Research: Substance Use/Abuse in MS; Nutrition for Recovery

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Research: Substance Use/Abuse in MS; Nutrition for Recovery

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2017 review: Nutrition for Substance Abuse Recovery

The importance of nutrition in aiding recovery from substance use disorders: A review
http://www.sciencedirect.com/science/ar ... 1617303915

"Highlights
•Malnutrition is prevalent among individuals with alcohol and drug use disorders.
•There is little nutritional advice for those recovering from substance use disorders.
•Addiction and appetite share interacting brain and behavioural processes.
•Malnutrition in substance use disorders may promote drug-seeking and impede recovery.
•Effective treatments should incorporate nutritional assessment and therapy.

Abstract

Background
Nutrition is a prerequisite for health; yet, there is no special nutritional assessment or guidance for drug and alcohol dependent individuals, despite the fact that their food consumption is often very limited, risking malnutrition. Further, the premise is examined that malnutrition may promote drug seeking and impede recovery from substance use disorders (SUD).
Method
A narrative review addressed the relationship between substance use disorders and nutrition, including evidence for malnutrition, as well as their impact on metabolism and appetite regulation. The implications of the biopsychology of addiction and appetite for understanding the role of nutrition in SUD were also considered.
Results
The literature overwhelmingly finds that subjects with alcohol use disorder (AUD) and drug use disorder (DUD) typically suffer from nutrient deficiencies. These nutrient deficiencies may be complicit in the alcoholic myopathy, osteopenia and osteoporosis, and mood disorders including anxiety and depression, observed in AUD and DUD. These same individuals have also been found to have altered body composition and altered hormonal metabolic regulators. Additionally, brain processes fundamental for survival are stimulated both by food, particularly sweet foods, and by substances of abuse, with evidence supporting confusion (addiction transfer) when recovering from SUD between cravings for a substance and craving for food.
Conclusion
Poor nutritional status in AUD and DUD severely impacts their physical and psychological health, which may impede their ability to resist substances of abuse and recover their health. This review contributes to a better understanding of interventions that could best support individuals with substance use disorders."

this is so important and has been pretty challenging to track down in the lit to date.
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2016 study: Impact of Nutrition on Alcohol & Drug Use

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You Are What You Eat: The Impact of Nutrition on Alcohol and Drug Use (2016)
https://www.tandfonline.com/doi/abs/10. ... 16.1212603

ABSTRACT
Background: Experimental research has shown that nutrition influences behavioral deviance. Objectives: The current project addresses the impact of nutrition on problem alcohol and drug use in a nationally representative sample of US adults. Methods: The study relies on the daily dietary nutrition data and the substance use measures in the 2007–2008 National Health and Nutrition Examination Survey. Results: The findings generally show that macronutrients increase the odds of substance use and micronutrients decrease the odds of substance use, especially among females. In addition, nutrient imbalance is a particularly strong predictor of substance use for both males and females. Depression partially accounts for the relationship between dietary nutrition consumption and substance use. Conclusions: Nutrition represents a promising extension of the biosocial perspective in substance use disorders.
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2016 study design: Nutritional Therapy for Opioid Addiction

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The Use of Sobriety Nutritional Therapy in the Treatment of Opioid Addiction (2016)
fft: https://hosting.uaa.alaska.edu/afpmc/Cu ... herapy.pdf

Abstract
Background: This paper describes a pilot project research methodology design to be used at a narcotic drug treatment Centre with patients, addicted to opioids, who are enrolled in a Methadone maintenance program.
Materials and method: The research question is, will sobriety nutritional therapy reduce the desire for opioids among patients who are participating in a methadone maintenance program, resulting in improved health, social functioning, and quality of life? An experimental group of 10 patients and control group of 10 patients will be selected from among the 121 patients currently served by the agency. Pre-testing and post-testing will occur with the study lasting for a six month period. The nutritional interventions will be individualized based upon the assessed needs of each participant in the experimental group. Review of the literature responding to the nutritional difficulties experienced by people who abuse opioids and various interventions inform how the study is conducted.
Conclusion: It is believed that the intervention proposed will be successful in improving not only the nutritional levels of patients but also resulting in improved social functioning in their environment.
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2010 paper: Nutrition in Addiction Recovery (or just Life).

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Nutrition in Addiction Recovery (2010)
fft: http://mhof.net/sites/default/files/Add ... Report.pdf

"This document has been prepared to educate people about how drugs and alcohol can disrupt the normal functioning of the body and how better nutrition can help diminish some of these biochemical and digestive problems. This document only focuses on one specific component of a comprehensive recovery treatment program—better nutrition. It is not intended to be used as a substitute for a doctor’s advice or as a recovery treatment program.

While research indicates that vitamin supplementation (e.g., amino acids, vitamins) may also be used successfully to support addiction recovery efforts, especially at the start of a recovery program when biochemical imbalances are at their highest, this document primarily focuses on how to get the proper nutrients from food. Although the information contained herein was specifically compiled to help recovering drug and alcohol addicts, it may be useful to a wide range of people who work or live with recovering addicts or for people who consume a “typical American diet” heavy in carbohydrates, sugar, and caffeine.
  • 'Although we all eat, few really think about what we are eating and what it can do to our bodies.
    We rely on very incomplete, simplistic, and often incorrect bits of nutritional “knowledge” in
    making our food choices, and we expect our bodies to cope with whatever we give them. In
    recovery, this kind of behavior simply doesn’t cut it (Beasley and Knightly, 1994).' "
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2004 study: Alcohol and drug abuse among persons with MS

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Alcohol and drug abuse among persons with multiple sclerosis (2004)
https://journals.sagepub.com/doi/abs/10 ... 504ms989oa

Abstract
Objective: To examine the one-month prevalence and impact of substance abuse in a large community sample of persons with multiple sclerosis (MS). Method: Members of the Multiple Sclerosis Society of King C ounty were surveyed by mail. This multifaceted health survey included questions pertaining to substance abuse. Seven hundred and thirty-nine out of 1374 potential participants (54%) returned the survey, while 708 reported a medically confirmed diagnosis of MS and provided sufficient data. Results: Fourteen per cent of the sample screened positive for possible alcohol abuse or dependence, and 7.4% reported misusing illicit drugs or prescription medications within the previous month. Possible alcohol abuse and drug misuse were associated with younger age, less severe MS related disability and being employed, as well as greater self-reported depressive symptomatology. Most persons with alcohol problems indicated interest in learning more about ways to stop or cut down. Conclusions: Substance abuse may be present in up to 19% of this sample and contribute to high rates of depression. There may be greater risk of harm due to substance abuse in people with MS because of the potential magnification of motor and cognitive impairments. Comprehensive MS care should include substance abuse screening and advice to cut down or abstain.
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2014 study: Alcohol and substance use in multiple sclerosis

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Alcohol and substance use in multiple sclerosis (2014)
https://www.sciencedirect.com/science/a ... 0X13031006

Abstract
Background
Few studies have examined the prevalence of alcohol and drug use in individuals with multiple sclerosis (MS). The current study sought to examine the prevalence and associated demographic, disease-related, and psychological correlates of substance use in an East Coast United States outpatient MS sample.

Methods
157 individuals with MS completed questionnaires prior to, during or after their visit with an MS neurologist. These questionnaires included: the Alcohol Use Disorders Identification Test—Consumption (AUDIT-C), CAGE, CAGE—Adapted to Include Drugs (CAGE-AID), Patient Health Questionnaire—9 item (PHQ-9), Beck Depression Inventory—Second Edition (BDI-II) and Hospital Anxiety and Depression Scale—Anxiety (HADS-A).

Results
On the AUDIT-C, 40% of individuals with MS met or exceeded the cutoff for excessive alcohol use. They were more highly educated and younger than non-drinkers. Utilizing the CAGE, 6% of the sample met criteria for a lifetime history of excessive alcohol use and men endorsed higher rates of alcohol use than women. Only a small portion of the sample endorsed a history of drug use (CAGE-AID, 4%). Drug use was associated with greater disability and depression symptoms, but lower self-reported anxiety.

Conclusions
Current alcohol use was prevalent in this sample, and excessive use was associated with men, younger age, and more education. Reported drug use was minimal and associated with greater disability, more self-reported depression, but fewer anxiety symptoms.
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2012 study: Tobacco Addiction, Magnesium and Zinc Involvement

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haven't read the full text yet, but it looks like the emphasis is definitely on the magnesium aspect:

Magnesium and Zinc Involvement in Tobacco Addiction (2012)
fft: http://citeseerx.ist.psu.edu/viewdoc/do ... 1&type=pdf

Abstract
This paper is a review regarding magnesium and zinc influence on smoking and tobacco addiction. Magnesium
and zinc are two very important bivalent cations involved in different functions of central nervous system. There are
different mechanisms by which magnesium can decrease the nicotine addiction. Magnesium decrease the dopamine
release and the NMDA receptor stimulation by glutamate (two essential steps in the devolopment of nicotine addiction).
This cation also inhibits the synthesis of substance P and nitric oxide, others important neurotransmiters involved in
addiction. Magnesium may decrease the nicotine effect on GABA synthesis and could reduce also NPY involvement
in nicotine addiction. Zinc also reduces the glutamatergic brain systems activity and modulates the nicotinic receptors
activity from brain. The hypomagnesemia favorises the development of tobacco addiction .The magnesium treatment
can be beneficial for reducing the smoking and nicotine addiction in heavy smokers. By increasing the magnesium
concentration we can moderately improve the stimulation of the reward system and can reduce the needs of stimulation
by nicotine or by others addictive substances. The treatment of intracellular and plasma magnesium deficit could be way
to minimize the development of tobacco smoking and nicotine addiction.
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2019 chapter: The Role of Nutrition in Addiction Recovery

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can't access more than this unfortunately

The Role of Nutrition in Addiction Recovery: What We Know and What We Don't (2019)
https://www.sciencedirect.com/science/a ... 856400002X

With substance use disorder rates rising, there is an urgent need for new and effective treatment modalities. The utilization of nutrition services in addiction treatment has not been standardized, but there is a growing trend toward incorporating registered dietitian nutritionists into the treatment team. Nutrition therapy should address the most serious medical and nutritional conditions first and then target the psychological and behavioral aspects of eating. This comprehensive review provides an overview on the impact of alcohol, cocaine, methamphetamine, and opioids on nutritional status. This chapter places particular emphasis on gut health, microbiome, and associated neural interactions. Homeostatic and hedonic mechanisms of eating behavior are discussed in the context of eating disorders and food addiction. In summarizing the available published evidence on human subjects, a case is made for both individual nutrition counseling and group education, as well as the implementation of food service guidelines. Given the current crisis of addictive disorders, consideration should be given to prioritizing efforts to improve eating habits and overall health in recovery programs. By promoting positive recovery outcomes, nutrition may reduce costs and improve resource allocation. Public health measures promoting nutrition standards in treatment settings should be implemented. Guidelines for nutrition interventions will be proposed, and a summary of where more information is needed will point toward future directions.
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RCT: Nutrition to Quit Smoking

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Novel Mineral–Vitamin Treatment for Reduction in Cigarette Smoking: A Fully Blinded Randomized Placebo-Controlled Trial (2019)
https://academic.oup.com/ntr/article-ab ... 96/5078611

"...
Implications
Micronutrients are being increasingly studied for the treatment of psychiatric conditions, but direct application of micronutrients as a treatment for addictions is novel. There is extensive evidence that micronutrients alleviate stress. Given that tobacco smoking is often used to cope with stress, taking micronutrients may moderate the stress of withdrawal and increase the chance of a successful quit attempt. This study is the first known RCT to investigate the use of micronutrients to support smoking cessation. Treatments that are safe, effective, relatively inexpensive, and readily available are needed and micronutrient supplements offer one such possible alternative."
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Nutrition and opioid use disorder

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Nutritional implications of opioid use disorder: A guide for drug treatment providers (2020)
https://psycnet.apa.org/doiLanding?doi= ... adb0000575

"... 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."
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quitting smoking = MS win win

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Modifiable risk factors for poor health outcomes in multiple sclerosis: The urgent need for research to maximise smoking cessation success (2020)
https://journals.sagepub.com/doi/full/1 ... 8519858730

"...smoking cessation significantly reduces the risk of reaching disability milestones, and the earlier people with MS or clinically isolated syndrome (CIS) quit, the stronger this effect (risk reduction is approximately 30% per 10 years).13
Given that increased disability leads to exponentially higher economic costs in MS, lowering smoking rates may lead to substantial economic benefits, in addition to improvements to health outcomes and quality of life. ..."
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smoking x MS: quit ASAP

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more smoking = more lesions

The impact of modifiable risk factors on lesion burden in patients with early multiple sclerosis (2020)
https://www.sciencedirect.com/science/a ... 4819309575

"... Our results show that smoking status, probably due to chronic vascular and neurotoxic effects of the cigarette components, can affect the brain damage from the early stages of MS. No association was observed with the other explored modifiable risk factors ... "
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smokers' nutrition FYI

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Cigarette smoking - nutritional implications
https://pubmed.ncbi.nlm.nih.gov/1784736/

"... imbalances in [macro- and micronutrients] may have a role in many of the pathological conditions attributed to smoking. ... Vitamin E, vitamin C, B-carotene and selenium are involved in the overall cellular anti-oxidant defense against deleterious effects of reactive oxygen species.

Smoking has been shown to lower the level of vitamin C and B-carotene in plasma. Cadmium, naturally found in tobacco, decreases the bioavailability of selenium and acts antagonistically to zinc, a cofactor for the antioxidant enzyme, superoxide dismutase.

Vitamin E, the principle lipid-soluble antioxidant, may be at suboptimal levels in tissues of smokers. In addition, tobacco constituents have been shown to reduce levels of several vitamins of the B-complex. Nutritional status in smokers may be further compromised by an inadequate diet."


Smokers report lower intake of key nutrients than nonsmokers ...
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5659353/

"... Compared to nonsmokers, the smokers reported lower intakes of energy, total polyunsaturated fatty acids, linolenic acid, docosahexaenoic acid, total sugars, calcium, iron, magnesium, phosphorus, potassium, vitamin C, riboflavin, niacin, pantothenic acid, vitamin B6, folate, vitamin A and vitamin E. ...

... the reported nutrient intake of the smokers was substantially lower than nonsmokers for key nutrients and they were more likely to not comply with the DRI for essential nutrients placing them as increased risk of chronic disease."
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