The effect of N-acetylcysteine on alcohol use during a cannabis cessation trial.
Individuals with alcohol use disorder (AUD) do not always respond to currently available treatments, and evaluation of new candidate pharmacotherapies is indicated. N-acetylcysteine (NAC), an over-the-counter supplement, has shown promise in treating a variety of substance use disorders, but little research has evaluated its merits as a treatment for AUD. This secondary analysis of data from NIDA Clinical Trials Network protocol CTN-0053 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.
Participants (N=302, ages 18-50) were randomized to double-blind NAC (1200mg, twice daily) or placebo. Neither alcohol use nor desire for alcohol cessation were requirements for participation. Participants that returned for at least one treatment visit and had recorded alcohol use data (i.e., total drinks per week, drinking days per week, and binge drinking days per week) were included in the 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 from alcohol was 37% in the NAC group. The NAC group was 33% less likely to increase their number of drinks, compared to the placebo group, and their drinking days were 31% less than those in the placebo group as well. NAC did not affect the number of binge drinking days, however participants were binge drinking, on average, less 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 efficacious in reducing cannabis use in an adult sample, this secondary analysis suggests that NAC may be effective at reducing consumption of alcohol by approximately 30% among treatment-seeking adults with CUD, suggesting a need for further trials focused on the effects of NAC on alcohol consumption among individuals seeking treatment for AUD.
Related protocols: CTN-0053