Skip to main content

Advertisement

SpringerLink
Log in

Rapid Assessment of Nutrition Services in Los Angeles Substance Use Disorder Treatment Centers

  • Original Paper
  • Published:
Journal of Community Health Aims and scope Submit manuscript

Abstract

The objective of this study was to determine the prevalence of nutrition services and utilization of registered dietitian nutritionists at substance use disorder treatment centers in Los Angeles. This cross-sectional descriptive study utilized phone interviews with facilities within a 25-mile radius of the Los Angeles metropolitan area using the Substance Abuse and Mental Health Services Administration Treatment Services Locator to identify facilities that included a listing of substance abuse as primary focus of care (n = 128). Facilities were asked if they offered any kind of nutrition services, the type of services that were offered, and the credential of the professional providing the services. We compared facilities that offered a residential level of care to those offering outpatient services only. The Fisher’s exact test was used to determine statistical significance. The study showed that only 39 sites (30.5%) offered any type of nutrition services on site, and the odds of a residential level of care offering nutrition services was 2.7 times higher than outpatient only facilities (p = 0.02). Of the 39 facilities offering nutrition services, only 8 (20.5%) utilized a registered dietitian nutritionist. Overall fewer than 7% of the facilities utilized the services of a dietitian. Recovery programs for substance use disorder should consider using a registered dietitian nutritionist as a member of the treatment team, which may contribute to better clinical outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Explore related subjects

Discover the latest articles, news and stories from top researchers in related subjects.

References

  1. Center for Behavioral Health Statistics and Quality, Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA 16-4984, NSDUH Series H-51). 2016.

  2. U.S. Department of Health and Human Services Centers for Disease Control and Prevention. (2014). Increases in heroin overdose deaths: 28 states, 2010 to 2012. Morbidity and Mortality Weekly Report, 63(29), 849–854.

    Google Scholar 

  3. American Dietetic Association, Position of the American Dietetic Association. (1990). Nutrition intervention in treatment and recovery from chemical dependency. Journal of the American Dietetic Association, 90(9), 1274–1277.

    Google Scholar 

  4. Pelican, S., Batchelor, B., Belshaw, J., Osborn, W., Pearce, J., & Przekurat, C. (1994). Nutrition services for alcohol/substance abuse clients. Indian Health Service’s tribal survey provides insight. Journal of The American Dietetic Association, 94(8), 835–836.

    Article  CAS  PubMed  Google Scholar 

  5. Engel, G. L. (1980). The clinical application of the biopsychosocial model. American Journal of Psychiatry, 137(5), 535–544.

    Article  CAS  PubMed  Google Scholar 

  6. Griffiths, M. (2009). A ‘components’ model of addiction within a biopsychosocial framework. Journal of Substance Use, 10(4), 191–197.

    Article  Google Scholar 

  7. McLellan, A. T., Luborsky, L., O’Brien, C. P., Woody, G. E., & Druley, K. A. (1982). Is treatment for substance abuse effective? JAMA, 247, 1423–1428.

    Article  CAS  PubMed  Google Scholar 

  8. McLellan, A. T., Luborsky, L., Woody, G. E., O’Brien, C. P., & Druley, K. A. (1983). Predicting response to alcohol and drug abuse treatments: Role of psychiatric severity. Archives of General Psychiatry, 40, 620–625.

    Article  CAS  PubMed  Google Scholar 

  9. McLellan, A. T., Woody, G. E., Metzger, D., McKay, J., Durell, J., Alterman, A. I., & O’Brien, C. P. (1996). Evaluating the effecitveness of addiction treatments: Reasonable expectations, appropriate comparisons. The Milbank Quarterly, 74(1), 51–85.

    Article  CAS  PubMed  Google Scholar 

  10. O’Brien, C. P., & McLellan, A. T. (1996). Myths about the treatment of addiction. The Lancet, 347, 237–240.

    Article  Google Scholar 

  11. McLellan, A. T., Alterman, A. I., Cacciola, J., Metzger, D., & OʼBrien, C. P. (1992). A new measure of substance abuse treatment: Initial studies of the treatment services review. The Journal of Nervous and Mental Disease, 180(2), 101–110.

    Article  CAS  PubMed  Google Scholar 

  12. McLellan, A. T., Hagan, T. A., Levine, M., Gould, F., Meyers, K., Bencivengo, M., & Durell, J. (1998). Supplemental social services improve outcomes in public addiction treatment. Addiction, 93(10), 1489–1499.

    Article  CAS  PubMed  Google Scholar 

  13. Substance Abuse and Mental Health Services Administration. (2017). National Survey of Substance Abuse Treatment Services (N-SSATS): 2016.

  14. Santolaria-Fernández, F. J., Gómez-Sirvent, J. L., González-Reimers, C. E., Batista-López, J. N., Jorge-Hernández, J. A., Rodríguez-Moreno, F., et al. (1995). Nutritional assessment of drug addicts. Drug and Alcohol Dependence, 38(1), 11–18.

    Article  PubMed  Google Scholar 

  15. Islam, S. N., Hossain, K. J., Ahmed, A., & Ahsan, M. (2002). Nutritional status of drug addicts undergoing detoxification: Prevalence of malnutrition and influence of illicit drugs and lifestyle. British Journal of Nutrition, 88(5), 507–513.

    Article  CAS  Google Scholar 

  16. Ross, L. J., Wilson, M., Banks, M., Rezannah, F., & Daglish, M. (2012). Prevalence of malnutrition and nutritional risk factors in patients undergoing alcohol and drug treatment. Nutrition, 28(7–8), 738–743.

    Article  PubMed  Google Scholar 

  17. Baptiste, F. (2009). Drugs and diet among women street sex workers and injection drugs user in Quebec City. Candian Journal of Urban Research, 18(2), 78–95.

    Google Scholar 

  18. Kampov-Polevoy, A., Garbutt, J. C., & Janowsky, D. (1997). Evidence of preference for a high-concentation sucrose solution in alcoholic men. American Journal of Psychiatry, 154(2), 269–270.

    Article  CAS  PubMed  Google Scholar 

  19. Neale, J., Nettleton, S., Pickering, L., & Fischer, J. (2012). Eating patterns among heroin users: A qualitative study with implications for nutritional interventions. Addiction, 107(3), 635–641.

    Article  PubMed  Google Scholar 

  20. Saeland, M., Haugen, M., Eriksen, F. L., Wandel, M., Smehaugen, A., Böhmer, T., & Oshaug, A. (2011). High sugar consumption and poor nutrient intake among drug addicts in Oslo, Norway. British Journal of Nutrition, 105(4), 618–624.

    Article  CAS  PubMed  Google Scholar 

  21. Alves, D., Costa, A. F., Custódio, D., Natário, L., Ferro-Lebres, V., & Andrade, F. (2011). Housing and employment situation, body mass index and dietary habits of heroin addicts in methadone maintenance treatment. Heroin Addiction and Related Clinical Problems, 13(1), 11–14.

    Google Scholar 

  22. Leclercq, S., Cani, P. D., Neyrinck, A. M., Stärkel, P., Jamar, F., Mikolajczak, M., et al. (2012). Role of intestinal permeability and inflammation in the biological and behavioral control of alcohol-dependent subjects. Brain, Behavior, and Immunity, 26(6), 911–918.

    Article  CAS  PubMed  Google Scholar 

  23. Leclercq, S., Matamoros, S., Cani, P. D., Neyrinck, A. M., Jamar, F., Stärkel, P., et al. (2014) Intestinal permeability, gut-bacterial dysbiosis, and behavioral markers of alcohol-dependence severity. Proceedings of the National Academy of Sciences, 111(42):E4485–E4493.

    Article  CAS  Google Scholar 

  24. Volpe, G. E., Ward, H., Mwamburi, M., Dinh, D., Bhalchandra, S., Wanke, C., & Kane, A. V. (2014). Associations of cocaine use and HIV infection with the intestinal microbiota, microbial translocation, and inflammation. Journal of Studies on Alcohol and Drugs, 75(2), 347–357.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Cowan, J. A., & Devine, C. M. (2008). Food, eating, and weight concerns of men in recovery from substance addiction. Appetite, 50(1), 33–42.

    Article  PubMed  Google Scholar 

  26. Warren, C. S., Lindsay, A. R., White, E. K., Claudat, K., & Velasquez, S. C. (2013). Weight-related concerns related to drug use for women in substance abuse treatment: Prevalence and relationships with eating pathology. Journal of Substance Abuse Treatment, 44(5), 494–501.

    Article  PubMed  Google Scholar 

  27. Bonfa, F., Cabrini, S., Avanzi, M., Bettinardi, O., Spotti, R., & Uber, E. (2008). Treatment dropout in drug-addicted women: Are eating disorders implicated? Eating and Weight Disorders, 13(2), 81–86.

    Article  CAS  PubMed  Google Scholar 

  28. Bulik, C. M., Slof, M., & Sullivan, P. (2004). Comorbidity of eating disorders and substance-related disorders. Medical Psychiatry, 27, 317–348.

    Google Scholar 

  29. Ho, V., Arbour, S., & Hambley, J. M. (2011). Eating disorders and addiction: Comparing eating disorder treatment outcomes among clients with and without comorbid substance use disorder. Journal of Addictions Nursing, 22(3), 130–137.

    Article  Google Scholar 

  30. Glasner-Edwards, S., Mooney, L. J., Marinelli-Casey, P., Hillhouse, M., Ang, A., & Rawson, R. & Methamphetamine Treatment Project Corporate Authors. (2011). Bulimia nervosa among methamphetamine dependent adults: Association with outcomes three years after treatment. Eating Disorders, 19(3), 259–269.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Gadalla, T., & Piran, N. (2007). Eating disorders and substance abuse in Canadian men and women: A national study. Eating Disorders, 15(3), 189–203.

    Article  PubMed  Google Scholar 

  32. Rieder, R., Wisniewski, P. J., Alderman, B. L., & Campbell, S. C. (2017). Microbes and mental health: A review. Brain, Behavior, and Immunity. https://doi.org/10.1016/j.bbi.2017.01.016.

    Article  PubMed  Google Scholar 

  33. Keightley, P. C., Koloski, N. A., & Talley, N. J. (2015). Pathways in gut-brain communication: Evidence for distinct gut-to-brain and brain-to-gut syndromes. Australian & New Zealand Journal of Psychiatry, 49(3), 207–214.

    Article  Google Scholar 

  34. Skosnik, P. D., & Cortes-Briones, J. A. (2016). Targeting the ecology within: The role of the gut-brain axis and human microbiota in drug addiction. Medical Hypotheses, 93, 77–80.

    Article  CAS  PubMed  Google Scholar 

  35. Temko, J. E., Bouhlal, S., Farokhnia, M., Lee, M. R., Cryan, J. F., & Leggio, L. (2017). The microbiota, the gut and the brain in eating and alcohol use disorders: A ‘Menage a Trois’? Alcohol Alcoholism, 52, 403–413.

    Article  CAS  PubMed  Google Scholar 

  36. Mutlu, E. A., Gillevet, P. M., Rangwala, H., Sikaroodi, M., Naqvi, A., Engen, P. A., et al. (2012). Colonic microbiome is altered in alcoholism. American Journal of Physiology-Gastrointestinal and Liver Physiology, 302(9), G966–G978.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Gorky, J., & Schwaber, J. (2016). The role of the gut-brain axis in alcohol use disorders. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 65, 234–241.

    Article  CAS  PubMed  Google Scholar 

  38. Prakash, M. D., Tangalakis, K., Antonipillai, J., Stojanovska, L., Nurgali, K., & Apostolopoulos, V. (2017). Methamphetamine: Effects on the brain, gut and immune system. Pharmacological Research, 120, 60–67.

    Article  CAS  PubMed  Google Scholar 

  39. Alcoholics Anonymous World Services. (2001). Alcoholics anonymous. New York: Alcoholics Anonymous World Services, Inc.

    Google Scholar 

  40. Popkin, B. M., & Gordon-Larsen, P. (2004). The nutrition transition: Worldwide obesity dynamics and their determinants. International Journal of Obesity and Related Metabolic Disorders, 28(Suppl 3), S2–S9.

    Article  PubMed  Google Scholar 

  41. Hall, K. D. (2018). Did the food environment cause the obesity epidemic? Obesity, 26(1), 11–13.

    Article  PubMed  Google Scholar 

  42. National Center for Chronic Disease Prevention and Health Promotion. (2017). National Diabetes Statistics Report.

  43. Balhara, Y. P. S., & Kalra, S. (2017). Drug addiction and diabetes: South Asian action. Recent Advances in Endocrinology, 67(6), 954–956.

    Google Scholar 

  44. Mies, G. W., Treur, J. L., Larsen, J. K., Halberstadt, J., Pasman, J. A., & Vink, J. M. (2017). The prevalence of food addiction in a large sample of adolescents and its association with addictive substances. Appetite, 118, 97–105.

    Article  PubMed  Google Scholar 

  45. Hardy, R., Fani, N., Jovanovic, T., & Michopoulos, V. (2018). Food addiction and substance addiction in women: Common clinical characteristics. Appetite, 120, 367–373.

    Article  PubMed  Google Scholar 

  46. García-García, I., Horstmann, A., Jurado, M. A., Garolera, M., Chaudhry, S. J., Margulies, D., et al. (2014). Reward processing in obesity, substance addiction and non-substance addiction. Obesity Review, 15(11), 853–869.

    Article  Google Scholar 

  47. Edge, P. J., & Gold, M. S. (2011). Drug withdrawal and hyperphagia: Lessons from tobacco and other drugs. Current Pharmaceutical Design, 17(12), 1173–1179.

    Article  CAS  PubMed  Google Scholar 

  48. Hodgkins, C., Frost-Pineda, K., & Gold, M. S. (2007). Weight gain during substance abuse treatment: The dual problem of addiction and overeating in an adolescent population. Journal of Addictive Diseases, 26(Suppl 1), 41–50.

    Article  PubMed  Google Scholar 

  49. Emerson, M. H., Glovsky, E., Amaro, H., & Nieves, R. (2009). Unhealthy weight gain during treatment for alcohol and drug use in four residential programs for Latina and African American Women. Substance Use & Misuse, 44(11):1553–1565.

    Article  Google Scholar 

  50. Calero-Elvira, A., Krug, I., Davis, K., López, C., Fernández-Aranda, F., & Treasure, J. (2009). Meta-analysis on drugs in people with eating disorders. European Eating Disorders Review, 17(4), 243–259.

    Article  PubMed  Google Scholar 

  51. Dennis, A. B., Pryor, T., & Brewerton, T. D. (2014). Integrated treatment principles and strategies for patients with eating disorders, substance use disorder, and addictions. In T. D. Brewerton & A. B. Dennis (Eds.), Eating disorders, addictions and substance use disorders. Berlin: Springer.

    Google Scholar 

  52. Leppert, W. (2015). Emerging therapies for patients with symptoms of opioid-induced bowel dysfunction. Drug Design, Development and Therapy, 9, 2215–2231.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. Reid, B. K. (2014). Assessment of wellness and nutrition in residential alcohol and drug abuse treatment, in Heller School for Social Policy and Management, Brandeis University ProQuest.

  54. Cowan, J. A., & Devine, C. M. (2012). Process evaluation of an environmental and educational nutrition intervention in residential drug-treatment facilities. Public Health Nutrition, 15(7), 1159–1167.

    Article  PubMed  Google Scholar 

  55. Cowan, J. A., & Devine, C. M. (2013). Diet and body composition outcomes of an environmental and educational intervention among men in treatment for substance addiction. Journal of Nutrition Education and Behavior, 45(2), 154–158.

    Article  PubMed  Google Scholar 

  56. Curd, P., Ohlmann, K., & Bush, H. (2013). Effectiveness of a voluntary nutrition education workshop in a state prison. Journal of Correctional Health Care, 19(2), 144–150.

    Article  PubMed  Google Scholar 

  57. Grant, L. P., Haughton, B., & Sachan, D. S. (2004). Nutrition education is positively associated with substance abuse treatment program outcomes. Journal of The American Dietetic Association, 104(4), 604–610.

    Article  PubMed  Google Scholar 

  58. Lindsay, A. R., Warren, C. S., Velasquez, S. C., & Lu, M. (2012). A gender-specific approach to improving substance abuse treatment for women: The healthy steps to freedom program. Journal of Substance Abuse Treatment, 43(1), 61–69.

    Article  PubMed  Google Scholar 

  59. Barbadoro, P., Ponzio, E., Pertosa, M. E., Aliotta, F., D’errico, M. M., Prospero, E., & Minelli, A. (2011). The effects of educational intervention on nutritional behaviour in alcohol-dependent patients. Alcohol and Alcoholism, 46(1), 77–79.

    Article  PubMed  Google Scholar 

  60. Moore, K. (2016). Hands-on nutrition and culinary intervention within a substance use disorder residential treatment facility. Journal of the Academy of Nutrition and Dietetics, 116(9), A20.

    Article  Google Scholar 

  61. Wiss, D. A., Schellenberger, M., & Prelip, M. L. (2017). Registered dietitian nutritionists in substance use disorder treatment centers. Journal of the Academy of Nutrition and Dietetics. https://doi.org/10.1016/j.jand.2017.08.113.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Fielding School of Public Health, Community Health Sciences, University of California Los Angeles, 650 Young Drive South, Los Angeles, CA, 90025, USA

    David A. Wiss & Michael L. Prelip

  2. Leonard Davis School of Gerontology, University of Southern California, 3715 McClintock Ave., Los Angeles, CA, 90089, USA

    Maria Schellenberger

Authors
  1. David A. Wiss
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Maria Schellenberger
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michael L. Prelip
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

MS collected the data and contributed sections to the manuscript. DW assisted with data collection protocols and wrote the first draft of manuscript. MP edited and contributed to the manuscript. All authors reviewed and commented on subsequent drafts of the manuscript.

Corresponding author

Correspondence to David A. Wiss.

Ethics declarations

Conflict of interest

David Wiss is the founder and owner of Nutrition in Recovery LLC which provides nutrition services to substance use disorder treatment facilities in Los Angeles, CA, including some in the sample. Mr. Wiss was not involved in contacting any of the facilities.

Ethics Approval

This study was approved by the University of Southern California University Park Institutional Review Board under Study ID: UP-16-00334.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wiss, D.A., Schellenberger, M. & Prelip, M.L. Rapid Assessment of Nutrition Services in Los Angeles Substance Use Disorder Treatment Centers. J Community Health 44, 88–94 (2019). https://doi.org/10.1007/s10900-018-0557-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10900-018-0557-2

Keywords

Search

Navigation