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

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.

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

“…It has been argued that failure to address nutritional conditions can severely undermine treatment (197). In Los Angeles, nutrition services are offered at less than a third of SUD treatment centers (198). Our work has shown educational and culinary interventions can be effective despite operational challenges (199).…”

“…With such strong evidence of overlapping pathways between drugs of abuse and food (220), it is surprising that food has not been investigated as a long-term modulator of reward pathways in humans. Meanwhile, authors from around the globe have suggested that nutrition interventions may be helpful in combating the opioid crisis (156, 198, 221). More evidence is needed before it will be recognized as a treatment modality.…”

Staff-perceived barriers to nutrition intervention in substance use disorder treatment

“…There has been an increasing interest in the role of nutrition in SUD recovery, although to date there are only a handful of intervention studies, using different outcome measures (25)(26)(27)(28)(29)(30)(31) . Opioid and alcohol users can be considered at high nutritional risk (32,33) , yet most treatment centres do not offer any nutritional counselling or support (34) . It is well established that SUD is associated with poor nutritional status, including malnutrition, and various forms of disordered eating, reviewed elsewhere (35) .…”

“…A recent survey showed that less than a third of SUD treatment centres in Los Angeles offer any nutrition services (34) . Some authors have suggested that individualised nutrition interventions may improve opioid treatment outcomes (44) , yet the role of nutrition in SUD recovery remains understudied.…”

Substance Use Disorder Treatment and Nutrition: A Multidisciplinary Approach

“…Additionally, dietitians have recognized the importance of their role in promoting wellness by diversifying multidisciplinary teams and providing nutritional evaluations and dietary assessments, nutritional therapy and education, menu design, and aftercare consultations [4] agreed that dietitians have an important role in improving the physical health of individuals with mental health problems and should be active members of a multidisciplinary team. Researchers have acknowledged that the current psychosocial treatment model of substance use treatment has been unsuccessful in providing the degree of desired outcomes and other aspects of treatment must be identified [5].…”