This rule will not be a lecture on clean eating. There may be a time and a place for that, but here and now is not it. The idea in sobriety is to break the over-night fast (break-fast) and feed the body first thing in the morning.
Breakfast is the crux of a sound nutritional program and essential to stabilizing the internal environment of the individual in recovery. Breakfast will help control blood-sugar problems, and prevent symptoms such as depression, irritability, shakiness, headaches and mental confusion. It will start stabilizing the body first thing in the morning and minimize the craving for drugs and alcohol that plague so many for months and even years after their last use.
If you're recovering from drug or alcohol addiction, you should not have to suffer continually. Life does not need to be waged like a continuous battle against the urge to use. The process will not be easy, and there is a long road of rehabilitation ahead, but that is not to suggest there aren't daily things you can change right now that will help. Many of the mood swings, anxiety, depression, irritability and lethargy experienced by people living a life of sobriety can be dramatically reduced by eating the right food at the right times. Again this is not a lecture on clean eating, it is about nourishing the body intelligently to stop the preventable problems that we see in almost every case of uncomfortable sobriety.
Most people in recovery have no idea that their diet can contribute to a relapse. The biggest problem we make is loading up on sweets to provide a quick fix to hunger or feelings of depression. They provide an immediate fix to the feeling, but the price to be paid FAR outweighs the momentary benefit. The recovering substance abuser who frequently skips meals, gives in to cravings for candy, pastries and sod, and drinks four or five cups of coffee loaded with sugar every day, is asking for trouble. We're not talking about the long-term trouble from eating this way. We mean the immediate impact from crashing blood sugar levels that will occur a couple hours later.
Blood sugar abnormalities seem to be more the rule than the exception with people in sobriety. That the great majority of alcoholic and drug addicted individuals suffer from various degrees of unstable blood-sugar chemistries is not our opinion, it is a repeatedly proven fact. There are different theories for why this is, but for now it is enough simply to point it out. In general, the 12 Daily Rules for Recovery are not so much about the WHY of addiction, they are about the HOW to fix it.
Careful nutrition is not going to work miracles all by itself. In fact, nothing that has been discovered over the past eight thousand years has been able to do it by itself. Addiction is an unbelievably complicated disease state with so many layers of complexity that all we can do is theorize as to the inter-related causes and then observe in practice what seems to be helping. No one would suggest that all a person needs to do it eat healthy, take nutritional supplements and he will have permanent, lasting sobriety. Recovery from addiction must involve a sequence of care of which nutritional therapy is just a part - albeit a crucial and essential part. Right after we make the decision to stop drinking and using drugs, we need nutritional therapy to go to work on helping the ravaged organs - the brain, liver, stomach - to stabilize and strengthen their defenses. Good nutrition is probably most important in the first few weeks and months of sobriety, but to increase the chances of a long-term and successful sobriety, it needs to be permanently worked into the individual's daily life.
The power of nutritious foods and vitamin and mineral supplements to promote healing and health in recovery is supported by research and clinical experience. The research is crystal clear in this area: there is a solid, non-debatable link to mental and physical health. What we eat and consume directly influences how we feel.
The research in nutrition has been invaluable in helping point us in the right direction as to what works and what doesn't, but ultimately - as with all the twelve rules - it is the real-life personal and observational experience that shows us how significantly impactful this stuff is for the person in recovery. It strengthens the groundwork for recovery upon which a sane and sound sobriety can be built.
In our clinical experience, those who can simultaneously focus on nutrition and supplementation seem to have much better outcomes. It literally has the ability to help transform sick and depressed people into stable and healthy individuals.
A quality sobriety calls for a structured and healthy routine in order to stabilize the internal environment and increase the likelihood of maintaining sobriety. This is going to begin with a large, healthy breakfast.
An unhealthy breakfast, or skipping breakfast entirely, leads to all sorts of problems affecting your weight and overall health. Recovering from alcohol and drug addiction often leads to frequent blood sugar abnormalities and dramatic fluctuations which will greatly impact overall mood. Early-mid-day lethargy, drowsiness, and disrupted cognition are direct effects of poor breakfast habits. Eating breakfast will regulate metabolism and stabilize mood. If we forego breakfast, the body will become famished around noon time which will increase the likelihood of indulging in sweets and junk food to quick fix the low blood sugar. This will perpetuate the blood sugar problem and the rest of the day will likely consist of the highs and lows of serum blood sugar concentration and all of the instabilities that are associated with them.
You will be more alert, with improved concentration if you feed the body with a nutritious meal first thing in the morning. This means a meal high in proteins and fats and low in refined sugars and simple carbohydrates. The vitamins, minerals, and fatty acids found in healthy breakfast foods have been shown to improve brain functioning.
Most importantly, a healthy breakfast will improve your mood. This is probably the best reason to start every day with a good breakfast. All of the previous benefits of eating a regular, nutritious breakfast at a regular time add up to increasing our overall well-being. In drug recovery, maintaining a sense of well-being as early and as often as possible is the name of the game. Establishing internal stability, which is the primary objective of the 12 Daily Rules for Recovery, will allow everything else in one's life to be accomplished with that much more ease. In short, we will no longer feel as if we are swimming against the stream.
SUMMARY - Consume proteins and fats right away after waking up. Avoid all carbohydrates (at least all simple carbohydrates) and sugars as they are digested rapidly and lead to blood sugar fluctuations and therefore energy and mood disruptions. Anxious and depressed people are already in a natural state of stress upon awakening; therefore an already elevated level of cortisol makes the body even more more vulnerable to the hyper-secretion of insulin when eating carbohydrates. This leads to hypoglycemia and physiological and emotional instability.
Long before fad diets and quick weight loss trends got all the attention, drug and alcohol researchers have understood how poorly nourished individuals attempting to get sober typically are. Nutritional deficiencies tend to be the rule rather than the exception and the appropriate approach seems to be long-term disciplined attention to one's diet. Like RULE 7, taking your nutrition seriously is also NON-NEGOTIABLE.
Early months of recovery, in particular, tend to be very touch-and-go for the individual. She experiences mood fluctuations throughout the day that are often mis-perceived and occasionally mis-diagnosed as other psychiatric illness (As a side note, this is one reason I recommend not to seek out any NEW psychiatric evaluations or clinical diagnoses during the first three months of sobriety). Just as the mind is adjusting to the dramatic and abrupt change in lifestyle, and the brain is adjusting to the disrupted and disarrayed neurochemical balance, the physical body is also struggling to keep up with the changes. One of the surest and most predictable ways to help stabilize the body during this process is through attention to our diet.
Becoming sober is a conscious decision to choose life over death. It is making the about-face away from self-injury towards self-healing. While we are serious about the decision not to put a substance of abuse into our bodies that would lead to quick destruction, we should also be committed not to voluntarily ingest food items that can lead to a slower destruction.
Opiates and alcohol, in particular, can affect so many organ systems that identifying the symptoms caused by these substances can be difficult to tease out. We know for certain that even slight deficiencies in many macro- and micro-nutrients can have significant impacts on mood, emotional behavior, and irregular thought patterns - all common complaints of both active users and those early in sobriety.
Incidentally, the symptoms that plague the post-acute withdrawal phase in opioid abuse- irritability, cognitive impairment, memory loss, mood swings, fatigue, depression, anxiety, etc. - are also the symptoms of the most common nutrient deficiencies. Unfortunately, most recovering substance abusers are completely unaware of these nutritional deficiencies and most treatment approaches completely ignore the impact that one's diet has on mood.
There are many reasons an active drug addiction cuts down on proper food intake. First, when individuals drink and consume drugs in large amounts, they often aren't motivated to eat nutritiously. There are other health complications that can have a significant impact on a healthy appetite - many experience frequent nausea, vomiting, abdominal pain from gastric ulcers, pancreatitis, etc. Also, many drug abusers also consume frequent and large amount of alcohol which we know depletes the body of many of the B vitamins and minerals that are important to stimulating a healthy appetite.
Even if the individual does not show signs or symptoms of an outright nutritional deficiency, there are often marginal ones which, although may not show up on a laboratory test, can have a significant impact. Anything that can reduce the exacerbation of depression, insomnia, lethargy, and apathy often experienced over the first months will greatly improve the likelihood of making it through this sensitive period and continuing into a life of recovery. Often blood sugar fluctuations, for example, can be mis-interpreted as drug cravings and aid to undermine all the work that is being done to avoid the drugs themselves.
For this reason, to neglect the impact of nutrition - even at the beginning of treatment - is inappropriate. We are not suggesting that you throw out everything in your pantry and adopt a vegan lifestyle. In fact, we are not at all suggesting that. But the internal physiology is so sensitive at this point in the process, that it would be absolutely irresponsible if we didn't stress the importance of diet right away.
The principles being discussed here are designed specifically to improve the immediate health, energy, and emotional well-being of the individual to improve the likelihood of sticking through the post-acute withdrawal phase which is typically when the recovering individual will revert back to his substance of choice. The diet is not intended for weight loss (although that may be a benefit for some). Alternatively, we are seeking to nourish the body with all of the nutrients it needs to reverse any deficiencies and stabilize blood sugar.
Changing the diet to one that is more aligned with a stable life of recovery is important. It's important enough to be rule number four. Although you are presented with a guide and an ideal to pursue, it is not realistic to think that years of unhealthy nutrition will be reversed overnight. For me personally, it took about a year to get a good handle on sugar cravings since I had lived decades of life fully indulging in these cravings whenever they arose. This is where compassion with one's self comes into play. Removing drugs and alcohol from one's life is incredibly difficult and everything else, though important, is still secondary. If you find yourself binging sweets and junk food while watching TV some night after mentally committing to eating more nutritiously, this does not constitute a failure. It is simply part of the process. With time you will be able to recognize and associate the way that you feel shortly after eating this type of food, and gradually this will make it less desirable. One final recommendation about eliminating sweets and junk foods that is perhaps the best piece of advice we can give - do not keep it in the house. Most intense sugar cravings last about five minutes so if you're searching your cupboards at 10pm for the Oreos and find that they are not there, you will inevitably turn to something else :-)
Surviving a modern day diet high in refined sugars, low in fiber, and very low in vitamins can complicate any individual's quest for good health, but it appears to be particularly destructive to the substance addict.
Many people who have sugar addictions also have alcoholics and drug addicts in the family. We know substance abuse is an illness with a strong familial component, therefore this association can't be overlooked. In fact, for many who can't seem to improve upon a life of sugar addiction, we might recommend the old gold standard written in 1959 by Roger J. WIlliams, Ph.D., titled Alcoholism: The Nutritional Approach. There have since been an inordinate number of studies linking the complications of sugar addiction with recovery from drug and alcohol abuse, however this research holds up today as some of the best.
In fact, it is only in more recent years that the idea of foods being addictive has become more widely accepted by the medical community. There are hundreds of case studies of sober individuals complaining of persistent depression and anxiety whose symptoms have been relieved with an appropriate diet adjustment (invariably removing refined sugars). Unfortunately, this process of reversing a sugar addiction is initially met with uncomfortable withdrawal-type symptoms and without support and encouragement, many do not successfully remove them from the diet for any long term. From my own experience and what I have seen in most others, it seems that a week of discomfort is about what one can expect if one's diet had been highly composed of refined and processed sugars.
Eliminating sugar and food additives from the common diet is a you-can't-miss concept. No one has ever died from cutting out sweets and sugar drinks. No one has been hurt from avoiding artificial chemical food additives. Considering the dietary history of the human race, the addition of refined sugars is relatively recent. Many people have suffered unnecessarily from poor nutrition, however no one has died from eating a healthy diet.
Substance abusers tend to be very sensitive to serum glucose changes, and nothing will more consistently affect mood than the ups and downs of blood sugar. Although the issue is incredibly common and troublesome to individuals in recovery, its solution is fairly simple. Eat three balanced meals spread out evenly (e.g. 8AM, 1PM, 6PM) with three nutritious snacks in between, being careful to avoid or limit refined sugars (white flour, white bread, fast foods, sweets...)
The principle behind the snacks is to never give your blood sugar an opportunity to crash, thereby avoiding the jitteriness, racing heart, irritability, etc. that follows. Try to space the snacks evenly between the meals (e.g. 10:30AM, 3:30PM, 9PM). A well-timed late evening snack also helps reduce intense sugar cravings that usually occur around this time.
You don't need to be around the recovery world long to see the questionable relationship many sober members have with caffeine. It's understandable on one hand, given its potent stimulatory effect and widespread acceptability as a safe alternative to illicit drugs and alcohol. I've heard many say about caffeine drinks, "It's all I got." So it would be ineffective (let alone hypocritical) to suggest eliminating caffeine, but its consumption needs to be minimized if one expects to feel physioloically stable throughout the day. Caffeine's affect on blood sugar is similar to simple sugars and has more of an effect on mood than many would care to believe.
Of all the suggestions and discussions within RULE 4, this is the most impactful. There is nothing more disruptive of strong nutritional habits than simple sugar. We are really trying to drive home this point through repetition. Not only are these products proven highly addictive in their own regard, their incorporation into the majority of U.S. diets make them a force with which to be reckoned. A high-sugar diet will lead to dramatic fluctuations in blood sugar levels and be the direct cause of depressive, lethargic, anxious, and irritable feelings.
Nutritionists, over the past two decades in particular, have targeted sugars as one of the most contributory culprits in disease today. Its effects can not be over-stated. Countless products that for decades have been marketed as healthy options are merely concentrated sugar drinks dressed up in a nice bottle (e.g. orange juice, apple juice, vitamin water, lemonade). The sugars often replace more nutritious foods leading to a weakening of tissue health and overall body resistance to disease.
This will be expanded upon in RULE 5. Supplementing the diet could be recommended for almost all individuals, but it is incredibly important for the recovering alcoholic and narcotic addict. We have discussed some of the long-term effects years of repeated use has on the brain's neurochemical makeup. It has been my experience that this does not seem to reverse on its own accord, and if it does, the process is painfully slow.
Nutritional supplementation is not a magic cure for this process, but they have been shown undoubtedly to help speed up cellular repair, restore nutrient depletion, and boost the immune system to help protect the body and allow its resources to be more effectively focused on physical rehabilitation of the mind, body, and spirit.