Dr. Amy Nett: We actually don’t exclude anyone from our practice, and I also have a few patients who are alcoholics and some patients who have other addictions as well. Yeah, it’s true; they do sometimes have a much more difficult time with compliance, and of course, one of the principles of a Paleo diet is trying to decrease alcohol. For a 30-day reset, we do ask patients to stop alcohol completely, and that doesn’t happen in our alcoholics. Oftentimes it’s part of that 75-minute case review, where we sit down, because I feel like a lot of our patients who are coming, they know that we’re going to ask them to decrease their alcohol intake, and I think a lot of our patients are ready to hear that, but they sometimes just need a little bit more support. Some of that support might be supporting the HPA axis. Some of it’s just listening to the patients and trying to figure out with them why they’re still drinking because if they’re coming to see you, they probably want to work through the addiction.
I think it’s good to have resources. In my area, I have a few different therapists that I refer people to as well if I feel like that might be appropriate. It’s hard when you have people coming from out of town because I don’t have a lot of resources in other states to give to people, but I would think about resources that you can have for people who do have addictions.
I completely agree. It’s definitely different in terms of compliance, and you have to approach things differently. I think about how many supplements I’m giving those patients. Again, if it’s an alcoholic or an addict who might not have the capacity to follow the complex protocols, think about modifying it and just make the treatment something that works for them.
I would say in terms of the specific tools used to address addiction, think about the HPA axis, but addiction is complex. Most of us here probably are not specialists in addiction, and it’s worth thinking about the resources, but it’s just letting them know that you’re going to support them as best you can, whether it’s from a nutrient perspective, HPA axis perspective, and be there to support them and help them. Also just let them know if they have trouble with the addiction, it’s OK; you’re still there as part of their team, and you’ll just work together as best you can.
I would do biofeedback support as part of the HPA axis support. I definitely use biofeedback for some of my patients. That’s a great option.
In terms of supplements that I use specifically for that, I wouldn’t say for addiction there are supplements I use specifically. Definitely in alcoholism you do need to think about B vitamin support. You might be starting them on methylation support. Still probably do functional methylation testing for them if you want. Do think about nutrients for alcoholics in particular because they might have more nutrient deficiencies, but in general, I’m not doing supplements specific for addiction. It’s approaching it as I would with any other patient. How can we best support their health and their well-being to help support them getting away from the addiction? Most addicts, if they’re showing up to your office, they want to get over this, so it’s just a matter of figuring out how you can support them from every angle you have available, and that’s most often just as you would any other patient.