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Do Addictive Substances Impact Nutrition? Nutrition for Addiction Recovery

              When someone is recovering from addiction to substances such as alcohol, cigarettes, marijuana, or opioids, they often wonder about their nutrition. Does the substance affect their nutrition status? What should they eat during recovery? Here we will discuss various addictive substances and how they affect nutrition.

plate of chicken, greens, rice for recovery

Nutritional Impact of Alcohol and Recovery from Alcohol Use

              Often people don't realize that alcohol contains calories. This is likely because alcoholic beverages are not required to have a nutrition facts label. Alcohol is under the jurisdiction of the Alcohol and Tobacco Tax and Trade Bureau, not the Food and Drug Administration, so it is exempt from the FDA's food label regulation of having a nutrition facts label. Despite not being labeled, alcohol itself has 7 calories per gram. When in various types of alcoholic beverages such as sweet wine or beer, there are other calories from carbohydrates.

              In minimal use, alcohol does not contribute much to an overall diet, but with high use, it can displace calories and protein, or just protein, leading to malnutrition. That is why general malnutrition is fairly common in people with alcohol use disorder. During recovery, attention to regular meals containing a variety of nutrients is important.

             Additionally, there are certain micronutrients that can be deficient in alcohol use. Thiamine (B1) deficiency is fairly common, and in extreme cases, it can lead to Wernicke-Korsakoff syndrome. Wernicke encephalopathy is the acute and reversible portion of this condition, and Korsakoff syndrome, is a non-reversible neurological disorder. Riboflavin (B2,) niacin (B3,) and folic acid (B9) deficiencies can follow thiamine deficiency. Vitamin C and zinc deficiencies can also occur. Many people with alcohol use disorder require thiamine repletion. Some will require supplementation of the other vitamins commonly deficient.

             There are several nutritionally pertinent diseases caused by chronic alcohol use. Pancreatitis can lead to food intolerances or needing to take enzymes to digest food. Liver disease can lead to further malnutrition due to changes in appetite and nutrient absorption. If someone has one if these diseases, they may require some nutrition changes to manage disease symptoms and slow the progression of their disease.

Nutritional Impact of Cigarettes

             Cigarettes' effect on nutrition is mainly on appetite--smoking decreases appetite. Many people find that when they stop smoking, they gain weight due to stopping the appetite suppressant effects of cigarettes. It is important to point out that smoking is exceedingly more harmful to health than gaining some weight. Smoking causes lung cancer, which is deadly. A higher weight can increase risk of certain metabolic health conditions, but is likely less harmful than smoking. In recovery from smoking, it is important to understand that good nutrition can lower risk of metabolic outcomes of higher weight.

              Another interesting impact of smoking cigarettes is on vitamin C status. Smoking cigarettes depletes vitamin C due to the oxidative stress from smoking. With the increased oxidative stress, there is a higher demand for the antioxidant vitamin, vitamin C, leading to its depletion. Smokers require higher vitamin C intake to supply for the higher demand.

Nutritional Impact of Marijuana

             Marijuana seems to have the opposite affect than cigarettes. Marijuana increases appetite and leads to what people refer to as marijuana “munchies.” Despite the increased appetite in those who smoke marijuana, studies actually show lower weight in marijuana smokers compared to nonsmokers. If someone is finding that their appetite is very poor while avoiding marijuana, behavioral strategies can help with improving nutrition intake.

Nutritional Impact of Opioids

             Opioids affect nutritional status in a few ways. First, opioids, especially with chronic use, decrease appetite. People who use narcotics overall eat less, and they also tend to replace protein and fat with sugar and alcohol. With this, the minimal calories that are consumed also provide minimal additional nutrition from vitamins and minerals. People who use opioids often have malnutrition.

             An additional affect opioids have is on the gastrointestinal system. Opioids decrease intestinal motility. This means that the movements of the intestines are slowed, causing constipation. This can further impact appetite and food intake.

              Recovery from the nutritional effects of opioid use disorder requires attention to food intake. Basic changes such as scheduling regular meals, prioritizing protein, and using high calorie nutrition shakes can help with weight gain. Engaging in physical activity can help those recovering gain muscle mass and improve fitness.

Nutrition in Addiction Recovery

             While there is no specific diet or nutrition regimen for addiction recovery, good nutrition in general is still key. Various addictive substances have effects on the user's nutrition. Alcohol, cigarettes, marijuana, and opioids all can lead to changes in food intake, and in some cases, malnutrition.

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