Rebuilding the Body’s Reserves
It is well established that chronic opioid use leads to severe nutritional deficiencies that can linger in those working to recover. 110 If left unaddressed, these nutritional deficiencies can make recovery more difficult and contribute to low energy, low mood, and long-term health problems.
You can target specific nutritional deficiencies with supplements, including everything from vitamins and minerals to amino acids, and we’ll talk about some of the most broadly useful ones later in this chapter. If you are able to identify the patterns that indicate specific imbalances in your energetic organ systems (see here), you can tailor your diet to correct those imbalances and bring your body back to a state of equilibrium and health. We’ll discuss the patterns that are most common among opioid users.
You can also adopt healthy eating habits, which, not unsurprisingly, go a long way toward rebuilding the body and correcting imbalances.
There is no lack of information on healthy foods and how to prepare them, so we will not review every bit of that detail. But we are approaching the topic of opioid abuse recovery from the perspective of TCM, which conceptualizes healthy eating in a way that differs from the common Western perspective.
Diet is a vital component of TCM. In fact, nutritional therapy, or food therapy, is one of the five main TCM branches — the others are acupuncture, herbal medicine, tui na (therapeutic massage), and qi gong (energy healing). Foods, just like herbs, have different energetic qualities; they can be warming or cooling, for example, or they can support yin or yang. A TCM practitioner is just as likely to prescribe dietary therapy as she or he is to prescribe herbs or acupuncture.
In terms of Chinese nutritional guidelines, no food is inherently “good” or “bad.” Instead, foods are simply appropriate or not appropriate for an individual, depending on each person’s unique constitution, energetic balance, and state of health. For example, yang warming tonic foods would be quite beneficial for an individual who is cold and fatigued; however, the same nourishing, warming foods would cause irritation and headaches in someone who is thirsty and experiencing night sweats, as is seen in cases of yin deficiency.
Throughout this book, we’ve looked at some of the more common imbalances that are seen in cases of extended opioid use. Food therapy can be a valuable partner in correcting these imbalances, and the following pages will show you which kinds of foods are best for these specific imbalances. However, people in the early stages of recovery from opioid dependency often experience lack of appetite and nausea. For them, food therapy may not seem like an attractive option. Keep in mind that lack of appetite and nausea are classic symptoms of Spleen qi deficiency. Once this energetic imbalance is resolved (see here for a targeted protocol), food therapy can be a tremendously valuable tool in rebuilding a person’s health, energy, and outlook.
Because the Kidney energetic system is the root of all yin of the body, foods that nourish Kidney yin would be appropriate for yin deficiency originating in any organ system. Heat is a common symptom of yin deficiency, resulting from a lack of yin’s cooling, moistening functions, and many yin-nourishing foods are cooling to help balance that heat. Foods that are overly stimulating, like coffee and spices, should be avoided.
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Foods to support Kidney yin |
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amaranth bananas barley beets black beans goji berry grapes kidney beans millet mung beans |
quinoa rice (preferably brown short grain) seaweed spirulina string beans tofu watermelon wheat germ white mulberry (fruit) |
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Foods to avoid |
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alcohol coffee fats |
red meat spices |
Foods that are warming support Kidney yang and qi.
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Foods to support Kidney yang |
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adzuki beans basil beef black beans black pepper butter cherries chicken chili peppers cinnamon cloves cooked fruit coconut cumin dates fennel ginger garlic |
guava kale lamb lentils molasses mussels mustard leaf onions peaches raspberries rosemary sesame seeds shrimp trout vinegar walnuts winter squash |
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Foods to avoid |
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asparagus dairy eggplant |
raw fruits or vegetables wheat |
Liver qi stagnation is a common phenomenon not only among opioid users but in Western culture generally. When Liver qi is congested, it tends to heat up and Liver yin is consumed.
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Foods to tonify Liver yin |
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artichoke avocado beef beets cardoon chicken soup blackberries blackstrap molasses blueberries dates eggs |
gelatin dark leafy greens (such as kale, spinach, and collards) kelp liver mulberries nettles oysters pork red grapes sesame seeds spirulina |
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Foods to cool Liver heat |
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amaranth celery cheese cucumbers lettuce mung beans mung sprouts millet mushrooms nettles |
plums quinoa radishes (including daikon) raw green vegetable juices rhubarb rye bread seaweed tofu watercress |
Heart blood deficiency is common among opioid users, as blood is a yin substance and opioid users often have overall yin deficiency. Heart qi deficiency is another common condition, but the influence of nutrition is less impactful for chronic Heart qi deficiency than it is for other organ imbalances (see a treatment protocol for Heart qi deficiency).
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Foods to support Heart blood |
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adzuki beans arugula avocado Brussels sprouts (cooked) chicory cooked/steamed vegetables (including kale) |
fish lamb legumes mung beans nuts |
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Foods to eat only in moderation |
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cayenne pepper cherry garlic goji berries hawthorn berry |
mulberry fruit papaya plum rye |
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Foods to avoid |
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hydrogenated oils processed carbohydrates refined vegetable oils |
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The Spleen system is damaged by cold foods, raw foods, sugar, and fried foods. According to TCM, once Spleen qi is deficient, the body is unable to absorb nutrients, thus rendering efforts to eat well moot.
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Foods to support Spleen qi |
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adzuki beans amaranth asparagus carrots (cooked, not raw) celery (cooked, not raw) garlic bitter greens (such as arugula and dandelion, but in moderation, as they are cold) horseradish kasha millet |
pumpkin radishes rye scallions soybeans (cooked, not raw) sunflower seeds turnips winter squash yams |
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Foods to avoid |
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cucumbers dairy eggs fried foods fruits and fruit juices |
meat refined carbohydrates sweets tofu watermelon |
The Lungs are often affected by dampness; because dampness is closely associated with the Spleen, nutritional recommendations for the Spleen would be appropriate in cases of chronic phlegm in the lungs. The influence of foods is less impactful for chronic Lung qi deficiency than for Spleen or Kidney yin deficiency, but the recommendations below are helpful.
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Foods to support Lung QI |
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almonds carrots (cooked, not raw) chard mushrooms |
mustard greens onions rice walnuts |
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Foods to eat only in moderation |
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cheese duck grapes pears |
radishes tangerines water chestnuts |
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Foods to avoid |
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black pepper excessive spicy foods such as hot peppers |
garlic ginger |
A traditional part of Chinese cuisine, medicinal soups are commonly used to promote longevity, good health, and a strong immune system. This slow-cooked soup is a pleasant way to nourish the body and correct deficiencies created by extended opioid use, especially for someone who has not been eating a consistently healthy diet for a time. The soup is wonderfully restorative and can be enjoyed by the entire family. Those recovering from debility should eat 1 cup of soup two times daily for 3 to 6 weeks.
Ingredients
Preparation
Place the herbs in a large pot and pour the broth over them. Bring the broth to a simmer over medium-high heat; once the soup is simmering, reduce the heat to medium-low and let simmer for 30 minutes. Then add the cooked chicken, scallions, and ginger, and season generously with salt and pepper. Simmer the soup for 2 to 4 hours. Add the vegetables in the last 15 to 30 minutes so that they will be tender but not mushy. When the soup is ready, stir in the cooked rice or noodles, if using. Serve hot, garnished with cilantro and/or scallions, if you like.
This herb mix is a classic addition to medicinal soups used to build strength, fortify the immune system, and restore health generally. The herbs used are mainly qi tonic herbs that can benefit all of the organ systems. Jujube dates are added to support the body’s absorption of the other herbs and are a vital qi tonic on their own.
Ingredients
Preparation
Combine all the herbs and mix well. Store the mixture in a cool, dry spot. When you cook with it, note that the goji berries and red dates are edible, but the astragalus and codonopsis are not; tie them up in a cheesecloth bundle that you can easily remove when the soup is ready to be served.
Most opioid addicts are significantly nutritionally depleted by the time they enter treatment. 111 Adopting a well-balanced whole-foods diet is crucial for maintaining sobriety, but most people will require additional supplementation during the early months of recovery because their bodies have been starved of nutrients for so long. 112 Additionally, the toxic nature of opioids in and of itself damages the tissues of the body, and extra efforts are required to give the body the resources it needs to repair that damage.
These supplements are readily available online and at health-food markets. However, you should consult with your health-care provider before taking any supplements. When you do take them, stay within the dosages recommended on the product labels.
Magnesium supplementation has been shown to lessen many symptoms related to opioid withdrawal, including anxiety, nervous tension, depression, and muscle spasms. Magnesium supplements also improve sleep patterns. 113 You might consider looking for a magnesium-calcium combined supplement, as the body requires calcium in order to absorb magnesium.
Omega-3 fatty acids can aid those recovering from opioid-induced brain damage by supporting the structural component of neuronal membranes in the brain. Omega-3s have also been shown to be beneficial in the treatment of depression, which is commonly seen in the aftermath of opioid addiction. 114
Probiotics restore the gut flora, which are often damaged by opioid use, and can be beneficial to those experiencing narcotic bowel disorder following withdrawal. 115
Vitamin B complex helps combat stress and supports the nervous system. This can be an important supplementation in sustaining opioid recovery, as stressors can trigger relapse. Vitamin B has also been shown to combat depression, a symptom that often appears when opioid use is discontinued. 116
Vitamin C reduces inflammation, which can be helpful for opioid users struggling with chronic pain. Those who have used opioids for a long time will want to bolster their immune system, and vitamin C is beneficial for this also. 117 One clinical study showed that high doses (15,000 to 20,000 mg) of vitamin C daily lessened withdrawal symptoms. 118 However, such extremely high doses of vitamin C daily can cause digestive upset and should not be maintained for more than a few days. From a TCM perspective, vitamin C is quite cold in nature, and high doses have the potential to damage the Spleen.
Zinc can help improve immune system and brain function. 119 Both are damaged by long-term opioid use, so zinc supplementation would be useful for anyone going through recovery to help bring their body back to health.
As we discussed in chapter 1, opioid drugs work by binding with the receptor sites for natural opioids in the brain. Over time, with ongoing overstimulation by opioid drugs, the cell membranes at the receptor sites become damaged and the receptors no longer function properly. These tissues are dependent on proteins for repair.
Amino acids are the building blocks of protein and the foundation for neuroregeneration. A nutritious diet rich in protein sources, such as eggs, meat, cheese, and fish, is crucial for good health in any human being. However, people who have suffered from long-term opioid dependency often require more amino acids for cellular repair than could reasonably be provided by food. For them, supplementation during the first few months of their recovery can be helpful.
While food sources of protein contain a wide range of amino acids, there are a few specific ones that are especially helpful in brain function repair and in mitigating some of the negative factors that make recovery challenging, such as poor sleep, depression, poor digestion, inability to concentrate, and cravings.
As is the case with any nutritional supplements, you should consult with your health-care provider before taking amino acid supplements. When you do take them, stay within the recommended dosages on the product labels.
L-tryptophan and 5-hydroxytryptophan (5-HTP) are necessary for the manufacture of serotonin, a neurotransmitter and the brain’s natural antidepressant. Both are naturally occurring amino acids, and L-tryptophan is converted in the body to 5-HTP, which itself is then converted to serotonin. Enhancing serotonin levels through L-tryptophan supplementation aids in opioid recovery in the following ways:
Mood. The body uses serotonin to transmit messages between nerve cells. It appears to play a key role in maintaining balanced mood. Low serotonin levels have been linked to depression. 120
Anxiety. Serotonin’s role in brain function is important in lessening anxiety and general feelings of unease, which can be debilitating to opioid users during the withdrawal period and can trigger relapse in the following months of recovery. 121
Digestion. Opioid use often leads to constipation. Serotonin is thought to be active in constricting smooth muscles and thus to play an important role in the function of the large intestines. 122
Sleep. Long-term opioid use disrupts sleep cycles. As the precursor for melatonin, serotonin helps regulate the body’s sleep-wake cycles and internal clock. 123
Gamma-aminobutyric acid (GABA) is the chief inhibitory neurotransmitter of the central nervous system. GABA supplements have often been touted as useful for treating alcoholism, but they can also play an important role in opioid recovery in the following areas:
Stress and anxiety. People in withdrawal often experience emotional stress and anxiety. GABA may help alleviate some of those symptoms. 124
Cravings. A recent study suggests that GABA may boost impulse control, and thus it may help prevent relapse. 125
Fatigue. Opioid users in recovery often experience fatigue that can last many months. One study suggests that GABA may help reduce both psychological and physical fatigue. 126
Muscle spasms. Those detoxing from opioids can experience very uncomfortable muscle spasms. GABA plays an important role in the regulation of muscle tone and can help prevent or ameliorate spasms. 127
The body uses L-tyrosine to manufacture dopamine, which in turn is used in the manufacture of norepinephrine and epinephrine. 128 Dopamine is our “focus” neurotransmitter; it regulates cognition and is involved with the executive brain functions that help us control impulses and withstand cravings. 129 It also regulates emotion, motivation, and feelings of pleasure.
L-tyrosine, which is essential for the production of dopamine, can be helpful to the recovering opioid user in a couple of ways:
Cravings. Prolonged opioid use causes structural changes in the brain that influence behaviors associated with the massive opioid-induced dopamine release. 130 The importance of cultivating proper dopamine reactions is most apparent when a person in recovery is exposed to stimuli they associate with the opioid use, such as certain people, places, and situations, as the association networks that have evolved in the brain will strongly interlink these environmental cues with opioid use and can prompt a relapse. 131
Cognition. Extended opioid consumption causes debilitating stress for the brain, negatively affecting cognition. And people in recovery often experience prolonged insomnia, which also can negatively affect cognition. L-tyrosine has been shown to improve cognitive function. 132
Note: L-tyrosine is contraindicated in those who suffer from melanoma, Grave’s disease, phenylketonuria (PKU), chronic migraines, Hashimoto’s thyroiditis, high blood pressure, or bipolar disorder.
The body uses DL-phenylalanine (DLPA) to convert L-tyrosine to dopamine, and the two are often packaged together in supplement form. DLPA is also key in the synthesis of endorphins, which are the brain’s natural, or endogenous, painkillers (see here). 133 Therefore, DLPA can be important in combating both dopamine and endorphin deficits — both of which are common in people recovering from opioid dependency.
Note: D- or DL-phenylalanine is contraindicated in those who suffer from melanoma, Grave’s disease, phenylketonuria (PKU), chronic migraines, Hashimoto’s thyroiditis, high blood pressure, or manic depression (bipolar disorder).
L-glutamine is another amino acid that impacts neurotransmission and participates in a variety of metabolic pathways, and it has been the subject of many recent studies. It is a precursor to GABA, and the two are often used together. Here are some of the ways it may be able to aid in opioid addiction recovery:
Digestion. Many of those using opioids experience digestive imbalances that last long after opioid use has stopped. Glutamine has been shown to improve gastrointestinal health by activating the repair of the intestinal lining and protecting it from deterioration. It promotes healthy bowel movements, lessens episodes of diarrhea and irritable bowel syndrome (IBS), and helps heal ulcers. 134
Memory. Glutamine is essential for nourishing the neuronal synapses responsible for transmitting information in the brain. It can stimulate repair of the damage done to opioid receptors while improving memory, focus, and concentration overall. 135
Detoxification. Glutamine improves liver and kidney metabolism of cellular toxins resulting from opioid use. 136
Note: Use caution when taking L-glutamine if you have bipolar disorder, as it can stimulate a manic episode.