Dietary Supplements For Opioid Detox
Wendy Komac is a well-seasoned business woman who spent a career at Fortune 500 companies. Her current venture, though, hits closer to home.
“I've got a decade of darkness that I'd prefer not to repeat or remember,” said Komac. “I sobered up when I was 27, and honestly I can remember my fifth day of detox like it was yesterday. So I know how painful and bad that is.”
She wanted to find a way to make the detox, or withdrawal, phase less unpleasant. That’s when she came across “nicotinamide adenine dinucleotide” or NAD, which is a coenzyme found in living cells. She and others formulated a dietary supplement using this coenzyme. They use it, along with behavioral therapies and medical oversight, at the addiction treatment facility in Chagrin Falls she started called Luna Living.
“It really helps restore people functionally at a cellular level. So our whole premise is based on, if you give people physical restoration, if you give them mental clarity, if you get rid of those cravings and you do it all in a couple days, then armed with that feeling of well-being, they’re better positioned to do the therapeutic work that they still have to do,” said Komac.
Komac is careful not to oversell NAD, since it’s a supplement and is not regulated as a drug by the federal government.
“You can’t make claims if you’re a supplement or a food. And this is a very vulnerable population,” she said.
MetroHealth’s Emergency Medicine Chairman Dr. Charles Emerman says the biggest risk of using a supplement for opioid detox is that you’re substituting an unknown, unproven approach in place of FDA-approved medications for opioid withdrawal and long-term maintenance.
“There’s not evidence that they work. So I don’t believe in doing things that don’t work,” he said. “We have ways of helping people with their opioid addiction, and to the extent that people are relying on these unproven supplements instead of getting proven therapy then it’s going to perpetuate their addiction.”
For him the bottom line is data.
“It's like any therapy I use. What’s the evidence for it? Are there studies? Do the studies support it? Does it have safety and efficacy? If they do, then we use it. If not, then it’s just anecdote,” he said.
Late last year the nonprofit advocacy organization Center for Science in the Public Interest investigated online supplement sales. They found several brands on the market with unproven opioid addiction treatment claims. The FDA followed up this report with a letter to 12 marketers and distributors saying they have to stop making these claims.
“I fully understand how desperate people can be and I fully understand that the government is not providing sufficient treatment slots for people,” said Peter Lurie, president of the Center for Science in the Public Interest and former associate commissioner with the FDA. “But I don't think that the solution to that is to resort to completely unproven treatments that will cost you an arm and a leg.”
At Luna Living, the long-range plan is to collect clinical data on the effectiveness of NAD in opioid detox treatment. Founder Wendy Komac says the escalating crisis is evidence that people need more options for getting clean, and soon.
“Nothing works for everybody. What I’m proposing doesn’t work for everybody. But we’re also watching the death toll in this country go even higher. I don’t think we can say that what we’re doing is working. You need a lot of different tools in the tool bag to figure out what is going to work for people,” she said.
Komac cautions that anyone considering supplement use for opioid detoxing should make sure to do their research and be wary of unproven claims.
And, both she and Emerman agree that the detox phase of recovery is just the tip of the iceberg, and that any addiction treatment program should include long-term therapy and care.