Addiction Unplugged: Nutrition’s Role
The complex relationship between nutrition and addiction is akin to a complicated dance – one where each partner’s move affects the other’s rhythm. Malnutrition appears to be a common companion of substance abuse, and the gut-brain axis has been implicated as having a significant role in this relationship. This blog will unpack the nutritional tie to addiction and offer effective treatment strategies for those struggling with substance abuse.
Nutrient Neglect: Malnutrition
The connection between substance abuse and malnutrition is more common than many might realize, and it can not only complicate their health but also exacerbate drug-seeking behavior. When people struggle with substance use disorders, they often find themselves in a cycle where nutrition takes a back seat. For one, substance abusers often experience decreased appetite, making it challenging to consume adequate nutrition. Additionally, the priority placed on purchasing drugs can lead to the neglect of basic needs, like food. This is compounded by the fact that processed foods, which are often less nutritious, are generally cheaper and more accessible, leading to poor dietary choices. These choices can lead to a cascade of nutritional deficiencies, making the journey to recovery even more challenging.
When we look at the dietary preferences of substance users, the patterns become even more intriguing. Cocaine users, for example, often have irregular eating habits and might rely on just one meal late at night, usually high in refined carbs and fats (Mahboub et al., 2021). On the other hand, opioid users tend to gravitate toward meals that are rich in sugar and alcohols. Stimulant and psychedelic users might cut back on food intake entirely, while those using THC may find themselves bingeing on snacks, especially sugary ones (Simpson et al., 2021). Across the board, there's a marked preference for sweet and sugary foods among the general drug-using population, which can create additional health challenges.
Adding to these challenges is a noticeable deficit in nutrition knowledge among individuals struggling with substance abuse. Recovery programs that include nutrition education have found that, while cravings don’t magically disappear, many people still make an effort to add healthier foods to their diets (Mahboub et al., 2021). This really underscores the need to address the nutrition knowledge gap, as once individuals have the right information, they appear more likely to prioritize nourishing foods.
Malabsorption is another critical factor contributing to malnutrition among substance users. Drugs and alcohol can cause gastrointestinal problems that prevent the body from effectively absorbing essential nutrients, and as a result, deficiencies in critical vitamins and minerals like selenium, potassium, iron, and vitamins A, C, D, and E are common. B vitamins and amino acids, important for energy metabolism and overall well-being, are often poorly absorbed as well. Thus, not only are many individuals eating poorly, but their bodies are also struggling to utilize whatever nutrients they manage to take in. Understanding this relationship between substance abuse and malnutrition is essential for developing effective interventions that address both issues, paving the way for improved health outcomes and recovery paths.
Appetite Regulation
The appetite regulation process has also been implicated in the science behind substance abuse. Your brain has specific regions responsible for controlling hunger and eating behavior, and guess what? Those exact same areas are believed to also be involved in substance use disorders. When we eat food, it triggers the release of dopamine, that “feel-good” chemical that makes us feel pleasure. But when we use drugs, especially those that are addictive, they can flood our brain with way more dopamine, sometimes up to 10 times more than what we get from food (Yale Medicine, 2022). This extreme rush reinforces the craving for the substance, making it harder to stop. It’s like the brain’s "feel-good" buttons get stuck on repeat, keeping you in a cycle of seeking more.
It’s also important to consider the role of gut microbes in addiction. Substances like opioids and alcohol can actually change the balance of bacteria in your gut, which has a ripple effect on your overall health and even how your body processes drugs. For example, opioids are infamous for causing constipation because they slow down gut movement, and long-term alcohol use can mess with liver function, metabolism, and even gut lining. But it’s not just about how drugs affect digestion. Our gut microbes play a role in how our body processes these substances, too. They can metabolize drugs, alter their effectiveness, and even modify withdrawal symptoms. Some studies suggest that our gut bacteria are involved in how we experience both natural rewards, like food, and artificial ones, like drugs (Barron, 2023). Additionally, poor gut health, marked by decreased microbial diversity and an increase in bad bacteria, like Staphylococcus, has been linked to an increased risk of developing substance use disorders.
Gut hormones play another crucial role in appetite regulation and addiction. Ghrelin, the hormone that makes you feel hungry, has been found to do more than just encourage eating. It also cranks up the craving for drugs. When ghrelin levels rise, it can make you want to use substances even more. With that, ghrelin continues to make drug experiences even more intense through its ability to activate the dopamine system. GLP-1, another hormone that regulates hunger, can reduce the rewarding effects of addictive substances. So, these hormones don’t just control what you eat; they also influence how your brain responds to drugs. And then there’s leptin, another hunger hormone that’s tied to addiction. When you’re going through withdrawal, leptin levels often increase, which may signal your body to start drinking or using again. But when leptin drops, it’s associated with more time in withdrawal. It’s all connected. This interplay of hormones and addiction is further illustrated by the concept of "locomotor sensitization," where repeated use of an addictive drug leads to heightened sensitivity to its effects, often causing a much stronger response to the drug over time. This phenomenon has been shown to play an important role in addiction. All in all, the relationship between appetite regulation, the brain, and addiction is a complex web, with hormones, gut microbes, and brain circuits all influencing each other.
Exercise Addiction and Eating Disorders
There’s a complex relationship between substance abuse, eating disorders, and exercise addiction, and research has shown that they often intersect in surprising ways. Research tells us that about 50% of people with an eating disorder also struggle with substance misuse, and those who engage in binge eating and purging behaviors report even higher rates of substance abuse (Eating Disorders Victoria, 2024). It’s clear that these conditions aren’t isolated from one another, rather, they share a lot of common ground, particularly when it comes to the brain’s reward systems. There's growing interest in how the brain's reward system, which governs both our drive for food and substances, plays a central role in these behaviors. Essentially, binge eating and drug abuse share a commonality of loss of control, driven by similar neurological processes. The dopamine and opioid systems are central to both. Dopamine drives the motivation to pursue rewarding activities, while opioids play a role in the pleasure and enjoyment we experience from those activities. When it comes to binge eating and substance use, both are influenced by dysfunctions in these systems. In fact, people with binge eating disorder and substance use disorders often have decreased activity in the prefrontal cortex, the area of the brain involved in decision-making and inhibitory control. This means that individuals with either condition struggle to control their impulses and are more likely to seek out rewarding behaviors, whether that’s food or drugs.
What we eat may also influence how we interact with substances. Recent studies have shown that the composition of a person’s diet, particularly the amount of sugar or fat, can affect their craving and consumption of drugs (Blanco-Gandia et al., 2021). In other words, high-fat and high-sugar diets have been shown to increase the intake of substances like alcohol or nicotine, suggesting that the foods we eat may actually prime our brains for more addictive behaviors.
Then there’s exercise addiction, which often co-occurs with eating disorders and substance abuse, further complicating the picture. Many individuals with exercise addiction also experience anxiety, depression, and body image issues, further fueling their addiction to working out. This compulsive exercise can become tied to restrictive eating habits, where the obsession with "perfecting" the body extends beyond exercise and into eating. In fact, the obsessive tendencies seen in exercise addiction can even extend to food, leading to conditions like orthorexia nervosa, where the individual becomes fixated on eating only “healthy” or “clean” foods. Research suggests that 15-20% of people with exercise addiction also struggle with substance misuse, including alcohol, nicotine, and illicit drugs, and when it comes to eating disorders, the overlap is even more pronounced (Freimuth et al., 2011). Between 39-48% of individuals with eating disorders also suffer from exercise addiction. Additionally, some estimates suggest that up to 80% of individuals with anorexia, bulimia, binge eating, or other eating-related disorders also engage in unhealthy exercise behaviors (Godoy-Izquierdo et al., 2021). In short, the relationship between substance abuse, eating disorders, and exercise addiction is deeply interconnected, and the same brain pathways that govern our cravings for food and drugs also play a role in compulsive exercise.
Nutrition for Recovery
Nutrition for addiction recovery is definitely not a one-size-fits-all approach, and it is heavily recommended that you seek guidance from a healthcare professional. That said, there are a few general tips that can help set you up for success:
Water: prevents dehydration and helps your body helps your body take in medications for mental health or withdrawal and stops symptoms like feeling agitated or having trouble concentrating.
Omega-3 fatty acids: foods like fatty fish, chia seeds, and walnuts are rich in omega-3s, which can help neurotransmitters to balance brain chemicals, making you feel more calm and content.
Complex carbohydrates: whole grains and legumes are rich sources of complex carbs, and they can help the brain produce more serotonin, helping to improve mood and sleep while decreasing irritation and depression.
Antioxidants: antioxidants can help reduce oxidative stress, support brain health, and support the detoxification process. Berries, nuts, and seeds are a few examples of foods rich in antioxidants.
Iron, folate, vitamin B12, vitamin B6: fruits, veggies, and lean meats are rich in these nutrients, and they can support sleep, lack of focus, and depression.
The connection between substance abuse and nutrition is a lot deeper, and more complicated, than we might first think. From malnutrition caused by poor eating habits and substance misuse to the gut microbiome’s sneaky role in fueling both addiction and cravings, it’s clear that what we put in our bodies impacts more than just our energy levels. Throw in the overlap with eating disorders and exercise addiction, and it’s easy to see why these issues so often go hand-in-hand. The brain’s reward systems, hormones, and gut bacteria all play a part in the vicious cycle of craving and using, making recovery a multifaceted journey. But understanding these connections is key to breaking the cycle and healing, whether it’s nourishing the body, resetting the gut, or learning to rebuild healthier relationships with food and exercise. With the right mindset, education, and support, it's totally possible to reset our bodies, balance our brains, and break free from those old, unhealthy habits.