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RULE 5

ESTABLISH A NUTRITIONAL SUPPLEMENT REGIMEN

There is perhaps no aspect of-addiction treatment less optimized than nutritional supplementation. At Reaction Recovery we are trained and experienced in pharmacy practice and certified in the review and recommendation of nutritional supplementation. Each individual recovering from a chemical addiction is a unique person with a unique personal and medical history, therefore there is no one-size-fits-all approach to supplementation. Each recommendation would be made on a case-by-case approach.  There is, however, enough research in the area for us to suggest some broad considerations that are applicable to the majority of cases. We can say with certainty that a majority of people who could be noticing improvements with a nutritional supplement regimen are not taking advantage of what's out there. 


If you have a known or suspected medical condition, or are prescribed medication for a particular disease state, please consult with your physician before following any of the suggestions on this page. Supplementation recommendations are intended only as guidelines.  Because this website can not respond to individual's needs and circumstances, as we would do one-on-one, we ask that you seek a qualified healthcare professional before electing for a dosage regimen on your own. 


NOTE: We have done our best to provide sound and useful information in this section. There are co-occurring disorders - including bipolar disorder and schizophrenia -  that could become exacerbated by the addition of any food or nutritional supplement. Given the complexity of the addictive disorders, we can not promise results, nor do we accept liability to anyone who uses the suggestions. 



Why should we consider nutritional supplementation?

Many people who are just getting sober or who have just finished a detox have persistent and recurring symptoms of anxiety, depression, stress, and fatigue. This is not unusual.  In fact, it is more the rule than the exception. 


What we are proposing is that much of the emotional distress that can not be directly attributed to a specific life event stems from correctable malfunctions in our body and brain chemistry - the result of critically unmet nutritional needs.  We have witnessed and experienced remarkable improvements in mood - often times within days - simply by implementing a nutritional repair plan. 


Keep in mind that we are referring to what has been referred to as "false moods", meaning those that are not true, genuine responses to the real troubles we deal with in life. Those "true" emotions are actually beneficial in that they can point us to areas in our lives that need attention. They are effectively treated and relieved with talk therapy and a strong fellowship network for support. Rather, the "false" moods are the ones that seem to come and go without reason that can severely disrupt an early sobriety attempt. 


The brain (and to a lesser extent, the gut) is responsible for most of your feelings.  It transmits feelings through four "mood chemicals" - endorphins, serotonin, GABA, and catecholamines.  In chemical addictions, to one extent or another (depending on the substance, amount consumed, and duration of use), it stops producing these chemicals on a regular basis.  Pharmaceutical companies have been developing drugs for decades that attempt to disguise or band-aid fix deficiencies in these areas. But that is not the same thing as true repair.  Our research and experience has shown that many, many people achieve relief through nutritional supplements and can all together avoid the use of incredibly powerful pharmaceutical alternatives. 

NUTRITIONAL supplementS

Why supplement?

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A sound nutritional program is essential to successful treatment. Giving vitamins and minerals in correct amounts and proportions will allow the cells to generate new cells, repair injured ones, and strengthen its defense against other diseases. 


Over the past two decades, we have been able to carefully study the social impact of opioid addiction and and variables that seem to support or hinder the recovery from it. For many sufferers, joining a fellowship with others suffering from a common illness produces a sense of belonging and involvement in a caring and supportive community. Psychological and family support counseling also help to process past traumas and pathological patterns of behavior that have been distrubing the individual's relationships with the people and institutions around them. 


In much the same way that these approaches target areas in need of improvement in order to maintain the type of stable environment that is supportive of successful recovery, the disrupted physiological environment, which has been neglected or outright harmed during active use, must be addressed.  Because every individual entering recovery is different, each recommendation will vary.  I recommend consulting a professional educated in the use of nutritional supplementation - e.g. physician, pharmacist, nutritionist - and who is also well-experienced in the nuances of substance use disorders and how this will affect recommendations. 


It may be tempting to do one's own research in this area and decide what would be best, but as a general recommendation, we discourage this. Being your own advocate is important (and necessary), however we believe there is too much information available, mostly unsubstantiated, and the probability that a random searching will lead one to an appropriate supplement approach is unlikely. Because the supplement market is not regulated to the same extent as the pharmaceutical industry, the discretion of an experienced professional is advised. 


He/she can help you navigate through which remedies are safe and which should be avoided. What works and what doesn't. Keep in mind, no nutritional supplement is a miracle cure. In fact, a good way to rule out a particular option is one that claims to be so.  Although supplementation is a significant component (enough to make an entire rule about), it is still just a component. Do not expect a quick fix.  In the world of drug recovery, THERE IS NO SUCH THING!

Conquering Addiction Nutritionally

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Successful recovery from substance abuse if optimized when the physical body is healthy and nutrition is optimized - this idea is one of the cornerstones of the 12 Rules for Recovery. If you drink too much or are chemically dependent on narcotics, you are almost certainly malnourished to some extent. Even those who remained so situated as to eat three healthy meals daily during the last years of one's addiction, the drugs and alcohol themselves have been affecting the absorption of key vitamins and nutrients needed to stabilize the mind and body. 


Malnutrition is one of the most common and disruptive symptoms following a successful drug detox. All the counseling sessions, prescription medications, and patience will not correct a depression caused by a lack of nutrients. Only a healthy diet rich in nutrients and low in junk food and refined sugars can correct the problem. 


DR. Lendon H. Smith famously said, "If you crave a food, it is probably bad for you." 


There is no magic formular that works for everyone, but there are some key features that apply to most. For example the water soluble vitamins B and C have a lasting impact at clearing out the acccumulation of fats in the liver. The liver can regenerate to a considerable extent, however it needs supplemental help. Every supplement regimen initiaally should include a Vitamin C tablet and a B-Complex. 

Protracted Withdrawal Syndrome

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Even if the individual is able to remain abstinent through the painful acute withdrawal phase, his difficulty is far from over. The majority of former abusers continue to experience symptoms of anxiety, depression, and irritability months and even years following the initial detoxification. 

Many people unfortunately mis-interpret this as proof that the individual is and has always been psychologically troubled. Although this may be the case for some, it is in no way the rule. These protracted symptoms indicate that the cells are still suffering from the damage caused by excessive drug use, and they will need time heal.  But they also need help to speed up the healing and ensure that it is complete. Abstinence alone does not make malnourished cells healthy again. The cells need vitamins, minerals and amino acids in therapeutic amounts and proportions.


Most individuals in early sobriety are not aware that they are malnourished and suffering from nutritional damage let alone that nutritional supplementation can repair that damage. 


These early months are often when an individual suffering from these protracted symptoms will seek medical advice for the "unexplainable" syptoms and typically leave an office with a prescription to treat these anxieties and mood disruptions. 


We want to drive home the point that although prescription pharmaceuticals may be indicated for some, the vast majority of recovering drug addicts during these early months simply need to supplement the body with vitamins and nutrients that are often severely deficient during this stage and have patience as the body moves itself out of this protracted withdrawal phase.

Autonomic Nervous System (ANS) Dysfunction and Cortical Atrophy

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Drugs of abuse at high doses consumed over long periods of time can wreak havoc on the normal functioning of the ANS. The ANS oversees the control of the cardiac muscles, and the smooth muscles of the digestive sytem. respiratory system, and the skin. This explains why the early months of sobriety are often complicated with excessive perspiration rapid hear rates, tremors, restless legs, etc.  Depending on the amounts consumed and duration of use, these symptoms can take a very long time to be fully relieved. As with nutritional abnormalities and hypoglycemic tendencies, this can be relieved and a rapid healing can ensue with proper nutritional therapy and supplementation.


 One of the most predictable and slow to heal affects of chronic substance abuse is the deteriouation of the pre-frontal cortex - specifically the grey mater that blankets the two hemispheres of the brain. This area is involved in the major areas of the senses, reasoning, and memory. Although occasionally permament, the majority of the damage can be reversed with time and nutritional therapy 

Neurotransmitter Depletion.

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During the protracted phase of withdrawal, the three significant brain amines that are greatly reduced are serotonin, norepinephrine, and dopamine. This partially explains the addict's continuing complaints of anxiety, depression and tension. These neurotransmitters are responsible for sending the signals between brain cells, therefore their disruption will have a marked effect on mood and sleep patterns. Serotonin deficiency, for example, explains why nearly all recovering substance abusers complain of sleep disturbances long after the acute detoxification phase. 


Amino acids build proteins, therefore it is important that we have enough in the body to replenish the severely depleted protein environment in drug addictions. If illlness or drug use destroys or disrupts the normal coversion of amino acids to neurotransmitters, the mood, emotion, and cognition will suffer. Individuals become more anxious, irritable, with angry and sudden outbursts of anger.  These are all signs that the internal environment is out of balance.  These substances are vital and their proper functioning depends directly on an adequate supply of amino acids.


With appropriate nutritional replenishment, however, the quality and consistency of sleep can improve very quickly, thereby improving the individual's quality of life and increasing the likelihood of continued sobriety.

Adaptogens

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Adaptogens are non-toxic plants that are used to help the body combat and resist daily stressors. They are meant to bring us "back to the middle" so to speak. Like all herbal and nutrient supplements, the literature will always be mixed, however most researchers and clinicians agree that adaptogens seem to do for your adrenal glands what exercise does for your muscles. 


The stress response inside the body is mediated by the hypothalamic-pituitary-adrenal (HPA) axis and the sympathoadrenal system.  It seems that these plant-based products interact directly with these systems. 


Although more research is needed, recent case studies suggest adaptogens are helpful with balancing the internal environment of the recovering alcoholic or drug addict. When taken at therapeutic levels, the side effects are virtually non-existant and drug-interactions are mostly unknown.


Most importantly, many symptoms and complaints that often lead to a prescription for a mood-stabilizer or anti-depressant can be relieved simply by the introduction of one of these herbal supplements, thus sparing the individual the complications and difficulties that often are associated with prescription medication.

THE four mood chemicals

Serotonin

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  • If you're receiving enough serotonin, you feel confident, easy-going, flexible, and generally positive feeling about your life.
  • As serotonin begins to drop, you will notice a more pessimistic outlook, feelings of irritability, sleeplessness, and obsessive thinking.

Endorphin

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  • Endorphins control the pain response, therefore if these levels are adequate you generally feel comfortable in your body and an overall sense of well-being.
  • If endorpin levels are low, you will experience more extreme moods, crying easily and have an overall low threshold for physical pain or temperature changes. 

Catecholamines

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  • If the catecholamine (including dopamine, epinephrine, and norepinephrine) levels are balanced, you will feel a naturally energetic, alert and upbeat.
  • When the catecholamine levels are low, individuals complain of a general feeling of apathy, lack of motivation and energy, and generally low motivation to accomplish the day's activities and responsibilities.

GABA

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  • GABA is primarily responsible for the feeling of relaxation.
  • When GABA levels are suppressed, you will feel more wired, stressed and overwhelmed.

identifying your deficiency: symptoms of low levels

Serotonin

  • Tendency to be very negative, with dark, pessimistic thoughts
  • Feelings of low self-esteem and low confidence
  • Overly self-critical 
  • Persistent feelings of guilt and shame
  • Repetitive and obsessive thoughts that seem to serve no purpose except to make you feel badly.
  • Maladaptive perfectionist - often being unable to comfortably transition or be flexible.
  • Noticeable dip in mood at night or during the cold months
  • Often irritable, edgy, angry or on edge
  • History of anxiety attacks or panic attacks (rapid HR, difficulty breathing)
  • Recurring low-level or chronic pain
  • Strong cravings for sweets and refined sugars, especially in the afternoon or evening
  • Benefited in the past from serotonin-targeting antidepressant drugs (e.g. SSRIs)


Endorphin

  • Very sensitive to emotional or physical pain
  • Easily tear up or cry easily at times when no one else is (e.g. TV commercials)
  • Tendency towards avoidance of painful issues
  • Difficulty getting over loss or dealing with grief when others seem to be moving on.
  • Chronically complaining about physical or emotional pain
  • Seek momentary and expedient pleasures and comfort from behaviors that you know are not good for you.

Catecholamine

  • Often feel flat, bored or apathetic
  • Regularly feeling a low level of physical or mental energy
  • Difficulty getting out of bed in the morning and afternoon desire to take naps.
  • Sensitivity to cold, often with cold hands or feet.
  • Tendency to put on weight or difficulty losing weight
  • Feel like you need a lot of caffeine or energy drinks throughout the day to keep you alert.
  • Difficulty finding the motivation or desire to exercise.

GABA

  • Difficulty relaxing or loosening up
  • Your body is often stiff, uptight, or tense
  • Easily upset, frustrated, or snap under stress
  • Often feel overwhelmed
  • Feel significantly worse if you skip meals or go too long without eating
  • Frequent need to eat or use tobacco products to relax
  • Often feel overworked or pressured

natural approach to reversing chemical mood imbalance

CLASSES OF NUTRITIONAL SUPPLEMENTS

VITAMINS & MINERALS

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AMINO ACIDS

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ADAPTOGENS

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The link between inflammation and depression

PROSTAGLANDIN E1 (PGE))

Another well-researched biochemical cause of depression in the alcoholic and drug addicted population is a genetic inability to manufacture enough prostaglandin E1 (PGE-1), a brain metabolite produced from essential fatty acids. This deficiency appears to be congenital and an inborn deficiency in omega-6 fatty acids.  Many sedative drugs (e.g. alcohol, benzodiazepine and barbiturates) temporarily stimulate production of PGE-1, which if consumed by an individual already deficient in this prostaglandin, produces a temporary production of PGE-1 thus lifting the depression.  Understandably, this feeling can provide considerable relief, but the problem is the relief is short-lived then the PGE-1 levels fall again and the user is then at an increased risk of developing an unconscious compulsion to continue consuming the chemical to keep the levels up to continue the temporary relief. This, of course, sets off a dangerous spiral known well to any one formerly or currently addicted to one of those chemicals. 


Studies involving the supplementation of PGE-1 have been conducted since the mid 1980s.  If an individual suffers from a natural deficiency in this prostaglandin, restoring normal levels of PGE-1 through supplementation significantly reduces both the underlying depression and the compulsive need to consume alcohol or other sedatives. 

GAMMA-LINOLENIC ACID (GLA)

 If your body can not normally convert essential fatty acids into PGE-1, you can correct the problem by taking Gamma-linolenic acid (GLA). GLA can work extremely well in this instance but requires three supportive nutrients in addition to GLA: magnesium to form the GLA, vitamin B-6 to metabolize its precursor, and vitamin C to increase its production.  


This is not a magic formula for everyone, but there are cases we have seen where the depression seems to magically lift and does not return as long as the formula is continued. Like many other nutritional supplements, this can prevent the unnecessary use of addictive and habit-forming prescription medications to relieve the underlying symptoms.