Diet and substance abuse recovery

Definition

Alternative Names

Substance abuse recovery and diet; Nutrition and substance abuse

Information

Substance abuse harms the body in two ways:

• The substance itself affects the body 
• It causes negative lifestyle changes, such as irregular eating and poor diet

For example, infants who were exposed to alcohol while in the womb often have physical and mental problems. The alcohol affects the growing baby by crossing the placenta. After birth, the baby may have withdrawal symptoms. The mother's poor nutrition while she is drinking can harm the baby's growth and development while still in the womb.

Recovery from substance abuse also affects the body in other ways, including metabolism (processing energy), organ function, and mental well-being. Proper nutrition may help the healing process. Nutrients supply the body with energy. They provide substances to build and maintain healthy organs and fight off infection.

The impact of different drugs on nutrition is described below.

OPIATES

Opiates (including codeine, oxycontin, heroin, and morphine) affect the gastrointestinal system. Constipation is a very common symptom of abuse. Symptoms that are common during withdrawal include:

• Diarrhea
• Nausea
• Vomiting

These symptoms may lead to a lack of enough nutrients and an imbalance of electrolytes (such as sodium, potassium, and chloride).

Eating balanced meals may make these symptoms less severe (however, eating can be difficult due to nausea). A high-fiber diet with plenty of complex carbohydrates (such as whole grains, vegetables, peas, and beans) is recommended.

ALCOHOL

Alcoholism is one of the major causes of nutritional deficiency in the United States. The most common deficiencies are of pyridoxine (vitamin B6), thiamine, and folic acid. A lack of these nutrients causes anemia and nervous system (neurologic) problems. Korsakoff's syndrome ("wet brain") occurs when heavy alcohol use causes a lack of enough thiamine.

Alcohol intoxication also damages two major organs involved in metabolism and nutrition: the liver and the pancreas. The liver removes toxins from harmful substances. The pancreas regulates blood sugar and the absorption of fat. Damage to these two organs results in an imbalance of fluids, calories, protein, and electrolytes.

Other complications include:

• Diabetes
• High blood pressure 
• Permanent liver damage (or cirrhosis)
• Seizures
• Severe malnutrition
• Shortened life expectancy

Laboratory tests for protein, iron, and electrolytes may be needed to determine if there is liver disease in addition to the alcohol problem. Women who drink heavily are at high risk of osteoporosis and need to take calcium supplements.

STIMULANTS

Stimulant use (such as crack, cocaine, and methamphetamine) reduces appetite, and leads to weight loss and poor nutrition. Abusers of these drugs may stay up for days at a time. They may be dehydrated and have electrolyte imbalances during these episodes. Returning to a normal diet can be hard if a person has lost a lot of weight.

Memory problems, which may be permanent, are a complication of long-term stimulant use.

MARIJUANA

Marijuana can increase appetite. Some long-term users may be overweight and need to cut back on fat, sugar, and total calories.

Nutrition and psychological aspects of substance abuse

When people feel better, they are less likely to start using alcohol and drugs again. Because balanced nutrition helps improve mood and health, it is important to encourage a healthy diet in people recovering from alcohol and other drug problems.

However, people who have just given up an important source of pleasure may not be ready to make other drastic lifestyle changes. It is more important that people avoid returning to substance abuse than that they stick to a strict diet.

Guidelines

• Stick to regular mealtimes
• Eat a low-fat diet
• Get more protein, complex carbohydrates, and dietary fiber
• Vitamin and mineral supplements may be helpful during recovery (this may include B-complex, zinc, and vitamins A and C)

People with substance abuse are more likely to relapse when they have poor eating habits. This is why regular meals are so important. People who are addicted to drugs and alcohol often forget what it's like to be hungry and instead think of this feeling as a drug craving. They should be encouraged to consider that they may be hungry when cravings become strong.

During recovery from substance abuse, dehydration is common. It is important to get enough fluids during and in between meals. Appetite usually returns during recovery. People in recovery are often more likely to overeat, particularly if they were taking stimulants. Eat healthy meals and snacks and avoid high-calorie foods with low nutrition (such as sweets), if possible.

The following tips can help improve the odds of a lasting and healthy recovery:

• Eat nutritious meals and snacks.
• Get physical activity and enough rest.
• Reduce caffeine and stop smoking, if possible.
• Seek help from counselors or support groups on a regular basis.
• Take vitamin and mineral supplements.

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References

O'Connor PG. Alcohol abuse and dependence. In: Goldman L, Schafer AI. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 32.