Post Acute Withdrawal Syndrome & Nutrition

The way we eat has a tremendous effect on the levels of stress we experience and our ability to manage the symptoms of post acute withdrawal. Poor health contributes to stress, and malnutrition contributes to poor health. Practically all alcoholics and addicts suffer from malnutrition to one degree or another when we first get clean and sober, and we may continue to feel the effects for months after adopting a healthier lifestyle. Unless we consciously attempt to improve our diets and properly supply our nutritional needs, the poor eating habits that have carried over from our using days pretty-much guarantee that we will continue to do so. Our bodies, damaged by alcohol and drugs, were not—and may still not be—able to absorb nutrients properly. This, combined with our inattention to diet, has created deficiencies that we must deal with in order to allow our bodies to repair themselves, reduce stress, and enjoy good health. We should take a multi-vitamin every day.

Hypoglycemia – the secret demon of relapse

We’re tired and hungry. It’s been a long day, and we won’t be able to have dinner for a couple of hours. A candy bar is just what we need to pick us up and get us through the rest of the day. So, we have our candy bar. Forty-five minutes later, we are angry at our boss, arguing with our co-workers, suffering with tense muscles and a nasty headache. We’re thinking that life sucks and maybe getting high isn’t such a terrible idea after all.   Has this ever happened to you?  Then you already know something about hypoglycemia. Our brains use glucose for fuel. If our brains are completely deprived of glucose, we will die just as quickly as we would if our air were shut off. Fortunately, our blood carries glucose to our brain, and as long as our heart is beating we don’t usually have to worry about its fuel supply. Usually. Glucose is manufactured by our bodies from the carbohydrates that we eat. Carbohydrates (carbs) are a class of nutrients that include sugars (several kinds), pasta, bread, potatoes, and similar “starchy” foods. Practically all foods contain some carbs, but the most concentrated sources of them are sugars and alcohol. In addition to fueling our brains, glucose provides energy for every cell in our bodies. Without glucose, in the right quantities, our bodies just don’t work right. The carbohydrates most easily converted into glucose are the sugars. This is why we like them so much. Our bodies recognize that they are a ready source of energy. Alcohol is easily converted, as well. The problem arises when we are in need of food and our bodies get a big jolt of sugar. The sugar—whether it is from candy or fruit—is quickly converted into glucose. The amount of glucose in our blood rises very quickly, and we feel a burst of energy. We may feel some mood alteration as our brains receive a huge jolt of fuel. We just received a reward for eating some sugar. The big jolt of sugar on an empty stomach causes the blood glucose to rise rapidly. A center in our brain detects the rise, and signals the pancreas to produce more insulin to deal with the sudden rise in blood sugar—too much insulin. The insulin causes us to burn the extra glucose rapidly, and our blood sugar comes down, but because there is so much insulin our blood glucose levels drop too far. Now our bodies—and our brains—are low on glucose. The brain functions poorly. Waste products build up in our muscles and cause, along with inefficient signals from the brain, tightness and muscle tremors. Our heads begin to ache. Our thinking gets fuzzy. Some of us get downright MEAN. Our energy levels drop. We push people away—if we don’t scare them away. We are HUNGRY, ANGRY, LONELY and TIRED. Most of us, in our addictions, knew all too well how to quell those nasty feelings by using. We taught ourselves to interpret the symptoms of hypoglycemia as wanting to use. So, how do we avoid the trap? Easy in principle, but it involves some attention, some learning, and some effort. Basically, we don’t let ourselves get hungry.


  • Three well-balanced meals each day
  • Three nutritious snacks each day, between meals and at bedtime
  • Avoid Sugar and Caffeine

Planning meals

Alcoholics and addicts in early recovery almost literally “take our lives in our hands” each time we plan our daily meals.   Our daily diets should consist of a balanced mix of vegetables, fruit, carbohydrates, (such as potatoes, whole-grain rice, and dark breads,) protein (not necessarily meat), fat, and dairy products. A nutritionist can be a great help in the beginning, and there are thousands of books on nutrition and meal-planning that may be consulted. If we don’t know how to shop and cook, now is a good time to learn. We should try to plan our eating schedules so that we do not skip meals—ever—and so that we can have nutritious snacks between meals. We must not snack on candy, donuts, soft drinks, (incredibly high in sugar,) potato chips, or other high calorie, low nutrient foods. Instead we should carry raw vegetables, wheat crackers, a half sandwich, nuts, or even a package of cheese and crackers. These, along with a glass of water or milk, will keep our blood sugar steady and our moods elevated until time for the next meal. Having a nutritious snack before we begin to feel hungry will prevent our craving for sweets, as well. These eating habits are not inconsistent with meal planning for weight loss. Competent dieticians and honest diet doctors know that several smaller meals are more conducive to weight loss than three larger meals, since the body more easily uses the smaller quantities of food, and is less likely to store it as fat. In fact, properly planned meals will contribute to our health, energy and feelings of well-being, and make it easier for us to engage in exercise, (the real secret to weight control.) (Adapted from Relapse Prevention seminars hosted by Terence Gorski and his book Staying Sober and its accompanying workbook)