Tuesday, February 26, 2019

Physical recovery is vital to sobriety

Addiction and Recovery

By Bob Gaydos
Alcoholism/drug addiction is often characterized as a threefold disease — mental, physical and spiritual. People in recovery hear a lot about the need for mental therapy and, especially in 12-step programs, the need for a spiritual awakening if they want to get and stay clean and sober.
    Experience has shown both to be important, but the physical aspect of the disease is frequently overlooked in recovery, even though prolonged substance abuse can wreak more physical havoc on the body than any other disease.
Depending on their drug (or drugs) of choice, people who abuse substances can do damage to their brain, liver and other organs, as well as their circulatory, cardiovascular, digestive and immune systems. Skin and teeth may also be affected. It’s not just that alcohol or drugs directly affect the body, dependence on them creates and reinforces negative lifestyles. Eating regularly becomes less important. A healthful diet isn’t even in the equation. Exercise? How fast can I walk to the liquor store?
Yet all too often, persons in recovery, thrilled or scared to be living without drinking or using, carry on with the same unhealthful lifestyle that has become their norm. A diet of fast food or processed food. Little to no exercise. Smoking. They may feel lousy and wonder what was the purpose of getting sober. They also may resort to habit and do what used to make them feel better — reach for a drink or pop a pill.
Recovering physically is a critical hedge against relapse. It is a vital part of the recovery process and establishing new, healthy lifestyle habits can lay the groundwork for years of healthy sobriety.
This is not to say it’s easy to all of a sudden start trying to eat healthfully and get exercise when the primary focus of one's life has become not drinking or using drugs. Quitting smoking may have to wait. Sobriety must come first. But it’s also possible — necessary — to begin to make changes in lifestyle. Start slowly.
The best approach would be to get a physical checkup so that a health care provider can assess what shape the abused body is in and what nutrients may be lacking. Taking that information to a nutritionist should be next. In a perfect world, a healthful diet and exercise regimen is suggested and followed and, eventually, a new, healthy person is created. Success!
But since we’re dealing with alcoholics and drug addicts, there’s bound to be resistance. So addiction counselors suggest keeping it simple to start. Set regular mealtimes and keep them. Drink plenty of water between meals to avoid dehydration. Eat more healthful foods and snacks.
For a guide, there's the United States Department of Agriculture’s pyramid of six healthful food groups. It’s a simple and basic foundation for a new diet. Here’s the hard part to start: Eliminate (as much as possible) processed foods, sodas, cakes, candy and fast food from the diet. They may make you feel good temporarily (especially the sugars), but your body will thank you for removing them or reducing their presence in your diet. Stop shopping in the middle aisles of the supermarket or stopping at the drive-up window of the Golden Arches. Instead, select foods from the USDA list:
1. Fruits: apples, berries, melons, pears, grapes, avocados, bananas, grapefruit and oranges. Fresh is best.
2. Vegetables: broccoli, squash, bell peppers, tomatoes, lettuce, spinach, other green, leafy vegetables, carrots, sweet potatoes, onions and asparagus. Be generous.
3.  Oils and fats: olive, safflower, corn. Avoid trans fats.
4. Healthy whole grains: oatmeal, 100 percent whole grain breads and cereals, brown rice, tortillas, pasta.
5. Lean meat, poultry and fish: salmon, mackerel, shellfish, turkey and/or chicken (remove the skin), eggs (sparingly), dry beans, nuts.
6. Milk and milk products: Try low fat or skim milk, nonfat cottage cheese, yogurt, high-fat cheeses.
Vitamin and mineral supplements may also be helpful.(The physical checkup should reveal deficiencies.) It’s not uncommon to be lacking in B-complex, zinc, vitamins A, C and. D.
Of course, the way to maximize the positive effects of a healthier diet is to exercise. For those in recovery, it’s good to know that becoming more fit not only improves cardiovascular health, reduces weight, builds strength and stamina and rejuvenates the immune system, it can also help alleviate depression and even add brain cells. That's huge in recovery. Another benefit of sticking to a healthier diet and fitness regimen — it can lead to a more normal sleep schedule.
Again, the key is to not be overwhelmed by the idea of exercising and at least do something within whatever physical limitations there may be. Walking regularly is a good start. Try gentle yoga.
Joanna (not her real name), is a health care worker from Ulster County. When she decided to stop drinking, instead of going to rehab she focused on improving her physical health. She was overweight and felt lousy.
She consulted doctors of osteopathic medicine locally and “wherever I could find them,” changed her diet and lifestyle, added the nutrients her body was lacking and started attending Alcoholics Anonymous meetings. She lost 35 pounds, feels “great” and recently celebrated one year of recovery — mentally, spiritually and physically.

The impact of drugs on nutrition:
OPIATES (including codeine, oxycodone, heroin, and morphine) affect the gastrointestinal system. Constipation is a common symptom of substance use. Symptoms common during withdrawal include diarrhea, nausea and vomiting. These symptoms may lead to a lack of enough nutrients and an imbalance of electrolytes (such as sodium, potassium, and chloride).
— ALCOHOL use is one of the major causes of nutritional deficiency in the United States. The most common deficiencies are of the B vitamins. A lack of these nutrients causes anemia and nervous system problems. Alcohol use also damages the liver and the pancreas. The liver removes toxins from harmful substances. The pancreas regulates blood sugar and the absorption of fat. Damage to these two organs results in an imbalance of fluids, calories, protein, and electrolytes. Other complications include: Diabetes, high blood pressure, permanent liver damage (or cirrhosis), seizures, severe malnutrition, shortened life expectancy. A woman's poor diet when pregnant, especially if she drinks alcohol, can harm the baby's growth and development in the womb.
— STIMULANTS use (such as crack, cocaine, and methamphetamine) reduces appetite and leads to weight loss and poor nutrition. Users of these drugs may stay up for days at a time. They may be dehydrated and have electrolyte imbalances during these episodes. Returning to a normal diet can be hard if a person has lost a lot of weight. Memory problems, which may be permanent, are a complication of long-term stimulant use.
— MARIJUANA can increase appetite. Some long-term users may be overweight and need to cut back on fat, sugar, and total calories.
(From the National Institutes of Health)

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