums were closed in Mexico, tourists from Egypt to Singapore were quarantined, and the surgical mask became a universal fashion accessory across Asia. Yet predictions that the global death toll from swine flu could reach 7.5 million were well off the mark. At most, the virus killed 14,000 people, and some of those had pre-existing conditions or had been infected by other dangerous bugs as well. Against a background death toll from seasonal flu of up to 500,000, the new H1N1 strain was invisible.

Professor Ulrich Keil, a World Health Organisation (WHO) adviser on heart disease, said the decision to declare a pandemic had led to a “gigantic misallocation” of health budgets. “We know the great killers are hypertension, smoking, high cholesterol, high body mass index, physical inactivity and low fruit and vegetable intake,” he told the Council of Europe. Yet governments “instead wasted huge amounts of money by investing in pandemic scenarios whose evidence base is weak”.

The suspicion that the response to the outbreak was an unnecessary panic has been spreading since the virus slipped from the front pages. Even the WHO, the UN body that first punched the big red button, may be having doubts. An external committee has been set up to review its reaction and will deliver an interim report this week, though at the moment no bombshells are expected.

The WHO faces two main charges. The first is that between the first cases of H1N1 being reported in March and the declaration of a full, phase 6 pandemic by its director-general, Dr Margaret Chan, in June, the organisation changed its definition of a pandemic. Critics say the old definition required that a virus result in “enormous numbers of deaths and illness”. The new definition applies only if the virus is new, if it spreads easily between people, and if the population has little or no immunity to it. A bug that causes a mild case of the sniffles could qualify.

A spokesman for the organisation insists there has been no change at all – that the old definition was an error on a single web page about bird flu, the last great influenza scare. But Peter Doshi, a doctoral candidate at MIT whose thesis is on science, politics and influenza policy, argued in a paper in the British Medical Journal in September that the old definition had been widely applied by the WHO since at least 2003.

The second charge, prominently made by Dr Wolfgang Wodarg, the former head of health at the Council of Europe, is that the WHO is unduly influenced by the drugs industry, which stood to make a fortune from selling anti-virals and vaccines. The Swiss giant Novartis, for example, saw its profits jump by nearly a third in the first quarter of this year to $2.95bn, much of it from delivering swine flu vaccines ordered last year. Debate rages over allegations that some experts who recommended the pandemic be declared, have links to drugs companies, although this has been denied. But critics note that it’s hard to become an expert in the field without having some funding from big pharmaceutical companies.

Others say that the problem is due to the spread of false assumptions. Most people think, for example, that when they have flu symptoms they must have influenza. But Dr Tom Jefferson of the Cochrane Collaboration, which reviews the evidence for various medical treatments, notes that more than 200 agents can cause flu-like illnesses. Only 7.5 to 15 per cent of cases are actually influenza. Anti-viral drugs and vaccines are aimed just at this group. “To stop one new case of H1N1, you’d have to inoculate 100 people,” says Dr Jefferson “or you could get four people to wash their hands.” Masks work too, he says, and so does sending people home from work if they have symptoms.

The usual justification for the massive response to H1N1 is that no one wants a repeat of the 1918 pandemic, which killed an estimated 50 million people. But scientists are not even sure if that plague was caused by influenza at all. The virus was not discovered until 1933. And outbreaks since then have been much milder.

The last time H1N1 showed up was in 1976, at a US army base. Washington ordered the immunisation of 40 million Americans before it discovered that it had only one death from the flu but hundreds of cases of severe side-effects to the vaccine. A review headed by Dr Harvey Fineberg put much of the blame on the “influenza fraternity”, arguing that expert panels tend towards “group think” and should be backed up by independent scientific advice. Dr Fineberg is now chairman of the WHO’s external committee evaluating its response to the 2009 outbreak whose final report next May could well lead to a radical rethink of the world’s reaction to new viruses.

Criminal gangs that cut their teeth selling fake Viagra on the internet and went on to push dummy drugs in poor countries are now suspected of infiltrating the supply of medicines in the developed world.

“Counterfeit drugs could be compared to arms trafficking. It really is the same kind of dangerous crime,” said Françoise Grossetête, a French MEP and member of the parliament’s public health committee, at an international conference on the problem in Brussels. “It could become a form of terrorism.”

The Medicines and Healthcare products Regulatory Agency (MHRA) has recalled 14 batches of counterfeit drugs in the past three years, compared with none in the previous decade. These included fakes claiming to be the world’s best-selling drug, Lipitor, which cuts cholesterol, Plavix, which helps to prevent blood clots, and Casodex, which fights prostate cancer. Criminals have also targeted Zyprexa, an anti-psychotic prescribed for schizophrenia and bipolar disorder.

The MHRA described the situation as “serious”, and said its enforcement and intelligence unit was dealing with the problem.

The World Health Organisation (WHO) estimates that 1 per cent of drugs in the developed world are counterfeit. In Britain, that would mean up to seven million fake prescriptions a year, almost all of them undetected. Illegal pills may contain little or none of the real medicine’s active ingredient, and because they are manufactured in unhygienic conditions, could have dangerous contaminants. Often the fakes can be spotted only with laboratory tests.

Patients who report to their doctors that a drug isn’t working are likely to be put on a higher dosage than they need, or be switched to alternatives that could be less effective or have more dangerous side effects. No Britons have died yet because of counterfeit drugs, the MHRA claims. However, any deaths would almost certainly be attributed to the patient’s illness. Medicines taken by people who appear to die of natural causes are not routinely checked.

The WHO has reported several cases where counterfeits have led to mass deaths. More than 2,000 people died during a meningitis epidemic in Niger in 1995 after being inoculated with fake vaccines.

Prescription drugs are traded throughout the EU and around the world. Often a packet of pills will pass through dozens of companies between the manufacturer and the chemist. They are frequently repackaged, with labels and instructions in different languages. Although British drug traders need a licence from the MHRA, it has no control over who handles the pharmaceuticals elsewhere in the EU.

Many of the fakes are produced in India or African countries, and then imported into the EU. John Taylor, the head of the anti-counterfeiting team in the EU Customs Department, said national authorities seized four million fakes last year, up 50 per cent on 2006. “Once they are in the EU, they travel around freely,” he said.

Aegate, a British company, has recently completed an audit of its successful system in Belgium, Greece and Italy that uses a bar code to check whether a drug is authentic. No counterfeits made it through to patients. Although the firm’s high-security computers are in the UK, efforts to provide the service to British pharmacies are at an early stage, partly because chemists here do not have integrated computer systems. Most still rely on paper prescriptions.