The importance of nutrition is often overlooked in the recovery process. If you’re eating enough to maintain your weight, you may assume you’re getting everything you need, but that may not be true. “Recovery” means gaining back what you’ve lost, and in addiction, one of the things that people have often lost is nutritional balance.
Your biology is unique, and each person in recovery will have slightly different nutritional needs, but there are common patterns based on the substances people consume.
Alcohol
Alcohol can interfere with your nutritional status in many different ways. The most basic and obvious is that sometimes people choose to drink instead of eating. The National Institute on Alcohol Abuse and Alcoholism reports that some people get as much as 50% of their daily calorie intake from alcohol. As a result, they’re missing nutrients that foods provide that alcohol doesn’t.
Alcohol can also affect nutrition by interfering with the way nutrients are digested, stored and used. Boulder Medical Center explains that metabolizing alcohol requires nutrients, and if the liver is running low, it takes them from the bloodstream, causing body cells and systems to lack what they need.
Drinking reduces the level of digestive enzymes in your body, which makes it harder for you to digest your food. Consequently, you aren’t able to efficiently utilize the nutrients that even healthy food provides. Drinking can also damage cells in the stomach and intestines, which can lead to malnutrition that gets increasingly worse. Once there are nutritional deficiencies, the problem tends to grow because some can cause the digestive process to work even less efficiently.
Common nutritional deficiencies in people with alcohol addiction include low levels of Vitamins A, B-complex, C, D, E and K. This can lead to a wide variety of symptoms, including fatigue,
night blindness, slow wound healing, excessive bleeding, softening bones and lowered immunity.
Opioids
Opioid drugs like oxycodone or heroin affect your nutrition in ways similar to alcohol through both inadequate food intake and the influence of the drugs on your metabolism. People who consume opioid drugs tend to eat less and have a lower appetite than those who don’t. Substance abuse nutrition tends to be poor in part because of food choices.
A study published in The British Journal of Addiction found that compared to the non-addicted population, people with addiction to opioids tended to eat foods higher in sugar and lower in fat and protein. The foods they consumed were relatively low in vitamin and mineral content.
Opioids commonly cause a reduction in gastrointestinal motility, which can produce constipation and a decrease in food intake. The U.S. National Library of Medicine notes that diarrhea and vomiting are common opioid withdrawal symptoms and can lead to nutrient and electrolyte imbalances.
Today’s Dietician magazine reports that opioid use disorder is associated with low levels of many nutrients, including B and C vitamins, calcium, magnesium, potassium, selenium and zinc.
Stimulants
The use of stimulant drugs like cocaine also tends to reduce appetite and impact metabolism. A study on the eating habits of people who use drugs found that cocaine users tend to rely mainly on one meal eaten late at night. The meal tends to be high in refined carbohydrates and fat and low in vegetables and fruits.
Recovery, Nutrition and Mental Health
The brain is part of the body, of course, and the nutritional challenges caused by alcohol and drug abuse can have mental effects. The Boulder Medical Center notes the importance of nutrition for maintaining mental health and positive mood states.
They note that low levels of B1 (thiamin), B2 (riboflavin), B3 (niacin), B5 (pantothenic acid), B12 or folic acid can each cause depression. In addition, low levels of B1 can lead to irritability, B3 to anxiety and apprehension, and B5 to chronic stress.
Much of how we feel emotionally at any given time is due to the action of neurotransmitters. In fact, one of the ways that alcohol and drugs make people feel temporarily happier or less anxious is through the way they cause levels of certain neurotransmitters to rise, at least in the short term. Unfortunately, over time, their use leads to the opposite situation.
With continued use, drugs and alcohol tend to lower levels of dopamine, serotonin and GABA (gamma-aminobutyric acid). Low dopamine and serotonin can contribute to depression, and low levels of GABA can contribute to anxiety.
Our neurotransmitter levels are influenced by our microbiome, the community of helpful and harmful bacteria, viruses and fungi living in the digestive tract. An article in the journal Brain Research notes that bacteria can produce or consume dopamine, norepinephrine, serotonin and GABA.
The makeup of the microbiome is greatly affected by diet. A Psychology Today article on nutrition and addiction recovery notes that a diet high in fat and sugar and low in fiber can change the microbiome’s makeup and that the microbiome may affect mental health, influencing depression and anxiety through the gut-brain axis. A Harvard Health article on nutritional psychiatry reports that people who eat a traditional Mediterranean or Japanese diet have a 25% to 35% lower risk of depression than those who eat the typical Western diet, which is higher in sugar and processed and refined foods.
Restoring Nutritional Balance in Recovery
Paying attention to nutrition in recovery involves re-supplying missing nutrients and focusing on strengthening the body and brain. Nutrition is an important and often overlooked tool to help guard against relapse. Utah State University (USU) notes that malnutrition can increase drug-seeking behavior and that treatment effectiveness is increased when nutrition is part of the focus.
A focus on nutrition can help people maintain their recovery goals in both direct and indirect ways. Certain nutrients, for example, have been shown to lower cravings directly. A study published in the journal Alcohol and Alcoholism found that alcohol-dependent patients who were given acetyl-L-carnitine showed a greater reduction of alcohol craving and remained abstinent longer than those given a placebo.
Nutrition may also assist in relapse prevention indirectly by helping people address the mental health symptoms that they may be tempted to manage with drugs and alcohol. The USU publication notes that decreased neurotransmitter signaling in the brain is associated with depression and suicidal thoughts and that increasing the consumption of certain nutrients can increase the signaling. These include fatty acids, B vitamins, zinc and antioxidants.
Avoiding Unwanted Weight Gain in Recovery
It’s not uncommon for people in recovery from an addiction to drugs or alcohol to develop a substitute addiction, such as smoking or gambling. Sometimes food, especially highly processed, high sugar food, can play a similar role and lead to a number of challenges. An article on nutritional guidance in substance abuse treatment quoted an author who noted that nutrition is often overlooked in recovery.
She pointed out that people often eat refined sugars and fried foods, which don’t replenish their likely low nutrient stores, and that “This can also lead to excessive weight gain, causing distress to many clients.”
In fact, weight gain can potentially increase the risk of relapse. An article on substance abuse and weight control published in the journal Eating Behaviors notes that young adult women, in particular, may use illicit drugs for weight loss. Stimulants, such as cocaine, amphetamine, methamphetamine and ecstasy, are the most likely drugs to be abused for weight control.
Addressing Nutrition Directly and Indirectly
Some traditional aspects of addiction recovery help address nutritional needs indirectly. Simply stopping the intake of addicting and gut-damaging substances is an obvious help. Recovery also tends to include a focus on stress-relieving and general relaxation practices. When we’re feeling stressed, the sympathetic part of the nervous system, which drives the “fight or flight” alarm system, is generally activated. In that state of mind and body, digestion slows down and we don’t get optimal nutrition from our diet.
On the other hand, calming practices like meditation and deep breathing exercises help us spend more time with the parasympathetic part of our nervous system in control. This method is sometimes called the “rest and digest” state because your heart rate slows down, and digestive activity ramps up. The more we can learn to live in a truly relaxed state of mind, the better our digestion, and therefore nutrition is likely to be.
Although those steps can help you begin to recover good nutritional status, it’s also important to focus on nutritional recovery needs more directly. Despite the importance of nutrition, many treatment facilities fail to address it. A study on nutrition services in treatment centers found that only about 30% offered any nutrition services at all and fewer than 7% used the services of a registered dietitian nutritionist.
There’s a lot to think about during recovery, and we know the thought of adding one more thing may seem a little overwhelming. Here at The Right Step Hill Country, we want you to succeed, and we want to make it as easy as possible for you to eat in a way that maximizes your physical and mental health, both now and into the future.
We’ll help you feed your body and spirit and teach you how to maintain your gains. We even offer cooking classes so you can learn to maintain good nutritional habits throughout your life.
If you’re ready to take the next step toward a healthy body and mind, free from the grip of alcohol or drug addiction, we’re ready to help. Give us a call at 844.675.1628 and begin recovering everything that addiction has taken from you.