HAMS: Harm Reduction for Alcohol

Niacin Therapy for Alcoholism

Niacin therapy for alcohol dependence has NOT been demonstrated effective in scientific studies

Niacin Megadosing Uses

Niacin is also known as vitamin B3, nicotinic acid, and vitamin PP. It also comes in an amide form called nicotinamide. Dr. Abram Hoffer and others began experimenting with megadoses of vitamin B3 to treat high cholesterol, schizophrenia, and alcoholism as early as the 1950s. Dr, Hoffer and his colleagues refer to this megadosing with vitamins as "Orthomolecular Medicine." Modern science rates the effectiveness of niacin megadose therapy on these conditions as follows:

There is some anecdotal and case-study evidence that niacin megadose therapy may be beneficial in treating alcohol dependence, however, the placebo controlled, randomized, double blind studies which would be required to verify such claims have not been conducted and published in peer-reviewed journals. Therefore we do not know if this anecdotal evidence is merely reporting a placebo effect or if niacin megadosing might have some actual effect greater than a placebo. Moreover, as we discuss in more detail below, niacin megadosing may have detrimental effects on the liver; hence we urge great caution in experimenting with niacin megadosing. It is best to have a physician's supervision to monitor regularly for effects of niacin on the liver.

Niacin Megadosing Safety and Side Effects

A typical megadose of niacin which may be prescribed for high cholesterol or for alcoholism is 3 grams per day--usually taken in three one gram doses over the course of the day. A frequent side effect of niacin megadosing is flushing and itching which may be ameliorated by taking 375 mg of aspirin together with the niacin. It is recommended that people start with small doses of niacin and build up to the megadose. Some people are allergic to large doses of niacin: discontinue niacin if a severe allergic reaction manifests itself. Megadoses of niacin can cause liver damage so all people taking megadoses of niacin should have their livers monitored by a physician. The Linus Pauling Institute reports that hepatotoxicity (liver cell damage), including elevated liver enzymes and jaundice, has been observed at intakes as low as 750 mg of nicotinic acid/day for less than three months. Hepatitis has been observed with timed-release nicotinic acid at dosages as little as 500 mg/day for two months. Nicotinamide is generally better tolerated than nicotinic acid. It does not generally cause flushing. However, nausea, vomiting, and signs of liver toxicity (elevated liver enzymes, jaundice) have been observed at doses of 3 grams/day.

Some History

Dr. Abram Hoffer introduced AA founder Bill Wilson to both LSD therapy for alcoholism and niacin therapy for alcoholism. Wilson became quite enthusiastic about both treatment modalities; however, he was censured by officials in AA for promoting niacin therapy on official AA letterhead. Hoffer referred to the use of vitamin megadosing for alcoholism and schizophrenia as "Orthomolecular Therapy" and Hoffer continued to tout the curative powers of niacin until his death in 2009. However, Hoffer's continued failure to verify his claims by using randomized controlled trials has earned Orthomolecular Therapy a place on quackwatch,org.


Altschul R; Hoffer A; Stephen JD. (1955). "Influence of nicotinic acid on serum cholesterol in man". Arch Biochem Biophys 54 (2): 558-559.

Barrett S. Orthomolecular Therapy. Quackwatch.org.

Hoffer A, Saul AW. (2009). The Vitamin Cure for Alcoholism: How to Protect Against and Fight Alcoholism Using Nutrition and Vitamin Supplementation. Basic Health Publications.

Niacin and niacinamide (Vitamin B3) MedlinePlus

The safety of over-the-counter niacin. A randomized placebo-controlled trial

Niacin Therapy as Used by Abram Hoffer, M.D.

Linus Pauling Institute

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