This comes from www.atforum.com
(monthly Addiction Treatment Forum)
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, ÒMany 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.Ó
Furthermore, the ADA suggests, ÒNutrition 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.Ó
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.
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., Òjunk foodsÓ), 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 brainÕs 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.
Basic recommendations for a healthy and balanced diet have
changed little over the years. The US Department of AgricultureÕs 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 Òrecovery-friendlyÓ 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.
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.