Tell us about you
Enter your details as show on your official documents e.g. Passport or driving licence
(Please complete all fields)
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Tell us about you
(We may need to contact you to discuss your treatment plan)
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Tell us about you
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Tell us about you
What was your assigned gender at birth?
Male
Female
(Please select one)
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Let's check you are suitable
Are you curently
Pregnant
Breastfeeding
Trying to become pregnant
None of the above
(Please select one)
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Next Y
Let's check you are suitable
Do you have any of the following conditions
Pancreatic and/or acute liver disease
Sever liver disease
Severe kidney disease
None of the above
(Please select one)
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Let's check you are suitable
Are you allergic to any of the following, including any of their ingredients?
Naltrexone
Nalmefene
None of the above
Naltrexone: Lactose monohydrate, Powdered cellulose,Microcrystalline cellulose, Silica - colloidal anhydrous, Crosprovidone, Magnesium stearate,Hypromellose, Titanium dioxide E171, Macrogol 4000, Black ferric oxide E172, Red ferric oxide E172, Yellow ferric oxide E172
Nalmefene: Microcrystalline cellulose, Lactose, anhydrous, Crospovidone type A, Magnesium stearate, Hypromellose, Macrogol 400, Titanium dioxide E171
(See full list of all ingredients above. Please select all that apply)
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Let's check you are suitable
Are you currently taking or do you sometimes take strong painkillers or pain medication?
Yes
No
The Nul Programme follows The Sinclair Method which utilises medication to help eliminate or reduce alcohol consumption. Taking these medications in conjunction with some pain medication is not safe.
I understand and wish to speak to a clinician about my options with medication.
If medication doesn’t sound like the right option for you, explore non medicated programmes here
(Please select one)
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