Using N-Acetylcysteine (NAC) for Alcohol and Drug Recovery: Benefits, Dosages and Research

Posted on by Stephen Brumwell

N-Acetylcysteine (NAC), a powerful antioxidant, has become a well-researched nutritional supplement in today’s literature for its potent effect in treating patients with substance abuse disorders (SUDs).

It has also become popular and widely purchased to improve therapeutic strategies for COVID-19 treatment (Wong et al., 2021), which at one point, couldn’t be purchased anywhere!

Mind you, though, we’re not here to talk about that.

What we want to talk about in this article is what N-Acetylcysteine actually is, and some of the evidence available on using NAC to assist with various substance use disorders, and manage our withdrawal symptoms.

What is N-acetylcysteine?

N-Acetylcysteine (NAC) is a precursor of the amino acid L-cysteine and acts as a strong free radical scavenger, making it a potent antioxidant.

NAC’s potency comes from its role to influence the production of glutathione, the body’s strongest and most naturally occurring antioxidant compound (Mokhtari et al., 2016).

This antioxidant potential is important for many things, including improving immune function and enhancing various detoxification pathways (Dröge & Breitkreutz, 2000), which we may need to support during alcohol or drug sobriety.

On top of this, glutathione also helps increase oxygen delivery to tissues, boosts the function of our mitochondrial powerhouses found in our cells, and improves blood flow to the liver to further assist in detoxification processes (Ershad et al., 2021).

In terms of clinical treatment, N-Acetylcysteine has been used for over 30 years in situations of paracetamol overdose, and also more recently in the treatment of chronic obstructive pulmonary disease, cystic fibrosis, and contrast-induced nephropathy (Ooi et al., 2018).

 In recent studies, NAC has been applied to conditions of oxidative stress and reduced antioxidant status, which is closely tied to psychiatric and psychiatric-related conditions, including substance abuse (Chang et al., 2021).

Is alcohol craving more of a major issue for you? Read this article on crushing alcohol cravings with L-Glutamine.

How does N-Acetylcysteine help with Alcohol Addiction?

NAC has many pathways that have been shown to assist with alcohol addiction, or more particularly, managing the cravings and withdrawal symptoms that come from it.

N-Acetylcysteine Helps to Increase Glutathione Production

Glutathione, a tripeptide with potent antioxidant properties, plays a pivotal role in maintaining balance in the body. It’s particularly noteworthy for its ability to regulate the immune system and restore the balance of antioxidants, which is often disrupted in psychiatric and addictive conditions.

According to Ooi et al. (2018), enhancing glutathione production can significantly impact mental health and addiction recovery. This process involves boosting the body’s natural ability to combat oxidative stress, a common feature in various substance use disorders.

Restore Dopamine Neurotransmitter Dysregulation

We’ve all heard of dopamine at some point. Dopamine is a key neurotransmitter that manages the body’s natural risk and risk behavioural system. Monti et al. (2016) highlight the importance of correcting dopamine dysregulation in addiction and mental health disorders.

This includes improving dopamine receptor binding and enhancing neuron survival. Restoring this delicate balance can create a substantial aid in the recovery from addictive behaviours and enhance overall mental well-being.

Glutamate Neurotransmitter Dysregulation in Addiction

Glutamate (and GABA) imbalances are quite common in alcohol addiction, and symptoms often manifest as anxiety, irritation and jitteriness. Interventions that rebalance glutamate levels (such as NAC) can have profound effects on addiction recovery (Gorelick, 2019).

NAC not only helps in regulating glutamate levels but also increases Gamma-Aminobutyric Acid (GABA) – Our primary inhibitory neurotransmitter known for its calming effects. It does this due to the Glutamate and GABA Seesaw effect, learn more here.

N-Acetylcysteine Modulates Inflammatory Pathways

Inflammation is a key factor in the pathology of many disorders, including those related to substance abuse. Elevated levels of cytokines such as interleukin-6, C-reactive protein, and tumour necrosis factor-alpha are common in these conditions.

As suggested by Ooi et al. (2018), reducing these inflammatory pathways can mitigate oxidative stress implications, thereby aiding in the recovery process. This reduction not only alleviates physical symptoms but also contributes to mental and emotional healing.

N-Acetylcysteine Dosages and Use in Treatment

While I like to focus my sobriety articles around alcohol addiction (as this is my previous experience), I feel it’s important here to highlight the wider use of NAC in other specific substance use disorders. Please don’t take these dosages as gospel, always do your research and consult with a health professional if needed first before jumping straight in.

Alcohol Use Disorder

Doses of between 1,000–2,400 mg/day have reported outcomes that NAC may reduce symptoms of withdrawal, prevent alcohol toxicity and reduce oxidative stress that comes from excessive alcohol use (Ooi et al., 2018).

Cocaine Use Disorder

Doses of between 1,200–2,400 mg/day have reported outcomes of a reduction in the frequency and intensity of cocaine cravings (Amen et al., 2010), and participants were more likely to remain abstinent for longer (LaRowe et al., 2013).

Methamphetamine Use Disorder

Doses of 1,200 mg/day have reported outcomes of a reduction in methamphetamine cravings during a crossover trial of four weeks, concluding it as a potentially efficacious method in the treatment of methamphetamine dependency (Schmaal et al., 2011).

Cannabis Use Disorder

Doses of 2,400 mg/day have reported outcomes of a reduction in cravings and the amount of cannabis use and “hits” per day. More research is suggested for further understanding of efficacy (Gray et al., 2010).

Tobacco Use Disorder

Doses of between 1,200–3,600 mg/day have reported outcomes of fewer symptoms of nicotine dependence (Grant et al., 2013) and a reduction in cigarette usage compared with placebo groups (Prado et al., 2015).

Other Psychiatric Uses

Due to NAC’s oxidative stress-reducing and anti-inflammatory properties, it has also been researched for schizophrenia, bipolar disorder, depression, irritability, and various mood-related symptoms (Ooi et al., 2018).

Potential Side Effects of NAC

NAC is generally well tolerated and has a strong safety profile when used appropriately.

Some people may experience:

  • Nausea
  • Digestive upset
  • Headaches
  • Bloating
  • An unpleasant sulphur-like taste or smell

If you are taking medications, have liver disease, or have an existing medical condition, it’s always best to speak with a healthcare professional before beginning supplementation.

Frequently Asked Questions on NAC and Alcohol Addiction

Is N-Acetylcysteine (NAC) effective in reducing alcohol consumption?

Some research does suggest that NAC can help reduce alcohol consumption. While further studies are still recommended, this study outcomes the potential for promising results in this area.

Does N-Acetylcysteine (NAC) provide benefits for substance cravings?

Yes, N-Acetylcysteine (NAC) has shown to offer noticeable benefits in reducing cravings from addictive substances. It can also help alleviate depressive and withdrawal symptoms associated with substance abuse.

Are there any side effects of using N-Acetylcysteine (NAC) for Alcohol Addiction treatment?

NAC is generally well-tolerated. No significant difference in adverse effects was found between NAC treatment and control groups in the studies. That being said, you should not use NAC alone to stop drinking, it is only a tool.

Are there any studies supporting the use of N-Acetylcysteine (NAC) in alcohol addiction treatment?

Yes, there are several studies, including clinical trials and preclinical studies, that support the use of NAC in the treatment of alcohol addiction​​​​​​. You can find one here, here, and here.

Is N-Acetylcysteine (NAC) suitable for patients with liver disease?

N-Acetylcysteine (NAC) Could be beneficial for patients with alcohol use disorder who also have liver disease. This is due to it’s anti-oxidant properties, which can be protective to the liver.

What NAC supplement brands do you recommend?

I can recommend, based on brands I’ve used and had good experience with, some of these include Switch Nutrition NAC or White Wolf Nutrition NAC.

The Takeaway

N-Acetylcysteine (NAC) is an amazing nutritional compound when it comes to supporting sobriety and has been well studied across various substance use disorders.

Not only may it help support neurotransmitter balance during alcohol or drug addiction, but it’s also a potent antioxidant and may help reduce inflammation associated with excessive substance use.

Personally, I found it extremely useful in managing alcohol withdrawal, but it has also shown promise in other addiction disorders including cocaine, methamphetamine, cannabis and tobacco.

Research has demonstrated potential benefits across a range of substance use disorders, although further studies are still required in some areas.

Have you used NAC before? What were your experiences with it? Let us know in the comments!

Stephen.

References:

  • Amen, S. L., Piacentine, L. B., Ahmad, M. E., Li, S., Mantsch, J. R., Risinger, R. C., & Baker, D. A. (2010). Repeated N-acetyl cysteine reduces cocaine seeking in rodents and craving in cocaine-dependent humans. Neuropsychopharmacology, 36(4), 871-878. https://doi.org/10.1038/npp.2010.226
  • Chang, C., Hsieh, P., Lee, H., Lo, C., Tam, K., & Loh, E. (2021). Effectiveness of N-acetylcysteine in treating clinical symptoms of substance abuse and dependence: A meta-analysis of randomized controlled trials. Clinical Psychopharmacology and Neuroscience, 19(2), 282-293. https://doi.org/10.9758/cpn.2021.19.2.282
  • Dröge, W., & Breitkreutz, R. (2000). Glutathione and immune function. Proceedings of the Nutrition Society, 59(4), 595-600. https://doi.org/10.1017/s0029665100000847
  • Ershad M, Naji A, Vearrier D. N Acetylcysteine. [Updated 2021 Jun 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537183/
  • Gorelick, D. A. (2019). N-acetylcysteine in treatment of substance use disorders. Biological Psychiatry, 85(11), e59. https://doi.org/10.1016/j.biopsych.2018.11.018
  • Grant, J. E., Odlaug, B. L., Chamberlain, S. R., Potenza, M. N., Schreiber, L. R., Donahue, C. B., & Kim, S. W. (2013). A randomized, placebo-controlled trial ofn-acetylcysteine plus imaginal desensitization for nicotine-dependent pathological gamblers. The Journal of Clinical Psychiatry, 75(01), 39-45. https://doi.org/10.4088/jcp.13m08411
  • Gray, K. M., Watson, N. L., Carpenter, M. J., & LaRowe, S. D. (2010). N-acetylcysteine (NAC) in young marijuana users: An open-label pilot study. The American Journal on Addictions, 19(2), 187-189. https://doi.org/10.1111/j.1521-0391.2009.00027.x
  • LaRowe, S. D., Kalivas, P. W., Nicholas, J. S., Randall, P. K., Mardikian, P. N., & Malcolm, R. J. (2013). A double-blind placebo-controlled trial of N-acetylcysteine in the treatment of cocaine dependence. The American Journal on Addictions, 22(5), 443-452. https://doi.org/10.1111/j.1521-0391.2013.12034.x
  • Mokhtari, V., Afsharian, P., Shahhoseini, M., Kalantar, S. M., & Moini, A. (2017). A Review on Various Uses of N-Acetyl Cysteine. Cell journal, 19(1), 11–17. https://doi.org/10.22074/cellj.2016.4872
  • Monti, D. A., Zabrecky, G., Kremens, D., Liang, T., Wintering, N. A., Cai, J., Wei, X., Bazzan, A. J., Zhong, L., Bowen, B., Intenzo, C. M., Iacovitti, L., & Newberg, A. B. (2016). N-acetyl cysteine may support dopamine neurons in Parkinson’s disease: Preliminary clinical and cell line data. PLOS ONE, 11(6), e0157602. https://doi.org/10.1371/journal.pone.0157602
  • Ooi, S. L., Green, R., & Pak, S. C. (2018). N-acetylcysteine for the treatment of psychiatric disorders: A review of current evidence. BioMed Research International, 2018, 1-8. https://doi.org/10.1155/2018/2469486
  • Prado, E., Maes, M., Piccoli, L. G., Baracat, M., Barbosa, D. S., Franco, O., Dodd, S., Berk, M., & Vargas Nunes, S. O. (2015). N-acetylcysteine for therapy-resistant tobacco use disorder: A pilot study. Redox Report, 20(5), 215-222. https://doi.org/10.1179/1351000215y.0000000004
  • Schmaal, L., Berk, L., Hulstijn, K. P., Cousijn, J., Wiers, R. W., & Van den Brink, W. (2011). Efficacy of N-acetylcysteine in the treatment of nicotine dependence: A double-blind placebo-controlled pilot study. European Addiction Research, 17(4), 211-216. https://doi.org/10.1159/000327682
  • Wong, K. K., Lee, S. W., & Kua, K. P. (2021). N-acetylcysteine as adjuvant therapy for COVID-19 – A perspective on the current state of the evidence. Journal of Inflammation Research, 14, 2993-3013. https://doi.org/10.2147/jir.s306849

Alcohol Cravings: Crush Alcohol Cravings With This Simple And Affordable Nutritional Supplement, Glutamine.

Posted on by Stephen Brumwell

When on the topic of addiction and my past history with alcohol and sobriety, people often ask me, how did you manage the alcohol cravings?

To set the stage first, there never is a one quick fix all solution, and alot of your sobriety journey will come with time. Of course, this is never the answer people want to hear, and if you really need a short-term solution to quell those alcohol cravings, I recommend Glutamine.

Glutamine is a bit of an underdog, but can really be a game-changer in regards to diffusing alcohol cravings, and having this tool in the toolkit can drastically reduce our risk of relapse.

Re-iterating again though, this is in no way, shape, or form the secret to long-term sobriety, and only a tool to diminish cravings and keep us from derailing off the train tracks of a sober life.

What is Glutamine?

Glutamine is a conditionally essential amino acid, meaning we produce it naturally, but in times of higher demand, we may require more through food or supplementation to meet our body’s demand.

Higher demand may relate to increased stress, physical injury or in a more relevant sense, excessive consumption of alcohol. Glutamine serves many purposes, with some primary roles in helping towards maintaining gut barrier function and integrity, and providing an energy source for intestinal and immune cells.

One important role that glutamine plays in this is its ability to kill off unwanted viruses and bacteria in the gut, some of which play a large key in controlling cravings (Kim & Kim, 2017).

The Role of Glutamine in Curbing Alcohol Cravings

Alcohol Depletes the Natural Reserve of Glutamine

When we consume alcohol, our body can use up its natural reserves of glutamine.

Once we stop drinking, our body can sometimes go into overdrive to replenish these levels, which can often result in an increase in alcohol cravings.

Supplementing with Glutamine can help balance these levels and reduce the intensity and frequency of alcohol cravings. This mechanism can also be triggered by something else, which involves our gut bacteria (see below!).

Alcohol Cravings and Gut Bacteria

As mentioned earlier, Glutamine can eliminate harmful bacteria that trigger common alcohol cravings.

Glutamine has the power to regulate the balance of good and bad bacteria in our gut. Specifically, it can modulate the ratio of firmicutes-to-bacterodetes. To put it simply, Firmicutes are bacteria that thrive on sugar.

Firmicutes are responsible for causing sugar cravings, which are often satisfied by drinking alcohol since most alcoholic beverages contain a boatload of sugar.

Alcohol actually stops our liver from releasing glycogen (our body’s natural sugar stores) into the blood. This causes a drop in blood sugar (Sharmin et al., 2013), and over a small period of time, can leave our firmicutes to send signals of cravings to our brain.

I suppose what I’m trying to say here is, when we experience intense alcohol cravings, they could actually be sugar cravings, and glutamine can help diffuse them.

Where Can I Buy Good Glutamine?

Glutamine is a very affordable supplement, and many brands on the market offer Glutamine. You could probably do a quick Google or AI search and find one, and while I could list out a mountain of brands, the few that come to mind include:

  1. Glutamine by Rule 1
  2. Glutamine by Legit

I could spout off an endless list here, so I’ve landed on two that are good quality, affordable, and just some i’ve had experience using.

Dosage and Administration of Glutamine

The best way to dose with Glutamine is a simple 5g per day, this should help keep cravings at bay and also do wonders for your gut and immune system.

Some studies do recommend you work up to 0.25g/kg body weight per day, this can be an optional tactic if you find the 5g dose isn’t helping.

Always keep in mind, though, you should be incorporating other long-term solutions, which I post in another blog extensively. These are things like staying connected, building a community and just staying physically active and eating well. Being a Nutritionist and Naturopath, covering these holistic foundations is crucial, and something I can support you with if needed.

Glutamine should be regarded as a tool and not just a one-time-fix-all solution for your sobriety. You should always also be looking at foundational health habits to support sobriety!

Frequently Asked Questions with Glutamine

I see Glutamine and L-Glutamine used. What’s the difference?

Glutamine is an amino acid, a building block of protein, important for our body. L-Glutamine is just a specific form of glutamine that our body uses. When people talk about glutamine in food or supplements, they’re usually referring to L-Glutamine. The “L” part just specifies its shape, but in everyday language, L-Glutamine and glutamine mean pretty much the same thing for our health.

Can Glutamine replace professional treatment?

No, Glutamine should only ever be used as part of a broader recovery plan, and that includes professional guidance.

Is Glutamine safe to consume?

Glutamine is generally well-tolerated with little to no known side effects. It’s recommended to consult with a healthcare professional, though, when starting any new supplement.

How long does it take for Glutamine to reduce cravings?

The time can vary for individuals, but some may notice a reduction in cravings within a few days of supplementation, and some may notice it much faster.

Remember, overcoming alcohol cravings is a step towards a healthier, more fulfilling life, and Glutamine is only a part of the process.

The Takeaway

Glutamine is a conditionally essential amino acid used by the body as a building block for proteins, and may also assist with the diminishment of alcohol cravings.

Through its ability to kill off bacteria in our gut, known as firmicutes, we can use a simple, fairly beneficial amino acid to support our sobriety and look after our body in the process.

Looking for another viable option for managing withdrawal symptoms associated with substance abuse? N-Acetylcysteine can also help!

When we use these “quick hack” tactics to push us further into sobriety, we can live an addiction-free life, without limits.

References

Kim, M., & Kim, H. (2017). The roles of glutamine in the intestine and its implication in intestinal diseases. International Journal of Molecular Sciences, 18(5), 1051. https://doi.org/10.3390/ijms18051051

Sharmin, F., Wakelin, S., Huygens, F., & Hargreaves, M. (2013). Firmicutes dominate the bacterial taxa within sugar-cane processing plants. Scientific Reports, 3(1). https://doi.org/10.1038/srep03107