A Biopsychosocial Overview of the Opioid Crisis: Considering Nutrition and Gastrointestinal Health

Abstract

The opioid crisis has reached epidemic proportions in the United States with rising overdose death rates. Identifying the underlying factors that contribute to addiction vulnerability may lead to more effective prevention strategies. Supply side environmental factors are a major contributing component. Psychosocial factors such as stress, trauma, and adverse childhood experiences have been linked to emotional pain leading to self-medication. Genetic and epigenetic factors associated with brain reward pathways and impulsivity are known predictors of addiction vulnerability. This review attempts to present a biopsychosocial approach that connects various social and biological theories related to the addiction crisis. The emerging role of nutrition therapy with an emphasis on gastrointestinal health in the treatment of opioid use disorder is presented. The biopsychosocial model integrates concepts from several disciplines, emphasizing multicausality rather than a reductionist approach. Potential solutions at multiple levels are presented, considering individual as well as population health. This single cohesive framework is based on the interdependency of the entire system, identifying risk and protective factors that may influence substance-seeking behavior. Nutrition should be included as one facet of a multidisciplinary approach toward improved recovery outcomes. Cross-disciplinary collaborative efforts, new ideas, and fiscal resources will be critical to address the epidemic.

The Association of Opioid Use Disorder and COVID-19 in Shahroud, Iran

“…Opioid use disorder is a common health problem in all societies, and people with OUD are susceptible to infectious diseases in biological, nutritional, behavioral, and quality of life aspects (17). Since the COVID-19 pandemic began, little information has been provided in Iran (18, 19) and sometimes misconceptions have been raised about the resistance of these people to COVID-19.…”

Epigenetic Alterations in Prescription Opioid Misuse: New Strategies for Precision Pain Management

“…Moreover, BDNF is a well-known mediator of the mechanism through which neuronal plasticity is affected by environmental experiences [83] and should be considered in association with the environment, which has mainly been explored in heroin-related research. Environmental risk factors for opioid misuse, abuse, or addiction have been identified as psychiatric comorbidities, substance abuse, adverse childhood experiences, general social or family environments, and psychosocial vulnerability [84,85]. Interestingly, pain and pain-related brain changes are also highly affected and can be reduced by socially and physically enriched environments, exercise, and mood [86].…”

Food insecurity partially mediates the association between drug use and depressive symptoms among men who have sex with men in Los Angeles, California

“…Our work provides additional support for the explanatory pathways suggested in their model, but there are many questions in the domain of nutritional psychiatry that remain unanswered. For example, there is a need to understand how drugs impact gut health in humans, and whether gut-based nutrition interventions can improve mental health during abstinence (62,63) or if/when the individual continues to use drugs. Future research should investigate if efforts to address FI lead to improved nutritional status, and whether or not improved nutritional status can improve mood.…”