By: Christina Veselak, MS, LMFT, CN;
Director, The Academy for Addiction and Mental Health Nutrition
I believe that Functional Nutrition and Functional Nutritionists hold the key to transforming the efficacy and success rate of addiction treatment and recovery efforts. However, addiction is not typically addressed nor taught in nutrition circles, and therefore people with addictive disorders as their primary complaint are a massively underserved population.
This is tragic! As I will explain later, the skills and tenets of Functional Nutrition and Nutritional Psychiatry have the power to significantly reduce the discomfort and cravings that people in early and later abstinence or recovery experience, and therefore may significantly reduce relapse and even addiction-related death caused by either overdose or suicide. This is because the underlying biochemical disturbances driving addictive behaviors and relapse are fully within the scope of Functional Nutrition.
The purpose of this article is to de-mystify addiction and the recovery process, address the hesitancy many nutritionists feel about taking on these clients, and to clearly lay out the steps of effective nutritional intervention. I believe that this information is crucial for all nutritionists to understand, even if you have no intention of working with an “addicted” population. Many of your existing clients may be struggling with an addictive disorder which they may not be sharing with you due to embarrassment or unwillingness to address it. Furthermore, many clients with disordered eating or sugar/carb addiction seek the help of nutritionists. Sugar addiction exists and follows the same patterns outlined below. The same biochemical restoration skills which help someone recovering from alcohol, cocaine or heroin use disorder, are also critical in helping someone recover from an unhealthy relationship to food
Addiction is a complex process, driven by brain-chemical imbalances, with psychological, social and spiritual elements. It is considered to be a “disease” or medical disorder because of the dramatic and measurable changes which take place in brain function and whole-body physiology during the addictive process. These changes and processes become self-perpetuating, and are what remove actual choice from the person with these disorders.
I avoid using the term “addict” and I don’t even like using the term “alcoholic” because of the stigma and connotations associated with these terms. These terms raise frightening and off-putting mental images of those with late-stage addiction – the bum living under the bridge, or the kid with heroin use disorder OD’ing behind the Wendy’s dumpster. These images, while accurate for some, only characterize a very small percentage of people living with and struggling with addictive disorders. They also obscure the humanity and the deep, hopeless, shame and suffering of people who have been unable to find a way out, no matter how hard they may have tried. Nobody chooses to become addicted or to stay addicted! The addictive process itself traps them, and progressively removes all ability to choose differently. Even when people do manage to stop using their drug of choice and even seek help, traditional treatment only addresses the psycho-social and spiritual aspects of this disorder – it doesn’t effectively name or address the actual underlying physiological drivers. This is like trying to sit on a 3-legged stool with only 2 legs – it doesn’t work!
Typically, psychotropic medication is the only option offered to alleviate the profound physical and emotional discomfort accompanying withdrawal and what’s called post-acute withdrawal. Oftentimes the meds don’t work, have serious side effects, or people are tethered to them for the rest of their lives, because no way off these medications is ever offered. Most importantly, none of these medications actually repair the underlying dysfunctions. Sometimes they even perpetuate them! So, the post-treatment relapse rate is extremely high, and even expected, because without an in-balance and functioning brain, people can’t even fully engage in the other aspects of the recovery journey. They get swamped by symptoms of depression, anxiety, insomnia, fatigue and cravings. Nobody has told them that they actually have the answer within their own grasp – feeding their brains what the brain needs to repair itself and function optimally. This is where you come in! You do have the training and the tools to help these clients repair their own brains and bodies from the progressive ravages of addiction. You do have the knowledge that can effectively address the biochemistry of addiction. Biochemical restoration through functional nutrition and nutritional psychiatry is the missing link!
We think of effective treatment and a successful recovery journey as a 3-legged stool with biochemical, psycho-social, and spiritual legs. All three legs of this stool need to be addressed at more or less the same time during the recovery process for people to achieve a stable, serene, addiction-free life. So, you as a nutritionist, don’t have to worry that you don’t know enough in general about addiction or the recovery process. Ideally, your clients will already be working with recovery specialists or be in a recovery group where they are focusing on psycho-social healing and spiritual transformation. If not, you can encourage them to find the right support for them. Many, many such resources exist. Your job is to teach your clients to optimally care for their brains and bodies using functional nutritional approaches as outlined below so that they can most robustly engage in the other aspects of their unique recovery journey. Our approach is not another “recovery pathway”! It actually provides the foundation for all of them because they all require an on-line, well-functioning brain, since the brain is our control panel. My motto is that “Its our brain’s job to allow us to cope with stress gracefully, but to do that it needs to be fed optimally!”
So, how specifically can Functional Nutritionists support recovery from addictive behaviors and substance use disorders? Our e-book expands on this, but here are the basics:
- Assess your client’s diet and support appropriate changes. An optimal pro-recovery diet typically includes 15-20 grams of protein every 4 waking hours to both keep blood sugar very stable and to provide sufficient amino acid precursors to re-build the 4 key neurotransmitters systems depleted by addictive behaviors. Of course, other healthy, brain-supportive foods are included as well, but this needs to be the backbone since low blood sugar drives cravings and relapse.
- Use the “Amino Acid Therapy Chart” developed by Julia Ross to evaluate neurotransmitter function and determine possible amino acid interventions. This chart is based on the known symptoms of neurotransmitter depletion and appear to drive accurate dosing 80% of the time. Since low blood sugar and neurotransmitter depletion are the most common saboteurs of a successful recovery journey, just these two interventions along can make a tremendous difference to your client.
- Trial the recommended amino acid in your office or have your client buy and trial them. Since amino acids bring about mood and behavioral change within 20 minutes of ingestion, this assessment process can be very quick and accurate. Other supportive nutrients can be brought in as well, such as a good multi-vitamin and omega 3 supplement.
- There are several other nutrients which can be utilized during an active detoxification process and can significantly reduce withdrawal symptoms and discomfort.
- In the 20% of clients where amino acid, nutrient and dietary interventions don’t make a difference, other underlying physiological issues are present which are within your typical scope of practice. These include digestive issues, food intolerances, hormonal irregularities, inflammation and toxicity. These issues are almost universally missed by the medical staff in a typical addiction treatment program, to the profound detriment of the client.
The book, Seven Weeks to Sobriety, by Joan Mathews Larson provides a thorough introduction to all the above points. The book, The Mood Cure, by Julia Ross, provides a thorough introduction to amino acid therapy. My school, The Academy for Addiction and Mental Health Nutrition provides in-depth training on all of the above.
So, you should now be much more confident about your ability to substantially help those with addictive disorders, as well as those with mental health disorders, with enough training and guidance. However, sometimes other, more emotional reasons exist for avoiding this population. I had several traumatic experiences when I was 16 with addicted friends and acquaintances at school. I had tried very hard to help them, and had failed miserably. It was very painful. So, by the time I was in graduate school at the age of 24 to become a psychotherapist, I was determined to not touch addiction with a ten-foot pole. They were “those” people over there, and so I avoided all addiction classes and training. However, the only job I could find after graduation to get my 3000 supervised hours for my license was in a residential treatment program for court-ordered teenage alcoholic boys! Baptism by fire! At the end of the 2 years there however, I realized that I loved the addiction field and never wanted to leave it. I also uncovered all the addiction in my family of origin. It became clear to me that the trauma in my own family was the other reason I wanted to avoid working with people with addiction. I needed to address my own painful feelings and reactions first. But now that I have, it makes me an even more compassionate and effective healer.
I hope that this introduction answers some of your questions and whets your appetite for more information. Next steps might include reading the above books, attending our free consultation groups and community forums to see how this all works in the real world, and reaching out to me directly with any questions you may have.