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N-Acetylcysteine Reduces Alcohol Use in Adults with Cannabis Use Disorder

May 1, 2018
Squeglia LM, et al.
Squeglia LM, et al. The Effect of N-Acetylcysteine on Alcohol Use During a Cannabis Cessation Trial. Drug and Alcohol Dependence 2018;185:17-22
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  • N-acetylcysteine (NAC) is an over-the-counter antioxidant with potential promise as a treatment option for substance use disorders.
  • Little research has been done on NAC as a treatment for alcohol use disorder (AUD), however.
  • This secondary analysis of data from the NIDA Clinical Trials Network examined the effects of NAC versus placebo on alcohol use among participants with cannabis use disorder (CUD) enrolled in a 12-week, multi-site cannabis cessation trial (CTN-0053).

Participants (N=302, ages 18-50) were randomized to double-blind NAC (1200mg, twice daily) or placebo. Participants that returned for at least one treatment visit and had recorded alcohol use data (total drinks per week, drinking days per week, and binge drinking days per week) were included in this analysis (n=277).

Results found that participants in the NAC group, compared to the placebo group, had increased odds of between-visit alcohol abstinence, fewer drinks per week, and fewer drinking days per week. The increase in odds of complete abstinence of alcohol was 37% in the NAC group. The NAC group was also 33% less likely to increase their number of drinks, compared to the placebo group, and their drinking days were 31% less than those on placebo as well.

NAC did not affect the number of binge drinking days, however participants were, on average, binge drinking fewer than one time per month, so a significant decrease may be hard to detect in this sample. Age, sex, and race did not affect findings.

Conclusions: Though the original study found that NAC was not effective in reducing cannabis use in an adult sample, this secondary analysis suggests that it may be effective in reducing alcohol use by approximately 30% among treatment-seeking adults with CUD, suggesting a need for further trials focused on the effects of NAC on alcohol consumption.

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