Drug use disorder is a major public health problem. Once people who use drugs (PWUD) are referred to treatment, addressing their lifestyle practices and improving their quality of life improves treatment outcomes. The present study assessed the nutritional status and lifestyle practices among PWUD undergoing treatment for recovery in Lebanon. Furthermore, it explored significant differences in these parameters depending on the offered treatment modality, namely opioid substitution treatment (OST) and rehabilitation. In total, 187 PWUD undergoing treatment for recovery participated in this cross-sectional study.
Nutritional status and anthropometrics, dietary intake, nutrition knowledge, food addiction, biochemical parameters, sleep and physical activity were measured using validated tools. Of the participants, 88⋅8 % were well nourished based on the Subjective Global Assessment. In total, 67 % gained weight during treatment placing them in the overweight category. This increase in weight was significantly higher in the rehabilitation group. It came in parallel with higher protein and energy intakes, higher rate of food addiction, and poor nutrition knowledge. Biochemical parameters, including fasting blood sugar, total protein, lipid profile and white blood cell count, were in the normal ranges. Moreover, the majority of participants exhibited poor quality sleep that was accentuated among the participants undergoing rehabilitation, in addition to activity levels that were mainly low in the OST group. PWUD undergoing treatment for recovery in Lebanon are subject to various vulnerability factors creating challenges to treatment. Longitudinal assessments to better understand health problems arising during treatment and to identify the components of a comprehensive health promotion intervention during treatment for recovery are needed.
Abstract
Summary
The results obtained provide evidence that PWUD undergoing treatment for recovery have a good nutritional status, but experience suboptimal dietary intake, weight gain and increased adiposity. They also have poor lifestyle practices, specifically poor quality of sleep and low physical activity levels.
In total, 67 % gained weight during treatment placing them in the overweight category. This increase in weight was significantly higher in the rehabilitation group. It came in parallel with higher protein and energy intakes, higher rate of food addiction, and poor nutrition knowledge. Biochemical parameters, including fasting blood sugar, total protein, lipid profile and white blood cell count, were in the normal ranges. Moreover, the majority of participants exhibited poor quality sleep that was accentuated among the participants undergoing rehabilitation, in addition to activity levels that were mainly low in the OST group. PWUD undergoing treatment for recovery in Lebanon are subject to various vulnerability factors creating challenges to treatment
Nutritional parameters and lifestyle practices of people who use drugs undergoing treatment for recovery in Lebanon: a descriptive study
Mahboub N, Rizk R, de Vries N.
Trained licensed dietitians assessed the participants for anthropometrics, conducted the 24-h dietary recall and administered the questionnaires. All questionnaires were administered in Arabic (the native language of the participants). A licensed phlebotomist drew the blood samples, and a licensed nurse measured the blood pressure (BP). Data collection required 40–50 min per participant
Methodology
Sample Size
187 PWUD (people who use drugs) undergoing treatment for recovery (OST: n 97; rehabilitation: n 90) participated in the study. Subjects met inclusion critieria being Lebanese, above 18 years of age and receiving treatment for more than 1 month from cross-sectional study in drug treatment facilities offering OST and institutionalised rehabilitation services post-detoxification in Lebanon.
92⋅0 % were males with the significant majority coming from the OST group (OST: 96⋅9 %; rehabilitation: 86⋅7 %; P < 0⋅05). The mean age of the participants was 32⋅0±8⋅3 years, only
5⋅3 % were illiterate, and the majority received at least an intermediate level of education. One-quarter of the participants were using antidepressants (25⋅7 %); this finding was more
common in the rehabilitation group (OST: 17⋅5 %; rehabilitation: 34⋅4 %; P < 0⋅05). This difference was no longer seen when females were excluded. More than one-third of them were on antipsychotic drugs (38⋅5 %) and 22⋅5 % on epilepsybipolar medications, with a significantly higher percentage of use in the rehabilitation group (OST: 11⋅3 %; rehabilitation:
34⋅4 %; P < 0⋅05).
Conclusion
The present study fills a gap in the literature regarding the nutritional parameters and lifestyle practices among PWUD in different treatment modalities. The results obtained provide evidence
that PWUD undergoing treatment for recovery have a good nutritional status, but experience suboptimal dietary intake, weight gain and increased adiposity. They also have poor lifestyle practices, specifically poor quality of sleep and low physical activity levels. Further research should be conducted on a more representative sample to examine the correlation between specific nutritional parameters and lifestyle practices with weight gain, disease development and risk of relapse across different treatment
modalities. Additional research is also needed to identify the components of a comprehensive and targeted health promotion intervention to be implemented during treatment to improve PWUD’s nutritional health and wellbeing throughout the recovery process. This vulnerable group faces many challenges in maintaining a healthy lifestyle, and health promotion programmes are essential to improve the treatment experience and prevent relapse.
URL
Drug use disorder: Drug abuse treatment centres: Health promotion: Healthy lifestyle: Nutritional status: Lebanon
Key Words
Mahboub, N., Rizk, R., & de Vries, N. (2021). Nutritional parameters and lifestyle practices of people who use drugs undergoing treatment for recovery in Lebanon: a descriptive study. Journal of Nutritional Science, 10. doi:10.1017/jns.2021.9