Over-the-counter antioxidant may help teens cut back on drinking

Those results led Gray and Lindsay Squeglia, Ph.D., an assistant professor at the Center for Drug and Alcohol Programs in the Department of Psychiatry and Behavioral Sciences at MUSC, to wonder whether NAC could also control alcohol use in adolescents who have high rates of alcohol use and combined alcohol and marijuana use. 

Gray said society recognizes that most problematic substance use begins in adolescence. “It’s pretty well-accepted,” he said. “But the large majority of the treatment research is focused on adults. We are interested in intervening very early in a robust but safe way, and that’s part of why we’re intrigued by NAC as a potential adjunct to established care.”

Recent preclinical findings suggest its promise. NAC has been shown to decrease alcohol consumption by up to 70 percent in rats.  Although NAC has also been shown to improve substance abuse treatment outcomes for a number of drugs, including marijuana, cocaine, methamphetamine and nicotine, little research has been done to explore the effect on NAC on alcohol use in adolescents. 

During the eight-week trial, the researchers collected alcohol, marijuana and other drug use data from 89 research participants. Forty-five got 1,200 milligrams of NAC daily. The other 44 received a placebo. 

Secondary analysis of the data showed that less marijuana use, measured by urine levels, was associated with a reduced number of drinks consumed by the NAC-treated group but not the placebo-treated group. Instead of compensating for reduced marijuana use by drinking more, the NAC-treated group actually decreased its alcohol use as well. 

These findings suggest NAC effects may generalize from marijuana to other substances and could be useful in decreasing adolescent alcohol use, specifically. Researchers say this is particularly compelling because the participants were not actively trying to reduce their alcohol use or being treated for alcohol use.

However, a limitation of the study is that investigation of the effects of NAC on alcohol use resulted from secondary analysis of the data. In other words, alcohol dependence was not an inclusion criterion, and measures of alcohol use were dependent on self-report rather than real-time or biological markers of alcohol use. 

Although preliminary outcomes are promising, further investigation of NAC using such markers in a larger clinical trial of alcohol-dependent adolescents will be necessary to determine whether it’s really an effective way to treat alcohol abuse.  

As the next step in this research, Squeglia wants to explore how NAC affects teenage alcohol use through a recently granted National Institute on Alcohol Abuse and Alcoholism award. She’ll study how NAC affects the glutamate systems in adolescents by comparing magnetic resonance spectroscopy taken before and after a ten-day course of NAC versus placebo. A secondary aim will be to evaluate whether NAC affects alcohol use over that very short period.

“We know adolescents are very different from adults developmentally and neurally,” said Squeglia. “So we’re trying to create developmentally appropriate treatments for adolescents.”

Tonisha Kearney-Ramos, Ph.D., is a second year postdoctoral fellow in the Department of Neurosciences at MUSC.