Don S

This comes from www.atforum.com
(monthly Addiction Treatment Forum)

Feeding Recovery

Some experts believe that advances in the treatment of addictions during
this century will involve physiologic healing via the restoration of
neurochemical balance in the brain. Diet and nutrition may play key roles in
that process.

The American Dietetic Association (ADA) has officially recognized that,
"Many debilitating nutritional consequences result from drug and alcohol
abuse. Chronic nutrition impairment causes serious damage to the liver and
brain, which reinforces the craving for more drugs and alcohol and
perpetuates the psychological aspect of addiction."

Furthermore, the ADA suggests, "Nutrition makes a difference in the rate and
quality of physical recovery, which prepares individuals to function at a
higher level in treatment - cognitively, mentally, and socially."

Rebalancing Neurochemistry
Many persons simply do not eat enough food or the right foods when they are
preoccupied with drug-taking. When they do eat, drugs of abuse and alcohol
keep the body from properly absorbing and breaking down nutrients and
expelling toxins.

In one clinical study, more than three-quarters of patients being treated
for addiction were classified as having unsatisfactory nutritional states,
with malnutrition predominating. Such patients were typically deficient in a
number of vitamins, minerals, proteins, and fatty acids.

Addictive substances - such as heroin, cocaine, alcohol, and marijuana -
affect food and liquid intake, taste preference, and body weight. Opioids
can alter cholesterol, calcium, and potassium levels. Potassium is
especially important because an imbalance in this electrolyte can influence
cardiac problems.

Nutritional supplements - e.g., vitamins, amino acids, herbal products - and
other nutrients are believed capable of restoring proper neurochemical
balance in the brain. Also, eliminating or reducing certain substances
(sugars, simple starches, caffeine) and increasing protein intake may help
rebalance brain chemistry.

During recovery, improved nutrition also can help heal physical damage to
the body caused by nutrient depletion. However, nutrition is often neglected
by patients and it might be unlikely to take top priority in addiction
treatment programs.

Food-Mood Connections
Depression and other mental illnesses commonly found in drug abusers have
been at least partially attributed to nutritional deficiencies, undiagnosed
hypoglycemia (low blood sugar), and/or unidentified food allergies.
Advocates of nutritional therapy claim that these conditions can be treated
through special diets, vitamin and mineral supplements, and regular
exercise.

A patient with a stable emotional state is more likely to abstain from
substances of abuse. However, nutrient deficiencies may contribute to
negative mood states - including anxiety and depression - serving as
obstacles to recovery.

For example, thiamine deficiency, common in alcohol abusers, can lead to
depression and irritability. Iron deficiency, frequently occurring in drug
and alcohol users, can result in anemia with symptoms such as lethargy and
decreased mental function.

An important relationship of blood-sugar levels and mood is often emphasized
in the literature. For example, alcohol can cause such levels to peak and
then dip rapidly.

Even moderate falls in blood glucose can cause irritability, and more rapid
glucose cycling can cause severe aggression in persons with antisocial
personalities. Such peaks and troughs, particularly associated with diets
rich in refined sugar (e.g., "junk foods"), also can negatively affect
cognitive performance, even if the person does not become clinically
hypoglycemic.

Deficiencies of nutrients like B-complex vitamins and amino acids can have
seriously negative effects. Certain amino acids are critical building blocks
for the brain's neurotransmitters that regulate mood and emotions.

For example, tryptophan is a precursor of serotonin, which is important in
combatting depression. However, adequate amounts of vitamins B3 and B6 are
needed to convert tryptophan to serotonin.

Recovery-Friendly Diets
Basic recommendations for a healthy and balanced diet have changed little
over the years. The US Department of Agriculture's Food Guide Pyramid
emphasizes ingredients from five major food groups, with each providing
some, but not all, necessary nutrients. However, this can be difficult for
many people to understand and put into daily practice.

Furthermore, even if it can be achieved, this balanced diet could need
adjusting for persons with unbalanced brain chemistries due to years of
substance abuse. Research has demonstrated that the brains of drug addicted
persons become chemically altered as substances of abuse diminish or destroy
key neurotransmitters.

Addiction recovery programs might consider how they can reload those
essential chemicals to foster biochemical repair processes and restore more
normal function. The ingredients of a "recovery-friendly" diet may vary from
what a non-addicted person would require and could be a dramatic departure
from what the patient is used to consuming.

Amino acid supplementation is believed to help restore critical
neurotransmitters in the brain, such as: endorphins, enkephalins, dopamine,
GABA, norepinephrine, and serotonin. Along with this, multi-vitamin/mineral
supplements are recommended since many of these serve as cofactors in
neurotransmitter synthesis. They also help restore overall health in
typically malnourished patients.

Herbal and other plant-derived products also have been promoted by some
authors for use in addiction treatment. Various proprietary mixtures have
been marketed with claims of efficacy; however, large-scale controlled
clinical trials in humans have been lacking.

Challenges & Caveats
Scientists seem to agree that substances of abuse may cause nutritional
deficiencies; however, a direct link between these and addiction has not
been fully accepted. Also, the notion that special diets and/or nutritional
supplements may be viable adjunctive or stand-alone treatments for addiction
requires further research.

Nevertheless, given an appreciation of the possible importance of diet
during recovery and an interest in better nutrition, there are some
obstacles and concerns to overcome, such as:

The nutritional component of addiction recovery does not appear to be an
exact science and it must be individualized for meeting particular patient
needs.

Patients must be motivated to change their eating habits and have access to
recommended nutritional items. They also need to know how to shop for and
prepare nutritious foods.

Some patients may not have the financial resources to purchase appropriate
foods and/or supplements.

Some foods and nutritional supplements may negatively interact with
prescribed medicines, such as methadone, antidepressants, and other drugs.

The prescription of multiple pills and tablets (e.g., vitamins, herbal
products, others) in persons already known to have a preference for using
chemicals to control their mental states may pose problems.

Dietary supplements are available at health food stores everywhere and via
the Internet, which may promote inappropriate consumption. Patients need to
understand that they should not take any products without the approval of
clinic staff.

Clinic medical staff must become familiar with the many nutritional
supplements available, their applications, and potential for harmful
interactions. This can be a daunting task.

Some specialists recommend that treatment providers should assess patients
for malnutrition and provide appropriate diet and nutrition education. And,
they should look to qualified nutritionists or dieticians for guidance as
appropriate.

The rationales for how nutrition may affect addiction recovery seem to have
some merit. However, relatively little is known for certain in this area
based on sound clinical research, so appropriate caution is advised.

Sandy Marie

Thanks Don. I made a copy and put it in my "folder". It's all good stuff.
Sandy

splendra

Don-

We don't need more studies we need more people demanding that they receive proper nutritional support to fully recover. The proof is already there. Drug companies have too much power and they can't regulate diet and that is why nutritional support is being flicked off. If someone can afford a $100.00 a day habit they can afford to have good nutrition..... Please don't get me started....

junem

Thanks for the excellent post Don.

Dan

Oh let's not do that. I might start feeling guilty about okra again

All I know is that what I eat and how I supplement my diet directly affects how I feel, most of the time. If I'm doing a couple pots of coffee a day, I shouldn't be surprised I'm edgy and irritable.
If I'm continually doing the burger and fries thing, I shouldn't be surprised I feel lethargic in the middle of the day.
Thanks for the post Don.
Some new ideas there, for me anyway.

Don S

Here is an email reply I got to the article above. I haven't asked the author for permission, so I won't attribute it, but he is a physician:

"A decent, cheap ($7-10/100...don't spend a lot of money for a fancy brand)
Therapeutic Vitamin (This is an FDA-designated category) taken twice a day
for a week then once a day, will likely correct virtually all vitamin
deficiencies relatively quickly. If the person has lost significant weight,
had significant diarrhea or been taking large amounts of alcohol for a long
time, then perhaps Therapeutic Vitamins with Minerals would be more
suitable. As for more subtle deficits, there is probably nothing other than
a good diet with plenty of fruit and vegetables that will be effective in
redressing the situation by replacing so-called "micronutrients". I would
not suggest pouring money down the drain by using "herbals" in this
particular situation, unless you are seeking an expensive (and possibly not
harmless) placebo."

Don

Brookie

Thanks for the timely reminder Don. It's probably time that I supplemented my diet to include sources of nutrition other than cheese, caffine and M&Ms.

Sandy Marie

Yeah, Brookie. You may be a candidate for irritable bowel syndrome.

lulu70

Hey Don--thanks for the post. I KNOW I need to do something about my diet, but I need serious help. I need to be told what to eat, when, and how much. Is there a place where we can get some kind of meal plan? I know I am being kind of a baby, but like I said, I need help!!!

Aimee2

I've read somewhere that a study found that moderate-intense aerobic exercise several times a week had the same improvement rate as Prozac for depression. I definitely find a difference in my mood when I work out at the gym 4-5 days a week as opposed to when a week goes by and I don't exercise. I handle stress better, for one thing. I really don't think I could remain abstinent for any amount of time without sweating at the gym...

Don, your post on nutrition was helpful...but I refuse to give up my chocolate addiction LOL

Aimee