Diet Intervention Could Aid Treatment of Substance Use Disorders

Making healthy food

Key Takeaways

  • Low nutrient intake is common among those with substance use disorders, but focus on diet is not a widespread part of treatment, a study suggests.
  • Rather than looking toward supplements first, there are some easy diet changes that may help, dietitians advise.
  • These kinds of dietary changes aren’t just for those with substance use disorders; they can be beneficial for anyone who wants to improve mental health.

Disordered eating habits and low nutrient intake is common among those with substance use disorders but dietary interventions seem to be an underrated aspect of care, according to a research review in the Journal of Human Nutrition and Dietetics.  

Researchers assessed over 9,000 studies to determine the prevalence of interventions aiming to improve dietary intake for those with these disorders but found only five studies showing the results of such interventions.

Of those studies, three reported small but significant changes in one or more dietary outcomes, including:

  • Reduced sweets and sugary foods
  • Less fast food
  • Reduced caffeine
  • Increased fruit and vegetable intake

They concluded that more research is needed, but that even the small number of studies shows strong evidence that dietary intervention can be useful when addressing substance use disorders.

Growing Evidence Shows Major Need

According to the Substance Abuse and Mental Health Services Administration, substance use disorders occur when the recurrent use of alcohol and/or drugs causes significant impairment, such as health problems, disability, or failure to meet responsibilities at work, home, or school.

A July 2020 study published in Psychiatry Research found that even early in the pandemic, substance use was on the rise, despite these disorders increasing the risk of severe symptoms of COVID-19.

Another study, in Molecular Psychiatry in September 2020, found that people with substance use disorders were significantly overrepresented among those with COVID-19, and are 10 times more likely to contract the virus and experience severe symptoms than those without these disorders.

With the growing prevalence of substance use disorders and the potential far-reaching health impacts in the midst of a pandemic, that makes the expansion of treatment options increasingly important, and dietary shifts may help.

Starting Points for Change

For those who have substance use disorders or other mental health challenges, making meaningful dietary changes can be important—and they can also provide benefits for those struggling with other issues like pandemic fatigue, ongoing stress, and everyday irritability, according to dietitian Michelle Routhenstein, RD, owner of Entirely Nourished.

Michelle Routhenstein, RD

Certain foods release the feel-good hormone, serotonin in the brain, while other foods help reduce inflammation, which may also impact mood.

— Michelle Routhenstein, RD

“Certain foods release the feel-good hormone, serotonin, in the brain,” she says. “While other foods help reduce inflammation, which may also impact mood.”

For example, she says research indicates that low intake of omega-3 fatty acids is linked to depressed mood, hostility, and impulsive behavior. Higher consumption is associated with elevated mood and decreased depression risk. Foods high in omega-3s include:

  • Salmon
  • Sardines
  • Arctic char
  • Walnuts
  • Chia seeds
  • Flax seeds

Routhenstein adds that foods containing melatonin can also be powerful since they promote optimal sleep, another crucial aspect of improving mental health. Those foods include oats, bananas, cherries, barley, radishes, and tomatoes.

In terms of what to avoid, she says highly processed foods tend to lead to spikes in blood sugar and chronic inflammation, which can increase risk of depressive symptoms.

Gut Health Connection

When focusing on better eating for brain health, the gut should be a major focus area, according to dietitian Mary Purdy, R.D.N., author of The Microbiome Diet Reset.

Mary Purdy, R.D.N.

Considering how large the role is for serotonin when it comes to emotional health, adding foods that support gut function can be a vital part of dealing with mental health

— Mary Purdy, R.D.N.

“About 90 percent of your body’s serotonin is made in the gut,” she says. “Considering how large the role is for serotonin when it comes to emotional health, adding foods that support gut function can be a vital part of dealing with mental health.”

Fermented foods are particularly good for this, including:

  • Yogurt
  • Kefir
  • Kim chi
  • Sauerkraut
  • Beet kvass
  • Kombucha
  • Pickles (fermented and not pasteurized)

Those tend to increase the diversity of your gut bacteria, and keeping them thriving once they're in the gut is the work of prebiotics, which includes choices like:

  • Onions
  • Garlic
  • Whole wheat
  • Bananas
  • Beans

“What’s happening in our guts based on what we eat influences nearly everything in the body,” says Purdy. “That definitely includes the brain, so if you’re feeling challenged by mental or emotional health issues, what you eat should be a component of addressing those.”

What This Means For You

If you find yourself struggling with emotional and mental health challenges and experiencing signs of substance use disorder, talk with your primary care physician or other healthcare provider for appropriate referrals. You may be able to do telehealth sessions with a therapist or counselor, even as a new patient.


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  1. Whatnall, M.C., et al. Efficacy of dietary interventions in individuals with substance use disorders for illicit substances or illicit use of pharmaceutical substances: A systematic review. J Hum Nutr Diet. March 2, 2021. DOI: 10.1111/jhn.12871


  2. Ornell F, Moura HF, Scherer JN, Pechansky F, Kessler FHP, von Diemen L. The COVID-19 pandemic and its impact on substance use: Implications for prevention and treatment. Psychiatry Res. 2020;289:113096. doi:10.1016/j.psychres.2020.113096

  3. Wang, Q.Q., Kaelber, D.C., Xu, R. et al. COVID-19 risk and outcomes in patients with substance use disorders: analyses from electronic health records in the United StatesMol Psychiatry 26, 30–39 (2021). DOI: 10.1038/s41380-020-00880-7