Nutrient and Food Component Supplementation for Substance Use Disorder Recovery: A Systematic Review
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The recovery stage of addiction is a challenging phase characterized by withdrawal symptoms, cravings, and a 40-60% risk for relapse. Nutritional psychiatry is an emerging field of medicine focused on optimizing mental and physical function by providing essential nutrients, treating deficiencies, and using food as medicine. Nutritional intervention has the potential to enhance recovery success by providing the brain with needed nutrients to heal and by reducing withdrawal and craving symptoms. To this end, we conducted a systematic review of preclinical and clinical nutrient and food-derived interventions showing evidence of reducing relapse or craving. Separate searches were conducted utilizing the SCOPUS and the PubMed databases. After eliminating duplicates, the combined search yielded 9,452 peer-reviewed studies. The original search ended on February 23, 2018 and a final search through PubMed and Scopus was performed on June 28, 2018, yielding 30 applicable studies. Articles were assessed by three investigators for inclusion using the following criteria: (1) Clinical or preclinical studies of any diet, nutrient, or food component including vitamins, minerals, amino acids, and fatty acids (or any miscellaneous food-based supplement); (2) Studies of any drug of abuse including alcohol, nicotine, and cannabis; (3) Randomized controlled trials; (4) Studies during abstinence with the outcome measure as reduction of craving or relapse. Studies including participants currently undergoing Medication-Assisted Treatment (e.g. methadone and buprenorphine) or smoking cessation (nicotine or cannabis) studies were also included. This systematic review encompasses trials that include male and female subjects, as well as individuals with different ethnic backgrounds to provide a subject pool representative of the population. Results of the review show that one amino acid, polyunsaturated fats, and one mineral may significantly reduce craving and/or withdrawal symptoms related to addiction. For each reviewed food component, possible mechanisms of action are explored, such as neurotransmitter regulation and gene regulation. Recommendations include research of the food components’ mechanisms of action in relieving symptoms of SUD and possible synergistic effects between food components.