Nutrition in Addiction Recovery: Reading List

It is not uncommon for individuals with substance use disorder (SUD) to experience conditions which make healthy eating and proper nutrition more challenging.

One of the widely overlooked health effects of addiction is deficiencies of key vitamins and nutrients. Research shows that chronic substance use can interact with and change brain chemistry. Some of these brain alterations can cause unhealthy eating patterns and impair the metabolic absorption of nutrients, leading to deficiencies and a broad spectrum of negative health outcomes in affected individuals.

Additionally, depending on individual circumstances, people with SUD can be challenged with food insecurity and the inability to obtain healthy food on a day-to-day basis. This is often compounded by infrequent eating due to diminished interest in food and appetite suppression from increased dopamine levels.

The list below contains a selection of resources on the role of diet and proper nutrition in promoting recovery that we hope will provide readers with a foundation for learning and further exploration of the subject. The list also includes scientific articles on nutrition that treatment and recovery professionals can use as reference works.

We thank Khary Rigg, Ph.D. and Kelly Miller, NTMC for providing us with references for this list. Read their article on Using nutrition to promote addiction recovery for an excellent introduction to the subject.

1. Opioid use disorder (OUD) can cause metabolic changes, constipation, and weight loss, or lead to a lifestyle that results in inadequate food intake and unhealthy eating patterns. Nutritional factors associated with OUD can also hinder treatment outcomes and recovery. This paper by Melody Chavez and Khary Rigg, published in the journal Psychology of Addictive Behaviors, describes the nutritional consequences associated with misusing opioids and serves as a guide for drug treatment providers to make more informed nutritional recommendations to their clients: 'Nutritional implications of opioid use disorder: A guide for drug treatment providers.'
2. Individuals with substance use disorder may experience unstable housing, have dysfunctional family relationships, and experience criminal justice involvement, all of which make healthy eating more challenging. This paper on ‘Family and social aspects of substance use disorders and treatment’ focuses on individual, group and family interventions and suggests a range of strategies to facilitate recovery.
3. SUD can cause diminished interest in food and appetite suppression from increased dopamine levels. This Science & Practice Perspectives Journal article explores 'The Neurobiology of Opioid Dependence: Implications for Treatment' and gives a detailed overview of how opioids affect brain processes, producing drug liking, tolerance, dependence, and addiction.
4. In this study, published in BMC Public Health, the extent and correlates of food insecurity among a sample of injection drug users (IDUs) was examined. The research also explored whether there is an association between food insecurity and injection-related HIV risk.
5. Common physical withdrawals during detox include nausea, abdominal cramping, vomiting, and diarrhoea. Individuals experiencing these symptoms can suffer from at least one nutrient deficiency due to loss of bodily fluids or lack of appetite. Utah State University published this useful fact sheet on 'Diet, Nutrition and SUD' containing tips for use when advocating for the integration of nutrition interventions into SUD treatment and recovery.
6. Cravings for sugar, sweets, and high caffeine energy drinks are normal during the detox phase of treatment because the brain is looking for mood stabilization and neurotransmitter stimulation. To promote better nutrition, caffeine intake in those undergoing treatment for SUD should be limited due to its appetite suppressant effect. Frontiers in Psychiatry journal published this article on the science behind how caffeine suppresses appetite.
7. The Protein, Fat, and Fiber (PFF) model is a useful framework for teaching individuals the benefits of eating a well-balanced diet that supports their recovery goals. The Institute of Medicine Panel on Micronutrients published a comprehensive set of reference values for nutrient intakes that can be used as a guide by treatment and recovery professionals.
8. Published in The Assessment and Treatment of Addiction journal, this comprehensive review titled 'The Role of Nutrition in Addiction Recovery: What We Know and What We Don't' provides an overview of the impact of alcohol, cocaine, methamphetamine, and opioids on nutritional status; with emphasis on gut health, microbiome, and associated neural interactions.
9. An important nutrient for people in recovery is healthy fats. In this study, published in the journal Biological Psychiatry, the researchers examined dietary deficiency of omega-3 polyunsaturated fatty acids (n-3 PUFAs) and their implicated role in the symptomatic onset of schizophrenia and mood disorders.
10. This systematic review article titled ‘Burden and Nutritional Deficiencies in Opiate Addiction’ and published in the Iranian Journal of Public Health, explores opiate addiction mechanisms, epidemiology and disease burden with specific emphasis on the dietary and nutritional status of opiate dependent patients in methadone maintenance therapy.
11. Thiamine deficiency, although rare in most developed countries, is common in people who drink excessive amounts of alcohol. This fact sheet produced by the Alcohol and Drug Foundation contains useful information on alcohol related thiamine deficiency.