Can you really flush your brain of toxins? Can IV administration of NAD, a co-enzyme of Niacin, really help reduce drug cravings during withdrawal? Basically, are the claims of Brain Restoration Therapy advocates too good to be true?
Today we are speaking with Dr. Ken Starr, addiction medicine physician and founder of DR. KEN STARR, MD Addiction Medicine Group. Dr. Starr is introducing to us the benefits of Brain Restoration Therapy administered via intravenous NAD infusions. He’ll help guide us through the process, and evaluate its risks. If by the end of the article you still have questions, please ask them in the comments section below. We’ll do our best to respond to you personally and promptly.
Hi Dr. Starr. Glad you could join us.
ADDICTION BLOG: Let’s start by explaining to our readers some of the basic principles of Brain Restoration Therapy. What is BRT?
DR. KEN STARR, MD: Many people continue with opiate use only because they fear or cannot tolerate the withdrawal syndrome that accompanies drug discontinuation. Well here’s your answer; essentially no unpleasant withdrawal. Anyone can take NAD, but that’s not BRT. You had mentioned that NAD is a co-enzyme of Niacin. While that’s true, it’s role in Niacin has really nothing to do with how it works in Brain Restoration. NAD is instrumental in mitochondrial energy production, drug detoxification, preventing free radical “ leak” and other SIRT1 transcription dependent pathways. One can take a lot of oral Niacin but it’s not going to do what NAD+ does.
ADDICTION BLOG: When is appropriate for this therapy to be applied, for which type of substance abuse disorders?
DR. KEN STARR, MD: BRT is very effective for treating chemical dependency. It’s most effective for alcohol and opiate recovery. It has significant benefit for benzodiazepine and stimulant dependence as well, but they typically require a longer coarse of treatment.
There is no time when the treatment is not appropriate. Any patient with substance abuse will benefit from the treatment. The only times in our practice patients didn’t get a great response were when they were dishonest about their drug use and/or weren’t really looking for a meaningful recovery solution.
ADDICTION BLOG: Can Brain Restoration Therapy be used in cases of dual diagnosis or co-occuring mental health disorders?
DR. KEN STARR, MD: Yes, I believe so.
BRT has been very beneficial for stress and anxiety symptomatology. Many patients have stopped their antidepressants and reported that NAD was more effective for their depression. The coarse of treatment is shorter than the dose used to treat chemical dependency. The treatment does seem to improve mood and create an internal calmness. I don’t put it out there for mental health reasons, but we often have patients wanting a short coarse of treatment for stress, anxiety and depression.
ADDICTION BLOG: What would you say is the success rate of Brain Restoration Therapy with NAD infusions in the first year of recovery from addiction?
DR. KEN STARR, MD: I can honestly say it’s the most effective medication I’ve ever used and the most effective medical treatment available for substance abuse.
Compared to the more commonly approved meds like Naltrexone and Camprol which I still use in the clinic regularly, it’s much more effective and rapid in onset. By effectively eliminating acute withdrawal and some post acute withdrawal you’re giving the patient an opportunity to feel well and clear headed. There’s just no other way patients are going to feel so much better so quickly. Now they’re in a place where cognitive treatments and supportive care are going to be more effective.
Patients still need recovery support and intense aftercare, just as they would with any detox program. BRT is not in place of cognitive treatment, it’s in addition to it. Don’t forget that the success rate with traditional treatment for opiate use disorder in the first year is in the single digits. It’s not hard to do better than that. When patients do slip up they usually respond very favorably to a 1or 2 day booster. If patients continue on oral NAD after the initial treatment or receive a booster dose frequently and continue their support I would say success rate is greater than 75%.
ADDICTION BLOG: Also, are there any reported adverse side effects to Brain Restoration Therapy?
DR. KEN STARR, MD: The only adverse effects are due to the rate of administration during the infusion. If the drip goes too fast for someone they immediately don’t feel well. Once it’s turned down that feeling immediately goes away. But the medication doesn’t seem to have any lasting adverse effects as far as anyone knows.
ADDICTION BLOG: Is Brain Restoration Therapy used only during drug detox? Or can non-drug dependent people benefit from this treatment modality?
DR. KEN STARR, MD: The real magic for me in my practice is how the IV infusion eliminates drug withdrawal and craving.
There is a huge population of folks using NAD for anti aging benefits and other who use it for general well being and stress reduction. The anti aging people are all over NAD. In fact, they’re the ones who have really delivered the best science on how NAD works in both drug treatment and aging. The best research on NAD is on longevity. A study came out showing reverse aging in mice so as you can imagine they are the biggest adopters.
ADDICTION BLOG: IV NAD infusions are used in performing the BR Therapy. What is NAD? Can any patient use it, or are there any restrictions?
DR. KEN STARR, MD: NAD is nicotinamideadenine dinucleotide. It’s a naturally occurring coenzyme found in every cell of the body where mitochondria produce energy. Without adequate NAD+, not all SIRT genes can be activated.
Aging, drug addiction and alcoholism deplete the body’s NAD. In alcoholism, NAD helps considerably with withdrawal, craving and reducing recidivism. In opiate addiction, NAD binds to opiate receptors , activates SIRT1 in the reward center of the brain, and reverses the reward effects of drugs at a molecular level. There is both a short term benefit for withdrawal and long term benefit reduce relapse.
ADDICTION BLOG: One of the services you offer includes Suboxone Detox. What are your methods of helping patients with this specific type of opioid dependence, especially in an outpatient setting?
DR. KEN STARR, MD: I like to detox people off suboxone with NAD. The regular 10 day drip is effective for them. If the infusion is not in the cards then I use a relatively rapid buprenorphine taper with medication assistance for withdrawal. The most important part of treatment for suboxone detox is knowledge about what to expect and how long symptoms will last. There’s been a lot written on the subject. I especially like the article by Steven Scanian who explains it better than anyone.
ADDICTION BLOG: You mostly run outpatient treatment services. In what ways do you monitor the process since the patients are not staying overnight at your facility? What do you do if you come to conclusion that inpatient treatment is preferable for certain patients?
DR. KEN STARR, MD: All of our encounters begin with an assessment. Often times the result of that encounter is that they need inpatient care. We can only do what we can do. We’ll always have patients in our program who should be inpatient. However, in-patient treatment is not an option for some of our working patients. They need to work and care for their families and often cannot afford that program.
A month in our program is $715. Compare that to a residential program costing tens of thousands. But we continually monitor their progress by evaluating their participation in the program, checking urine drug screens, and having a good collaborative relationship. Relapse doesn’t get anyone kicked out of the program, only unwillingness to do the program. Our programs are voluntary. Our patients want to be here and when they don’t, they stop coming.
ADDICTION BLOG: Do government and private insurance plans cover NAD infusion therapy?
DR. KEN STARR, MD: We’re able to get some patients reimbursed by billing for the IOP (intensive outpatient treatment) on the counseling end. The infusion itself isn’t covered. We’re out of network and they consider it a nutritional infusion which has little to no reimbursement. Depending on insurance we’ve seen from 0% to 60% coverage.
ADDICTION BLOG: Is there anything else you would like to add?
DR. KEN STARR, MD: I would strongly suggest patients looking for an effective recovery solution that maybe haven’t responded to more traditional treatments or are withdrawal fearful would really benefit from BRT. Depending on where a patient lives we can usually find a qualified person in their region where they can receive treatment.