One of the first things clinicians at the Addiction Treatment Center at Suburban Hospital in Bethesda, Maryland, do when they meet new patients is ask them to provide a recent history of their consumption -- of food.
"We conduct a nutrition screening during intake. We ask them what they've been eating and how often, to provide their eating habits, such as how many meals they eat, do they eat many fruits and vegetables and whether their addiction has impaired them to the point they have trouble getting organized enough to buy food and feed themselves, and whether they've lost or gained weight without trying to in the last three months," says Beth Kane-Davidson, director of the treatment center. "That tells us whether we want them to see a nutritionist or a physician." Patients in particularly poor nutritional shape are typically sent to a physician, who can order lab work to determine the need for nutritional intervention, including supplements or an IV with nutrients.
Of course, clinicians at the treatment center also quiz new patients about their drinking and drug use; their goal is to help people stop abusing those substances. But the nutrition screening shows the vital role healthy eating habits play in the process of early recovery from drug addiction and alcoholism. Clinicians and people with years of sobriety often advise newly sober people to remember HALT, an acronym common in the recovery community. It means people should not get too " hungry, angry, lonely or tired," any of which could trigger a relapse, Kane-Davidson says.
There's no specific diet that's best for alcoholics and addicts in early recovery, Kane-Davidson and other experts say. But the optimal eating regimen for people trying to kick their alcohol and drug habits do share some common elements with many of the eating plans that perform well on U.S News' annual Best Diets rankings. An optimal plan emphasizes protein from fish, poultry and lean meat, fresh vegetables and fruit, legumes and whole-grain breads and cereals.
[See: U.S News' 38 Best Diets Overall.]
Abstaining from alcohol or drugs is a challenging task, and maintaining good eating habits helps people in early recovery stay away from drugs and alcohol. Here are five nutrition tips from experts:
Establish a healthy eating routine. "It's critical for people in early recovery to develop a foundation of good eating," Kane-Davidson says. "People who've been abusing alcohol and drugs often haven't been practicing good nutrition. Addicts are focused on getting their next high. Many people consuming alcohol excessively don't feel hungry because they're putting a lot of fluids in their body. They're not thinking about what to have for breakfast, lunch or dinner. They need to build up their physical defenses, their whole foundation of health. The importance of overall health in recovery can't be overstated." Newly sober people should try to not only eat healthy foods, but to get in the habit of eating at regular times and make that part of their daily routine, Kane-Davidson says.
Many people who abuse alcohol and drugs struggle with depression, particularly when they're trying to stop drinking and using drugs, says Clare Waismann, a certified addiction treatment counselor at the Waismann Institute, which runs an opioid treatment center in Anaheim Hills, California. Following a healthy diet can help mitigate these mood swings, which helps protect their sobriety, Waismann says. "Depression makes you crave the drug you just detoxed from," Waismann says. "Many alcohol abusers and drug abusers self-medicate to deal with emotions they can't handle. When they feel emotional distress, they reach for the drug or the drink."
Avoid sugar. People trying to kick their alcoholism and drug addiction often battle another habit detrimental to their health: consuming too much sugar. The body converts alcohol to sugar, which causes a spike in blood sugar levels, Kane-Davidson says. When alcoholics quit drinking, their blood sugar levels drop, and they develop sugar cravings. "Their bodies perceive they need more sugar, and they start looking for ways to spike their blood sugar levels," Kane-Davidson says. Keeping blood sugar levels stable is crucial for alcoholics and addicts in early recovery, because dramatic fluctuations could make people feel anxious or depressed and more likely to relapse. Many drug addicts also grapple with sugar cravings, Waismann says, adding that research has shown that sugar has a similar effect on the brain's levels of dopamine -- a neurotransmitter that helps control the brain's reward and pleasure centers -- as drugs and alcohol. Drug and alcohol abuse causes a surge in dopamine levels, which activates feelings of pleasure. "Sugar gives you that fast high and deep crash, which gives you depression," Waismann says. "And when you're in early recovery and feel depressed, you crave the drug you've just detoxed from."
At New Directions for Women, a 30-bed addiction treatment center for women in Costa Mesa, California, the menu features lots of fresh vegetables, fish and whole grains -- but no refined sugar, says Rebecca Flood, chief executive officer of the facility. "We don't want sugar creating elevated levels of dopamine," Flood says. "Sugar is like a drug."
[See: How to Stop Emotional Eating.]
Be careful with caffeine. People in early recovery should limit their caffeine intake to one cup of coffee daily -- ideally in the morning, says Anita Gadhia-Smith, a psychotherapist who practices in the District of Columbia and Bethesda, Maryland. Caffeine can spike sugar levels, she says. "For people in early recovery, caffeine can be highly attractive, because they get a 'hit' but are still sober," Gadhia-Smith says. "But there is a blood sugar crash on the other side of the caffeine." And when people in early recovery crash, they are susceptible to reaching for their drink or drug of choice, she says.
Opt for easily digestible foods. Drug addicts, particularly opioid abusers, often suffer from gastrointestinal distress, says Aimee Noel, clinical director at Sober College, a substance abuse rehabilitation facility for young adults with treatment centers in San Diego and Woodland Hills, California. Opioid abusers often develop constipation, and when they stop using drugs, they may suffer from diarrhea and nausea, she says. Easily digestible foods, such as oatmeal and rice and offerings high in fiber, like vegetables and fruits, are good for substance abusers who have gastrointestinal problems, Waismann says.
Get your vitamins and minerals. Alcoholics are often malnourished because of their poor eating habits, which result in many excessive drinkers obtaining an unhealthy amount of their calories from alcoholic beverages, says Dr. Adrienne Youdim, medical director of the Center for Weight Loss and Nutrition at the Lasky Clinic in Beverly Hills, California. Alcoholics are often deficient in B vitamins, which help the body produce energy from food; vitamin D, which regulates calcium absorption; and minerals like thiamine, which is important for healthy neurological functions, she says. Eating a healthy, balanced diet with lots of fresh vegetables, including green leafy ones, avocados, nuts, fresh fish, poultry and lean meat can help people in recovery get the vitamins and minerals they need, Youdim suggests. Some people may also need vitamin and mineral supplements, something they can talk about with their physician or a nutritionist, Youdim says.
Ruben Castaneda is a Health & Wellness reporter at U.S. News. He previously covered the crime beat in Washington, D.C. and state and federal courts in suburban Maryland, and he's the author of the book "S Street Rising: Crack, Murder and Redemption in D.C." You can follow him on Twitter, connect with him at LinkedIn or email him at firstname.lastname@example.org.