The doctor apologized for his office at the end of a long day but in truth his desk was neat, his examining table was fresh, the blood-pressure cuff was neatly hung and the air smelled, wait for it, medicinal.

I had a late appointment. No, fine, thanks for asking. But there was something I wanted to discuss with Dr. Chetan Mehta.

He works at the Community Health Centre at the corner of Bathurst and Queen. In his practice he sees and treats some people who live rough, and some of these are men and women who live rough because they have a problem with the bottle.

Here, you should remember that most addicts are not seeking pleasure, they are seeking relief from pain. Sadly, the relief provided by an excess of drink ruins the liver, causes cancers of the throat and stomach and many other illnesses, not to mention the usual broken families and social problems.

Here’s news:

Dr. Mehta has had some success in treating hard-core alcoholics with one of two drugs: naltrexone, known as Revia; or acamprosate, known as Campral. They were developed for use in treating opioid addiction, but it turns out they have the lovely side effect of diminishing the urge to go overboard with drink.

Better still, they do not cause nausea and vomiting the way some drugs do, nor do they make life grey; they simply reduce the desire to get blotto.

Anecdotal evidence?

Dr. Mehta said, “I had a patient today, I’ve given him every cessation drug there is. He used to drink mouthwash and hand sanitizer. He’s gone from one or two bottles of liquor a day down to a couple of beers every couple of days.”

A million questions, all at once.

He began at the beginning: “With all medicines, there is what is known as the number needed to treat — the NNT — to prevent one bad outcome.

“For example if we look at people with a risk of heart attack, we can put them on aspirin or beta blockers or ACE inhibitors; with some of these drugs, the NNT is somewhere between 80 and 100 to prevent a bad outcome.” And here he paused.

“Naltrexone, I think, is nine.”

My jaw dropped.

He said, “It blunts the positive enforcement — you know, you have a few drinks, you get lubed up and you pound them back — but with this, people may have one or two drinks and say, ‘Meh, I’m done.’ ”

Side effects?

“Some people get flushed; or, if you’re using opiates, it may throw you into withdrawal.” That, of course, is something a good doctor would find out during an examination.

So what’s the problem?

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He said, “The drugs are not on the formulary.”

In other words, if he want to prescribe one or the other, he has to go through days’ and weeks’ worth of hoops, those hoops being paperwork; it’s worse if his patient is aboriginal, in which case there is yet another month of hoops, because now the feds are involved.

And here, you should remember that when a hard-core alcoholic wants to quit, the time to act is now and not a month or two from now; fact is, if you’re on the street, you could be dead a month from now.

Why aren’t these drugs easily available?

Dr. Mehta doesn’t know. He said, “The drug formulary is pretty good, and most times the province is logical, but sometimes you scratch your head.” I scratched mine.

And then I asked the Ministry of Health about these drugs, and I was told that the government won’t fund them unless the drinker can show some proof of sobriety, or some commitment to a treatment program.

Are you kidding? How old-fashioned. What a waste of time. So moralistic. Such a bloody a shame. Is it because of cost?

Not really; these drugs cost somewhere between $6 and $10 a pill; once a day. Here, Dr. Mehta pursed his lips and said, “Alcohol costs the economy roughly $7 billion a year in direct health-care costs — stomach bleeds; cancer; care related to trauma; lost work days.”

Do the math.

There was someone close to me who lost his life to drink. I wish this stuff had been available for him; he might still be alive. And if you know someone going down that road, I’m guessing you want to run up to the rooftops now and shout.

Also, you are a smart person, and so I presume that you know what to shout, and who to shout it at.