Background: Nutrition is a prerequisite for health; yet, there
is no special nutritional assessment or guidance for drug and alcohol
dependent individuals, despite the fact that their food consumption is
often very limited, risking malnutrition. Further, the premise is
examined that malnutrition may promote drug seeking and impede recovery
from substance use disorders (SUD).
Method: A narrative review addressed the relationship between substance
use disorders and nutrition, including evidence for malnutrition, as well
as their impact on metabolism and appetite regulation. The implications
of the biopsychology of addiction and appetite for understanding the role
of nutrition in SUD were also considered.
Results: The literature overwhelmingly finds that subjects with alcohol
use disorder (AUD) and drug use disorder (DUD) typically suffer from
nutrient deficiencies. These nutrient deficiencies may be complicit in
the alcoholic myopathy, osteopenia and osteoporosis, and mood disorders
including anxiety and depression, observed in AUD and DUD. These same
individuals have also been found to have altered body composition and
altered hormonal metabolic regulators. Additionally, brain processes
fundamental for survival are stimulated both by food, particularly sweet
foods, and by substances of abuse, with evidence supporting confusion
(addiction transfer) when recovering from SUD between cravings for a
substance and craving for food.
Conclusion: Poor nutritional status in AUD and DUD severely impacts their
physical and psychological health, which may impede their ability to
resist substances of abuse and recover their health. This review
contributes to a better understanding of interventions that could best
support individuals with substance use disorders.