We are living in a protein-obsessed world... It’ s never been easier to sneak in some protein without needing to cook or refrigerate anything, but this isn’ t the case for people on low – or no – incomes.
leptin and ghrelin, which affect energy sensing and hunger signalling, ultimately shifting eating behaviour towards highreward foods. Together, these factors can lead to a lack of key nutrients like essential amino acids, vitamins, and minerals.
We know good nutrition is important. But for people who use stimulants, it can be particularly significant in supporting mental and physical health, even when it comes to respiratory conditions.
RESPIRATORY HEALTH Take vitamin C, for example. Studies have shown that it plays a role in respiratory function, and high doses can reduce incidence and mortality of pneumonia – albeit marginally. Research suggests that 400mg / day( ten times higher than the recommended daily amount) can benefit lung function in people with COPD. Offering vitamin C( in multivitamins or dissolvable tablets) can be a simple way for drug services to assist people to care for their physical and respiratory health – and to engage in vital further respiratory and physical support pathways.
Protein is another big one. Not only is it crucial for tissue repair and immunity, it also helps synthesise neurotransmitters like dopamine and serotonin which can be depleted by sustained stimulant use. Plus, protein helps wounds heal faster, which is important for people dealing with injuries sustained while living on the streets and / or in relation to use of unsafe drug equipment such as blunt needles or improvised pipes.
We are living in a proteinobsessed world. What used to be the territory of gym bros and fitness fanatics is now widely available, though they can be expensive – think chocolatey protein bars, protein coffee drinks, grab-and-go shakes. It’ s never been easier to sneak in some protein without needing to cook or refrigerate anything, but this isn’ t the case for people on low – or no – incomes. Drug services can help here, if they’ re able to obtain the funding to do so.
Meal replacement shakes are also an option if they’ re available. They’ re quick, may be better tolerated than solid food when someone’ s high or coming down, and contain balanced amounts of calories, protein, vitamins, and minerals.
Good nutrition doesn’ t have to mean expensive ingredients or fully equipped kitchens. Practically supporting people to eat a wide range of food, even if it’ s in small quantities, can help people get the mix of nutrients
VITAMIN C
The human body is unable to store vitamin C efficiently due to it being water soluble. It is therefore one of the vitamins / minerals that should ideally be consumed daily. Offering vitamin C( in multivitamins or dissolvable tablets) can be a simple way for drug services to assist people to care for themselves. As well as respiratory support, vitamin C is also vital for:
Wound healing, tissue repair and collagen production Vitamin C is crucial for producing collagen, a protein essential for making and repairing skin, tendons, ligaments, blood vessels, bones, cartilage, and teeth.
Antioxidant protection As a powerful antioxidant, vitamin C neutralises harmful toxins that can damage cells and contribute to illness and disease.
Immune system support Vitamin C helps the immune system function properly by supporting various cellular functions, which helps the body fight off infections.
Iron and calcium absorption Vitamin C enhances the body’ s ability to absorb iron and calcium from the diet, essential minerals for overall health.
they need. Tinned fruits and vegetables are a good source of vitamins and minerals, while tinned fish or beans are good for protein. They are generally cheap( especially own-brand tins), have a long shelf life, and don’ t require a fridge or cookers to store and eat. Where possible, linking people up with the local food banks or having a small food stock available within the service can make difference.
But it doesn’ t need to stop there. Services might consider seeking funding to bring in local dietic support, even on a part-time or consultancy basis. A dietician could offer training alongside practical support, develop simple nutrition resources, or run occasional drop-in sessions – including for staff. This kind of support doesn’ t necessarily need to be intensive to be impactful, but it could help build capacity within services to recognise nutrition as a core part of care.
PRACTICAL CHANGE We talk a lot about harm reduction, but we sometimes forget that harm includes poor nutrition. If we’ re serious about supporting people who use stimulants we need to start asking them how easy they find it to access food and what they’ re able to eat, with an eye toward practical, positive change.
There’ s no need for gourmet intervention. Providing multivitamins, protein snacks, meal shakes, and nutrition advice at little or no cost can go a long way. And it sends a powerful message – we care about more than just drug use, we care about health, dignity, and meeting people where they’ re at( even if where they’ re at is in need of a sandwich).
So next time you’ re stocking up supplies at your service, consider adding some protein bars, canned fruit, and vitamins alongside the naloxone kits and syringes. Because sometimes, reducing harm starts with something as simple as a snack.
Alexandre Piot is research fellow at the London School of Hygiene and Tropical Medicine
Professor Magdalena Harris is professor of inclusion health sociology at the London School of Hygiene and Tropical Medicine
Dr Jenny Scott is senior lecturer at Bristol Medical School
Philippe Bonnet is overdose prevention lead at Cranstoun
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