Role of Intravenous N-acetylcysteine for Addiction Therapy

Drug addiction is a vice that many people are fighting with today. In fact the world’s economy has been seriously affected by drug addiction due to the huge amounts of money that many governments and organizations spend in rehabs to help those who are fighting addiction. Addiction recovery has never been an easy procedure. It takes time and resources and most importantly the input of the addict matters a lot. Doctors have been involved in research in the past to try and come up with better ways of help addiction patients through addiction recovery. However, in most cases addicts are treated by using medication detoxification drugs which are chemically similar to the chemical being removed from the body. The patient is given this substance to manage the severity of withdrawal symptoms.

In most cases the substitutes for the chemical used is either Librium or Valium. These drugs are used because they can calm the nervous system. When using these drugs the dose is gradually reduced as symptoms subside. The drugs however do have a half-life for several days after the course is completed. During this process the patient can still experience severe discomfort with tremors, nausea, vomiting, and occasionally even delirium tremens (DTs). These are just some of the disadvantages of using advent pharmaceuticals in fighting addiction in patients besides medical detoxification in drug addiction patients take longer than the IV N-acetylcysteine therapy because the addicted person has also to withdraw from the substitute drug. The fight against addiction from a substance may get complicated when the patient become dependent on the substitute drug.

Intravenous N-acetylcysteine

What is NAC?

NAC or N-acetylcysteine is an acetylized version of the natural amino-acid cysteine that is a precursor to Glutamate, which affects the Glutamate system and is responsible for learning, memory, motivation and cognition. Though still unknown to many patients as an effective medicine in treatment of addicts, N-acetylcysteine has been used by many doctors in treatment of various diseases. This may be because it has psychiatric effects on the glutamate, dopamine and NMDA brain systems.

Effects of NAC on glutamate system

NAC is the most sought after type of Cysteine. N-acetylcysteine works in various ways to help in treating addiction, thanks to its effects on the glutamate system. When the level of N-acetylcysteine is altered it will not only have an effect on oxidative balance but will also modulate neuro-transmitter pathways, including glutamate and dopamine. NAC assists in the regulation of neuronal intra- and extracellular exchange of glutamate through the cysteine–glutamate antiporter. Whereas this antiporter is abundant throughout all cell types, in the brain it is preferentially located on glial cells. The dimer, cysteine, is taken up by astrocytes and exchanged for glutamate, which is released into the extracellular space. This free glutamate appears to stimulate inhibitory metabotropic glutamate receptors on glutamatergic nerve terminals and thereby reduce the synaptic release of glutamate. Given that relation, the amount of N-acetylcysteine in the system as well as the feedback via glutathione (GSH) production by neurons may directly regulate the amount of glutamate present in the extracellular space. Furthermore, GSH itself has been shown to potentiate brain N-methyl-d-aspartate receptor response to glutamate in rats. Changes in the levels of neuronal GSH may not only alter available glutamate levels, but also have direct consequences on glutamatergic function.

Research study on effectiveness of NAC in treatment of addiction

Intravenous N-acetylcysteineA research study done by Steven D. LaRowe, PhD, Pascale Mardikian, MD, Robert Malcolm, MD, Hugh Myrick, MD, Peter Kalivas, PhD, Krista McFarland, PhD, Michael Saladin, PhD, Aimee McRae, PharmD, and Kathleen Brady to investigate  the Safety and Tolerability of N-Acetylcysteine in Cocaine-Dependent Individuals, It was found that N-acetylcysteine (NAC) was safe and well tolerated in thirteen non-treatment-seeking cocaine-dependent adults. The report also showed that the side effects were rather mild. Despite the mild side effects of N-acetylcysteine, it’s effective in treatment of addiction as these mild side effects shown by those patients who were put on NAC therapy did not differ significantly with the side effects that were exhibited by the patients who were on placebo.

For this study; six males and seven females aged between 23 and 45 were used. Of the 13 participants, nine were of African-American origin while four were Caucasian, who met DSM-IV criteria for cocaine dependence but were non-treatment seeking. Of those subjects, eight were primarily crack smokers; two primarily used nasal powder, while the remaining subjects used a mixture of crack, powder, and freebase cocaine. Self-report accounts of cocaine use for the ninety days prior to study participation indicated that subjects used forty out of the ninety days on average or about 44% of the time, spending a daily average of $30 on the drugs. Subjects were recruited flyers, newspaper ads, and word-of-mouth. These research findings pointed out at the effectiveness of N-acetylcysteine in addiction treatment.  This study however was done on a smaller scope but its results may lay a great foundation for further research studies that might be done on this subject.

Finally, Drug Addiction is a vice that should be fought by all means that is why we at AWAREmed Health and Wellness Resource Center are committed to availing help to addicts and offering them a place to call home. It does not matter what kind of addiction you are wrestling with right now, just call on Dr. Dalal Akoury (MD) today and begin your journey to victory against addiction.

Role of Intravenous N-acetylcysteine for Addiction Therapy