Drug Rehab from the Inside Out?

The best drug rehab and alcohol rehab centers are those that take a holistic approach to drug and alcohol treatment. Most say that healing takes place from "the inside out". Basically, this means that you are making internal changes in your thinking and behavior that leads down a path of sobriety.

I want to point out that a truly holistic drug or alcohol treatment program also promotes healing from the outside in. Like we have talked about before, addiction recovery involves a multi-faceted but integrated treatment approach. The treatment approach does not focus solely on what's inside. Sometimes, things need to change on the outside before the inside can begin to change. For example, there are certain nutritional needs that you are going to have in early recovery. The provision of food and the food being seen as medicine is an outside change that will begin to affect the inside of your body and allow it to heal. Acupuncture is an external process that literally goes from outside in, and works to promote internal healing as well. Physical exercise and your physical environment certainly play a role in the healing process.

So, when drug rehabs promote healing from the inside out, they are missing a big part of the best treatment that can be used for addiction recovery.

Alcoholism and Brain Function... or lack thereof!

(This is a continuation of the blogs on the relationship between alcoholism and nutritional deficiencies) Our body is a complex system with many interacting parts. One example is how alcoholism affects the pancreas, which then affects the brain. Let me explain. Chronic alcohol use can cause impaired insulin secretion from the pancreas. Insulin is a hormone that controls our blood sugar, also known as blood glucose. Alcoholism can result in both overly elevated blood sugar (making you look like you might be diabetic) as well as low blood sugar if too much insulin is secreted.

Guess what the "food" is for the brain? Glucose. Remember alcoholism can produce a state of low glucose in the body. The brain uses glucose in order to work properly. It is the fuel of the brain. Let's make this simple: low blood sugar = starving brain = brain does not work well = you don't think straight, you make poor decisions, you don't function like you used to.

Got that? But wait, there is yet another way alcoholism affects the brain. Remember how we talked previously about impaired B-Vitamin and other vitamin absorption as well as poor nutrition with alcoholism? Chronic alcohol use results in a thiamine deficiency. Thiamin is one of those B-Vitamins. Guess what thiamine does? If you guessed that it is involved in glucose metabolism, you guessed correctly!

No big deal, right? A little vitamin deficiency shouldn't be that bad. Well, chronic thiamin deficiency, which is seen time and time again in alcoholics, causes certain areas of the brain to shrink, also called atrophy. These areas of the brain are involved with different things, some of which are memory. The alcoholic begins to develop a condition called Wernicke-Korsakoff's syndrome. Wernicke's encephalopathy, as it is called, rears it's ugly head most commonly with ataxia (trouble walking straight), an eye condition called nystagmus, and confusion. It can lead to coma or death on occassion. Next comes Korsakoff's psychosis. It is a combination of psychosis, amnesia for recent and past events, and confabulation. In other words, you become psychotic, can't remember what you the hell you did today or yesterday (although memories from a long time ago might still be there), and you make up stories when people ask you a question to try to hide the fact that you can't remember (confabulation).

These conditions can all be treated to varying degrees, depending on how progressed the condition is. Success depends on the competent staff at a "best" alcohol rehab. By that I mean an alcohol rehab that takes a holistic approach to you as an individual, looking at your physical needs as well as emotional, psychological and spiritual needs.

Nutritional Problems in Alcoholism

Alcoholism or heavy alcohol consumption causes a constellation of physical problems for the alcoholic. I am going to address some of these problems in a general way right now. Later, I will address some of the more specific body systems that are altered and damaged due to the alcohol.

Alcoholics that are admitted to alcohol rehab are often surprised to hear of the high percentage of daily calories they are getting from their alcohol use. Sometimes, a person is consuming 70-80% of their calories through alcohol consumption! Obviously, alcohol is not like consuming V-8. It is not a very nutritious drink! It is generally what nutritionists call "empty calories", devoid of protein, vitamins, and minerals.

So one way that the alcoholic becomes nutritionally deficient is by consuming less calories through nutritious food and more empty calories through alcohol. That's the easy part to understand. As you look deeper, you see that alcohol damages the lining of the small intestine and stomach. These damaged cells can not absorb nutrients as well. Next, alcohol inhibits the breakdown of nutrients by decreasing the secretion of important digestive enzymes from the pancreas. So, even when the alcoholic is eating good food, they are less able to absorb the nutrients from it.

One of the nutritional deficiencies that occurs is with a B-complex vitamin called Folic Acid (Folate). As folate levels decrease, it alters further the cells of the small intestine such that even less folate can be absorbed along with other nutrients.

As you can see, one facet of alcohol addiction treatment and alcohol detox involves a nutritional re-feeding and vitamin supplementation. Any good holistic addiction treatment program will address nutritional deficiencies seen in alcoholism with a good dietary evaluation and treatment plan. There will be much more detailed information to follow in future posts!

John Neuhaus, M.D.