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Barbara Koffske Reid, Ph.D., M.A., M.Ed., LMFT Core Faculty, Cambridge College

The Role of Wellness and Nutrition in the Prevention and Treatment of Substance Use Disorders. Barbara Koffske Reid, Ph.D., M.A., M.Ed., LMFT Core Faculty, Cambridge College Chair, Bachelor of Science in Wellness & Health Promotion. Why Wellness & Nutrition.

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Barbara Koffske Reid, Ph.D., M.A., M.Ed., LMFT Core Faculty, Cambridge College

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  1. The Role of Wellness and Nutrition in the Prevention and Treatment of Substance Use Disorders Barbara Koffske Reid, Ph.D., M.A., M.Ed., LMFT Core Faculty, Cambridge College Chair, Bachelor of Science in Wellness & Health Promotion

  2. Why Wellness & Nutrition • Increased risk and co-occurrence of physical health problems • Increased risk and co-occurrence mental health problems • Those with substance use disorders often have poorer nutritional status • Stress well known risk factor for substance use disorders • Elements of wellness have been shown to be effective in conditions that often co-occur in substance use disorders (managing stress, reducing symptoms of depression) • Nutrition & wellness initiatives can increase protective factors that may positively affect treatment and recovery

  3. Particularly Relevant for Women • Women report significantly higher levels of chronic stress than men (Matud,2004) • Rate their life events as more negative and less controllable than men (Matud,2004) • Women more likely to report stress related health problems such as hypertension, depression, anxiety and obesity(APA, 2012) • Stress increases the likelihood of alcohol and drug use - can precipitate relapses following treatment (Sinha, 2007) • Mood and anxiety disorders higher in women with & without SUD’s (Conway et al., 2006)

  4. Particularly Relevant for Women • Depression, 2nd leading cause disability globally 2020 – twice as common in women (WHO, 2013) • High rates of PTSD/trauma in women and substance use disorders – poorer treatment outcomes (Shafer & Najavits, 2007) • Women who abuse opioid medications have an almost 200 percent greater chance of developing PTSD (Meier et al., 2014) • Women typically enter treatment with more medical, behavioral, psychological and social problems than men (Hernandez-Avila et al, 2004)

  5. Elements of Wellness • Stress Reduction • Exercise • Sleep • Nutrition

  6. Stress Reduction • Help to lessen the negative effects of chronic stress reduce stress hormones like cortisol and activate hormones such as serotonin, GABA and oxytocin • Breathing exercises • Meditation • Guided visualizations • Yoga • Music • Mindfulness

  7. Mindfulness • Being fully in the present moment. • Awareness without judgment, mindful savoring practice, nature, smells, colors, appreciating the present moment • Contemplative practices and a psychological state of awareness • Non denominational – a tool/function that may enhance sacred and everyday experiences • People have become dulled to the joys of everyday life • Mindfulness meditation can reorient them to appreciating the present moment Garland, 2008

  8. Mindfulness • Mindfulness-based cognitive therapy effective in treating depression (Segal et al., 2010) • Positive effect on mood, may be useful preventing relapse (Zhunag et al., 2013; Bowen & Kurz, 2010) • Mindfulness-Oriented Recovery Enhancement (MORE) reduce cravings for opioid drugs • Helping patients find happiness in their day to day experiences – the more meditation – brain scans revealed more activity – less cravings for opioids Garland, 2008

  9. Exercise • Sedentary lifestyle – changes in technology (Eaton, 2005) • 4th leading risk factor – mortality (WHO, 2013) • Biking, swimming, walking, dancing, sports, aerobic, high intensity, strength training • Numerous physical & mental health benefits • Improve mood • Increase energy • Better physical health • Reduce stress, anxiety, • With many populations

  10. Exercise in SUD • Reduced cravings • Reduced substance use • Increased energy • Overall wellbeing • Aerobic strength • Muscle capacity • Endurance • Youth active or involved with sports less likely to use – although context matters • Better treatment outcomes (Rosseler, 2010; Dolezal, 2013; Brown et al, 2009; Terry-McElrath et al., 2011)

  11. Standard American Diet • Highly refined, processed foods • High in refined sugars • High in unhealthy fats, animal fats • High in omega 6’s (veg, corn & soy oils) • Lower consumption of nutrient dense foods • Low in omega 3’s (avocados, cold water fish, walnuts, dark green leafy veggies) & other essential nutrients • Low in plant-based foods, veggies, fruits, seeds • Low in fiber • Implications for brain health and mental health (Grotto & zeid,2010; Hibbeln, 2009; Wiles, 2009; School et al., 2003; Waylon, 2008)

  12. Problem..... • Omega 6’s INCREASEinflammation • Omega 3’sdecrease inflammation • Ideal ratio 1:1 to 4:1 • Our ratio 15:1 – 30:1 • High omega 6’sinflammationDISEASE

  13. Nutrition and Omega 3’s • Elements of nutrition key to brain health • Vitamin B, D, Antioxidants, Essential Fatty Acids • Vision, memory, cognitive function, mood, CNS • Essential Fatty Acids - Omega 3’s • Critical to every cell • Development, structure & functioning of the brain • Development of fetus, neuronal pathways, vision • Maintain fluidity of cells & aid in communication • Tend to reduce inflammation • Must be obtained through diet • Upto 90% of population deficient

  14. Omega 3’s & Mental Health • Deficiencies reported in a variety of mental health conditions – schizophrenia, ADHD, dyslexia, depression, bipolar disorder • Low levels associated with self harm & impulsivity • Positively associated with depression • Associated with suicidal behavior in depressed patients • Low levels increased depression in women • Supplementing decreased symptoms of depression in pregnant & post partum women

  15. Omega 3’s and SUD • Decrease in anger, anxiety & aggression (Burdens-Branchey et al., 2008) • Decrease in depressive symptoms, suicidality and a greater ability to cope with stress (Hallahan et al, 2007) • Reduced relapse vulnerability (Burdens-Branchey & Branchey, 2009) • Decrease in anxiety when given supplementation - results lasting three months after treatment (Burdens-Branchey & Branchey, 2006) • Reduced depression with increased omega 3’s (Beydun et al., 2013) • Less neuroinflammation(Tajuddin et al., 2013)

  16. Move Towards Wellness • Shifting to a more comprehensive approach   • SAMHSA - integrating wellness & health promotion strategies  • Strong evidence base on elements of wellness • Stress reduction strategies • Meditation • Mindfulness strategies • Exercise • Nutrition

  17. Bureau of Substance Abuse Services • Integration of wellness and nutrition as part of Approved Addictions Educational Providers • “Holistic and nutritional approaches to recovery: Awareness that a range of approaches support recovery, including (but not limited to) acupuncture, naturopathic/homeopathic medicine, chiropractic, healthy eating/exercise, and mindfulness” • Careers of Substance – careersofsubstance.org • Wellness & Nutrition in Substance Abuse Treatment • Self-Care for Providers • Trainings on Wellness & Nutrition in Treatment

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