Synopsis

Source of validity: Traditional
Rating (out of 5): 1

Vitamin B3 (niacin) has a traditional association with the treatment of alcoholism, largely rooted in practices promoted by figures such as Dr. Abram Hoffer and the orthomolecular medicine movement in the mid-20th century. This tradition suggested that high doses of niacin could help reduce cravings and support recovery in individuals with alcohol dependence. The rationale was partly based on the observation that chronic alcohol use is associated with nutritional deficiencies, including B vitamins, and that severe deficiency in niacin can cause pellagra—a disease that can include neuropsychiatric symptoms. However, while it is well-established that alcoholics are at risk for B vitamin deficiencies and may benefit from supplementation to prevent or treat deficiency syndromes (such as Wernicke-Korsakoff syndrome with thiamine, or pellagra with niacin), there is little high-quality scientific evidence supporting the use of vitamin B3 specifically to reduce alcohol cravings or directly treat alcoholism itself. Most clinical guidelines focus on correcting deficiencies rather than using niacin as a primary treatment for alcohol use disorder. Thus, while the use of niacin in this context has historical precedent, current scientific validation is minimal, and evidence-based guidelines do not recommend it as a frontline therapy for alcoholism.

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