NAD therapy: definition, benefits, addiction treatment, and duration

NAD therapy is the administration of nicotinamide adenine dinucleotide (NAD), a substance found in every cell of the human body. The substance declines with age, persistent inflammation, and chronic substance abuse. NAD is administered via intravenous infusion, injections, nasal sprays, or oral supplements to boost its reserves in the body.

The benefits of NAD therapy are replenishing NAD stores in the body, maintaining and supporting the normal functioning of cells, promoting cell energy metabolism, and preventing the occurrence or reducing the symptoms of many aging-related disorders.

NAD therapy supports addiction treatment by reducing the severity and frequency of withdrawal symptoms and substance-related cravings and boosting physical energy levels to help the person undergoing treatment heal faster.

The duration and the number of sessions required for NAD therapy vary depending on factors like the condition for which the therapy is being administered, mode of administration, dosage strength, nature of the NAD product being administered, and how the patients respond. Individual variations in responsiveness to treatment, which depend on age, gender, genetics, and baseline health, also determine the duration and number of sessions required for NAD therapy.

What is NAD therapy?

NAD therapy is the administration of lab-produced nicotinamide adenine dinucleotide (NAD) or NAD supplements to replenish the bodily stores of NAD. However, the use of NAD or NAD supplements as a medicine is not approved by the Food and Drug Administration (FDA). As of 29 September 2023, NAD is placed in the 503A Category 1 – Bulk Drug Substances Under Evaluation list. This was clarified by the FDA in their 2023 release titled “Bulk Drug Substances Nominated for Use in Compounding Under Section 503A of the Federal Food, Drug, and Cosmetic Act” on their website.

NAD is a co-enzyme form of vitamin B3 or niacin. Vitamin B3 naturally occurs in some foods and is sold as a supplement. The vitamin is mostly found as nicotinamide and nicotinic acid in foods and supplements.

NAD is naturally produced by the human body but its levels decline due to age, persistent inflammation, and chronic substance abuse. Reduced levels of NAD in the human body have been linked to neurological disorders, increased inflammation, and impaired cell functionality that trigger physiological decline normally associated with aging, per the findings of a 2021 research review by Amjad et al., published in the journal Molecular Metabolism, titled “Role of NAD+ in regulating cellular and metabolic signaling pathways.”

Preliminary research suggests that NAD therapy improves cell functionality; reduces high blood pressure, body weight, and total cholesterol; reduces the risk of cancer; improves the symptoms of Parkinson’s disease; strengthens muscles; and supports the treatment of addiction.

Intravenous (IV) NAD infusion is the most effective way to increase NAD levels in the body. The other routes of administration are injections, nasal sprays, and oral supplements. NAD IV therapy must be administered by a licensed healthcare provider while the injections, nasal sprays, and oral supplements are self-administered.

NAD therapy is safe for most people because the substance being administered naturally occurs in the human body.

What are the benefits of NAD therapy?

The benefits of NAD therapy are listed below.

• Supporting addiction treatment: NAD therapy supports addiction treatment by reducing cravings and lessening the symptoms and severity of withdrawal symptoms, as reported in a 2020 literature review by Braidy et al., published in the journal Antioxidants, titled “Sobriety and Satiety: Is NAD+ the Answer?” The authors point to historical evidence where complete withdrawal from addictive substances was achieved after IV NAD therapy. However, the authors caution that using NAD in addiction treatment does not allow for the continuous use of addictive substances.

• Boosting energy and stamina: NAD therapy boosts bodily energy levels by supporting cellular activity and improving muscle functionality, as suggested in a 2021 research by Covarrubias et al., published in the journal Nature Reviews Molecular Cell Biology, titled “NAD+ metabolism and its roles in cellular processes during aging.”

• Reducing cholesterol and blood pressure: A study on 30 middle-aged and older overweight or obese adults found that increasing NAD levels in the body significantly decreased total cholesterol, including the harmful LDL (low-density lipoprotein). High levels of LDL raise the risk of heart attacks and strokes. The subjects also experienced a significant reduction in their blood pressure levels. These findings were reported in a 2023 paper published by Pencina et al., in The Journal of Clinical Endocrinology and Metabolism, titled “Nicotinamide Adenine Dinucleotide Augmentation in Overweight or Obese Middle-Aged and Older Adults: A Physiologic Study.” Although the sample size of this study is small, the authors argue that the promising results warrant larger clinical trials.

• Supporting brain health: Depleted NAD reserves in the body are intricately associated with aging-related neurodegenerative disorders, the most common among them being Alzheimer’s disease and Parkinson’s disease. It is believed that boosting natural NAD stores in the body with supplementation has a neuroprotective effect. However, there is limited research in these areas, and more clinical trials are necessary to confirm that NAD therapy protects against age-related cognitive impairment.

• Reducing the risk of cancer: In a 2016 article by Borut Poljsak in the Journal of Clinical and Experimental Oncology, titled “NAD⁺ in Cancer Prevention and Treatment: Pros and Cons,” it is hypothesized that NAD therapy reduces the risk of cancer by promoting healthy cellular repair and initiating a robust immune response in the body.
  However, the study also mentions that NAD-boosting therapy is believed to be detrimental as cancer progresses. Cancerous cells require energy to proliferate. By supporting cell energy metabolism and cellular growth, therapy-boosted NAD levels will supposedly promote the growth and proliferation of existing cancer cells and make them more resilient. It is strongly advised that people who have a family history of cancer, have cancer, or had a prior cancer diagnosis should consult a physician before initiating NAD therapy. Meanwhile, clinical trials are underway to investigate NAD pharmacology in cancer before researchers present conclusive evidence

• Aiding weight loss: It was found in a study that increasing NAD levels in the body after a 28-day therapy reduced body weight in the overweight or obese, middle-aged and aged participants (Pencina et al., 2023). NAD therapy also supports weight loss indirectly by regulating the circadian or sleep-wake cycle.

• Improving sleep quality: Increasing NAD levels in the body via NAD therapy improves sleep quality. This finding was reported by Kim et al., in their 2022 paper published in the journal Nutrients, titled “Effect of 12-Week Intake of Nicotinamide Mononucleotide on Sleep Quality, Fatigue, and Physical Performance in Older Japanese Adults: A Randomized, Double-Blind Placebo-Controlled Study.” The study suggests that administering NAD therapy in the afternoon rather than in the morning had the greatest positive effect on the sleep quality of the participants.

• Increasing physical performance during exercise: A clinical trial on amateur runners found that NAD therapy improved physical performance during exercise by helping skeletal muscles optimally utilize oxygen. The findings were reported in an article by Liao et al., published in the Journal of International Society of Sports Nutrition in 2021, titled “Nicotinamide mononucleotide supplementation enhances aerobic capacity in amateur runners: a randomized, double-blind study.” The authors clarify that this improvement is related to muscle, not cardiac fitness, and depends on dosage.

• Improving exercise performance in the elderly: NAD-boosting therapy improves exercise performance in older adults with lower levels of NAD. These findings were reported in a 2019 study by Dolopikou et al., in the journal European Journal of Nutrition, titled “Acute nicotinamide riboside supplementation improves redox homeostasis and exercise performance in old individuals: a double-blind cross-over study.” However, the authors of the above-mentioned article clarify that they have not found any evidence that NAD supplementation improves exercise performance in young and middle-aged people.

• Improving immunity in older adults: There is a natural age-related decline in NAD levels in the body. Preliminary evidence suggests that boosting NAD levels in the body improves aging-related immune system dysfunction and inflammation, protects the elderly from viral diseases, and triggers their bodies to respond to vaccines. These findings were reported in a 2020 literature review published in the journal Pharmaceuticals by Radenkovic et al., titled “Clinical Evidence for Targeting NAD Therapeutically.” The authors indicate that more human clinical trials need to be carried out to confirm the positive correlation between NAD therapy and improved immunity in the elderly.

• Preventing aging-related disorders: NAD influences key cellular processes like regulating metabolic pathways, cell health, DNA repair, immune cell response, and cellular aging. In this 2018 article by Aman et al., published in the journal Translational Medicine of Aging, titled “Therapeutic potential of boosting NAD+ in aging and age-related diseases,” the authors report that a few studies on diseased animals and healthy and ailing aged humans have shown evidence that NAD therapy prevents aging-related disorders. However, the authors suggest that more large-scale human clinical trials are necessary before NAD therapy is prescribed as treatment.

How does NAD therapy work?

NAD therapy works by increasing the natural reserves of NAD in the body. Low NAD levels in the body have been linked to accelerated cellular aging and impaired cellular energy metabolism and DNA repair that cause neurodegenerative and metabolic diseases; increased inflammation; and low immunity and energy levels. These findings were reported in a 2020 scientific study by Radenkovic et al., published in the journal Pharmaceuticals, titled “Clinical Evidence for Targeting NAD Therapeutically.”

NAD is a critical co-enzyme that occurs in every cell of the human body. NAD occurs in two forms: NAD+, which is the oxidized form that is attained after losing one electron, and NADH, which is the reduced form that has one extra electron. An electron rarely exists in an unpaired state and seeks to combine with another electron.

NAD is involved in redox reactions that promote cellular energy metabolism. Redox reactions are oxidation-reduction reactions where electrons are transferred between two reactants.

NAD+, which is the oxidized form of NAD, accepts electrons from other molecules. It accepts H+ from NADH and reduces to form NADH. NADH, which is the reduced form of NAD, gives up its electrons to other molecules. It gives up H+ to NAD+ and oxidizes to form NAD+. The transfer of electrons supports the production of ATP (adenosine triphosphate), which is the “energy currency” of the cell and drives many physiological processes in the body.

NAD thus promotes cellular health and functionality. It is a key molecule in several pathways associated with DNA repair and regeneration, energy production, immune cell response, gene expression, circadian rhythms, and inflammation regulation, according to this 2020 article by Xie et al., in the journal Signal Transduction and Targeted Therapy, titled “NAD+ metabolism: pathophysiologic mechanisms and therapeutic potential.” Reduced levels of NAD in the body cause these pathways to malfunction.

By boosting NAD levels in the body, NAD therapy maintains these key metabolic pathways and leads to improved health and well-being.

Is NAD therapy effective?

Yes, NAD therapy is effective, according to preliminary studies, in reducing blood pressure, body weight, and LDL cholesterol; improving the symptoms or delaying the progression of age-related and neurodegenerative diseases like Alzheimer’s and Parkinson’s diseases; delaying aspects of accelerated aging; supporting addiction by removing withdrawal symptoms; and reducing the risk of cancer.

A 2023 paper published by Pencina et al., in The Journal of Clinical Endocrinology and Metabolism, titled “Nicotinamide Adenine Dinucleotide Augmentation in Overweight or Obese Middle-Aged and Older Adults: A Physiologic Study” reported that NAD therapy significantly reduced body weight, diastolic blood pressure, total cholesterol, and LDL cholesterol in overweight or obese middle-aged or older adults.

A 2022 article by Igarashi et al., published in the journal NPJ Aging, titled “Chronic nicotinamide mononucleotide supplementation elevates blood nicotinamide adenine dinucleotide levels and alters muscle function in healthy older men” reported that the participants in the study showed small but significant improvements in muscle functionality.

According to the findings of studies and outcomes of therapies delivered in healthcare settings published in this 2021 release from the University of Maryland (Baltimore) Digital Archive, titled “Nicotinamide adenine dinucleotide: Summary Report,” use of NAD oral supplementation and IV infusion on patients with Parkinson’s disease reduced disability and improved posture and motor functions like walking and pushing. The authors noted that younger patients with a shorter duration of the disease showed more improvement than the older ones and those with a longer duration of the disease.

IV NAD therapy has led to complete withdrawal from addictive substances without subjects experiencing painful withdrawal symptoms, according to findings reported in a 2020 literature review by Braidy et al., published in the journal Antioxidants, titled “Sobriety and Satiety: Is NAD+ the Answer?“

According to a 2020 article in the journal Biomolecules by Nikas et al., titled “The Role of Nicotinamide in Cancer Chemoprevention and Therapy,” NAD-boosting therapy in combination with chemotherapy and radiotherapy showed promising results in cancer chemoprevention.

However, research on NAD therapy is still in the nascent stages. The above-mentioned studies do not prove the efficacy of NAD-boosting therapy. More large-scale trials are needed before NAD therapy is accepted as a treatment method.

How is NAD therapy used in addiction treatment?

NAD therapy is used in addiction treatment to boost the body’s natural NAD reserves that get depleted after prolonged periods of substance abuse. By increasing the levels of NAD in the body, this therapy optimizes detoxification, reduces withdrawal symptoms and cravings, and energizes the person undergoing the treatment so that they heal faster.

NAD IV therapy has been found to significantly reduce cravings and withdrawal symptoms in people with alcohol and opioid addiction, as mentioned in this 2020 literature review by Braidy et al., published in the journal Antioxidants, titled “Sobriety and Satiety: Is NAD+ the Answer?“

Reducing the severity of withdrawal symptoms during the detoxification stage makes the process bearable and comfortable. So, the person undergoing addiction treatment is more likely to continue with the treatment.

NAD therapy supports detoxification by boosting the body’s rate of metabolism. Increased metabolism hastens the removal of drugs and alcohol from the person’s body.

Reducing cravings is critical to achieving and sustaining sobriety. The faster withdrawal symptoms and cravings disappear, the quicker the person undergoing treatment gets back to leading a healthy and productive life.

Chronic substance abuse often causes fatigue in a person. NAD therapy reduces the symptoms of persistent moderate/severe fatigue, according to the findings of a 2024 study by Isman et al., published in the journal Brain, Behavior, & Immunity – Health, titled “Low-dose naltrexone and NAD+ for the treatment of patients with persistent fatigue symptoms after COVID-19.“

By improving energy levels, NAD therapy helps the person undergoing the treatment cope better with the rigors of detoxification, which tends to be physically draining as the body strives to flush out the toxins.

NAD therapy regulates moods and emotions in people undergoing treatment for substance abuse issues and has been found to reduce symptoms of depression and anxiety, according to the findings of a study published in 2022 by Blum et al., in the journal Current Psychiatry Research and Reviews, titled “Nicotinamide Adenine Dinucleotide (NAD+) and Enkephalinase Inhibition (IV1114589NAD) Infusions Significantly Attenuate Psychiatric Burden Sequalae in Substance Use Disorder (SUD) in Fifty Cases.“

When substance abuse issues co-occur with mental health conditions like depression and anxiety, it is critical to manage and improve the symptoms of either disorder to treat the other disorder. By reducing the symptoms of depression and anxiety, NAD therapy increases the efficacy of the addiction treatment.

What are the administration methods for NAD therapy?

The administration methods for NAD therapy are listed below.

• NAD IV therapy
• NAD injection
• NAD supplement
• NAD nasal spray

1. NAD IV therapy

NAD IV therapy is the administration of a NAD solution into the veins of a person and directly into their bloodstream. The solution is infused into the vein at a specific rate in a session that lasts several hours.

NAD IV therapy consists of a single infusion session daily across successive days till the withdrawal symptoms and cravings disappear. The infusion sessions taper off with daily administrations replaced by maintenance doses once or twice a month till all symptoms of addiction disappear.

Currently, NAD IV therapy is the most effective way to increase NAD levels in humans, according to a 2021 research published in the journal Aging and Diseases by She et al., titled “Pharmacology and Potential Implications of Nicotinamide Adenine Dinucleotide Precursors.“

NAD infusions generally contain synthetic NAD, which is more bioavailable. The solution is delivered in concentrated doses, so NAD levels in the body get a quick boost.

Intravenous administration is more efficient and manifests quicker results than administering via the oral route. The results show up quicker because the fluids enter the bloodstream directly, bypassing the waiting period required by the digestive system to metabolize and absorb oral supplements.

Intravenous infusion hydrates the body and thus helps eliminate toxins. This especially benefits people who are undergoing detoxification as part of their substance abuse treatment program. By flushing out toxins from the body, IV NAD therapy helps a person in recovery heal faster.

2. NAD injection

NAD injections are intramuscular (IM) or subcutaneous (SQ). NAD IM injections are administered directly and deeply into the muscle tissue. NAD SQ injections are administered in the fatty tissue underneath the skin and are self-administered.

NAD injections take only a few seconds to administer and deliver concentrated doses that the body uptakes quickly. This method of administration allows people with active or busy lifestyles to get their dose of NAD without sitting through an IV session lasting several hours.

Muscles have a robust network of blood vessels. Intramuscular NAD injections deliver the substance to the bloodstream quickly without going through the digestive system, according to this 2023 StatPearls publication by Javier J. Polania Gutierrez and Sunil Munakomi, titled “Intramuscular injection.” So, the positive effects manifest quicker than when NAD is administered orally.

Various factors like age, obesity, or the peculiar nature of the vein make it difficult to access a person’s veins. NAD IM injections are administered in such instances to achieve almost the same degree of efficacy as an IV infusion.

There is a wealth of information on the internet on how to self-administer SQ injections. So, most people self-administer these injections safely. This saves time and the effort required to make trips to a clinic.

3. NAD supplement

NAD supplements are available as capsules. They are consumed orally and absorbed by the body through the digestive system. The capsules are available in dosage strengths ranging from 250mg to 1,000mg.

There are several benefits of NAD supplements. They are less expensive than IV infusions and injections and online retailers or pharmacies sell these supplements without a prescription.

People who are uncomfortable with invasive procedures are less anxious about following a regimen of oral NAD supplements.

People who develop painful skin and soft tissue infections at the injection site after injecting drugs are wary of needles and fear contracting an infection. Administering oral NAD supplements to these people lessens their anxiety and ensures therapy adherence.

NAD oral supplements allow people with an active lifestyle and those who are always on the move to receive the dose they need without having to sit through an IV session.

Not all people who self-administer NAD injections know how to take adequate care of the injection site or manage common injection site reactions like itching, swelling, and pain. These people have an increased risk of developing an infection. Oral NAD supplements are safer alternatives for these people.

4. NAD nasal spray

NAD nasal spray is available as a solution containing NAD molecules and is applied directly to the nasal cavity. The spraying action directs a fine mist of NAD molecules to the mucosa or mucous membrane lining the nasal cavity. The mucosa absorbs the NAD and transports the substance to the brain.

The NAD nasal spray is available in a 15ml bottle with a concentration of 300mg/ml. It should be administered as directed by a physician. These sprays are conveniently self-administered at home.

Using a nasal spray is a non-invasive strategy to administer NAD, which appeals to people who are uncomfortable with invasive procedures using IV drip infusions and injections. In humans, the blood-brain barrier controls the entry of foreign particles from the blood to the brain. This poses a peculiar challenge when doctors want to deliver therapeutic substances to the brain of their patients, according to the 2012 research by William M.Pardridge published in the Journal of Cerebral Blood Flow & Metabolism, titled “Drug transport across the blood-brain barrier.” Administering through the nasal route delivers the NAD directly to the brain bypassing the blood-brain barrier.

The intranasal method of administration is more effective than using the oral route because it optimizes delivery of the intended substance to the brain, as suggested in the 2023 research by Jeong et al., published in the Journal of Pharmaceutical Investigation, titled “Drug delivery to the brain via the nasal route of administration: exploration of key targets and major consideration factors.”

What are the side effects of NAD therapy?

The side effects of NAD therapy are listed below.

• Swelling, tenderness, or redness at the injection site: These mild reactions are caused by the needle of the syringe or the infusion fluid penetrating and irritating the skin barrier and the vein. If there is a reaction, it occurs right after the infusion begins or a few hours afterward, but it resolves on its own.
• Headaches: Nicotinamide at doses of up to 6g ingested on an empty stomach produced headaches, according to a 2020 research by Eun Seong Hwang and Seon Beom Song, titled “Possible Adverse Effects of High-Dose Nicotinamide: Mechanisms and Safety Assessment” that was published in the journal Biomolecules. The headaches range from mild to severe and generally resolve within a few hours or days. Hydrating adequately before and after the therapy decreases the chances of experiencing headaches.
• Shortness of breath: This reaction is due to a fast rate of infusion, which is more than 35 drops per minute, according to the findings of studies and outcomes of therapies administered in clinical settings published in this 2021 release from the University of Maryland (Baltimore) Digital Archive, titled “Nicotinamide adenine dinucleotide: Summary Report.”
• Nausea: One reason for this reaction is the fast drip-rate. Healthcare practitioners operating in clinical settings suggest that IV NAD should be administered slowly over 6 to 8 hours. Since NAD IV therapy is administered by and in the presence of a qualified healthcare professional, the drip rate is quickly corrected when symptoms manifest.
• Dizziness: Dizziness is due to a sudden drop in blood pressure caused by a fast infusion rate. It was found that dizziness occurred if NAD supplements at doses of up to 6g were ingested on an empty stomach (Hwang and Song, 2020). The reaction is minor and resolves when the therapy stops. Patients are advised to rise slowly after infusion to avoid dizziness.
• Vomiting: Vomiting is common if NAD supplements at maximum doses of up to 6g are ingested on an empty stomach (Hwang and Song, 2020).
• Flushing: Flushing, a condition where the skin simultaneously turns red and feels warm to the touch, is a common reaction to NAD therapies. The possible reasons include a rapid infusion rate or administration of more than 50mg of nicotinic acid (NA, also called niacin) per day. High doses of NA are known to trigger the secretion of a hormone-like substance called prostaglandin that causes flushing by dilating small subcutaneous blood vessels, as stated in a 2022 fact sheet released by the National Institutes of Health, titled “Niacin.”
  

  Whether the person undergoing NAD therapy will experience flushing depends on the nature of the ingredients in the supplements. For example, instead of NA, newer formulations of NAD supplements contain ingredients like NR (nicotinamide riboside) and NMN (nicotinamide mononucleotide) that are believed to be better tolerated and hence, do not trigger side effects like flushing.

• Allergic reactions: These are rare because NAD occurs naturally in the human body. Allergic reactions occur in individuals who are allergic to the additives and preservatives in the NAD solution. The symptoms include redness, itching, swelling, and hives. Since NAD IV therapy is administered in the presence of a licensed healthcare provider, the symptoms are managed as soon as they appear.

How many sessions are required for NAD therapy?

The sessions required for NAD therapy vary widely and depend on several factors, which include the condition for which the therapy is being administered, the route of administration, the dosage strength, the purity of the product being administered, and how well the patients absorb the co-enzyme. Individual variations in responsiveness to treatment, which depend on age, gender, genetics, and baseline health, also determine the number of sessions required for NAD therapy.

To date, there is no scientific consensus on the number of sessions required for NAD therapy. So, practitioners generally depend on the outcome of ongoing or previous sessions to formulate the subsequent course of treatment. For example, according to a 2021 publication from the University of Maryland (Baltimore) Digital Archive, titled “Nicotinamide adenine dinucleotide: Summary Report,” patients with addiction who show positive results after 4-5 IV NAD sessions and never relapse do not undergo additional therapy. Patients who experience cravings after going through 7-12 days of therapy have to undergo 2-day booster sessions every three months.

What is the recommended frequency of NAD therapy?

The recommended frequency of NAD therapy varies depending on the nature and severity of the condition that is being treated and the unique needs of the individual undergoing the therapy. For example, NAD IV therapies are administered on several days per week for a couple of weeks followed by maintenance sessions every few months. In the case of addiction recovery, NAD IV therapy is usually administered daily for 10-15 days, and thereafter, the patient has to go through 2-day booster sessions every three months if they experience cravings.

How long do the effects of NAD therapy last?

The effects of NAD therapy last from 3 to 14 days depending on the health of the person undergoing the therapy, the nature and severity of the condition being treated, the dosage strength administered, and the frequency of infusions in the initial stages of the treatment. It is recommended that at least 1-2 IV sessions are scheduled every week in the initial stages of the therapy to trigger a robust treatment response, followed by maintenance sessions every few months. This ensures that the effects of the therapy last for months in between booster doses. However, there is no scientific consensus on how long the effects last.

How much does NAD therapy cost?

NAD therapy costs vary from $500 to $2,000 per session. Total therapy costs depend on factors like the nature and severity of the condition being treated, the number of sessions required, and the form of NAD or NAD supplement being used in the therapy.

Nutrients, such as vitamin B12, vitamin C, vitamin D, magnesium, zinc, and taurine, are added to the NAD infusion to address deficiencies, which are common in people with alcohol and substance use disorders. Patients with severe or chronic conditions and people with addiction who relapse have to undergo more intensive or frequent sessions than those who have mild health issues or don’t experience addiction relapses. These factors drive up the costs of single NAD sessions and the whole therapy.

The price of NAD injections varies from $69 to $549 depending on dosage strength and whether a single vial is bought or a bulk purchase is made. NAD injections are commonly available in dosage strengths of 100mg, 500mg, and 1,000mg. The cost of a bottle of NAD nasal spray varies from $59.95 to $139 depending on factors like dosage strength, net contents of the bottle, and the specific formulation of NAD used.

Who performs NAD therapy?

NAD therapy is performed by qualified healthcare providers like doctors and drug and alcohol addiction treatment and rehabilitation centers.

Drug and alcohol addiction treatment and rehabilitation centers perform NAD therapy as part of a comprehensive treatment program to support detoxification, provide treatment, and prevent relapse. The therapy is initiated during the detox stage. Maintenance therapies are added to the treatment plan after withdrawal symptoms and cravings disappear.

A qualified physician at the addiction treatment center decides the duration and frequency of the NAD therapy. Intravenous administration of NAD is performed by a registered nurse.

Many addiction treatment centers create personalized NAD therapy programs tailored to individual comfort and convenience needs, privacy concerns, and scheduling constraints.