NAD+ Therapy for Addiction: Does It Work?
Addiction is today’s most common modern disease (1). It is the most common untreatable disorder of the 21st century, and it has a profoundly damaging effect on individuals’ physical, social, economic, and financial wellbeing.
Unfortunately, current mainstream addiction treatment programs have low success rates. Even the most successful addiction programs have a relapse rate of 56% (1).
Since addiction is a growing problem in modern society, and most people have little to no recourse, there has been a growing interest in using NAD+ therapy to help lower relapse in addiction by replenishing or increasing the body’s baseline level of NAD+.
What Happens to NAD+ in the Bodies of People with Addictions?
In short, people with addictions have (1):
- Impaired mitochondria function
- Increased inflammation of the neurons
- Alterations in the dopamine pathway of the frontal cortex
- Dysregulated hormones
- Alterations in circadian rhythms (sleep-wake cycle)
- Activation of endogenous opiates, which are implicated in the addiction-reward cycle
What does NAD+ Supplementation Have to Do with Addiction?
Oxidative stress has a central role in alcoholism and addiction. Both alcoholism and addiction are associated with a deficiency in protective enzymes that help to neutralize oxidative stress. When NAD+ is increased through NAD+ therapy or supplementation, harmful and destructive effects of genetically determined oxidative stress are counteracted (2). In other words, increasing NAD+ in cells via supplementation or therapy helps counteract the very process by which oxidative stress and psychological damage associated with addiction occur.
In cocaine addiction, specifically, supplementation with NAD+ and NAD+ precursors directly affects addiction by targeting the SIRT1 signaling pathway in the brain (3). Nicotinamide phosphoribosyltransferase (NAMPT) is a rate-limiting enzyme found around the body that converts the body’s pool of NAD+ into nicotinamide mononucleotide (NMN). NAMPT contributes to the cocaine reward system through SIRT1, reducing cravings for the drug (3, 4).
Below is a summary of the research regarding the effect of NAD+ supplementation on addiction and dependencies (1):
1. NAD+ targets the SIRT1 signaling pathway in the brain, which regulates behavioral responses associated with drug addiction
2. NAD+ and SIRT1 work together to regulate the parts of the wake portion of the circadian rhythm that is associated with addiction behaviors. In other words, it can help to limit addiction impulses.
3. NAD+ increases adenosine levels, which counteracts the degenerative effects of dopamine on brain cells.
4. NAD+ and SIRT1 work together to regulate Monoamine Oxidase A, helping to ensure healthy levels of the hormone serotonin. Low serotonin levels are associated with anxiety and depression, both contributors to addiction behaviors.
5. NAD+ regulates FGF21 and Oxytocin Signalling. FGF21 (Fibroblast growth factor 21) is a modulator hormone of metabolism in health and diseases. Resistance to FGF21 and low levels of oxytocin is associated with metabolic disorders.
6. NAD+ and SIRT1 Regulate Drp1. Drp1 levels are increased in people with chronic exposure to cocaine, and inhibition of Drp1 helps reduce cocaine-seeking behavior.
Why Isn’t NAD+ Therapy More Popular for Addiction Treatment?
Currently, data from experimental and clinical studies to promote the use of NAD+ for addiction treatment is limited. This has been a primary factor that has not allowed approval from the FDA to approve and promote the use of NAD+ therapy for addiction as a public health measure.
Nonetheless, available data shows promising results for using NAD+ therapy to ameliorate alcohol and opioids withdrawals during treatment. Many specialized clinics can provide NAD+ therapy as part of off-label use of the component.
To quote a recent study that reviews the potential of NAD+ therapy to treat addictions (1),
“IV NAD+ therapy may provide significant improvement in addictive disorders likely due to increased NAD+ availability. Further longitudinal and follow-up studies are necessary to cement the role of IV NAD+ in addiction therapy. In addition, the effect of oral administration of the NAD+ precursors, NMN and NR, as potential therapeutic agents for raising NAD+ and improving addictive symptoms warrants further clinical investigation.”
Bottom Line: Does NAD+ Therapy Help Treat Addictions and Dependencies?
Initial evidence is promising regarding the beneficial effects of NAD+ supplementation to treat alcohol and cocaine addiction. In fact, clinics specializing in addictions through NAD+ therapy are becoming increasingly popular around North America and Europe (5, 6).
Nonetheless, since different drugs have different effects on the body and different factors influence addiction, it would be inaccurate to make sweeping statements about the effect of NAD+ supplementation to treat all addictions.
If you are living with a dependency or addiction, or you know someone who is, and you are interested in exploring how NAD+ therapy may benefit you, reach out to a NAD+ clinic near you and request an evaluation.
References
1. Braidy, N., Villalva, M. D., & Eeden, S. V. (2020). Sobriety and Satiety: Is NAD+ the Answer? Antioxidants, 9(5), 425. https://doi.org/10.3390/antiox9050425
2. Maclean, M. (2013). The Genetics and Neurochemistry of Schizophrenia and Addiction: Enhanced Options for Treatment Using Nicotinic Acid (Vitamin B3). Journal of Orthomolecular Medicine, 28(2), 55–60. https://www.researchgate.net/publication/287276439_The_genetics_and_neurochemistry_of_schizophrenia_and_addiction_Enhanced_options_for_treatment_using_nicotinic_acid_vitamin_B3
3. Kong, J., Du, C., Jiang, L., Jiang, W., Deng, P., Shao, X., Zhang, B., Li, Y., Zhu, R., Zhao, Q., Fu, D., Gu, H., Luo, L., Long, H., Zhao, Y., & Cen, X. (2018). Nicotinamide phosphoribosyltransferase regulates cocaine reward through Sirtuin 1. Experimental Neurology, 307, 52–61. https://doi.org/10.1016/j.expneurol.2018.05.010
4. Kong, J., Du, C., Jiang, L., Jiang, W., Deng, P., Shao, X., Zhang, B., Li, Y., Zhu, R., Zhao, Q., Fu, D., Gu, H., Luo, L., Long, H., Zhao, Y., & Cen, X. (2018). Nicotinamide phosphoribosyltransferase regulates cocaine reward through Sirtuin 1. Experimental Neurology, 307, 52–61. https://doi.org/10.1016/j.expneurol.2018.05.010
5. Radenkovic, D., Reason, & Verdin, E. (2020). Clinical Evidence for Targeting NAD Therapeutically. Pharmaceuticals, 13(9), 247. https://doi.org/10.3390/ph13090247
6. Witt, E. A., & Reissner, K. J. (2019). The effects of nicotinamide on reinstatement to cocaine seeking in male and female Sprague Dawley rats. Psychopharmacology, 237(3), 669–680. https://doi.org/10.1007/s00213-019-05404-y