IV NAD evaluating and refining assessment of withdrawal symptoms associated with opioid and alcohol use disorders

LL23 Evaluating and refining assessment of withdrawal symptoms associated with opioid and alcohol use
disorders using Intravenous administration of nicotinamide adenine dinucleotide detox protocols

S. L. BROOM1,2, T. OLDS2,3, R. F. MESTAYER2
1Psychology, William Carey Univ., Hattiesburg, MS; 2NAD Research, Inc., Springfield, LA; 3Springfield Wellness Ctr., Springfield, LA

INTRODUCTION

Hospitalizations, overdoses and deaths due to substance use disorders (SUD) are increasing demand for healthcare involving detox and support for long term recovery. Treatment facilities using medical assistance therapy show success, however they rely on use of opioid agonists to achieve stabilization. Nicotinamide adenine dinucleotide (NAD) is a coenzyme of vitamin B3, and patented in the 1960’s as a treatment for alcohol and drug abuse. A clinic in Springfield, LA developed intravenous (IV) NAD administration protocols known as BR+NAD® for treatment of withdrawal (WD) symptoms associated with SUD; retrospective analyses showed a significant decrease in drug cravings while maintaining sobriety over time. Recent protocols incorporated standardized assessments with clinic derived questionnaires to provide comprehensive measures of efficacy. This pilot study examined withdrawal symptoms associated with opioid (OUD) and alcohol use disorder (AUD) following IV NAD administration in a group of 26 patients.

METHODS

Patients (14 OUD/ 12 AUD) received treatment at Springfield Wellness Center comprised of IV infusions of NAD (500-1500mg) with supportive WD medications and oral vitamins for up to10 days ranging from 5-10 hours daily. Clinicians measured WD symptoms using the Clinical Opioid Withdrawal Scale (COWS), Clinical Institute Withdrawal Assessment of Alcohol Scale, revised (CIWA-Ar), and symptom checklist (0-10 scale) recorded in nurses’ notes. These assessments took place at the beginning of the treatment day and patients were monitored for any adverse side effects or need for adjustments in IV infusion protocol/medications. Descriptive analyses were performed on composite scores, individual symptoms and comparison with previous patient data. Positive drug screens, no shows, and interrupted treatment days were noted.

RESULTS

  • Majority in both AUD and OUD groups were male 72.37% AUD and 92.86%OUD, with AUD patients averaging 10 years older (38.14 OUD vs 48.33 AUD).
  • Both groups completed at least 4 days (1 pt) up to the expected 10 days (17 pts).
  • 12/14 OUD patients and 2/12 AUD patients had positive drug screens on their first treatment day (prior to IV).
  • One patient (OUD) received 100mg subcutaneous NAD injections plus 800mg iontophoretic patch in place of IV. Cows scores averaged in the mild range, with anxiety, pulse rate, and GI upset most noted.
  • CIWA-Ar scores averaged in the mild range, with hand tremor and anxiety most noted.
  • Composite scores for both groups were consistent with previous patient data across first 5 treatment days.

CONCLUSIONS

1) Results show that NAD is an effective supportive detox treatment for AUD and OUD.

2) Composite scores for both groups were consistent with previous patient data across first 5 treatment days, however, cravings were lower and more variable from D1-D10.

3) Results suggest that self report ratings with COWS/CIWA-Ar improves measures of WD.

4) Future studies should include training in administration/scoring of assessment forms and encourage patient participation during initial and follow-up phases.

ACKNOWLEDGMENTS/DISCLOSURE

Thank you NAD Research, Inc. in full support of this project.
Previous patient data were presented at the National Association for Alcohol and Drug Addiction Counselors (NAADAC) in Orlando, Fl (2019). More details on this research and related projects are available at https://nadresearch.org/
Thank you to Springfield Wellness Center for providing patient data.
S. L. Broom -Research Consultant/Science Advisory Board Member (NAD Research, Inc) received consulting fees as a Researcher /Statistical Analyst on this project.
S. L. Broom thanks WCU for providing travel reimbursement related to SfN attendance.