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, “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.”
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., “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.
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.
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.