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Nutrition and Relapse Prevention

By: Dr. Keith Kantor, CEO of NAMED Program


A person with substance abuse is more likely to relapse when they are malnourished. Some research suggests drug and alcohol addiction causes a person to forget what it is like to be hungry and they may crave the addicted substance instead of true hunger. The person should be encouraged therapeutically to think that they may be hungry when cravings become strong.

During recovery from substance use, dehydration is also common. It is important to get enough fluids during and in between meals. In some cases if weight gain has occurred, eating foods that are nutrient dense not calorically dense is a strategy that can be used to avoid further weight gain, promote weight loss and most importantly prevent health related issues to increased levels of adipose tissue (body fat). By following these guidelines through the recovery process it will have a small but statistically significant effect on helping a patient withdrawal from addiction while reducing symptoms of their addiction.

Develop a meal and snack schedule and adhere to the routine daily. This will reduce cravings while keeping the body in a state of balance.
Aim to eat 9-11 servings of fruits and vegetables daily. Preferably a ratio of one fruit to three vegetables. This keeps fiber intake at optimal levels, sugar intake is within optimal range when more vegetables are consumed then fruit and provides vitamins and minerals in their most raw form.
Drink at least half of your body weight in ounces of stable alkaline water (Aqua OH-) daily. This will promote optimal organ function, electrolyte balance, and reduce cravings. The typical American diet is packed with sugar and processed foods, which throws off your body’s ability to optimize your pH. Although your body naturally has it’s own mechanisms to buffer your pH, many of us are likely living in a state of low-grade acidosis from eating too many low-quality processed, depleted foods [6,7].
Include a high quality source of protein, a heart healthy fat and fibrous carbohydrate at each meal. This is the most absorbable form of amino acids that have been shown to be critical in addiction and recovery.
Vitamin and mineral supplements may be helpful during recovery. A high quality multi-vitamin and mineral supplement, B-complex, vitamin D, omega 3 fish oil, and a probiotic are all recommended to take daily with meals for optimal absorption [3]. Get regular exercise, at least 30 minutes most days of the week.
Aim to get at least 7-8 hours of quality sleep per night.
Reduce caffeine and stop smoking.
Seek help from counselors, therapist and/or support groups on a regular basis.
Another important area in the use of nutrition in recovery and relapse prevention is the addition of appropriate amino acids that serve as the building blocks for powerful chemicals in the brain called neurotransmitters. These neurotransmitters, including epinephrine and nor-epinephrine, GABA, serotonin and dopamine, are closely tied to addiction behavior. With the use of various amino acids, brain chemistry can be changed to help normalize and restore deficiencies in the neurotransmitters that spur cravings that can lead to addiction and relapse. Amino Acid injections are the most potent and effective, and optimal to use during recovery. Oral supplementation is good for long-term use after neurotransmitters have initially been changed. This is also known to suppress the opiate receptors, which greatly aids in recovery.


Simple Carbohydrates/Sugar and Opiate Receptors

Research on mice has shown that their body reacts to sugar through opiate receptor binding. The opiate receptors react to sugar just like it does to addicting substances, which also increase the opiate receptor binding activity. Those who are regularly exposed to sugar tend to consume 30% more calories daily then those who eat a balanced diet that is not particularly high in sugar, this is measured specifically through opiate receptor binding [8]. Aim for more complex carbohydrate sources like quinoa, steel cut oats, sweet potatoes, flax seed, to name a few.

Artificial Sweeteners and Opiate Receptors

Also avoid chemically based non-calorie sugar substitutes, these include, saccharin, aspartame, and sucralose. Non-calories sugar substitutes are typically found in drinks, and diet marketed foods like yogurts, nutrition bars, frozen meals and desserts. Although these sweeteners are not full of calories our brain still recognizes that there is something sweet inside of our body and it instinctively sends a signal to the pancreas to secrete insulin.

Gluten and Opiate Receptor Activity

Gluten has become a common intolerance both mild and more severe with those who suffer from Celiac Disease. Experts believe that the low nutrient over processed broken down wheat in our mainstream cooking flour has caused us to become intolerant to gluten resulting from compromised gut function. The gut and gastrointestinal system is the body’s dashboard for good health, containing healthy bacteria that help keep unhealthy bacteria levels at bay.

In reference to addiction, research has also revealed that gluten like sugar has a similar increased opiate receptor activity. The brain tissue in mice revealed an increase in opiate response specifically when gluten was consumed [11].

Caffeine and Coffee with opiate response

Consuming coffee has been shown to cause opiate receptor binding [12]. This further explains why most people who drink coffee drink it daily and if they consume more than 24 ounces daily they would have withdrawal symptoms if they stopped. Excessive consumption of coffee and caffeine can cause anxiety, auto-immune pain disorders, inflammation, and sleep disturbances. Eliminating coffee and other caffeinated substances from the diet will help reduce the opiate response.

Consuming a diet rich in nutrient dense palatable foods is the key to offsetting the negative effects of opiate receptors [13]. It is common among anyone who is trying to eat healthy, that the food at first will taste and appear bland due to the reduction in sodium, fat, and sugar and in most cases calories [14]. Using fresh herbs, spices, fruits, vegetables and healthy fats will improve the overall enjoyment of the foods, leaving one feeling rewarded and satisfied, not craving anything else. Suppressing the opiate response is a valuable key to successfully beating the addiction and maintaining this will drastically lower the relapse rate.


Nutrition In Recovery by Margaret Soussloff, M.S. & Cara Zechello, R.D., Massachusetts Food Banks and Maria F. Bettencourt, MPH, Massachusetts Department of Public Health – See more at: