Nutritional implications of opioid use disorder: A guide for drug treatment providers.

Abstract

The number of Americans seeking treatment for opioid use disorder (OUD) continues to increase. However, there are important nutritional implications of having OUD that often get overlooked by drug treatment providers. OUDs can cause metabolic changes, constipation, and weight loss, or lead to a lifestyle that results in inadequate food intake and unhealthy eating patterns. Nutritional factors associated with OUD can also hinder treatment outcomes and recovery. Addiction providers tend to give little attention to the nutritional implications of OUD, and this knowledge is rarely incorporated into treatment plans. The goal of this article, therefore, is to summarize the existing literature on the connection between OUD and nutrition to help guide treatment programs. This article (a) describes the nutritional consequences associated with misusing opioids, (b) discusses the role that nutrition can play in OUD treatment and recovery, (c) summarizes the nutritional implications of medication treatment for OUD, and (d) recommends nutritional interventions that might aid in the treatment of OUD. This article directly fills a gap in the OUD literature and has the potential to serve as a guide for drug treatment providers to make more informed nutritional recommendations to their clients. Treatment programs may wish to consider the issues raised in this paper before launching nutritional programs at their facility.

Patterns and Determinants of Weight Gain among People Who Use Drugs Undergoing Treatment for Recovery in Lebanon

“…This finding is supported by many studies showing weight gain and an increase in BMI among PWUD undergoing methadone maintenance treatment (MMT) [ 36 , 54 , 55 ] and residential rehabilitation [ 13 , 56 ]. This increase in weight may be related to engaging in atypical eating habits, where patients substitute their obsession with drugs with that of sweet taste, seeking common euphoric rewards [ 3 , 57 ], impulsive unhealthy eating patterns following drug cessation leading to increased energy intake [ 58 ], and the impact of the psychotropic medications prescribed [ 3 , 30 , 59 ]. Several studies have also reported that MMT practitioners encounter greater consumption of sweet and other palatable foods, leading to higher energy intakes and thus, weight gain and higher BMIs [ 24 , 53 ].…”

“…Considering this, one would assume that this would be ideal for promoting better health in patients, but binging on sugary and high-fat foods has been observed as a compensation for drug use and as a result of boredom from the strict environment [ 37 , 71 ]. Another explanation for this higher weight gain is the highly processed foods offered instead of healthy options due to the limited financial resources of these institutions [ 37 , 57 ]. Finally, weight gain is perceived by underweight participants as a healthy indicator that was targeted and well received in the early phases of the treatment [ 36 , 37 ].…”

A Qualitative Exploration of the Functional, Social, and Emotional Impacts of the COVID-19 Pandemic on People Who Use Drugs

“…In many ways, this suggests that while PWUD should receive tailored risk communication about the COVID vaccine, the content can remain similar to that delivered to other groups with some additional considerations. For example, PWUD may have suppressed immune systems due to HIV infection [ 39 ] and inadequate nutrition and hydration, especially during periods of heavier drug use [ 40 ]. This increased susceptibility to morbidity from COVID-19 should be communicated in a non-judgmental manner.…”

Nutritional parameters and lifestyle practices of people who use drugs undergoing treatment for recovery in Lebanon: a descriptive study

“…To assess the participants’ nutritional status, anthropometric indices alone are not the best indicator. This population group displays hidden deficiencies and disturbed metabolic parameters that need to be deeply investigated by biochemical data, nutrition focused-physical findings, in addition to food addiction (44,49) . Furthermore, validated tools to assess the nutritional status of this population group need to be developed.…”