Substance abusers who work with nutritionists have better chance at recovery

December 20, 2017

For substance abusers who want to recover from their addiction, working closely with nutritionists might just help, according to a team of authors writing in the Journal of the Academy of Nutrition and Dietetics.

They say registered dietician nutritionists could help patients at addiction recovery centers think about the ways food affects mental health, eating disorders and cravings.

Nutrition therapy could include cooking classes, mindful eating, and exploration of food fads and myths, they suggest.

“There really hasn’t been much conversation about substance use disorders and nutrition, unfortunately,” said lead study author David Wiss.

Wiss, a registered dietician nutritionist, is the founder of Nutrition in Recovery LLC in Beverly Hills, California, which focuses on incorporating nutritionists into treatment centers.

About 21 million Americans ages 12 or older – or 8 % – meet criteria for substance use disorder, according to the Substance Abuse and Mental Health Services Administration. Poor nutrition and eating disorders are often secondary health effects that stem from substance abuse, both during use and after recovery.

Wiss and his coauthors Maria Schellenberger, of the University of Southern California at Los Angeles, and Michael Prelip, of the University of California, Los Angeles, point out that in 1990, the Academy of Nutrition and Dietetics published a position paper supporting the need for nutrition intervention in treatment and recovery from addiction.

The academy described registered dietitian nutritionists as essential members of the treatment team, but, “Unfortunately, the position paper had little impact, was not renewed, and limited progress has occurred in incorporating (these professional) into drug rehabilitation programs despite the continued growth of substance abuse,” Wiss, Schellenberger and Prelip write.

They say weekly group sessions on emotional eating and eating for mental health could focus on dietary deficiencies that alter mental status and ways to combat them with healthy food. They also suggest talking about the harms of inflammation, caffeine, and nicotine, as well as the benefits of anti-inflammatory foods, fiber, slow and mindful eating, and exercise.

Hands-on nutrition classes covering easy recipes, snack preparation, grocery shopping, and budgeting may help addicts transition to a healthy life at home after leaving the treatment center, they suggest.

At the same time, the efficacy of nutrition interventions in substance use disorder treatment settings is unproven. “Unfortunately, this type of data is difficult to obtain given the small sample sizes at treatment centers, presence of confounding variables and poor patient follow-up,” Wiss said.

“Given the high relapse rates with available treatments, it’s obviously important to investigate the effect of unconventional approaches on substance abuse problems,” said Dr. Fatih Canan of the University of Louisville School of Medicine in Kentucky. Canan, who wasn’t involved with this study, researchers eating disorders and food addiction as it relates to substance abuse.

Canan is planning a study on food addiction treatment and relapse rates in patients with opioid use disorder. Future studies that evaluate different kinds of diets for patients with different substance abuse disorders may help, he said.

“The treatment of substance use disorders is complicated and multifaceted,” Canan said. “Nutritional interventions can be of help for certain patients.

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