Jason was hallucinating. He was withdrawing from drugs at an addiction treatment center near Indianapolis, and he had hardly slept for several days.
"He was reaching for things, and he was talking to Bill Gates and he was talking to somebody else I'm just certain he hasn't met," his mother, Cheryl, says. She remembers finding Jason lying on the floor of the treatment center in late 2016. "I would just bring him blankets because they didn't have beds or anything."
Cheryl had taken Jason to the clinic out of desperation. Jason, now in his late 30s, has struggled with addiction since he was a teenager. Cheryl saw his drug use escalate after he was prescribed a benzodiazepine for his anxiety, and he eventually began using heroin and meth. Over the years, Jason would try to get into recovery, but treatment programs didn't help him for very long.
"I thought he was going to die," Cheryl says. (KHN and NPR are using only first names because Jason worried he would lose his job if his employer found out about his addiction history.)
In late 2016, she saw a local TV news segment about a clinic called Emerald Neuro-Recover. The staff there treats addiction with something called NAD therapy, an IV infusion that can contain amino acids and other nutritional supplements, including nicotinamide adenine dinucleotide, a compound found in living cells.
The infusion, which is delivered over 10 to 15 days, cost $15,000, and it wasn't covered by insurance. But the TV report said Emerald's treatment was "proven to wipe drug cravings away." Cheryl was intrigued.
Emerald and dozens of other companies across the U.S. say NAD therapy can address conditions from anxiety to depression to chronic fatigue and even Alzheimer's.
And clinicians offering the treatment say that it reduces or stops cravings for alcohol or illicit drugs in up to 90% of patients. The treatment has gained attention on addiction recovery blogs and in the mainstream media.
But such claims about NAD therapy and addiction are not supported by scientific evidence, and they may conflict with federal and state regulations against deceptive marketing of medical treatments. Emerald and other addiction treatment clinics use these claims on websites, social media and in the news to attract clients looking for help. Emerald even used patients' stories to promote the therapy _ in some cases, more than a year after the patients returned to using illicit drugs.
In an interview with Side Effects Public Media, Emerald leadership defended its use of the therapy. "It's not really controversial; it's just novel or new," says John Humiston, a family medicine physician and the company's medical director. "The cravings we expect to be gone within days."
Earlier this year, Emerald leadership discussed NAD therapy with Side Effects but cut the interview short amid questions about the treatment's efficacy. Company officials declined another interview and did not respond to follow-up questions via email. For that reason, Side Effects was unable to ask them about Jason's case.
Treatment centers touting high success rates can sound appealing to vulnerable people suffering from addiction or to their families, even if there's no solid evidence to support their methods. "(Clinics) know this is a really desperate population," says Basia Andraka-Christou, a health policy researcher focused on substance use disorders at the University of Central Florida.
Unsubstantiated claims have long been a part of addiction treatment. For instance, in the late 19th century, a doctor dubbed his formula the "Double Chloride of Gold Cure" and sold it via mail order for addiction, claiming a 95% cure rate. "In a week the desire to drink will be gone," read one advertisement.
More recently, NAD therapy is among a wide range of unproven treatments currently marketed to people with addiction, including the herbal extract kratom and other types of supplements. The FDA and the FTC cracked down on a few of these last year but have limited resources to police the market for unproven treatments. And that leaves consumers on their own to sort out fact from fiction.
While patients spend time and money on ineffective treatments, they miss out on proven therapies that can reduce their risk of relapsing, including behavioral counseling and medications approved by the FDA for treating addiction, says Andraka-Christou. "We do actually now have evidence-based treatments available," she says. "But you still do have these quack treatments popping up."
