À la Carte -- 9. Addiction and Recovery

Active Use

People who use street drugs usually don't get enough nutrition (macronutrients or micronutrients). In HIV-positive users, problems with nutrition, such as wasting, may be driven more by drug use than HIV status. Some people who regularly use substances such as heroin, cocaine, crack and crystal methamphetamine don't have a regular place to live may find it hard to get food and to get the care they need for their health problems. And when it comes time to decide how to spend limited money, food is often a low priority. The downside is that malnutrition, HIV infection and addiction together place HIV-positive drug users at high risk of becoming sick and needing to go to the hospital. Eating better may help you stay healthier while you are using.

Maintaining Nutritional Health While Actively Using

• Drink high-calorie fluids like meal replacement drinks, milkshakes, chocolate milk, fortified malted drinks or soy milk.
• Take a daily multivitamin-mineral supplement.
• Eat as well as you can when you're not high.
• Find out about food programs in your neighbourhood.
• Try to purchase some groceries that last a long time. Stock up on peanut butter, oatmeal, powdered milk and canned stews and soups before spending money on drugs.

Detoxification

When people begin to detox from active use, they often feel sick to their stomach or throw up and can find it impossible to eat certain foods. During this time it is important to drink enough fluids and to eat bland, low-fat foods that are easy to digest. Remember that detoxification is just a phase. It may last from a few days to a few weeks, but it will pass. And it is an important first step.

Eating Through Detox

• Start with clear fluids. Rehydration drinks like Gatorade may help.
• Move on to high-calorie fluids and gradually to a full diet.
• Eat small meals and snacks frequently.
• Limit caffeine intake.
• Take a daily multivitamin-mineral supplement.

Recovery

Recovery goes on for life and many recovering addicts relapse from time to time. It is important to remember that if it happens, it is a normal part of recovery.

People in recovery sometimes gain a lot of weight. This can be due to having an insatiable appetite in early recovery, uncontrollable sugar cravings or a shift in the addiction from drugs to food.

When eating during recovery, the goals are to 1) set up a normal eating pattern, 2) keep levels of sugar in the blood as steady as possible, and 3) eat lots of healthy foods that replenish the body.

Recovering With Nutrition

• Eat 3 meals and 2 to 3 snacks at regular times each day. Don't miss meals, as this can trigger binge eating.
• Emphasize complex carbohydrates to enhance serotonin levels in the brain. Have grains, breads and cereals at every meal and snack.
• Snack on fruits rather than sweets.
• Limit coffee to 2 cups daily.
• If constipated, increase fibre, especially wheat bran and bran cereals (see "Figuring out fibre," Chapter 6).
• Drink plenty of fluids. Drink more water and limit soft drinks, juices and powdered fruit drinks.
• Work hard on curbing sugar cravings. For example, try sugar substitutes in coffee.
• Get regular exercise, such as walking. This will improve mental and physical well-being and help decrease weight gain.
• Get plenty of rest to allow the body to heal.
• Learn to deal with stress. It is a natural part of life. Explore techniques such as yoga, Tai Chi, meditation, exercise, visualization, group support and counselling.
• Take a daily multivitamin-mineral supplement.