Addiction Recovery and Nutrition

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Recovering from addiction is an incredibly personal journey filled with physical, emotional, and mental challenges. While therapy and medical support are often at the forefront of recovery, the role of nutrition is less frequently discussed—despite its potential to make a substantial impact on the path to healing.

Addiction affects the body’s nutrient balance, metabolism, and overall health in complex ways, often resulting in deficiencies that can leave a person feeling depleted, vulnerable, and unable to process therapy to their greatest potential.

Nourishing the body through recovery isn’t just about replacing lost nutrients; it’s about supporting brain health, stabilizing mood, restoring energy, and rebuilding resilience.

In this article, I’ll explore how nutrition can help support addiction recovery, including the general impacts of substance use on nutrition and the specific effects of different substances.

Together, we’ll look at ways to use nutrition as a tool to help the body recover, stabilize, and strengthen while recognizing that this journey is about progress, not perfection.

The Impact of Addiction on Nutritional Health

Addiction brings significant physical and mental challenges that often result in nutritional deficiencies and poor dietary habits. The focus on substances can lead to erratic eating patterns, limited food choices, and even food insecurity, where basic access to nutritious foods becomes a struggle.

As many as 70% of individuals with at least one substance use disorder (SUD) are food insecure.

For many, financial resources are redirected towards obtaining substances, leaving little left for balanced (or any) meals. When combined with addiction’s physical impact on appetite, digestion, and nutrient absorption, these factors can quickly result in malnutrition, creating further obstacles on the road to recovery.

It should be noted that this is actually a two-way street. Those struggling with food insecurity are also more likely to develop substance abuse disorders. This makes the CDR’s recent emphasis on health equity CEUs even more important! Read more.

How Addiction Can Lead to Poor Dietary Choices and Malnutrition

Substance use often alters appetite, inhibits nutrient absorption, and dysregulates appetite and satiety hormones. This leads to inconsistent meals, overconsumption of high-sugar or high-fat foods, or simply eating too little.

Many individuals might reach for easily accessible, highly processed foods because of limited time or budget constraints, especially when food insecurity is a factor.

Over time, these patterns cause the body to deplete essential nutrients, further weakening physical and mental health.

Dietary choices are also often a response to the immediate highs and lows in energy caused by substances, which can drive cravings for quick energy sources—usually in the form of sugary or other calorie-dense foods that lack other nutrients.

Nutrient Deficiencies

Chronic substance use significantly impacts specific nutrients, and deficiencies in these can profoundly affect health. Importantly, malnutrition is often undetectable using anthropometric measures or the traditional ASPEN model for diagnosing it.

Common deficiencies include:

• B Vitamins (especially B1, B6, and B12): Alcohol and other substances can deplete these essential vitamins, crucial for energy production, nervous system health, and cognitive function. Low levels of B vitamins are associated with fatigue, memory issues, and increased anxiety and irritability.
• Zinc and Magnesium: These minerals are often depleted by drug and alcohol use and are essential for immune function, muscle health, and mood stabilization. Deficiencies can lead to muscle weakness, poor wound healing, heightened stress response, and even increased susceptibility to infections.
• Vitamin D and Calcium: Many substances affect the body’s ability to absorb calcium, which, combined with low vitamin D levels, can weaken bones and increase the risk of fractures. These deficiencies also contribute to poor immune function and mood dysregulation.
• Iron:  Iron deficiency and anemia, particularly in women, are common.
• Others: Vitamins A, C, and E deficiencies are also common.

Note: If using serum levels to determine if a deficiency is present, remember that magnesium, zinc, copper, phosphorus, and sodium can all appear artificially elevated in dehydrated individuals.

Impact on the Gut

Substance use, particularly alcohol abuse, can profoundly impact gut health, disrupting the delicate balance of bacteria and causing inflammation that damages the gut lining.

This disruption allows bacteria, microbial antigens, and undigested food particles to pass through the intestinal lining and enter the bloodstream, triggering systemic inflammation.

Poor gut health doesn’t just affect digestion; it can also influence mental health. The gut-brain connection means that imbalances in gut bacteria or inflammation in the digestive system can lead to changes in mood, increased anxiety, and even depression.

Given that many substances already affect mood, poor gut health can further compound these effects, creating a cycle of mental and physical health challenges.

Brain Health and Neurotransmitter Function

Substance use can profoundly impact gut health, disrupting the delicate balance of bacteria and causing inflammation that damages the gut lining.

This increased intestinal permeability, sometimes called “leaky gut,” allows toxins and undigested food particles to pass through the intestinal lining and enter the bloodstream, triggering systemic inflammation.

Poor gut health doesn’t just affect digestion; it can also influence mental health. The gut-brain connection means that imbalances in gut bacteria or inflammation in the digestive system can lead to changes in mood, increased anxiety, and even depression.

Given that many substances already affect mood, poor gut health can further compound these effects, creating a cycle of mental and physical health challenges.

Brain Health and Neurotransmitter Function

Addiction’s effects on the brain are well-documented, with substances impacting neurotransmitters like dopamine, serotonin, and GABA, which are crucial for mood, motivation, and emotional stability. Here’s how different neurotransmitters are affected:

• Dopamine: Many addictive substances trigger an artificial surge in dopamine, the “reward” neurotransmitter, reinforcing the euphoric feelings the substance can cause.
  • Over time, this can deplete natural dopamine reserves and lead to feelings of depression, low motivation, and emotional numbness. Without sufficient nutrition, it becomes even harder for the brain to restore dopamine balance.
• Serotonin: Often associated with feelings of well-being and happiness, serotonin levels can be depleted by substance use, especially with alcohol and stimulants. Low serotonin can increase feelings of anxiety, depression, and impulsive behavior, making it harder to resist cravings and maintain a stable mood.
• GABA and Glutamate: These neurotransmitters are essential for calming the brain and maintaining relaxation. Substances like alcohol and benzodiazepines mimic GABA’s effects, but long-term use can reduce the body’s ability to produce it naturally, leading to heightened anxiety and agitation.

Inadequate nutritional intake exacerbates these neurotransmitter imbalances, as essential nutrients like amino acids and B vitamins are critical building blocks for producing these brain chemicals.

Together, these factors highlight the complex relationship between addiction, nutrition, and overall health. Poor dietary choices, nutrient deficiencies, and the impact on the gut and brain make nutrition an essential part of the recovery journey, helping to rebuild both the body and mind in ways that support long-term healing.

Nutrition and Health Impacts of Specific Substances of Abuse

The nutritional challenges associated with substance use vary significantly depending on the substance, but they often share themes of malnutrition, impaired absorption, and increased strain on the body’s systems. Understanding these impacts can highlight the role of nutrition in recovery, helping to rebuild health and resilience.

Alcohol

• Malnutrition and Nutrient Deficiencies: Chronic alcohol use disrupts the absorption of vital nutrients, particularly B vitamins (like thiamine), folate, magnesium, and zinc. These deficiencies can lead to fatigue, poor wound healing, neurological issues, and memory problems.
• Alteration of Hunger Hormones: Initially, alcohol use increases hunger and reduces inhibitions to restrict foods. However, as alcohol use becomes chronic, ghrelin activity is suppressed, drastically reducing appetite. This is the lead driver of the one meal per day dietary pattern often seen in individuals struggling with Alcohol Use Disorder.
• Liver and Digestive Health: Alcohol damages the liver, a critical organ for processing nutrients, resulting in poor nutrient metabolism and storage. Additionally, alcohol irritates the digestive system, increasing the risk of conditions like gastritis, which further impairs nutrient absorption.
• Blood Sugar Fluctuations: Alcohol causes unstable blood sugar levels, sometimes leading to hypoglycemia. This can increase cravings for sugary foods or high-glycemic snacks, perpetuating unhealthy dietary habits.

Stimulants (e.g., Cocaine, Methamphetamine)

• Suppressed Appetite and Weight Loss: Stimulants often reduce appetite, leading to prolonged periods of insufficient food intake. This can result in significant weight loss and deficiencies in protein, vitamins, and minerals essential for overall health. In addition to suppressed appetite, stimulant abuse tends to lead to food insecurity and other financial distress, compounding poor food intake.
• Dental Issues: Methamphetamine (MA) tends to be disastrous to dental care, increasing the incidence of dental caries, infection, and tooth loss. As in any other population, this can be a contributor to malnutrition.
• Increased Risk of Malnutrition: Chronic stimulant use leads to widespread nutritional deficiencies, impacting immune function, energy levels, and muscle health. A lack of sufficient protein intake can further degrade muscle mass.
• Adrenal Strain and Dehydration: Stimulants stress the adrenal glands, depleting the body’s resources and causing electrolyte imbalances. They also promote dehydration, exacerbated by caffeine consumption, which is often increased by stimulant users.
• Eating Disorder Aid: My work in a residential treatment center that specialized in concurrent eating disorders showed an astonishing number of individuals who initially sought out amphetamines (both ADHD meds and MA) to silence the hunger pain of their anorexia.

Opioids (e.g., Heroin, Prescription Painkillers)

• Digestive Issues: Opioid use commonly results in constipation, which can damage gut health and disrupt the absorption of essential nutrients, compounding the effects of malnutrition. It can also make eating regular meals uncomfortable for some.
• Metabolic Changes and Cravings: Opioids slow metabolic rates, which can affect energy levels and appetite. Additionally, blood sugar dysregulation may drive cravings for unhealthy foods, further impairing nutrition. In fact, new blood sugar cravings often coincide with heroin use relapse.
• Bone Health Risks: Long-term opioid use can deplete calcium and other vital minerals, increasing the risk of bone density loss and fractures.

Benzodiazepines

• Sedative Effects and Nutritional Neglect: The sedative effects of benzodiazepines can reduce motivation for meal preparation, leading to irregular eating habits and poor nutritional intake.
• Impact on Digestive Health: Prolonged use of benzodiazepines can affect the digestive system, hindering nutrient absorption and contributing to deficiencies.
  • In recovery, many individuals experience what is called “Benzo Belly.” This causes abdominal pain, nausea, vomiting, severe bloating, diarrhea, and constipation. These symptoms tend to appear while or immediately after eating, resulting in further resistance to regular meals.
• Cognitive and Mental Health: Deficits in nutrients like magnesium and B vitamins can exacerbate cognitive issues such as memory loss and mood instability, which are already common with benzodiazepine use.

Cannabis

• Impact on Appetite and Eating Patterns: Cannabis often increases appetite, sometimes referred to as “the munchies.” This can lead to overconsumption of high-calorie, low-nutrient foods, exacerbating nutritional imbalances.
• Blood Sugar and Weight Management: Increased consumption of sugary or calorie-dense foods during cannabis use can affect blood sugar control and contribute to weight fluctuations.
• Immune and Mental Health Impacts: Prolonged cannabis use can impair immune function and deplete nutrients that are vital for brain health, such as omega-3 fatty acids, which are essential for mood regulation and cognitive function.

Nicotine

• Increased Metabolic Demand: Nicotine accelerates metabolism, creating a higher need for calories and nutrients. However, many users do not meet this increased demand, resulting in unintended weight loss and micronutrient deficiencies.
• Reduced Appetite and Poor Diet: Nicotine suppresses appetite, which often leads to a low intake of protein, fiber, and essential nutrients like vitamins C and E. This dietary imbalance can impact immunity and overall health.
  • Of note, nicotine is often used for this effect in chronic dieters and other individuals with disordered eating or eating disorders.
• Increased Oxidative Stress: Smoking and nicotine use generate oxidative stress, increasing inflammation and the body’s need for antioxidants like vitamins C and E and selenium, which are often depleted in smokers.

The Role of Nutrition in Early Recovery

Addressing the nutritional impacts of substance use is critical in recovery. Nutrition helps restore the body and mind, making it easier to manage cravings, stabilize energy, and support overall healing.

• Restoring Nutritional Deficiencies: Focus on foods rich in essential nutrients, such as leafy greens for B vitamins, nuts and seeds for magnesium, and lean proteins for overall repair and recovery.
• Stabilizing Blood Sugar: Blood sugar regulation is vital for maintaining steady energy and reducing mood swings. Regular meals with low-glycemic foods like whole grains, legumes, and non-starchy vegetables can help achieve this.
• Rebuilding the Gut Microbiome: The gut plays a crucial role in both physical and mental health. Fiber-rich foods like whole grains, fruits, and vegetables, along with fermented foods like yogurt and kimchi, support a healthy gut microbiome, which aids in nutrient absorption and mood regulation.

Nutrition is a powerful tool for rebuilding a solid foundation for physical and emotional well-being in recovery. Each meal is an opportunity to heal, grow, and strengthen the body and mind for long-term success.

Addressing Cravings and Emotional Eating in Recovery

Substance recovery often brings intense cravings and emotional eating tendencies. Understanding and addressing these challenges with practical strategies can empower individuals to make mindful, nourishing food choices.

Understanding Cravings: Cravings often stem from nutrient deficiencies caused by substance use, like magnesium or zinc depletion, leading to a heightened desire for sweets or salty foods. For example, craving sugary foods might indicate low energy reserves or blood sugar instability.

Strategies for Managing Cravings

• Have Nutrient-Dense Snacks Handy: Keep snacks like nuts, seeds, fruit, or whole-grain crackers available to provide quick energy and curb cravings.
• Practice Mindful Eating: Pause to identify what the body truly needs—water, food, or rest—before reacting to a craving.
• Add Protein to Meals: Protein stabilizes blood sugar, reducing spikes and crashes that can trigger cravings.

Emotional Eating vs. Nourishment

Many in recovery turn to food for emotional comfort, but it’s essential to distinguish emotional needs from physical hunger.

• Ask Key Questions: “Am I hungry for nourishment or comfort?” If it’s emotional, non-food coping strategies like journaling, deep breathing, or connecting with a support system can help.
• Meal Ideas for Balanced Nutrition: Encourage meals with protein, fiber, and healthy fats. Examples include a quinoa bowl with roasted vegetables or peanut butter on whole-grain toast with sliced bananas.

Note: In recovery, our goal should not be to restrict sugary foods. Instead, nutrition counseling should focus on adding foods and nutrients the individual lacks.

Intense sugar cravings tend to subside within 1 year. Trying to enforce a sugar-free diet will only lead to binging. As we encourage mindful eating and add foods to restore good health, the sugar cravings will gradually abate.

Meal Planning Tips for Recovery

Meal planning can provide structure and stability during recovery, supporting both physical and emotional healing.

Creating Structure: Regular meal timing helps stabilize blood sugar, reducing impulsivity and mood swings. For instance, aim for three meals and two snacks daily, spaced evenly. A simplified exchange system can also be helpful for some.

Incorporating Comfort Foods: Including familiar, comforting foods—like mashed potatoes or mac and cheese—alongside nutrient-dense options helps build a healthy relationship with food. Pair comfort foods with nutrient-rich sides, like a green salad or steamed broccoli.

Practical Meal Ideas

• Smoothies: Blend fruits, leafy greens, yogurt, and a scoop of protein powder for an easy-to-digest, nutrient-packed option.
• Soups: Prepare broths with beans, vegetables, and whole grains for a warming, nutrient-dense meal.
• High-Protein Snacks: Opt for boiled eggs, Greek yogurt, or hummus with vegetables to maintain energy.

The Importance of Hydration

Hydration is often overlooked but plays a significant role in recovery, affecting mood, cognition, and cravings.

Link Between Hydration and Cognitive Function: Dehydration can lead to fatigue, irritability, and difficulty concentrating, hindering recovery. Proper hydration supports brain function and reduces the perception of cravings.

Hydration Strategies

• Simple Tips: Set reminders to drink water throughout the day or carry a refillable water bottle.
• Flavoring: Flavored water is still water. Using flavoring packs and liquids or buying flavored sparkling water are all great options.
• Hydrating Foods: Incorporate water-rich foods like cucumbers, watermelon, and oranges. Smoothies, soups, and stews are great for this.

Substance Use Disorders and Concurrent Eating Disorders

It’s common for individuals in recovery also to face eating disorders, particularly Binge Eating Disorder and Bulimia Nervosa. Furthermore, recovery from Substance Use Disorder can trigger eating disorder thoughts and behavior. And recovery from eating disorders can trigger substance cravings. These MUST be treated together.

Addressing both conditions requires a sensitive approach, including:

• Focusing on Nonjudgmental Support: Helping clients rebuild trust in their bodies and food choices.
• Maintaining Autonomy: Many times, eating disorders develop in the face of intense feelings of lack of control compounded by other mental health struggles.
• Emphasizing Small, Manageable Changes: Gradually increasing nutrient-dense food choices without overwhelming the client.
• Monitoring: Labs should be closely monitored, especially in those who have been purging, excessively exercising, or severely restricting intake.

Addressing Common Challenges in Nutrition for Recovery

Obviously, every person will have different challenges that require different solutions. However, here are some basic examples of challenges with possible suggestions. Before offering suggestions to your client, make sure you know their individual barriers, beliefs, desires, and abilities.

Low Appetite

Start Small: Offer nutrient-dense options in smaller portions, like a handful of trail mix or half a sandwich.

Focus on Calorie-Dense Foods: Avocado, nut butters, and olive oil add calories without requiring large meal sizes.

Fed is Best: The most important thing is that they eat, even if it doesn’t fit our or our clients’ goals. As they continue to recover from the physical effects of substance abuse, their appetite will improve. Along with this is their ability to commit to more specific goals.

Financial Barriers

Budget-Friendly Choices: Beans, lentils, canned vegetables, and frozen fruits are affordable and nutritious staples.

Know Your Local Resources: Keep a list of local food banks, thrift stores, and other financial aid services so you can refer your clients as needed. For instance, there are some offices that can help individuals set up their application for SNAP and WIC benefits.

Plan Meals: Help clients maximize their grocery budgets with simple recipes and batch cooking ideas. Even if they don’t qualify for WIC, have them visit the WIC website for recipes. These should be RD-evaluated and cost-effective.

Mental Health Considerations

Anxiety and Depression: Foods rich in omega-3 fatty acids (like flaxseeds and salmon) and magnesium (like leafy greens and nuts) can support mood.

Comfort Through Routine: Encouraging consistent meals can provide a sense of stability and self-care during difficult times.

Recovery is a multifaceted journey, and nutrition is a key pillar. Through thoughtful guidance, clients can rebuild their health, manage cravings, and develop a positive, nourishing relationship with food.

Conclusion and Encouragement

The journey to recovery is complex, but by addressing the physical body’s needs through nutrition, we can offer meaningful support in rebuilding health, resilience, and well-being.

Incorporating nourishing foods can be a powerful, stabilizing force, helping ease some of the physical and mental strain of recovery. It’s important to remember that nutrition alone isn’t a cure. Still, when integrated into a holistic approach, it can help people regain strength, focus, and stability—qualities that support long-term recovery.

For healthcare professionals, introducing even small nutritional recommendations can make a real difference.

These suggestions provide much-needed nutrients and offer clients a sense of agency over their health and healing. Recovery is a long road, but with the right nutritional foundation, it can be traveled with renewed strength, greater balance, and hope.