The Case For A Health & Wellness Approach to Addiction
Allison Futter ’23
Community Member: Yvette Williams; Faculty Advisor: Susan Masino
3b. The Big Picture
*Click on any Figure/image below to enlarge it.
1. The Pressing Issue of Substance Use Disorder
1a. Substance Use Disorder, Prevalence, and COVID-19 Impact
Substance use disorders are conditions based on continued substance use despite negative consequences. Illicit drug use and lack of treatment causes an undue burden nationally and in the state of CT. Within the past year, there was an increase in the percentage of those who used illicit drugs, reaching 20.8 percent from 17.8 percent in 2015, as well as 20.4 million people who had a SUD (SAMHSA’s 2019 National Survey on Drug Use and Health (NSDH), 2020).
Substance use disorder definition and prevalence rates
CT vs US opioid overdose death rate
Source: KFF analysis of CDC Multiple Cause of Death 2008-2018 from: “Mental Health and Substance Use State Fact Sheets.” KFF, Kaiser Family Foundation, Nov. 19, 2020, https://www.kff.org/statedata/mental-health-and-substance-use-state-fact-sheets/connecticut.
The COVID-19 pandemic has been worsening the substance use epidemic and is expected to increase the rate of overdose deaths by 18% (Yeager, 2020). Isolation, limited treatment options, and economic pressures are factors brought by the pandemic that threatens those with substance use disorders. Just within the first three months of 2020, drug overdose deaths have increased more than 10%.
First three months of 2019 vs 2020’s overdose death rate
Source: Stephenson, Joan. “Drug Overdose Deaths Head Toward Record Number in 2020 on CDC Warns.” JAMA Health Forum, JAMA Network, Oct. 20, 2020, https://jamanetwork.com/channels/health-forum/fullarticle/2772241
I think it’s [COVID-19] having a huge impact on the addiction population … isolation is the worst thing you can do for an addict, even for one in recovery.- Interviewee #2, Narcotics Anonymous Interviewee
1b. Community Partnership: 2 Your Health, LLC
The founder of 2 Your Health, LLC, Yvette Williams, through years of research and integrative therapy, was able to overcome life-threatening illnesses. Understanding the value of a health and wellness approach, 2 Your Health offers non-clinical health consultation and education as well as its own vegetarian food truck.
2 Your Health, LLC is working towards piloting an all-natural approach to addiction recovery. The foundation of this approach includes nutritionally dense foods, supplements, and herbs paired with supportive mental and physical activities, and without the use of regulated or synthetic substances or medication. This intervention works to support the body’s own detoxification, nourishment, and healing abilities. Offering a natural approach will help combat the urgent need for an effective alternative response to addiction.
2 Your Health, LLC information
1c. Treatment Rates and Approaches
Among people aged 12 or older in 2019, 21.6 million people needed substance use treatment in the past year. Yet, only 4.2 million people received any substance use treatment.
Number of people who received substance use treatment vs who needed it
Source: “Key Substance Use and Mental Health Indicators in the United States: Results from the 2019 National Survey on Drug Use and Health.” SAMHSA Substance Abuse and Mental Health Services Administration, Sept. 2020, https://store.samhsa.gov/product/key-substance-use-and-mental-health-indicators-in-the-united-states-results-from-the-2019-national-survey-on-Drug-Use-and-Health/PEP20-07-01-001.
The all-natural pilot study will utilize an integrative/ holistic approach. This approach differs from conventional medicine.
Conventional medicine vs integrative/holistic remedies
In order to pilot and demonstrate the efficacy of its natural, holistic addiction treatment approach 2 Your Health has been seeking grant funding. An important first step towards obtaining funding is to show the existence of preliminary, empirical research that supports the proposed holistic approach. Accordingly, identifying, organizing, summarizing, and graphically representing the existing evidence-based research was the main goal of the project.
We focused on the research related to 17 holistic remedies which are included in protocols or recipes (e.g. Nutrition, Hydrotherapy, Turmeric). I evaluated the empirical research along with reports from cultural/traditional uses regarding the efficacy of holistic methods to improve health and treat 53 typical substance abuse issues/problem symptoms (e.g. Poor health/nutrition, depression, cramps).
Holistic remedies researched and examples of substance abuse problem symptoms examined
The field of natural, unconventional medicine is vast. Confidence continues to grow in natural/integrative remedies. More and more empirical studies continue to reveal the efficacy of these remedies, though as is common in research, not all results are affirmative.
1e. Research Questions
My guiding research questions throughout the literature review were:
- To what extent does the existing evidence-based research support the effectiveness of the 17 holistic remedies in treating addiction-related issues?
- Of the investigated therapies, which appear to be the most bioactive?
The answers to the two questions above will inform the development of grant applications from 2 Your Health, LLC and will hopefully help to secure funding to pilot the holistic addiction project.
2a. Literature Review
Literature review and data collection process
To gather empirical research articles we began by searching databases such as PsycINFO, PsycARTICLES, and Google Scholar. We researched 17 specific natural health remedies: chlorophyll, glutathione, antioxidants, turmeric, wheatgrass, milk thistle, dandelion root, hydrotherapy, social connectedness, natural/outdoor therapy, acupuncture, spiritual belief/support, massage, MCT oil, CBD oil, exercise, and nutrition. In cases where there were initially few results returned after a search, I used different keyword searches, substituting “substance abuse treatments” with “health benefits” for example. After summarizing, or using direct quotes, from references, I isolated generalized and specific health benefits. The health remedies were then evaluated against 53 substance abuse issues/symptoms/ sequelae. To indicate the strength of support provided by the primary and secondary empirical research sources for each addiction issue, we created a color-coded rating system, with the 53 typical addiction problem symptoms found on the left and the 17 health therapies on the top.
Checkmark key utilized during data collection
- Red checkmark meant that the research showed a strong indication that a particular remedy would relieve the issue it was associated with
- Blue checkmark meant that the research showed indicative evidence that a particular remedy would relieve the issue it was associated with
- Green meant that the effectiveness of the remedy in relieving an addiction issue was deduced through student analysis because of similar functions and properties
- Black meant that the remedy has been found in traditional/historical/anecdotal/cultural reporting
Below is an example of the natural remedies to addiction problem symptoms correlation matrix.
Correlation matrix example
Two 30 minute interviews were conducted via zoom, to gather broad but substantive feedback and insight into the drug addiction epidemic in the Hartford area as well as the impact of the coronavirus pandemic on a problem that was already at crisis level. Interviewee #1, a specialist in addiction medicine and infectious diseases at Hartford Hospital, was asked 10 questions addressing addiction, its prevalence in Connecticut, the type of drugs abused, current treatment available, and holistic treatment. Interviewee #2 was a member of Narcotics Anonymous who was asked the same 10 questions, but from the perspective of someone who has gone and continues to go through recovery and treatment.
3. Results and Discussion
The research indicated:
- 8 (Chlorophyll, Wheatgrass, Dandelion Root, Social Connectedness, Spiritual Beliefs, MCT Oil, CBD Oil) or 47% of the 17 remedies may help with 30-49% of the addiction issues.
- 8 (Glutathione, Antioxidants, Turmeric, Hydrotherapy, Nature Therapy, Acupuncture, Massage, Exercise) or 47% of the 17 remedies may help with 50-69% of the addiction issues.
- 1 (Nutrition) or 6% of the 17 remedies may help with >90% of the addiction issues.
Remedy to symptom correlation
The 30-49% Addiction Problem Symptoms to Remedy Correlation is broken down into how supportive the research was. There were 424 opportunities for these 8 remedies to help one of the 53 addiction issues within the correlation table. Research indicated they may help 170 times. Level of effectiveness: Strong: 36, Indicated: 65, Deduced: 69, Blanks: 254.
The 50-69% Addiction Problem Symptoms to Remedy Correlation is also broken down. There were 424 opportunities for these 8 remedies to help one of the 53 addiction issues. Research indicated they may help 222. Level of effectiveness: Strong: 43, Indicated: 105, Deduced: 74, Blanks: 74
Finally, >90% Addiction Problem Symptoms to Remedy Correlation is broken down. There were 53 opportunities for the 1 remedy to help one of the 53 addiction issues. Research indicated they may help 50 times. Level of effectiveness: Strong: 20, Indicated: 22, Deduced: 8, Blanks: 3
The most Bio-Active Protocols were: Nutrition, Turmeric, Acupuncture, Exercise, and Glutathione. The least Bio-Active Protocols were: Social Support, MCT and CBD Oil, Milk Thistle, and Spiritual Support.
Symptom “hits” and symptom “misses” for the most and least bio-active remedies
3a. The 5 Most Bio-Active Holistic Remedies:
5 most bio-active remedies and summarized benefits
3b. The Big Picture:
- A heatmap was created based on the analysis done and described under the ‘Methodology’ section to provide a big picture, at-a-glance summary image of our research findings.
- Through its numerous shaded cells, the heatmap below shows the likelihood that one or more of the 17 holistic remedies (row #1) will help with each of the 53 addiction problem symptoms (column #1).
Legend for the heat map
Figure 14b. (Summary Heatmap).
Heatmap diagram of remedies and addiction problem symptoms
It’s [using drugs] a coping strategy for many people. If you take away a mechanism that people are using to cope with life and you don’t help train them on something to replace it with by teaching them other coping strategies, then it’s hard to expect them to do well. But people, even after they stopped using drugs, they can continue to have difficulty sleeping, have mood changes, have less appetite, and have cravings and they’re still at high risk of having a relapse. It really needs to be multimodal [intervention]. Medications do have best track record at helping people have the best success over time. There may be a role for nutritional interventions and other integrative approaches as a complement to medication therapies or as more of the mainstay for people who may not be interested in taking medications. It’s a conversation that they should have with their health care provider to see what the best fit is.- Interviewee #1, addiction specialist
4. Conclusion and Future Directions
Given the high prevalence of substance use disorders and their related challenges, we strongly believe that other interventions besides conventional approaches need to be employed. This belief is supported by the results of a public survey conducted by 2 Your Health in 2019 where 86% of respondents thought that drug addiction was either a serious issue or a crisis. In the same survey, 73% of respondents thought that current treatment options were inadequate compared to the need and 96% said they would prefer an effective, science-supported, all-natural addiction recovery approach over a medication-driven one. Accordingly, the overall result of the preliminary research described above, strongly indicates that utilizing a holistic/integrative approach, whose components have evidence-based research support for their effectiveness, has a real potential to help people with substance use disorder, even those who may have become discouraged. The literature review revealed that numerous holistic remedies, proposed by 2 Your Health, LLC, hold promise for treating symptoms and sequelae of addiction. The most promising or bioactive interventions appear to be: Nutrition, Exercise, Acupuncture, and Turmeric. Through the process of conducting this research, we learned how to refine our searching strategies in cases where the available research initially appeared to be very limited.
Listening to the perspective of a clinical practitioner and a person in recovery from the Hartford area, helped us understand the struggles with substance use disorder people are dealing with right around us. We also were able to gain a better understanding of how people facing addiction may view the holistic addiction treatment approach developed by 2 Your Health, LLC.
Future human-focused research may employ the most bioactive interventions simultaneously to assess their effect on addiction symptoms and sequelae.
- This research did not focus on a comparison between conventional addiction recovery treatment and a holistic approach as data is generally unavailable on holistic program outcomes. Rather, the goal was to gather, assess the effectiveness, organize and present the strength of the existing evidence-based research on a number of remedies that are part of 2 Your Health’s natural addiction recovery program.
- The documented evidence-based research is clear; however, the ranking of its strength is subjective since it is the assessment of the student.
- There is confidence in the deduced assessments of the remedies’ effectiveness; however, these conclusions are subjective as they are the extrapolation of the student.
- The bioactive level of a remedy does not necessarily predict the level of the positive health impact. It is conceivable that a remedy can be active and effective against a single major addiction symptom and provide a greater level of recovery benefits because of the breadth and depth of its primary and secondary impacts upon a person’s addiction problem symptoms.
Bengmark, S. (2006). Plant-derived Health-Effects of Turmeric and Curcumenoids. KUWAIT MEDICAL JOURNAL, 9.