NAD⁺ and alcohol come up in two completely different sales pitches. One is the Sunday-morning hangover drip. The other is a clinic telling a family that infusions will help with cravings and withdrawal.
They deserve different answers, and most coverage gives them the same one. For hangovers there is nothing — not a weak study, nothing. For addiction there is something real, and it is much weaker than the clinics imply and much more interesting than a flat denial.
First, why the idea is not stupid
Drinking genuinely does consume NAD⁺. Your liver clears ethanol using alcohol dehydrogenase and then aldehyde dehydrogenase, and both reactions strip NAD⁺ down to NADH. A review of the enzymology describes alcohol metabolism in the body as primarily regulated by alcohol dehydrogenase and by mitochondrial NADH reoxidation in the liver[1] — which is to say the bottleneck on how fast you sober up is partly how fast you can turn NADH back into NAD⁺.
So a heavy night really does push your hepatic redox balance around. That is a solid mechanism, and it is the reason the hangover drip is an easy sell — the same shape of argument that runs through the whole NAD⁺ category. Whether topping the molecule up from outside changes anything you would notice is a separate question, and it is the one nobody has asked.
Hangovers: the census
We searched PubMed three ways on September 13, 2026. A search for NAD+ infusion hangover clinical trial returned zero results. A search for NAD+ hangover randomized returned one record — a study of electrolyzed-reduced water in Sprague-Dawley rats. A broader search for nicotinamide adenine dinucleotide hangover returned nine records, and every one of them is a rodent or cell-culture study of something else: lactic acid bacteria, a Schisandra extract, probiotics, cucumber juice, asparagus extract, twenty kinds of fruit.
There is no human study of NAD⁺ for hangover. Not a randomized trial, not an open-label trial, not a case series. The most expensive hangover cure on the market has never been tested on a hungover person, and the comparison it needs is not difficult: a drip with NAD⁺ against a drip with the same fluid and no NAD⁺. Until somebody runs it, a hangover drip is saline, vitamins and several hundred dollars, and what an infusion actually does in the bloodstream gives you reason to be skeptical that the NAD⁺ is the active part.
Addiction: what actually exists
This is where a flat “no evidence” would be wrong, and where most of the honest work on this page went.
Two papers describe a series of fifty poly-drug patients (n = 50) attending inpatient and outpatient chemical dependency programs, all of whom had failed between one and ten previous treatment attempts. Each received at least seven infusions over an average of four weeks, with craving, anxiety, depression and sleep scored on self-reported 1-to-10 scales through a counselor interview [2].
The reported changes are large. Comparing baseline with post-infusion scores using Wilcoxon signed-rank tests: craving at P = 1.063E-9, anxiety at P = 5.487E-7, depression at P = 1.763E-4, with a dose-dependent linear trend across infusions (cravings p = 0.015, anxiety p = 0.003, depression p = 8.74E-5). Of 40 patients whose urine was tested mid-course, all 40 came back negative for illicit substances[3].
Now the four things that have to travel with those numbers.
It was not NAD⁺. The infusion contained NAD⁺ plus enkephalinase inhibition, plus d-phenylalanine, plus glycine, plus alanylglutamine dipeptide, plus a Myers’ cocktail of B vitamins[2]. Six or more active components, one outcome score. Nothing here can be attributed to the NAD⁺.
There was no control group and no blinding. Every comparison is a patient against their own earlier self, while enrolled in an addiction treatment program whose entire purpose is to reduce cravings. A self-reported score collected by a counselor cannot separate the infusion from the program, or from the patient knowing they were being treated.
It is one cohort, written up twice. The 2022 paper and the 2024 paper each describe fifty cases and each carry the identical three p-values [2] [3]. If you are counting how much evidence exists, count one.
The authors say so themselves. Their own discussion calls it a pilot study and states that “larger randomized double-blinded placebo-controlled studies are needed” [3]. That is the correct reading of their data. It is also the sentence that never survives the trip to a clinic’s website.
One more detail worth having, because sleep is marketed alongside this: in the 2024 write-up, sleep rose from 6.28 hours before infusions to 7.34 after, and the authors describe the improvement as non-significant [2].
The 1971 paper, and why we will not tell you what it found
The idea is older than the clinics. A search for NAD+ alcohol withdrawal clinical trial returns exactly one record, published in 1971 in the Quarterly Journal of Studies on Alcohol, titled “Sleep, psychological and clinical changes during alcohol withdrawal in NAD-treated alcoholics”[4].
PubMed carries no abstract for it. We can tell you the paper exists, who wrote it and what it is called. We are not going to tell you what it concluded, because we have not read it and a title is not a finding — which is a rule we would rather keep than break for a good line.
What it does establish is that treating alcohol withdrawal with NAD⁺ was being tried more than fifty years ago, and that in the half-century since nobody has run the randomized trial. Searches for NAD+ therapy alcohol use disorder randomized placebo-controlled, nicotinamide riboside alcohol use disorder trial and NAD+ craving randomized controlled trial each returned zero results on the same day.
What we would say to someone considering it
If this is for a hangover: there is no evidence of any kind, the drip has never been compared against the same fluid without NAD⁺, and a clinic session costs several hundred dollars. Hydration and time are not being outperformed by anything that has been demonstrated.
If this is for addiction, the answer is more careful and it is not no. There is one uncontrolled series suggesting a combination infusion may be worth a proper trial, and its own authors are asking for one. That is a reasonable basis for a researcher to act on. It is not a basis for a clinic to bill a family several thousand dollars for a course, and it is certainly not a substitute for treatment with an actual evidence base — which is a conversation for an addiction clinician, not a website.
And whichever you are asking about, the general picture is the same one that runs through this whole category. A 2026 PRISMA-guided systematic review of 113 studies found that no eligible outcomes trials evaluated intravenous or intramuscular NAD⁺ itself for anti-aging or wellness indications [5]. The formats with the trials are the oral ones, they cost a fraction as much, and even their results are narrower than the marketing.