Evidence supporting the use of: N-acetylcysteine
For the health condition: Addictions (drugs)

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Synopsis

Source of validity: Scientific
Rating (out of 5): 2

N-acetylcysteine (NAC) has garnered attention in recent years for its potential role in treating or supporting recovery from various substance use disorders, including cocaine, cannabis, nicotine, and alcohol addictions. The scientific rationale is primarily based on NAC’s ability to modulate glutamate, a key neurotransmitter involved in the brain’s reward and addiction pathways. By restoring the balance of glutamate transmission, which is often disrupted in addiction, NAC may help reduce cravings and improve self-control in individuals attempting to abstain from addictive substances.

Several small randomized controlled trials and meta-analyses have investigated NAC’s efficacy in this context. For example, studies in cannabis dependence (Gray et al., 2012) and cocaine addiction (LaRowe et al., 2007) have shown modest but statistically significant reductions in cravings and use, especially in younger populations. However, results are mixed, and not all studies find a benefit. Evidence for NAC’s use in treating alcohol and nicotine addiction is less robust, with some studies failing to find significant effects.

Overall, while the mechanism of action is plausible and some early trials are promising, the evidence base is still limited by small sample sizes, methodological differences, and inconsistent results. As a result, NAC cannot yet be recommended as a mainstream or first-line treatment for addiction, but ongoing research may clarify its role. Current scientific support is considered modest (rated 2 out of 5).

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