Presented by:
Presented by
Josephine C. Kannike-Martins, PhD., RD., RASi
Medi-Cure Health Services, Inc.
P. O. Box 8360, Los Angeles,
CA 90008
P: [323-295-1136; F: [323] 295-1071
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Examine the Implication of addiction on
nutritional well being
Strategies for intervention
Create awareness
Become an advocate
Understand it’s prevalence within our
population
Terminology:
Substance Use Disorders (SUDs) aka
(Substance Abuse)/addiction
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20% of total hospital costs in the U.S. are due
to medical care caused by SUDs
Up to 40% of all Americans in hospital beds
are treated for complications of alcohol abuse
& alcoholism
One in every five Medicaid dollars spent on
hospital care and one in five hospital daysattributed to SUDs
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Individuals who abuse alcohol, tobacco &
other drugs are hospitalized twice as long as
other individuals
75% of chronic pancreatitis is caused by
alcohol abuse
65% of the strokes among young Americans
are related to cigarette, cocaine or
amphetamine use
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Youth under fifteen years of age are
hospitalized longer for illness if they abuse
psychoactive substances
SUDs (all inclusive) psychoactive drugs/
OTC/Rx
Nutrition & Addictions A Guide for Professionals: Ann S. Hatcher, EdD, RD (ret) CACIII, NCACII,2008
Direct effects
 Depletion of nutrient stores
 Malabsorption of nutrients
 Disrupts utilization of nutrients
Indirect effects
 Irritation of the mucous lining of the stomach
 Diuresis, Constipation, decreases sensitivity
of taste, altered perception of odors,
decrease sense of feeling, decreases
motivation & alterations of visual perception
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Malnutrition may be visible.
Weight loss – may be the intended reason for
using.
Dry skin and hair.
May be concealed by weight gain & the
appearance of health
Prevalence of fractures common among
alcoholics
Impaired nutritional status
Emilio Gonzalez-Reimers et al., Vitamin R & Nutritional Status are Related to Bone Fractures in Alcoholics;
Alcohol & Alcoholism, Vol. 46, N2., pp148-155, 201.
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Preoccupation with acquiring and
using drugs
Compulsion to use despite
negative consequences
High relapse rate regardless of
negative consequences.
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Addiction is a chronic disorder lasting over
time
Effects on the body depends on substance of
choice
Major physical impact is on the hepatic system
Regular use enables reward from the drug and
decreases reward from non-drug related
activity & controls major decision making
High risk: - The elderly, adolescents, binge
drinkers
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Possible individual difference in sensitivity to
neurochemical reward
Commonalities between SUDs & overeating
associated with obesity
SUDs & obesity aggravated stressors leading
to dopamine-modulated neurobiological
adaptation
Positive correlation between alcohol &
anthropometric markers of adiposity
Davis C., Patte K, et al., From Motivation to Behaviour: A Model of Reward Sensitivity, Overeating, & Food
Preferences in the Risk Profile for Obesity.
Volkow N D, et al., How can Drug Addiction help us Understand Obesity? Nat. Neuroesci. 2005;8(5: 555-560.
(PubMed: 15856062).
C. Dumesnil et al., Alcohol Consumption Patterns & Body Weight; Annals of Nutrition Metabolism, 2013; 62:91-97.
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There are many nutrition-related
consequences of SUDs
Diet history – reveals changes in eating
patterns
Often ignored due to shortcuts
Lacking the motivation to change or
readiness for change
Stage of change model
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The goal is to assist recovery/harm reduction
Repair damage to health, mental, physical &
emotional
Treatment Programs do not always include
nutritional assessment or nutrition education
May not show nutritional deficiencies at
admission, often develop nutritional
health problems
Good nutrition replenishes nutrient
deficiencies
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Assessment information should drive the
treatment plan.
Working with high risk populations
Collaboration of services with care providers
Well designed health education
Good nutrition & self-efficacy
Diet & Exercise
Crucial pathway: self-care & commitment to
staying sober
P. Bardadiri et al., Effect of Edu. Intervention on Nutritional Behavior in Alcohol-Dependent
Patients, Alcohol & Alcoholism, Vol. 1, pp 77-79, 2011
David A. Wiss, Self-Efficacy & Nutrition: Promoting Behavior Change in Substance Abuse Recovery, BHN
Newsletter, pp 12-13. Winter 2012.
Questions/Answers
Thanks for your participation!!