An effective treatment for the craving for alcohol would be a breakthrough, not only for those struggling with addiction (for whom the mainstay of treatment is often social support) but also for social drinkers who are trying to cut back for other health reasons. So I was intrigued when I heard about the use of high-dose vitamins to treat alcohol addiction and withdrawal symptoms.
After reading the short book written by Abram Hoffer MD, PhD, that detailed the vitamin therapy protocol for alcohol withdrawal, I took a deeper dive to see if I could find clinical evidence to support Hoffer’s claims and figure out how and why these vitamins might work for alcohol cravings. Vitamin therapy isn’t a replacement for many types of addiction treatments, including recovery programs (and it may not be the right pathway for you if you’ve just completed a program). Read on to better understand how supplements may be able to curb alcohol cravings in certain cases.
Dr. Hoffer was a physician and biochemist who became interested in psychiatry after analyzing vitamins in cereal products for his doctoral thesis. He started working with high-dose vitamin therapy in 1950 during a research internship in a psychiatric ward. He successfully treated delirium tremens (a severe and sometimes deadly form of alcohol withdrawal) with high-dose niacin (vitamin B3) and vitamin C. He experimented with high-dose niacin for other psychiatric indications like depression, anxiety and schizophrenia. A good proportion of his patients responded and most of the ones who did carried a concurrent diagnosis of alcoholism.
He began to use the protocol for recovered alcoholics who were suffering from depression and anxiety in the absence of alcohol and noticed a marked resolution of their mood symptoms with vitamin therapy. His work with the community eventually led him to befriend the founder of Alcoholics Anonymous, Bill Wilson. After two weeks on Hoffer’s protocol, Wilson reported being permanently cured of the anxiety and fatigue that he had lived with since quitting alcohol, without the need to continue the vitamins. Hoffer and Wilson continued to work alongside each other for years, enlisting the participation of AA members to help refine Hoffer’s vitamin cocktail.
Hoffer proposed a few mechanisms by which his protocol might fight alcohol cravings, but one that particularly stood out to me hinged on a derivative of niacin called NAD+. The molecule has been the darling of anti-aging science since the publication of a seminal paper about its role in mitochondrial dysfunction in 2011. The main job of NAD+ in the body is in the cellular production of energy, but it’s also an important cofactor in the detoxification pathway of alcohol.
NAD+ can be made from niacin via certain vitamins like nicotinamide riboside, which comes in supplement form, and taking either compound as a supplement has been shown to increase NAD+ levels inside the cell. In recent years, IV therapy with NAD+ has been used to treat alcohol and opiate addiction; a rapidly growing body of research suggests a role for NAD+ in the therapy of neurodegeneration Type II diabetes, fatty liver disease, and metabolic decline.
Was Hoffer’s high-dose niacin working through the same pathway as the high-priced NAD+ drips offered in addiction centers today? If the answer is yes, we can use recent science to tweak Hoffer’s protocol and aim for the highest elevation in intracellular NAD+ that’s possible with oral supplementation.
First of all, if you think you might be dealing with alcohol addiction or any other substance use disorder, get in touch with an addiction specialist or a local rehabilitation facility. And before you begin any new supplement regimen , consult your primary care physician.
In addition to adjusting the protocol to increase NAD+ as much as possible, I swapped out a few vitamins to ensure they were easiest for the body to use and suggested some blends to make the protocol easier to follow. The core protocol involves four supplements, and there are two additional optional supplements, as well as two more supplements you can take if your goal is reinvigorating your energy levels. A supplement protocol such as this should be done under the guidance of a provider.
Reducing or eliminating alcohol from your lifestyle involves more than just taking supplements (and in some cases, the vitamin protocol might not be the right fit for your relationship with alcohol). There are other changes in your habits that can also help you curb alcohol cravings and feel healthier overall.
1. Work with a clinician.
Your provider can help you get medical grade supplements , suggest testing to track important measures like your inflammation , and check in with you about your progress. It’s good to make sure they have an updated list of all your supplements on record, too. Parsley Health providers also offer a support system and tools to help you reach your goals.
2. Address stress reduction and exercise first.
Trying to change your habits around alcohol with medicines or supplements alone won’t be possible. Mindfulness is just as relevant to this process, which is a muscle that takes time to flex. Try to put a plan in place for a small amount of daily meditation (the easiest way is by downloading an app such as Headspace or the Calm app). If sitting still for meditation or breathwork is difficult, give a movement-heavy mindfulness practice like yoga a try.
In addition to stress management, exercise is going to be key. 150 minutes of moderate intensity exercise weekly (that’s about a half hour of exercise for five days out of your week) is ideal to lay the foundation for the vitamin therapy. Sweating is the best for detoxifying your body, so getting moving and doing anything that makes you sweat the most should be most helpful in starting that detox process.
3. Make sure your diet is not overloaded with sugar.
When you’re cutting back or eliminating alcohol, removing sugar from your diet , as much as possible, is important. Sugar contributes to inflammation (like alcohol) and can cause gut health along with blood sugar management issues. Loading up on protein , healthy fats , and fiber rather than carbs can help you stay full and keep your blood sugar stable. A Paleo diet can be a good solution for keeping these three macros at the forefront of your diet, as opposed to eating refined carbs and sugars and inflammation-triggering foods, such as gluten and dairy .
4. Improve your sleep hygiene.
While alcohol might put you to sleep right away, drinking is not conducive to a healthy sleep cycle . Alcohol might be an anesthetic, but once those effects wear off, the brain becomes overactive, which can keep you awake or prevent you from getting a restful night’s sleep.
Better sleep hygiene starts with your bedroom: Try to reduce how much blue light you’re exposing your eyes to, and make sure your bedroom is dark when it’s time for bed. Blue light-blocking glasses may help with electronic exposure during the day and evening, too. Talk to your health coach about melatonin supplements to get you into a better rhythm to sleep, if that feels necessary.
5. Get a pill organizer.
Keeping your supplements organized in a compartmentalized box can help you remember to take them, of course, but also can keep you from getting overwhelmed by the amount of vitamins you’re taking. It’s handy for traveling and keeping in line with your healthy habits, too.
6. Celebrate wins.
Even the small health victories deserve acknowledgement. Track positive changes in your health habits as you move through your journey with biohacking your alcohol consumption. The Winstreak app can be a helpful tool for reminding you of how far you’ve come with any health goal.
Dr. Alexandra Palma is a physician with a background in Functional Medicine, Internal Medicine, and Anesthesiology. Her interest in Functional Medicine began in college when she studied Human Evolutionary Biology at Harvard University.