Sometimes we’d like a reset button, to help overcome unhealthy behaviors or to restore some youthful vitality. NAD infusion therapy is one treatment that some people look to, hoping that it can help them break free of addictive behaviors or serve as a sort of fountain of youth.
Because nicotinamide adenine dinucleotide—NAD for short—is a naturally occurring cofactor the body generates as part of its energy production process, that can make it all the more appealing for some. It’s offered as an intravenous infusion therapy with claims that it can help with drugs and alcohol withdrawal and prevent relapse, as a possible way to reboot the brain of bad behaviors.
When something sounds like it’s too good to be true, however, it’s not a bad idea to dig a little deeper into the promises being made. NAD treatment might help alleviate some of the pains of withdrawal, but to call it a miracle in an IV bag—that’s a bit of a stretch.
What Is NAD?
NAD, sometimes referred to as nadide, is a naturally occurring coenzyme in the body that helps generate adenosine triphosphate (ATP), energy-carrying molecules found in the cells of any living organism.
NAD is made in the body from both L-tryptophan, an amino acid or building block, and nicotinamide riboside, a form of vitamin B3, or niacin. Vitamin B3 can be found naturally in a number of foods, including liver, some poultry, pork, fish, peanuts, whole grains, and many fortified breakfast cereals. Niacin is important for proper nervous system and metabolic functioning.
NAD also comes in two forms — NAD+, which is oxidized or active, and NADH (the H stands for hydrogen), which is reduced, or inactive. The interchange between the oxidized and reduced forms of NAD allows for electrons to be transported in a process that ultimately allows for the production of ATP, an energy-carrying molecule.
Benefits of NAD
NAD is thought to play a part in treating several health problems, including heart, brain, and metabolic disorders. A drop in NAD levels has been correlated with age-related disease. As a person grows older or as their health wanes, NAD levels tend to go down. Part of that is due to less NAD production, but it’s also due to it being metabolized at a higher rate.
Because NAD has a role in energy production, it’s been looked at as a potential source of vitality. According to the U.S. Food and Drug Administration (FDA), NAD has been used since the late 1960s to lessen withdrawal from alcohol and some drugs. The keyword there is “lessen.” It’s not a cure, but an aid. The FDA also notes that NAD alone doesn’t appear to be enough, but the addition of amino acids to the IV fluid seems to improve the result.
NAD is thought to help repair DNA and promote mitochondria function, among other cellular activities. Because body levels of NAD may influence various processes, including aging. Researchers at several institutions including Harvard Medical School are currently studying whether raising NAD levels would prevent a number of age-related illnesses, including diabetes and cancer, or even slow aging.
How is NAD Treatment Administered?
Proponents of NAD therapy say NAD can be taken in supplement form, but they contend the best way is via IV drip, since it’s a more direct route.
Some people go for an infusion every few weeks, for ongoing maintenance. That can run around $600 a session. Others get NAD therapy through a series of NAD injections administered intravenously over a couple of weeks, sometimes daily, during the earlier stages of detoxification. The cost of such a NAD infusion regimen can be as much as $15,000 a treatment, which is not likely to be covered by insurance.
How is NAD Therapy Used?
In the United States, NAD treatment for addiction is being marketed as an effective way to ease withdrawal and prevent relapse from alcohol, benzodiazepines, cocaine, and opioids. It is also claimed to help certain brain functions.
While the potential effectiveness of NAD in helping to overcome substance use disorder is still being explored, NAD therapy may make the detoxification and withdrawal processes easier to endure.
Other potential benefits of NAD therapy that are being explored include:
- Increasing energy
- Repairing DNA
- Strengthening the immune system
- Lowering cholesterol and blood pressure
- Enhancing mood and brain function
- Improving endurance and reducing fatigue
Much of the evidence today indicates that addiction can’t be cured, as addiction rewires the brain, making relapse a lifelong risk. Still, some researchers believe that it may be possible to use hallucinogenic drugs to help rewire the brain to its pre-addiction state. While NAD is not a hallucinogen, it may be a useful tool in treatment of substance use disorders.
Why Use NAD Therapy to Treat Addiction?
Proponents say NAD therapy may improve brain health, regenerate cells, and reduce inflammation, which may help repair or undo some of the changes caused by substance use. The result, they claim, maybe reduced cravings and a less painful withdrawal process.
Despite some glowing reports and anecdotal evidence that NAD therapy works, at least for the short term (about eight days), there are no large randomized-controlled, double-blinded, placebo-controlled peer-reviewed studies confirming its potential to help with substance use disorders.
Other anecdotal reports say it is of no help. Journalists who followed several cases over a longer period found multiple relapses or outright failures of the treatment. Even cautious advocates recommend more testing and acknowledge that the therapy is not approved by the U.S. Food and Drug Administration (FDA)—which chose not to approve its use in pharmacy compounding—for any specific condition.
The Need for Caution
Claims that NAD therapy reduces withdrawal are particularly concerning if these claims are exaggerated. Stopping drugs known as benzodiazepines (Xanax, Klonopin, Ativan, Valium) or alcohol (especially in cases of heavy alcohol abuse) suddenly can be fatal, so gradual weaning is advised. Two individuals receiving NAD therapy experienced seizures when their rehab centers required them to endure withdrawal without weaning or medications to reduce the risk of seizures, according to an NPR story.
NAD isn’t the first natural substance suspected of anti-aging properties or other benefits. A few years ago, resveratrol, a chemical found in red grape skins and red wine, was touted by some researchers. So was nicotinamide riboside (NR), a substance found in milk in trace amounts that is also believed by some to boost quantities of NAD.
The dangers of NAD treatment and similar unproven treatments are that it may discourage people from using proven treatments—cognitive behavioral therapy (CBT), mindfulness, medication-assisted treatments (MATs)—that require hard work and are no quick cures. Other treatments are also currently being studied.
Although it is promising, NAD therapy for substance use is unproven and can be as costly as more traditional treatments. Therefore, it should not be a first-line of treatment for the sole treatment of substance use.
- britannica.com – Adenosine triphosphate
- healthline.com – 16 Foods That Are High in Niacin (Vitamin B3)
- ncbi.nlm.nih.gov – Therapeutic potential of NAD-boosting molecules: the in vivo evidence
- ncbi.nlm.nih.gov – Nicotinamide Riboside—The Current State of Research and Therapeutic Uses
- fda.gov – Pharmacy Compounding Committee Review: Nicotinamide Adenine Dinucleotide (NAD+)
- acs.org – Nicotinamide adenine dinucleotide
- npr.org – Addiction Clinics Market Unproven Infusion Treatments to Desperate Patients
- sunshinebehavioralhealth.com – Hallucinogen Addiction and Abuse
- vice.com – I Got a $600 Brain ‘Reboot’ and It Changed My World
- blogs.scientificamerican.com – Beyond Resveratrol: The Anti-Aging NAD Fad
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