The opioid crisis has reached epidemic proportions in the United States with rising overdose death rates. Identifying the underlying factors that contribute to addiction vulnerability may lead to more effective prevention strategies. Supply side environmental factors are amajor contributing component. Psychosocial factors such as stress, trauma, and adverse childhood experiences have been linked to emotional pain leading to self-medication. Genetic and epigenetic factors associated with brain reward pathways and impulsivity are known predictors of addiction vulnerability. This review attempts to present a biopsychosocial approach that connects various social and biological theories related to the addiction crisis. The emerging role of nutrition therapy with an emphasis on gastrointestinal health in the treatment of opioid use disorder is presented. The biopsychosocial model integrates concepts from several disciplines, emphasizing multicausality rather than a reductionist approach. Potential solutions at multiple levels are presented, considering individual as well as population health. This single cohesive framework is based on the interdependency of the entire system, identifying risk and protective factors that may influence substance-seeking behavior. Nutrition should be included as one facet of a multidisciplinary approach toward improved recovery outcomes. Cross-disciplinary collaborative efforts, new ideas, and fiscal resources will be critical to address the epidemic.
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Sorting Through Dialectical Truths
In this webinar, David Wiss MS RDN helps you sort through dialectical truths that plague the nutrition profession. People seem to pick a “campsite” and then wage war at the other camps. In other words, there are false dichotomies in the nutrition field. For example, someone once said that one cannot believe in food addiction and treat eating disorders at the same time. Such an interesting comment, particularly with the use of the word “believe.” In this presentation, David discusses how these topics converge and how they diverge. Mr. Wiss uses concepts of statistics to set the stage for a presentation of dialectical truths. Useful terms are defined and the broad category of nutrition for mental health is explored. This presentation is particularly useful for those who are interested in theory, and philosophical debates. Tips for assessing food addiction are offered.
Read more of David’s thoughts on food philosophies.
David is currently doing virtual sessions with people all over the world who have co-occurring eating and substance use disorders. Feel free to reach out and find out more about working with him.Read more
Hot Topic: Nutrition for Mental Health
David Wiss MS RDN presents to students at California State University Northridge about the connection between nutrition and mental health. This presentation covers the microbiome, substance use disorders, disordered eating, depression, recovery, and more. It’s just over 50 minutes long, but worth every second! Why? Because nutrition for mental health is the future! Read more about this topic and check out some recent references HERERead more
“Nutrition Interventions Amidst and Opioid Crisis: The Emerging Role of the RDN” by David Wiss MS RDN
The opioid crisis has reached epidemic proportions. The time to include nutrition into the treatment paradigm has arrived. David Wiss is not afraid to take the lead, and is doing research on this topic at the University of California, Los Angeles.
This presentation was given at the Food and Nutrition Conference and Expo (FNCE) on Sunday October 21, 2018 in Chicago which was an invited presentation in response to the opioid crisis. Here David Wiss describes the impact of opioids on nutritional status and gastrointestinal health, identifies common disordered and dysfunctional eating patterns common to opioid-addicted populations, and describes nutrition therapy protocols for specific substances including opioids and for poly-substance abuse.
The presentation is 1:29:01 and was moderated by my dear friend and colleague Tammy Beasley, RDN. If you want to skip the video, and go straight to the slides, you can do so HERE.
In summary, nutrition interventions have not yet been standardized or widely implemented as a treatment modality for substance use disorder (SUDs). Emphasis should be placed on gastrointestinal health, and reintroduction of foods high in fiber and antioxidants such as fruits, vegetables, whole grains, beans, nuts, and seeds. Adequate intake of protein and omega-3 essential fatty acids should be consumed daily. Regular meal patterns can help to stabilize blood sugar. Water should replace sweetened beverages. Caffeine and nicotine intake should be monitored. Dietary supplements can be very helpful in the recovery process, but should not supplant whole foods. Once nutrition behavior has improved, use of dietary supplements should be reevaluated. Lab tests and stool samples assessing gut function should provide valuable insights in upcoming years. In addition to expertise with the interaction between specific substances and nutritional status, RDNs working in treatment settings should specialize in gastrointestinal health, eating disorders, and should be current with food addiction research. There is a timely need for specialized nutrition expertise in SUD treatment settings, including outpatient clinics and “sober living” environments. Public health campaigns and specialized training programs targeting primary care physicians, mental health professionals, and other SUD treatment professionals are warranted.Read more
Peer-Reviewed Journal Articles by David A. Wiss MS RDN
(ORCID Link Takes You Directly To The Articles)
Wiss, D. A., Avena, N., & Rada, P. (2018). Sugar addiction: From evolution to revolution. Frontiers in Psychiatry, 9(545). doi:10.3389/fpsyt.2018.00545
Wiss, D. A., Schellenberger, M., & Prelip, M. L. (2018). Rapid assessment of nutrition services in Los Angeles substance use disorder treatment centers. Journal of Community Health. https://doi.org/10.1007/s10900-018-0557-2
Wiss, D. A., Schellenberger, M., & Prelip, M. L. (In Press). Registered dietitian nutritionists in substance use disorder treatment centers. Journal of the Academy of Nutrition and Dietetics. doi:10.1016/j.jand.2017.08.113
Wiss, D. A., Criscitelli, K., Gold, M., & Avena, N. (2017). Preclinical evidence for the addiction potential of highly palatable foods: Current developments related to maternal influence. Appetite.doi:10.1016/j.appet.2016.12.019
Wiss, D. A., & Brewerton, T. B. (2016). Incorporating food addiction into disordered eating: The disordered eating and food addiction nutrition guide (DEFANG). Eating and Weight Disorders. doi:10.1007/s40519-016-0344-y
Wiss, D. A., & Waterhous, T. S. (2014). Nutrition therapy for eating disorders, substance use disorders, and addictions. In Brewerton, T. D., & Dennis, A. B., Eating disorders, substance use disorders, and addictions (pp. 509-532). Heidelberg, Germany: Springer Publishing.
Specter, S. E., & Wiss, D. A. (2014). Muscle dysmorphia: Where body image obsession, compulsive exercise, disordered eating, and substance abuse intersect in susceptible males. In Brewerton, T. D., & Dennis, A. B., Eating disorders, substance use disorders, and addictions (pp. 439-457). Heidelberg, Germany:Springer Publishing.Read more
Is There Science to Sugar Addiction???
I know, I know, I know…food addiction and sugar addiction are controversial topics, especially in the eating disorder community, where any kind of “diet” beliefs or behaviors are viewed as harmful. I agree that many of the proponents of sugar addiction and food addiction carry a very punitive “food negative” message. Is there a way to accept the science of food addiction AND be “eating disorder friendly” at the same time??? That takes skill. One has to be able to hold multiple things true at the same time, and separate emotions and personal bias from their work. But it can be done!!! In fact, it HAS TO be done!
The revolution is now.
Our latest publication: “Sugar Addiction: From Evolution to Revolution” has been recently published in the prestigious Frontiers in Psychiatry. I will say this was the hardest peer-review I have ever gotten through! It is published OPEN ACCESS so download it HERE. For those who work with eating disorders, there is a special section to address the controversies! Enjoy! Feedback always welcomed.
Want to learn more about Food Addiction? Check out our FAQ page on it.
Want to learn more about Eating Disorders? We got that too.
Nutrition in Recovery specializes in the nutritional management of addictions, eating disorders, body image, mental health, and weight management. We offer group education and individual counseling. We love to help people finally make peace with food and exercise. Nutrition in Recovery also offers general wellness services, sports nutrition, and medical nutrition therapy for various chronic diseases, including gastrointestinal issues. Whatever brings you into our office, we are prepared to help you on your journey to recovery.
We pride ourselves on being flexible with different food philosophies. We do not believe that any single food philosophy works for all people. In fact, we think that only having one food philosophy is not scientific. We are skilled in making an individual assessment in order to figure out the best treatment approach for you. We have a team of experts at Nutrition in Recovery and can therefore get you in touch with the best person for your specific needs.Read more