NAD+ IV Therapy

What this page is. A neutral, sourced look at NAD+ IV therapy as it’s sold and used in recovery contexts. NAD+ infusions are investigational, not FDA-approved for any addiction indication, and not standard of care. The published clinical evidence is thin and mostly comes from clinicians who run the NAD+ infusion clinics. People still pay for it; some report meaningful benefit; the page exists because readers ask.

The first half describes what’s offered, where, and at what cost. The second half describes what the evidence actually supports.

NAD+ IV in one paragraph

NAD+ (nicotinamide adenine dinucleotide) is a coenzyme involved in cellular energy metabolism. The therapy delivers IV doses orders of magnitude higher than the body normally maintains, on a multi-day schedule, in a clinical setting. In recovery contexts it’s marketed for withdrawal symptoms, cravings, and post-acute fatigue and mood. It is not FDA-approved for any of those uses, and the published clinical evidence is small and largely produced by the clinics that sell it.

Protocols typically offered

What commercial NAD+ programs publish as their standard protocols. Descriptions of what’s offered, not protocol recommendations.

The most-published version is the BR+NAD® protocol from the Springfield Wellness Center / Mestayer group (BR+ = Brain Restoration Plus). It runs an average of 10 consecutive days at 5 to 10 hours daily, with NAD+ at 500 to 1,500 mg per session, paired with amino acids (threonine, glycine, phenylalanine, alanylglutamine), NAC, B vitamins, and supportive PRN medications. Many other clinics describe similar protocols.

The pharmacokinetics of the infusion itself are documented in a 2019 pilot study (Grant et al., Front Aging Neurosci) sponsored by NAD+ Research Inc.: 750 mg over 6 hours in 11 men, with plasma NAD+ rising modestly and clearing rapidly. The study measured plasma and urine; it did not measure intracellular NAD+, the cellular-delivery question that comes up further down this page.

Methylation support paired with the infusion

NAD+ metabolism consumes methyl groups; many practitioners pair the infusion with methyl-donor supplementation. These ranges come from the methylation and supplement community, not from NAD+ randomized trials.

The methyl-depletion concern has more established basis with oral NAD+ precursors (NR, NMN) than with IV NAD+ directly. For IV NAD+ specifically, methyl support is a precautionary practice extrapolated from precursor pharmacology, not a measured requirement.

For sourcing, see Vitamins & Supplements. Third-party testing certifications (USP, NSF, ConsumerLab) exist for readers who want to evaluate supplement quality without specific-brand endorsements.

Provider categories

The infusion requires a clinician to prescribe and a clinical setting to administer. Providers cluster into a few categories:

• Specialty IV therapy clinics (drip bars, IV hydration / wellness lounges)
• Addiction-focused NAD+ programs running multi-day intensive courses with on-site clinical staff
• Functional and integrative medicine practices
• Mobile IV services in some metropolitan areas
• Some concierge medical services

This site does not link to specific providers and does not recommend any clinic. See Where we stand for the broader posture on this kind of question.

Cost

The NPR investigation cited below documented one clinic charging $15,000 for a 10- to 15-day course. Pricing varies by region, clinic, and add-ons.

Insurance generally does not cover NAD+ IV therapy because it isn’t FDA-approved for any addiction indication. The methylation supplements are inexpensive in comparison.

Mechanism, hypothesized

The proposed story: chronic substance use depletes cellular NAD+ levels; IV repletion restores mitochondrial function and rebalances neurotransmitter systems.

NAD+ is a large, charged molecule. Direct cellular uptake of intact NAD+ across plasma membranes is not well established, and there is no demonstrated cellular NAD+ transporter analogous to those that import the NAD+ precursors NR and NMN. Extracellular NAD+ is also rapidly degraded by CD38, a NAD-consuming ectoenzyme (Schultz & Sinclair, Cell Metabolism 2016). Whether IV NAD+ produces meaningful intracellular elevation, particularly in brain tissue behind the blood-brain barrier, is open in the literature.

The Grant et al. pilot above measured rapid plasma clearance and inferred cellular uptake from metabolite patterns; it did not demonstrate direct intracellular delivery. Elysium Health, a longevity company that sells competing oral NAD+ precursors, has stated publicly that there is “no credible evidence to suggest that externally supplied NAD+ (ingested or injected) gets inside cells, where they are needed.” That position comes from a company with a competing product to defend; the factual point about absent direct intracellular evidence is consistent with what the published literature shows.

The mechanism story is a hypothesis with limited human evidence, not established pharmacology.

The published clinical evidence

A small literature, dominated by clinic-affiliated authors.

Pilot case series, uncontrolled. Blum et al. 2022 (PMID 36118157) reported on 50 SUD patients given a proprietary NAD+ formulation, with pre/post improvements in craving, anxiety, and depression. No control group, no blinding. Author affiliations include commercial NAD+ ventures and patent-holding interests. A 2024 republication in J Addict Psychiatry (PMID 39949994) appears to draw on the same patient cohort.

Springfield Wellness Center / Mestayer-affiliated reporting. The widely-circulated “~90% craving reduction” figure traces to a Springfield pilot that, per NPR’s reporting, was not peer-reviewed or published in a scientific journal. Treat as clinic marketing, not as published evidence.

No randomized controlled trials. As of 2026, there is no published RCT of IV NAD+ for opioid use disorder or alcohol use disorder. The standard of evidence for accepted addiction treatments includes placebo-controlled RCTs; NAD+ IV does not have these.

Independent assessment. NPR’s 2019 investigation of NAD+ addiction clinics quoted addiction-medicine specialists. Dr. Emily Zarse said “there’s no actual data on any of these things.” Dr. Leslie Hulvershorn (Indiana University) called the brain-scan marketing “totally bogus.” Dr. Basia Andraka-Christou (University of Central Florida) described clinics as targeting “a really desperate population.” The article also documented a clinic continuing to use a patient’s recovery testimony in marketing more than a year after the patient had returned to using.

For 7-OH and the kratom synthetics specifically: no published evidence. All NAD+ addiction research is in opioid use disorder broadly or in alcohol use disorder. Application to 7-OH dependence is extrapolated, not studied.

Reader reports

Some readers who have done a multi-day NAD+ course describe meaningful reductions in withdrawal symptoms, lower cravings, and feeling more themselves. Those experiences are not nothing.

What the evidence does not let anyone determine is which part of the package produces the benefit:

• the NAD+ itself
• the co-administered amino acids, B vitamins, and NAC, some of which independently affect withdrawal physiology
• days of supportive clinical care, hydration, and structured routine
• placebo effects, large in craving and pain contexts

Something in the package may help some people. The price tag attaches to the whole package, not to NAD+ specifically.

Options the evidence supports more strongly

For opioid-receptor dependence, including from 7-OH and the kratom synthetics, several paths have stronger evidence than IV NAD+ does:

• Suboxone (buprenorphine), accessible through telehealth providers at a small fraction of the cost of an NAD+ course, with decades of clinical evidence behind it
• SR-17 is the other medication-assisted path the community has converged on for getting off the synthetics, off-prescription and with thinner clinical literature
• Tapering with kratom leaf and cold turkey with helper medications are the non-MAT options

None of these are exclusive with NAD+ IV; readers do combinations. The point of the comparison is that the major medical decision for someone in withdrawal is rarely “NAD+ or nothing,” and the budget that an NAD+ course consumes can fund a year of telehealth bupe with money left over for the rest of recovery.

The decision

NAD+ IV therapy is investigational, expensive, and offers thin published evidence alongside consistent anecdotal reports. People do it; some describe benefit; the evidence does not let anyone confidently say what’s producing the benefit. A 10-day course commonly costs $10,000 to $15,000, paid out of pocket. The same dollars can fund the evidence-based options above with substantial money left over.

A reader making this decision deserves both sides of the picture. This page does not tell anyone what to choose; it makes sure the comparison is part of the picture.

For a far cheaper withdrawal adjunct with a more-established (though still preliminary) literature behind it, see Mega-Dose Vitamin C.

Talking it through

NAD+ IV therapy requires a clinician to prescribe and a clinical setting to administer. The clinicians who actively offer it are typically functional and integrative medicine practitioners, addiction-specialty NAD+ programs, or specialty IV therapy clinics. Most standard addiction-medicine prescribers (the kind reachable through general telehealth platforms) will not have a substantive position on it; some have a one-line stance, supportive or skeptical, and few will engage with the dose-and-protocol nuance the published literature does not yet support.

The decision itself is closer to community ground than clinic ground. The most useful conversation is usually with someone who has done a course and can describe what the experience was like, what they paid, and what they think they got. The Discord and r/quitting7oh are reasonable starting points.

For drug-interaction questions about your other medications, a prescriber is the right address.

Further reading

• Mega-Dose Vitamin C: a far cheaper adjunct with older and stronger preliminary literature
• Peptides for Opioid Withdrawal: BPC-157, Selank, Semax, DSIP, TB-500; what the evidence supports per peptide and the supply-chain safety reality
• Vitamins & Supplements: supplement stack background and sourcing notes
• Helper Medications: prescription comfort meds with established evidence
• Tapering Off 7-OH: community taper patterns and what tends to help
• Withdrawal Help: what to actually do during acute withdrawal
• Telehealth Providers: addiction-medicine telehealth options