Produced by Tricia Parido March 3, 2016
The purpose of this study is to validate the relationships between substance dependence, withdrawal, food addiction and recovery. The intention is to show how most afflicted with substance addiction have disordered eating habits that during detoxification turn into highly intense cravings for particular food ingredients. And also to illustrate how these particular attributes can be attributed to increased post-acute withdrawal, relapse, and the development of a potential food addiction.
In a brief summary of the specific section on the particular topic, “When drug addicts turn into food addicts” in the course manual for Nationally Certified Food Addictions Coach NCFAC-I, (Dr. Cali Estes, The Addictions Academy), it is documented that many people with substance abuse cross over to food addiction. The eating issues are due to a low level of dopamine receptors, either from the outset or caused by the behavior, meaning they increasingly have to seek more dopamine inducing substances to reach a level of reward they can enjoy. After someone dependent on a substance or food stops using it, it takes time for depleted dopamine receptors to return to baseline. During this resetting, the person may feel down, irritable, or lethargic.
As this brief study illustrates, with the attention, education and discipline surrounding a dietary plan and impulsivity during recovery and throughout life, an individual can achieve homeostasis. Without a healthy nutrition plan and without actively working on impulse control issues, food addiction can develop, substance use relapse can occur, and emotional instability will be reinstated.
The primary reason that sparked my decision to conduct research on the relationships between substance dependence detoxification and food addiction was the high levels of specific food cravings reported among the early stage addiction treatment clientele on my specific case load. During session conversation, one of the many topics that are reported on is the individual’s’ appetite. Therefore, it was easy to observe that there was a significant amount of statements reporting high sugar craving along with the compulsive consumption of processed foods high in fats, sugars, and preservatives.
With a caseload at any given time of 8 or more clients, the pattern of strong cravings and compulsive food indulgence intrigued me. The understanding of this observation and the desire to search for a solution or at best become armed with the knowledge to properly educate the population I serve became of importance to my practice. (Institute for Inquiry, par.3) Cross addiction from one substance or behavior to another is a statistical fact that is highly prevalent within the recovery practice, and the ability to counsel around it is taught in the certifying educational paths. However, the focuses found in the courses that discuss cross addiction are generalized, and nutrition is not a major topic. In fact, the discussion is typically approached by noting issues such as cortisol and dopamine levels, which are important to know, however, would be more impactful if the role of sustenance was incorporated.
It was not until I completed my credentialing for Food Addiction Coaching at The Addictions Academy that I realized the benefits my observations could provide scientifically to my profession. It is of my opinion and the intent of this study to show that with the implementation of nutritional guidance the detoxification process and the cross over into food addiction can be improved. Such an achievement can be accomplished by educating the professional providers and this specific population on the importance of nutritional practices, the role it plays in the health of every being, and the importance gathering the appropriate data for each individual to find the right fit for their physical make-up. (Pearson Benjamin Cummings. Chapter 1, pp. 31-32).
Methods and Materials:
The first step that I took to launch my study was to increase the depth of the questions around appetite from the simple “How is your appetite?” to “How is your appetite? Are you having any specific cravings? Do you notice any specific times of the day when the cravings are higher? What types of food are you eating? And, Do you notice any specific mood or emotional state around your eating periods?” This conversation then allowed for me to note specific data as well as make dietary recommendations to ease the episodes of compulsive consumption of foods and illustrate the association in the behaviors that mirrored the addiction to their substance of choice.
Following the increased focus on food cravings, the presentation of other physiological symptoms began to be presented. Of these were reports of shakiness, night sweats, fatigue, low or flat affect, and vivid “using” dreams. In my studies on food addiction, the professor introduced us to several tools that are useful for tracking and identifying behavior one of which was a food/mood journal. This simple form gets the client engaged in the process of self-identification by having them fill in the blanks with each meal and snack answering the questions; I ate, I felt, I was doing, and reporting any specific triggers, and cravings at each occurrence. Believing that this form of journaling could have benefit to my clients progress and assist them in their stabilization through the detoxification period, I began to use it as an assignment for the week between sessions.
The next step was the review and self-realization period. My standard length of time with any particular client is 12 weeks. The first two weeks entail rapport building and getting to know each other. The first two steps mentioned previously typically take place in weeks 3 through 6 which allowed for sufficient time for me to analyze behavior spark interest in the client’s desire to make adjustments to their impulse control opposed to only focusing on abstinence from their substance of choice. By week 6 or 7, the client now has developed objective data surrounding their behavior, thoughts, feelings, and emotions around their dietary habits. They have recorded days where they have followed recommended nutritional practices and days that they have given in to their impulses and had the outcome of each day in writing. We now can review and discuss how their food intake influences not only their recovery from substance abuse but also how it affects their interpersonal relationship, emotional well-being, and life balance.
Results and Conclusion:
The results and findings that were most prevalent among eight particular clients both male and female, with varying substances of choice as well as differing cognitive abilities and levels of emotional stability and history of trauma were consistent as follows:
- Depending on the substance of choice, dietary practices are maladaptive through restricting or abstaining during addiction.
- During withdrawal, the intensity of cravings for these foods is very high, and impulse control is fragile.
- Through session interaction, appropriate questioning, and data compilation through the food/mood journal the withdrawal period as well as the early stages of recovery revealed binge and compulsive eating consisting of high levels of processed foods high in fats, sugars, and preservatives.
- With a nutritional plan that consisted of 4-6 small meals containing natural foods, fruits, vegetables, lean protein, and other healthy choices, the emotional state balanced out, cravings for substance use were significantly reduced or nonexistent, agitation and irritation tolerance levels were greatly improved, higher levels of concentration were reported, statements of symptomology around post-acute withdrawal severity were drastically reduced, and the clients experienced dramatic increase in feelings of progress toward achieving their desired goals.
- During reported periods of deviation from the nutritional plan clients reported a reduction in coping skills, an increase in impulsive behavior; returning cravings as well as using dreams were evident.
- The three clients that did experience a relapse during their treatment program all reported that they were not following the dietary plan with or without other non-compliant issues.
- With a return to the nutritional plan, a balance was restored after each deviation or relapse.
Conclusion with this particular focus group is that during the detoxification period and through the early stages of recovery subjects presented most with high levels of specific food cravings. With a balanced nutrition plan, stability was attainable, without it, stability was disrupted.
Institute for Inquiry http://www.exploratorium.edu/IFI/about/philosophy.html
Course Text: Thompson, J., & Manore, M. (2013). Nutrition for life (3rd ed.). Upper Saddle River, NJ: Pearson Benjamin Cummings. Chapter 1, pp. 27-34.
Nationally Certified Food Addictions Coach NCFAC-I
Presented by Cali Estes Ph.D, MCAP, ICADC. The Addictions Academy. Course manual pp.35