Nutritional status and eating habits of people who use drugs and/or are undergoing treatment for recovery: a narrative review

Abstract

A comprehensive overview is presented of the nutritional issues faced by people who use drugs or are undergoing treatment for recovery. Chronic substance use affects a person’s nutritional status and body composition through decreased intake, nutrient absorption, and dysregulation of hormones that alter the mechanisms of satiety and food intake. Anthropometrics alone is not the best indicator of nutritional status, because this population has hidden deficiencies and disturbed metabolic parameters. Socioeconomic factors (eg, higher education, higher income, presence of a partner, living at home) positively affect nutritional status. Scarce available data on users undergoing treatment indicate improvement in anthropometric and metabolic parameters but with micronutrient intake remaining suboptimal. Weight gain is noted especially among women who use drugs and potentially increases their risk of relapse. Finally, specific amino acids and omega-3 fatty acids are promising in decreasing relapse and improving mental health during treatment; however, additional high-quality studies are needed. Nutrition intervention for people who use drugs or are undergoing treatment for recovery is underused; comprehensive programs addressing this population’s unique needs are necessary. Future research will identify which components are needed.

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

“…This was specifically among PWUD undergoing MMT ( 6 , 7 , 10 , 39 , 40 ) and residential rehabilitation programme ( 41 – 43 ) . The increase in weight, which was more common in the rehabilitation group, could be also attributed to the structured meals offered in the in-patient residential centres, the cravings for sweets as a replacement for drugs, and the excessive eating as a diversion from the frustration of the strict environment imposed ( 38 , 44 ) . Furthermore, this weight gain was perceived as a sign of health to compensate for the weight lost during addiction ( 38 ) .…”

“…Excessive weight gain promotes risk for a variety of health outcomes and remains of a potential clinical and medical significance. Additionally, body dissatisfaction, usually arising from overweight, may be a trigger relapse, especially among females who use drugs ( 10 , 44 , 45 ) . This increase in weight, high adiposity and overnutrition comes in parallel with the high reported energy intake among the participants undergoing both treatment modalities.…”

“…The short duration of treatment among our participants, mainly in the rehabilitation group, may explain this weight gain observed. Available studies confirm increased weight gain and binge eating during the early phase of treatment, as opposed to a more structured pattern in the latter phase, which typically occurs 6 months post-treatment entry ( 41 , 44 ) . Regardless of the precise mechanism involved in the weight gain among this population group, identifying predictors of weight gain would be extremely helpful allowing for preventive measures to be adopted during treatment.…”

“…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.…”

“…Their finding was mainly attributed to the increased intakes of energy-dense foods, rather than nutrient-dense ones ( 11 , 12 , 59 ) . Nevertheless, assessing the nutritional status of PWUD only by anthropometric measurements and dietary intake may not reveal severe malnutrition, as hidden deficiencies might exist and can only be detected through measuring plasma nutrients ( 2 , 44 ) .…”