Evidence supporting the use of: Niacin (vitamin B3)
For the health condition: Alcoholism

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Synopsis

Source of validity: Traditional
Rating (out of 5): 2

Niacin (vitamin B3) has a traditional association with the treatment and support of alcoholism, primarily stemming from the mid-20th-century practices advocated by figures such as Bill W., the co-founder of Alcoholics Anonymous, and psychiatrist Abram Hoffer. Hoffer and others promoted high-dose niacin therapy as part of a regimen to help manage alcoholism and its psychological effects, citing anecdotal reports of improved mood and decreased cravings. This practice became part of "orthomolecular psychiatry," which emphasized the use of high doses of vitamins for mental health conditions. However, rigorous scientific evidence supporting niacin’s benefit in treating alcohol use disorder is very limited. Most modern clinical guidelines do not support niacin as a direct treatment for alcoholism itself.

Nevertheless, niacin supplementation is medically justified in individuals with alcoholism when there is evidence or risk of deficiency, particularly pellagra—a disease caused by severe niacin deficiency, which can occur in those with chronic alcohol use due to poor diet and impaired absorption. In such cases, niacin is used to treat the deficiency, not the addiction per se. In summary, while niacin’s use in alcoholism has historical and traditional roots, current scientific validation for its direct efficacy in treating alcohol dependence is lacking, and its main role is in addressing nutritional deficiencies.

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