Researchers have looked at a number of possible targets for substance use disorder pharmacotherapy, including replacement therapy, attenuating reinforcement and reward pathways, and treatment of comorbid psychopathology. They have tested a number of agents already approved by the Food and Drug Administration for indications other than substance use disorder. Evidently, investigators need look only as far as the supplement section of their local grocery store or pharmacy to find NAC. Although it has been used for several decades, its use has more recently expanded to target psychiatric disorders as varied as schizophrenia, obsessive-compulsive disorder, bipolar disorder, deliberate self-injurious behaviors, and now the addictions or substance use disorders. Such wide-ranging use suggests its effect on a more general mechanism of psychopathology. Although research has identified glutamate as having an important role in development and maintenance of addiction, up-regulation of the cysteine-glutamate exchanger resulting from NAC administration may have benefits throughout the brain (7). In addition to having effects on neurotransmission, NAC has been shown to have anti-inflammatory properties that are linked to oxidative pathways, a role in oxidative homeostasis where NAC results in increased plasma cysteine levels, ultimately leading to increases in brain glutathione (7, 8). Each of these potential mechanisms suggests a role in the treatment of substance use disorders, although the mechanism may be more nonspecific in the case of substance use disorders.