Most people are in a state of malnutrition and physical deterioration when they enter addiction rehab. Proper nutrition helps these issues and supports mental health. Common medical conditions in addicts vary by what substance they’ve abused and include hypertension, cardiovascular disease, malnourishment, gastrointestinal issues, mental health disorders, kidney and liver damage, and obesity or emaciation. Adrien Paczosa is a licensed, registered dietician, owner of iLiveWell Nutrition Therapy, and works with clients in alcohol and drug rehab at Promises P.A.T.H drug rehab center, which has a robust fitness and nutrition program. She stresses the importance of proper nutrition and fitness as part of whole-person healing in recovery and long-term sobriety. “People sometimes think treatment is about fixing everything above the neck — just the emotions and thoughts,” says Paczosa, “but if we don’t also fix what’s below the neck, a person’s overall health and well-being is disconnected.” Poor nutrition and poor mental health can go hand in hand. The body of research that supports proper nutrition as armor against addiction, depression and other mental health issues continues to grow. A large amount of the body’s serotonin is located in the specialized cells in the gastrointestinal tract, not the brain. “Sixty percent of your happiness comes from your gut, so it is important to pay attention to it,” Paczosa says.
Nutrition’s Role in Addiction Rehab
Paczosa begins working with clients after they’ve safely progressed through medical detox. The first step is an initial one-hour assessment where they discuss what the client’s diet has consisted of during active addiction, any history of health problems, and begin creating a treatment plan to heal their nutritional deficiencies and embrace a healthy lifestyle. Clients keep food diaries, meet with Paczosa regularly, attend nutrition and cooking classes weekly, and work with a personal fitness instructor. People who abuse alcohol and other drugs typically score low on nutrients across the board, but especially suffer from deficiencies in zinc, calcium, iron, and vitamins B and D. Paczosa teaches clients the importance of eating foods like whole grains, beans, shellfish, leafy greens, nuts and seeds to repair those nutritional deficits. She works directly with the treatment center’s chef to create meals for each client targeting their particular deficiencies and health goals. “Another nutrition intervention with clients recovering from addiction is making sure there is a balance of carbohydrates, protein and healthy fats,” says Paczosa. Omega 3 is an important component of recovery, with research showing that the fatty acid can help control and prevent depression and addiction. Salmon, walnuts and flax seeds are examples of foods incorporated into menus to support this. Many individuals with addictions also have co-occurring disorders. Sometimes these issues are discovered in the nutritionist’s office, such as in the case of an eating disorder. Paczosa works closely with each client’s mental health therapist, physician, fitness instructor and others on the treatment team to ensure all underlying issues are attended to and treatment is cohesive.
How Nutrition Can Prevent Relapse
Proper nutrition can play a key role in preventing relapse once a client leaves treatment, says Paczosa. In addition to supporting physical and mental health, behaviors around food can provide warning signs of potential relapse. People with any kind of addiction — alcohol, drugs, gambling, sex, and other behavioral addictions — are at high risk for developing cross or transfer addictions. For example, a recovering alcoholic may quit drinking, but begin abusing food or sex as a self-medicating tactic, essentially replacing alcohol with another addiction. This is why it is important to address the underlying mental, physical and emotional issues that are propelling destructive behaviors to maintain recovery and prevent cross addictions. Paczosa teaches clients to pay attention to their food choices and behaviors as important clues to potential emotional issues or triggers that need to be addressed. “When you start to use and abuse food, it’s a sign you could be about to relapse,” she says. “You may be using food to numb out and disassociate in ways you previously used drugs or alcohol.” This is particularly true of foods that digest quickly and raise dopamine levels. Research shows that the effects of foods like these can be similar to the feel-good, dopamine-increasing qualities of drugs and alcohol that act on the reward center of the brain and encourage addiction. For instance, a binge on foods high in sugar or simple carbohydrates like ice cream or chips can indicate that a former addict is being triggered and self-soothing through food. Paczosa encourages her clients to be mindful of these problematic food patterns, and seek out help as soon as possible from their therapist, nutritionist, 12-step group or other support system to address the issues behind the behavior.
Nutrition as a Recovery Skill
People in recovery need to learn new healthy coping skills and activities to replace the space previously filled by drug and alcohol abuse. Paczosa says that proper nutrition and eating habits can be a valuable part of this pursuit. Three square meals a day is usually not at the top of an addict’s agenda. When they are active in their addiction, they may skip meals altogether or eat sporadically. “Learning about nutrition and healthy eating habits in treatment can provide structure to a person’s day, which may have been lacking previously,” says Paczosa. For example, instead of waking up in the afternoon and reaching for a drink, a former addict learns to start their day with intention: wake up, make a nutritious breakfast, pack a healthy lunch, go to work, come home, make dinner, etc. A focus on healthy eating can also provide a new hobby. Many of Paczosa’s clients start taking an active interest in nutrition and cooking. “Healthy eating and fitness add a different slice of life,” she says. “So, instead of getting off work and going to the bar, they might attend a cooking class, cook a meal at home or head to the gym.” Paczosa says that ultimately the goal of a nutrition program in addiction rehab is to create a “nutrition prescription” that promotes physical health and long-term recovery, and is in tandem with the behavioral and spiritual work clients are doing in treatment. By Sara Schapmann Sources: Nutritional Medicine as Mainstream in Psychiatry Serotonin Relative Ability of Fat and Sugar Tastes to Activate Reward, Gustatory, and Somatosensory Regions Understanding Nutrition, Depression and Mental Illnesses