Proper nutrition and hydration are key to the substance abuse healing process because they help restore physical and mental health and improve the chance of recovery. Macro- and micronutrient deficiencies can lead to symptoms of depression, anxiety, and low energy, all of which can lead someone to start using drugs or alcohol or trigger a relapse. Substance abuse generally leads to a lack of proper nutrition, either because of not eating enough throughout the day or eating foods that are low in necessary nutrients. Certain substances, such as stimulants, may suppress appetite and disrupt metabolic and neuroendocrine regulation, leading to improper calorie consumption and impaired nutrient processing. Other substances may lead to an increase in appetite, causing weight gain.

Mental Health Medical Nutrition Therapy Goals

  • Heal and nourish the body damaged by alcohol or substance abuse
  • Stabilize mood and reduce stress;
  • Reduce cravings for drugs and alcohol
  • Encourage self-care and a healthful lifestyle through balanced nutrition
  • Educate the clients on physical hunger cues
  • Educate how balanced eating will help the clients maintain a normal level of hunger and satiety rather than getting overly hungry.

Understanding the Effects of Balanced Nutrition

To help our clients recover from the effects of substance abuse, it’s important to supply them with balanced nutrition. It’s vital to correct any nutritional deficiencies and address any medical conditions, as continued malnutrition and instability increase disease risk and will produce cravings for drugs or alcohol. Increased consumption of nutrient-dense foods (fruits, vegetables, whole grains, fish) and antioxidants is important; these foods help decrease inflammation, reduce cell oxidation, and provide the basics of a balanced diet.

An understanding of how food affects mood and the risk of substance abuse begins with macronutrients. Carbohydrates are the body’s main source of energy; without this macronutrient, the brain can’t properly function, blood sugar becomes unstable, and neurotransmitters become disrupted. Unstable blood sugar can lead to feelings of frustration, anxiety, and cravings. Carbohydrates aid in the production of serotonin, which facilitates a happy, stable mood; aids in sleep; and helps curb food cravings. Low serotonin levels can result in sleep problems, irritability, and depression.

Amino Acids, the building blocks of protein, also are the foundation of neurotransmitters. Low levels of neurotransmitters, particularly dopamine, can trigger an individual to turn to substances to feel better, as most substances markedly impact the body’s dopamine levels. Dopamine is made from the amino acid tyrosine, and serotonin is made from tryptophan. If an individual lack either of these amino acids, synthesis of the respective neurotransmitter is disrupted, which affects mood, aggression, and the desire for drugs or alcohol.

Dietary fat also plays a role in maintaining mental health. Because it affects inflammation and cell membrane integrity, limiting dietary fat directly influences mood.

Omega-3 fatty acid consumption may help with depression by assisting in the uptake of neurotransmitters and decreasing inflammation. Having a proper balance of omega-6 and omega-3 fatty acids helps neurotransmitter receptors function, which in turn helps increase the number of neurotransmitters that can be active in the brain.

Other vitamins important for mental health include iron, folate, and vitamins B6 and B12. Deficiencies of any of these nutrients can mimic mental health problems such as depression, fatigue, poor attention, and altered sleep.

Encouraging clients to drink adequate amounts of hydrating fluids will help them manage mood while ensuring adequate absorption of any medications they take to prevent side effects from withdrawal or underlying psychiatric disorders. Common symptoms of dehydration include irritability, trouble concentrating, and disorientation.

How Can We Reduce Cravings?

Anxiety, irritability, and low mood or energy levels are triggers for cravings. These symptoms can result from low blood sugar, dehydration, high levels of caffeine, and an unbalanced diet. Increased relapse occurs when an individual has poor eating habits, mainly because of the impact on cravings. Generally, a diet relatively high in complex carbohydrates, moderate in protein, and moderate fat and sugar is recommended to help sustain recovery

Often in early recovery, clients struggle with differentiating hunger from cravings for drugs or alcohol and emotions. It is common for addicts to forget what normal hunger feels like and may perceive a craving for substances when they’re just hungry. Similarly, many addicts will switch to sweets to replace their drug dependency; some of this is a result of seeking pleasurable foods that trigger a physiological response (such as increasing dopamine), emotional eating, or experiencing irregular blood sugar levels. Monitoring sweets intake may be important with some clients because approximately 50% of substance abusers also have co-occurring eating disorders, so monitoring signs of binge behavior may help in properly identifying possible binge-eating disorder or bulimia.

Written by: Julia Cassidy, MS, RDN, CEDRD-S


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