NAD+ Therapy for Addiction Recovery: How IV NAD+ Supports Detox and Healing at The Runway Recovery
When someone enters addiction treatment, their body is not simply adjusting to the absence of a substance. It is attempting to repair, from the inside out, the biological damage that substance use has caused at a cellular level.
One of the most significant — and most overlooked — aspects of that damage is the depletion of NAD+.
At The Runway Recovery in Santa Ana, Orange County, we offer intravenous NAD+ therapy as part of our holistic residential treatment program. Not as a cure. Not as a shortcut. But as a clinically informed, evidence-informed tool that supports the body's natural healing capacity during one of the most demanding transitions it will face.
Here is what NAD+ is, why it becomes depleted during substance use, what the research says about its role in recovery, and what IV NAD+ therapy looks like at The Runway.
What Is NAD+?
NAD+ — nicotinamide adenine dinucleotide — is a coenzyme found in every living cell in the body. It is not a drug or a supplement in the conventional sense. It is a molecule the body produces naturally, and one that is absolutely essential to life.
NAD+ plays a central role in energy metabolism — it is required for the process by which cells convert nutrients into usable energy (ATP). It is involved in DNA repair, regulating cellular stress responses, supporting immune function, and maintaining the health of the mitochondria — the energy-producing structures inside each cell.
It also plays a critical role in brain function. NAD+ is required for the synthesis and regulation of neurotransmitters — the chemical messengers that govern mood, motivation, focus, impulse control, and the experience of pleasure and reward. These are precisely the systems that chronic substance use disrupts most severely.
Think of NAD+ as cellular fuel. When levels are adequate, the body's repair and regulatory systems function well. When levels are depleted — as they are in addiction — those systems begin to fail.
How Substance Use Depletes NAD+
The relationship between substance use and NAD+ depletion is not incidental. It is a direct, measurable biological consequence of chronic use.
Alcohol and NAD+ depletion
The metabolism of alcohol in the body consumes enormous quantities of NAD+. When alcohol is broken down in the liver, NAD+ is required at every step of the process — converting ethanol to acetaldehyde and then to acetate. During heavy or binge drinking, this process depletes free NAD+ to critically low levels throughout the body.
A peer-reviewed study published in Experimental and Molecular Pathology found that NAD+ levels are markedly reduced when blood alcohol levels are high, causing liver injury and systemic multi-organ damage because the enzymes that depend on NAD+ can no longer function properly. pubmed.ncbi.nlm.nih.gov A 2024 study in Food Science and Nutrition further confirmed that restoring NAD+ levels prevents alcohol-induced liver injury and supports liver regeneration. onlinelibrary.wiley.com
Opioids, stimulants, and NAD+ depletion
Opioid and stimulant use also depletes NAD+ — through different mechanisms but with similar consequences. Chronic opioid use disrupts mitochondrial function and increases oxidative stress, both of which consume NAD+ at accelerated rates. Stimulant use, particularly methamphetamine and cocaine, drives intense neurological activity that rapidly burns through the brain's NAD+ reserves.
A comprehensive review published in Antioxidants by researchers at the University of New South Wales titled "Sobriety and Satiety: Is NAD+ the Answer?" concluded that NAD+ depletion is a consistent feature of substance use disorders and that replenishing NAD+ represents a clinically meaningful pathway for supporting recovery. ncbi.nlm.nih.gov
The result: a depleted, impaired system trying to heal itself
When someone enters detox after chronic substance use, their NAD+ levels are often significantly below baseline. The cells that need to repair are short on the very fuel required to do so. The brain that needs to recalibrate its neurotransmitter systems is low on the coenzyme those systems depend on. The liver and other organs attempting to restore normal function are operating in an energy-deficient state.
This is the biological environment that IV NAD+ therapy is designed to address.
What the Research Says About NAD+ and Addiction Recovery
The clinical research on IV NAD+ therapy in addiction treatment is still developing — and intellectual honesty requires saying so clearly. Larger randomized controlled trials are still needed. But the existing body of evidence is meaningful, mechanistically coherent, and increasingly cited in addiction medicine literature.
Reducing cravings and psychiatric burden
A peer-reviewed study published in Current Psychiatry Research and Reviews — and indexed on PubMed — examined 50 cases of poly-drug addiction treated with IV NAD+ infusions in standard chemical dependency programs. The study found that NAD+ infusions significantly attenuated substance craving behavior and reduced psychiatric burden across multiple measures including anxiety, depression, and cognitive impairment. pubmed.ncbi.nlm.nih.gov
A follow-up study published in the Journal of Addiction Psychiatry in 2024 replicated these findings, again reporting significant reductions in craving behavior and improved clinical outcomes in substance use disorder patients receiving NAD+ infusions. addiction-psychiatry.org
Reducing withdrawal symptoms
NAD Research Inc. presented clinical data at a neuroscience conference showing that IV NAD+ protocols were effective at evaluating and reducing withdrawal symptoms associated with both opioid and alcohol use disorders — offering a non-opioid-agonist pathway for withdrawal support that is particularly relevant given the limitations and risks of traditional medication-assisted detox. nadresearch.org
Cellular repair and oxidative stress reduction
Research published in the Journal of Cellular Neuroscience and Oxidative Stress found that intravenous NAD+ effectively increased the NAD metabolome, reduced oxidative stress and inflammation, and increased expression of longevity-associated genes — confirming the cellular repair mechanisms that make NAD+ relevant beyond immediate withdrawal management. dergipark.org.tr
Brain function and neuroplasticity
The neurological recovery required for lasting sobriety — rebuilding executive function, restoring emotional regulation, repairing reward system dysregulation — depends on the brain's capacity for neuroplasticity. NAD+ is a required cofactor in the cellular energy processes that drive neuroplastic change. By replenishing NAD+ during the early recovery period, IV therapy supports the neurological substrate of the behavioral and psychological work happening in parallel through therapy.
How IV NAD+ Therapy Supports the Specific Challenges of Detox and Early Recovery
Deep fatigue and energy depletion
The exhaustion of early recovery is not ordinary tiredness. It is the result of mitochondrial dysfunction, neurotransmitter depletion, disrupted sleep, nutritional deficiency, and cells operating on depleted energy reserves. NAD+ is the primary coenzyme in the mitochondrial energy production pathway — replenishing it gives cells the fuel they need to begin producing energy normally again.
Clients receiving IV NAD+ therapy during detox frequently report a meaningful improvement in energy and a sense of physical reawakening — feeling more present and capable of engaging with the therapeutic work of treatment.
Brain fog and cognitive impairment
One of the most disorienting experiences of early sobriety is the cognitive fog — difficulty concentrating, slow processing, memory gaps, emotional flatness — that follows chronic substance use. This fog has a biological basis: chronic substance use reduces cerebral NAD+ levels and impairs the neurotransmitter synthesis that underlies cognitive function.
IV NAD+ therapy delivers the coenzyme directly into the bloodstream at concentrations significantly higher than oral supplementation can achieve, supporting more rapid restoration of cognitive function and mental clarity in the critical early weeks of recovery.
Mood instability and anxiety
The mood dysregulation of early detox — anxiety, irritability, emotional unpredictability, and in many cases acute depression — is partly driven by neurotransmitter imbalance created by substance use and withdrawal. Serotonin, dopamine, and GABA synthesis all depend on NAD+-dependent metabolic pathways.
By supporting neurotransmitter function at a biochemical level, IV NAD+ therapy may help create a more stable emotional baseline — one from which clients can engage more fully with individual therapy, group work, and the psychological dimensions of recovery.
Cravings
Cravings in early recovery are not simply psychological — they are neurological. The reward pathway dysregulation caused by chronic substance use creates intense biological drives that the prefrontal cortex struggles to override, particularly in early sobriety when NAD+ levels are depleted and executive function is impaired.
The clinical evidence cited above suggests that IV NAD+ infusions can meaningfully reduce craving intensity — not by suppressing the brain's reward system pharmaceutically, but by supporting its natural restoration.
What IV NAD+ Therapy Looks Like at The Runway Recovery
NAD+ therapy at The Runway is administered intravenously by licensed medical staff in a calm, private, and comfortable setting — consistent with the overall environment of our residential program.
Each session is 2 to 4 hours depending on the individual protocol determined by your clinical team. The IV infusion delivers NAD+ directly into the bloodstream, bypassing the digestive system to achieve significantly higher bioavailability than oral NAD+ supplements can provide.
The experience is gentle and restful. Clients recline comfortably, and many read, listen to music, or sleep during the infusion. The setting is quiet and supportive — paired with hydration, nutritional support, and the presence of clinical staff throughout.
Sessions are integrated into the broader detox and residential treatment schedule at The Runway — not delivered in isolation, but as one component of a comprehensive program that includes medically supervised detox, individual therapy, group therapy, DBT skills, mindfulness practices including yoga and meditation, acupuncture, HBOT, family therapy, and personalized aftercare planning.
NAD+ therapy at The Runway is not a standalone treatment. It is one carefully chosen, evidence-informed piece of a holistic program designed to support the whole person — mind, body, and spirit — through recovery.
Who Is IV NAD+ Therapy Appropriate For?
IV NAD+ therapy is generally well-tolerated and may be particularly beneficial for clients presenting with significant fatigue, cognitive impairment, intense cravings, mood instability, or a history of heavy or long-duration substance use.
All clients at The Runway are assessed individually before any integrative therapy is incorporated into their program. Your clinical team will review your full health and substance use history to determine whether NAD+ therapy is appropriate for your specific presentation and where it fits within your personalized treatment plan.
Some clients experience mild nausea, chest tightness, or light-headedness during infusion — symptoms that are typically managed by slowing the infusion rate. These effects are temporary and well-managed within a clinical setting.
A Holistic Approach to Detox and Recovery in Orange County
The body carries the history of addiction in its cells, its mitochondria, its neurotransmitter systems, and its NAD+ reserves. Healing it requires more than willpower and abstinence. It requires targeted, compassionate clinical support — and a full range of evidence-informed tools that help the body do what it is designed to do: repair, regenerate, and recover.
IV NAD+ therapy is one expression of The Runway's broader commitment to treating addiction holistically. Alongside HBOT, acupuncture, yoga, meditation, individual therapy, DBT, and comprehensive aftercare planning — it is part of how we give every client the most complete foundation for lasting recovery that we know how to provide.
If you or someone you love is considering addiction treatment in Orange County, our admissions team is available 24 hours a day.
(866) 969-3686 | therunwayrecovery.com | 1245 W Chestnut Ave, Santa Ana, Orange County, CA State-licensed by California DHCS — License #300262AP
