Substance Abuse Treatment Modalities: Literature Review

Nutritional Counselling

Nutritional counselling is a popular component in most residential treatment centres in Canada and the U.S. This modality is often associated with broad based treatment approaches that target areas that are not directly concentrating on substance abuse, such as: family relations, employment, education, and social and recreational counselling. Essentially, we are referring to treatment strategies designed for severe substance abusers that take place at residential settings.

Within corrections, nutritional counselling is not used in any of the national substance abuse programs. Nutritional counselling remains a common intervention technique outside of these programs. Community residential sites are the primary locations employing nutritional counselling techniques.

Nutrition is targeted at most residential sites for obvious reasons, the lifestyles of substance abusers are not typically associated with healthy diets. In fact, one study in the United States found that one-fifth to one-half of alcoholics total energy (caloric) intake was from alcohol (Hauser & Iber, 1989). It is fair to point out that the lifestyles of most addicts prevents them from maintaining a well balanced diet that use each of the recommended food groups (Iber, 1988).

Most residential sites include some form of nutritional guidance during the course of treatment. In many instances, residential sites employ experts (e.g. dieticians, physicians, health care workers) to make presentations on how to develop healthy eating patterns as a means of improving recovery goals. Medical tests are also conducted in order to detect elevated blood sugar, elevated biochemical tests, and elevated blood cholesterol (Hurt et al., 1981). Residential sites often attempt to offer healthy meals at regular times during the day with the intention of targeting coping skills, such as improved interpersonal communication with fellow residents (Herzog, & Copeland, 1985).

There is no scientific evidence that demonstrates that nutritional counselling reduces substance abuse (Schafer et al., 1991). There is data that supports the use of nutritional counselling in achieving more modest outcome gains, such as retention in training or improved awareness of health risks associated with poor diet (Hauser, & Iber, 1989). Overall, nutritional counselling will remain a standard modality used at most residential treatment sites that are directed at non-offender populations.

References for Nutritional Counselling:

Baum, R., & Iber, F. (1988), “Initial treatment of the alcoholic patient”, In: Gitlow, S., & Peyser, H., eds. Alcoholism: A Practical Treatment Guide. New York: Grune & Stratton. 73-87.

Hauser, M.., & Iber, F. (1989), “Nutritional Advice and Diet Instruction in Alcoholism Treatment”, Alcohol Health & Research World, 13 (3), 261-266.

Herzog, D.B., & Copeland, P.M. (1985), “Eating disorders”, New England Journal of Medicine, 313 (5), 295-303.

Hauser, M., & Iber, F. (1989), “Nutritional Advice and Diet Instruction in Alcoholism Treatment”, Alcohol Health & Research World, 261-266.

Hurt et al. (1981), “Nutritional status of a group of alcoholics before and after admission to an alcoholism treatment unit”, American Journal of Clinical Nutrition, 34:386-392.

Iber, F. (1988), “Alcohol associated diseases”, In: Kinney. J.; Jeejeebhoy, K.; Hill, G.; & Owen, O. (Eds.) Nutrition and metabolism in Patient Care, Philadelphia: W.B Saunders Co. 429-447.

Schafer et al. (1991), “Neuropsychological differences between male familial and non familial alcoholics and non-alcoholics”, Alcohol Clinical Experiment Research, 347-351.

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