As scientists, physicians, government officials, and individuals with substance use disorders look for a solution to the opioid addiction and overdose epidemic, the desire for a magic bullet is understandable.

Mercury for syphilis, laetrile for cancer, urine to treat AIDS, and the Gold Cure for alcoholism are a few examples. One of the latest proposed panaceas is NAD infusion therapy.

What Is NAD Treatment?

What does NAD mean? Nicotinamide adenine dinucleotide, NAD for short, sometimes known as nadide, is a naturally occurring coenzyme in the body that helps with the production of energy for the body.

NAD therapy is a series of NAD injections administered intravenously over a couple of weeks. The cost of such a NAD infusion regimen can be as much as $15,000 a treatment, which is probably not covered by insurance.

Bodily levels of NAD may influence various processes, including aging. Harvard Medical School and other researchers are currently studying whether raising NAD levels can reverse aging.

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 also is claimed to reboot the brain.

One addiction clinic providing NAD therapy says that it has an 87% success rate and that, after a month, it is still effective. The clinic doesn’t conduct long-term tracking, however.

The Benefits of NAD Therapy

Other potential benefits of NAD therapy include:

  • Increasing energy
  • Repairing DNA
  • Strengthening the immune system
  • Lowering cholesterol and blood pressure
  • Enhancing mood and brain function
  • Improving endurance, reducing fatigue

Much evidence today indicates that addiction can’t be cured, as addiction rewires the brain, making relapse a lifelong worry. Still, some researchers believe that it may be possible to use hallucinogenic drugs to return the brain to a pre-addiction state. Though NAD is not a hallucinogen, if it can reboot the brain, it may be a powerful treatment for substance use disorder.

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Does NAD Therapy Work for Addiction?

Despite some glowing reports and anecdotal evidence that NAD therapy works, at least for the short term (about eight days), there are no published, peer-reviewed, scientific studies that confirm that it works. One of the companies administering the treatment couldn’t or wouldn’t provide evidence that the treatment works.

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 pain are particularly worrying if the claims are exaggerated. Stopping drugs known as benzodiazepines (Xanax, Klonopin, Ativan, Valium) or alcohol cold turkey 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 anti-seizure medication.

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 that is a precursor vitamin to NAD and is found in milk in trace amounts.

The danger of NAD treatment and similar unproven treatments is that it discourages people from trying proven treatments—cognitive behavioral therapy (CBT), mindfulness, medication-assisted treatments (MATs)—that require hard work, not instant cures. Other promising treatments are also currently being studied.

Although it is promising, NAD therapy is unproven and is as costly as more traditional treatments. It should not be a first resort or the sole treatment.

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References

  • ncbi.nlm.nih.gov – After Venus, Mercury: Syphilis Treatment in the UK Before Salvarsan
  • ncbi.nlm.nih.gov – Laetrile Treatment for Cancer
  • bbc.com – Brighton Hairdresser Daryll Rowe Drank Urine to ‘Cure’ HIV
  • daily.jstor.org – Inside a Nineteenth-Century Quest to End Addiction
  • ncbi.nlm.nih.gov – Antioxidants & Redox Signaling
  • acs.org – Molecule of the Week Archive: Nicotinamide Adenine Dinucleotide
  • genetics.med.harvard.edu – Research (The Sinclair Lab) 
  • vice.com – I Got a $600 Brain ‘Reboot’ and It Changed My World
  • npr.org – Addiction Clinics Market Unproven Infusion Treatments to Desperate Patients 
  • federalregister.gov – Amendments to the List of Bulk Drug Substances That Can Be Used to Compound Drug Products in Accordance with Section 503A of the Federal Food, Drug, and Cosmetic Act
  • blogs.scientificamerican.com – Beyond Resveratrol: The Anti-Aging NAD Fad
  • mayoclinic.org – Cognitive Behavioral Therapy
  • ncbi.nlm.nih.gov – Mindfulness-Based Cognitive therapy: Theory and Practice
  • samhsa.gov – Medication and Counseling Treatment
  • ncbi.nlm.nih.gov – Psychedelic-Assisted Psychotherapy: A Paradigm Shift in Psychiatric Research and Development