Eating Disorders & Drug Abuse Rochelle, Mikayla, Helen

Commonly Abused Drugs in the U.S. Nicotine Suppresses appetite Amphetamines Marijuana Painkillers/Prescription Drugs Cocaine Heroin Benzodiazepines Ex: Valium, Xanax

Pathophysiology Dependent on type of drug Nicotine, marijuana, amphetamines and cocaine cause large amounts of dopamine to be released This can alter the normal cycling of dopamine throughout the body Malnutrition Use substances to replace dietary needs Negative health risks (Ex. CVD, stroke, cancer, etc.) Liver damage Gastrointestinal issues

Diagnosis Substance Abuse Disorders Patterns of substance use will lead to impairment in one or more of the following ways: Failure or inability to fulfill major role obligations at work, school, or home Recurrent use of substance in situations that would be hazardous such as while driving, supervising small children, or operating machinery Recurrent substance-related legal problems Continuing to use a substance despite persistent interpersonal or social problems that result from using the substance

Diagnosis Eating Disorders Anorexia Nervosa Person has reached a “significantly low weight” Bulimia Nervosa Binge eating and compensatory behaviors must occur once a week for at least three months

Diagnosis ED and Substance Abuse Co-occurring Disorder A person has a mental disorder along with a substance use disorder About half of all individuals with eating disorders struggle with substance use disorder The risk for substance use disorder is prominent among those with bulimia nervosa and those engaging in binge/purge behaviors Co-occurring disorders can be difficult to diagnose due to complexity of symptoms as both may vary in severity

Treatment Inpatient preferred Healthcare providers have awareness of the comorbid diagnosis Usually aggressive, integrated treatment based on individuals’ needs Requires substance abuse professionals and ED professionals Proper communication and teamwork Treating comorbid patients for ONLY ONE disorder in isolation may trigger the OTHER disorder to exacerbate (worsen) current symptoms (Woodside & Staab, 2006) “Address needs of the whole person, not just their abuse, addiction, or disorder.”

Treatment Roles of SUD (Substance Abuse Disorder) Professionals Therapies and rehabilitation Cognitive Behavior Therapy Environmental and emotional dysregulation Drug detoxification Pharmacological treatments discouraged due to varied chemical dependencies and unpredictable processing of substances (Elmquist, J., et. al, 2015) Roles of Eating Disorder Professionals Must take caution when prescribing diet and exercise as treatment Why? Regular diet and exercise can enhance recovery in addicted individuals, but those with compulsive disorders given dietary restrictions or exercise routines may worsen symptoms (Elmquist, J., et. al, 2015)

Recovery Much more complicated than recovering from just an ED Treatment dropout common (Elmquist, J., et. al, 2015) Prevent relapses Relapse occurrences normal, individual to resume treatment or try something new (Volkow, 2018) Seeing changes in deeply rooted, addictive behaviors Decreased dependencies on drugs Long term support to help individual maintain healthy relationship with food

Questions?

Content Questions Which eating disorder has the highest prevalence of substance abuse? Why do you think substance abuse goes hand in hand with eating disorders? Why must eating disorder professionals take caution when prescribing treatment and how might it affect a person struggling with substance abuse?

References Cowden, S., Gans, S (n.d.) It’s Now Easier to Be Diagnosed With an Eating Disorder. Retrieved from https://www.verywellmind.com/diagnostic-changes-in-the-dsm-v-1138301 Co-Occurring Disorders: Bulimia and Substance Abuse. (2018, October 17). Retrieved from https://www.drugrehab.org/bulimia-substance-abuse/ Elmquist, J., Shorey, R. C., Anderson, S., & Stuart, G. L. (2015). Eating disorder symptoms and length of stay in residential treatment for substance use: A brief report. Journal of Dual Diagnosis, 11(3-4), 00. doi:10.1080/15504263.2015.1104480 National Institute on Drug Abuse. (n.d.). Treatment and Recovery. Retrieved March 5, 2019, from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery On the path towards health and healing, it's important to help people address their eating disorder and substance abuse simultaneously. (n.d.). Retrieved from https://www.eatingdisorder.org/treatment-and-support/specialized-treatment-tracks/substance-abuse/ Herzog, D., Franko, D., Dorer, D., Keel, P., Jackson, S. & Manzo, M. (2006). Drug abuse in women with eating disorders. International Journal of Eating Disorders 39, 364-368.