The brain circuits involved in disordered eating appear to be the very same involved in substance use disorders. Specifically, the dopamine pathways that detect rewarding stimuli and motivate individuals to seek out the same stimuli again. In typical circumstances, the reward system tells the individual to seek out natural rewards such as nutrient-rich food or comforting social interaction. When these pathways are damaged, individuals engage in behavior and/or seek types of food or substances that harm rather than nourish their bodies.
Malnutrition and Substance Use Disorders (SUD)
The path to disordered eating – bulimia or anorexia, for example – may differ from the path to substance abuse. But the resulting damage to the dopamine pathways show many similarities – malnutrition, compulsive cravings, poor judgement, negative mood, and anxiety. This insight has inspired researchers to consider the role of nutrition therapy in promoting recovery from substance use disorders.
Prolonged exposure to substances of abuse typically causes malnutrition because the disrupted reward system can prompt individuals to seek drugs or alcohol rather than nourishment. To be malnourished means to be lacking in one or more important nutrients the body relies upon to function well. One of the indicators of being malnourished is that individuals seek out less nutritious food, such as highly sweetened or foods high in fat content. Prolonged exposure to substances of abuse may also suppress appetite, resulting in individuals not getting enough nutrients to promote overall health.
Individuals living with prolonged SUDs are likely to have serious deficiencies in a variety of nutrients crucial for optimal brain function such as vitamins, minerals, and amino acids. These deficiencies can lead to digestion and nutrient absorption issues, negative moods, inflammation of organs, disrupted neurotransmission of dopamine, and alteration of the gut microbiome. The latter – the gut microbiome, researchers are increasingly finding, plays a significant role in managing stress because of its role in mediating communication along the hypothalamic pituitary adrenal axis (HPA). The HPA axis, when functioning well, enables successful management of stress.
Nutrition Therapy in Recovery
Some studies have considered the role that vitamin or mineral supplements can play a helpful role after prolonged substance abuse. The idea is that through taking supplements, individuals can start to repair the cellular damage in various systems, including the gastrointestinal tract. This then enables healthier digestion and absorption of food. Detoxification is followed up with introducing individuals in recovery to healthier eating – namely, more complex, nutrient-rich food foods that maintain and support the systems of the body. Healthier, more nutritious eating also appears to improve mood and mental functioning in general.
Nutrition therapy promises to be an important intervention in recovery from addiction. Ignoring the important role of nutrition may leave unaddressed part of the damage caused by substance use disorders. Substance misuse and malnutrition seem to be mutually reinforcing. Substance misuse hijacks the reward system and starts to reinforce behavior that leads to malnutrition. Malnutrition then causes cellular damage, such as disrupting healthy dopamine transmission that, in the case of substance abuse, reinforces drug seeking behavior.
The goal of nutrition therapy – or simply eating a healthy, balanced diet while in recovery – is to end the mutually reinforcing cycle of substance misuse and malnutrition by ensuring individuals living with SUDs get the proper nutrients to restore the reward and stress response systems to healthy functioning. Nutrition therapy can be an important and effective complementary element in a holistic, integrated treatment plan, alongside medication therapy, psychotherapy, and exercise for individuals seeking lasting recovery from SUDs.