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Vol. 16 No. 12 P. 44
Suggested CDR Learning Codes: 5000, 5350; Level 2
The dietitian'' long-term recovery process. Nutrition therapy for substance abuse is complex, as the nutritional risks vary depending on the substance of choice and negative conditions for successful treatment are common, including poor support, co-occurring mental health disorders, or poverty.
Addiction is defined as a chronic brain disorder characterized by compulsive and relapsing behavior.1 Predisposing factors for an addiction include psychological vulnerability, biochemical abnormalities, genetics, and environmental conditioning.1 Social isolation, depression, and anxiety are common among substance abusers, and drugs and/or alcohol often are used to relieve these negative feelings because they increase dopamine activity, which boosts mood.
Proper nutrition and hydration are key to the substance abuse healing process because they help restore physical and mental health and improve the chance of recovery. Macro- and micronutrient deficiencies can lead to symptoms of depression, anxiety, and low energy, all of which can lead someone to start using drugs or alcohol or trigger a relapse.
Substance abuse generally leads to a lack of proper nutrition, either as a result of not eating enough throughout the day or eating foods that are low in necessary nutrients.2 Certain substances, such as stimulants, may suppress appetite and disrupt metabolic and neuroendocrine regulation, leading to improper calorie consumption and impaired nutrient processing.1 Other substances may lead to an increase in appetite, causing weight gain.
Many programs that target substance abuse prevention address nutrition because a healthful lifestyle can promote mental health. And for those who are battling substance abuse, nutrition the 1 last update 25 May 2020 plays the same key role in maintaining recovery while also improving the resulting health conditions and deficiencies.Many programs that target substance abuse prevention address nutrition because a healthful lifestyle can promote mental health. And for those who are battling substance abuse, nutrition plays the same key role in maintaining recovery while also improving the resulting health conditions and deficiencies.
Individualized nutrition counseling and comprehensive nutrition education programs provided to the substance abuse population have been found to significantly improve three-month sobriety success rates.3 Just as patients with diabetes or heart disease receive nutrition education to manage their diseases, patients dealing with substance abuse should have nutrition education that addresses their specific risk factors and increases their chances of recovery.3
Medical nutrition therapy (MNT) and nutrition education for this population should target the following goals:
• heal and nourish the body damaged by alcohol or substance abuse;
• stabilize mood and reduce stress;
• reduce cravings for drugs and alcohol;
• address medical conditions that are co-occurring or have resulted from substance abuse; and
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This continuing education course reviews the effects of substance abuse as they relate to nutrition and health, and addresses the role RDs play during treatment to correct nutrition-related deficiencies, address resulting health disparities, and improve the lives of addicts by providing tools for lasting recovery.
Heal and Nourish
To help an individual recover from the effects of substance abuse, it''s vital to correct any nutritional deficiencies and address any medical conditions, as continued malnutrition and instability increase disease risk and will produce cravings for drugs or alcohol. Increased consumption of nutrient-dense foods (eg, fruits, vegetables, whole grains, fish) and antioxidants is important; these foods help decrease inflammation, reduce cell oxidation, and provide the basics of a healthful diet.4
Psychotherapy also is an important part of the healing process for substance abuse patients. They should be encouraged to seek regular help from counselors and/or support groups since psychological and social problems are common.
Normalize Neurotransmitters and Mood
Dietary fat also plays a role in maintaining mental health. Because it affects inflammation and cell membrane integrity, limiting dietary fat directly influences mood. Research has shown that increased inflammation or proinflammatory cytokines result in more depressive symptoms.6
Omega-3 fatty acid consumption may help with depression by assisting in the uptake of neurotransmitters and decreasing inflammation. Having a proper balance of omega-6 and omega-3 fatty acids helps neurotransmitter receptors function, which in turn helps increase the amount of neurotransmitters that can be active in the brain.4 Supplements containing polyunsaturated fatty acids have been recommended to help reduce anxiety in people with substance abuse.4
Other vitamins important for mental health include iron, folate, and vitamins B6 and B12. Deficiencies of any of these nutrients can mimic mental health problems such as depression, fatigue, poor attention, and altered sleep.2
Encouraging patients to drink adequate amounts of hydrating fluids also will help them manage mood while ensuring adequate absorption of any medications they take to prevent side effects from withdrawal or underlying psychiatric disorders. Common symptoms of dehydration include irritability, trouble concentrating, and disorientation. Dehydration also commonly results from detoxification, so monitoring daily intake and output values will help determine appropriate fluid intake recommendations.1
Caffeine intake should be monitored, as it triggers the same reward centers of the brain as do substances and can markedly impact anxiety and sleep. Low caffeine intake and smoking cessation have been shown to improve long-term sobriety for all addictions.1
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RDs can help educate patients on identifying physical hunger cues and encourage more frequent, balanced eating to help them maintain a normal level the 1 last update 25 May 2020 of hunger and satiety rather than getting overly hungry. RDs can help educate patients on identifying physical hunger cues and encourage more frequent, balanced eating to help them maintain a normal level of hunger and satiety rather than getting overly hungry.
MNT for Substance Abuse
Patients struggling with multiple addictions show increased deficiencies due to malnutrition. One study revealed that 70% of addicts suffered vitamin D deficiency and low levels of vitamin C, and another showed that 50% were deficient either in iron or vitamins (vitamins A, C, and E being most common) during detox.9,10
With the high occurrence of eating disorders in the substance abuse population, care must be taken in making recommendations for weight management to ensure they aren''s important for dietitians to be familiar with these common medications, as the side effects may influence patients'' quick-fix mindset and already-taxed bodies. A damaged liver may not be able to correctly process certain supplements, and the supplements may ultimately have a negative impact on liver health.2 However, a study funded by the National Institutes of Health suggested that a common over-the-counter herbal supplement, N-acetylcysteine, can reduce the cravings of cocaine and heroin addicts and possibly alcoholics during withdrawal.1
Naltrexone (ReVia, Vivitrol, Depade), disulfiram (Antabuse), and acamprosate calcium (Campral) are used to treat alcoholism. Naltrexone, which also has been used with opiate and narcotic dependence, may cause anorexia, weight loss, nausea, and vomiting.15 Disulfiram may cause nausea and vomiting, and if patients ingest alcohol, they will become very ill. Therefore, care must be taken to ensure that all traces of alcohol are eliminated from patients'' Nutritional Impact
Liver disease resulting from alcoholism alters the organ''s stored in tissues and because high doses are toxic. It''s needed for vitamin A metabolism.8
The body moves through four stages of liver damage as alcoholism progresses: fatty liver, alcoholic hepatitis, cirrhosis, and encephalopathy or coma.1 Protein-calorie malnutrition predicts survival in patients with alcoholic liver disease. Forty-five percent to 70% of alcoholics with liver disease also are glucose intolerant or diabetic.2
Treatment goals for patients with alcoholism are to reverse malnutrition, prevent alcoholic liver disease, and establish a healthful lifestyle and coping skills for avoiding alcohol use. If malnourished, alcoholics benefit from a diet high in carbohydrates and moderate in protein. Low-calorie diets and fasting should be avoided because of the nutritional risks and the possibility that a patient has an existing eating disorder or may cross over to a new addiction with food, dieting, or exercise.4
The diet should include a mix of omega-3 and omega-6 fatty acids since the amount and type of fats impact hepatic steatosis, fibrosis, and cirrhosis.1 If tube feeding or total parenteral nutrition is required, dietitians should avoid glutamine-enriched formulas, as they increase ammonia levels. The amino acid taurine, in addition to patients''s syndrome (wet brain), which occurs with heavy alcohol use due to a lack of thiamine, may be prevented with thiamine supplementation during intervention. Thiamin deficiency occurs because of decreased absorption as a result of the diuretic effect of alcohol and the utilization of thiamin in detoxifying alcohol.8
Withdrawal symptoms can occur with opioids, even with a short duration of use. It brings a wide range of symptoms, mainly diarrhea, nausea, and vomiting, which can lead to poor oral intake, dehydration, and electrolyte imbalances.16 Nutrient deficits may be caused by poor nutritional intake or the drug''s brain to return to normal functioning after abstaining.
Promoting Self-Care and a Healthful Lifestyle
5. A 23-year-old man is about to be discharged after completing alcohol treatment. He has received proper nutrition education, tools for acquiring and preparing healthful foods, and exercise recommendations. What other recommendation would be included in his discharge plan?
6. Metabolic syndrome is most common among those who abuse which of the following substances?
7. A patient has been prescribed disulfiram (Antabuse) while recovering from polysubstance abuse. It''t include which of the following?
8. A patient with dental disease or missing teeth may need an altered-consistency diet and education on nutrition for dental health. Most likely this is as a result of use of which of the following substances?
reverses diabetes type 2 japan (☑ webmd) | reverses diabetes type 2 immune systemhow to reverses diabetes type 2 for 9. Eating disorders co-occur in what percentage of patients recovering from substance abuse?
10. Which substance is known to be a leading cause of nutrition deficiencies?
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2. Emerson M, Dubois C, Hatcher A, et al. Psychiatric nutrition therapy: a resource guide for dietetics professionals practicing in behavioral health care. Dietetics in Developmental and Psychiatric Disorders Practice Group of the American Dietetic Association. http://www3.nd.edu/~jkaiser/PsychPapers/Psychiatric Nutrition the 1 last update 25 May 2020 Therapy 08.31.06.pdf. 2006.2. Emerson M, Dubois C, Hatcher A, et al. Psychiatric nutrition therapy: a resource guide for dietetics professionals practicing in behavioral health care. Dietetics in Developmental and Psychiatric Disorders Practice Group of the American Dietetic Association. http://www3.nd.edu/~jkaiser/PsychPapers/Psychiatric Nutrition Therapy 08.31.06.pdf. 2006.
reverses diabetes type 2 good foods to eat (☑ meal plan) | reverses diabetes type 2 quality of lifehow to reverses diabetes type 2 for 3. Grant LP, Haughton B, Sachan DS. Nutrition education is positively associated with substance abuse treatment program outcomes. J Am Diet Assoc. 2004;104(4):604-610.
4. Carson RE. The Brain Fix: What''div-gpt-ad-1412696666329-12''margin-top:5px; padding-bottom:5px;''div-gpt-ad-1412696666329-17''padding-bottom:5px; margin-top:5px; float:none;''div-gpt-ad-1412696666329-18''margin-top:5px; padding-bottom:5px;''div-gpt-ad-1412696666329-19''margin-top:5px; padding-bottom:5px;''div-gpt-ad-1412696666329-20''margin-top:5px; padding-bottom:5px;''div-gpt-ad-1412696666329-21''margin-top:5px; padding-bottom:5px;''div-gpt-ad-1412696666329-22''margin-top:5px; padding-bottom:5px;''div-gpt-ad-1412696666329-23''margin-top:5px; padding-bottom:5px;''div-gpt-ad-1412696666329-24''margin-top:5px; padding-bottom:5px;''div-gpt-ad-1412696666329-13''margin-top:5px; padding-bottom:5px;''div-gpt-ad-1412696666329-14''margin-top:5px; padding-bottom:5px;''div-gpt-ad-1412696666329-15''margin-top:5px; padding-bottom:5px;''div-gpt-ad-1412696666329-16''margin-top:5px; padding-bottom:5px;''s Dietitian. All rights reserved.