Avoidant-restrictive food intake disorder (ARFID) involves a person either avoiding or being uninterested in food and eating for various reasons. The condition can lead to weight loss, nutritional deficiencies or the need for supplemental feeding options.
Although ARFID usually begins during childhood, it may affect adults and cause a range of effects on their physical and mental health. Some people may experience ARFID and substance abuse concurrently, which can complicate diagnosis and treatment.
Stimulants and ARFID
Accurately assessing and diagnosing ARFID is critical. An important aspect of ARFID is that another medical or mental health condition cannot cause the limited food intake. This is important because while some people with substance use disorders may show signs and symptoms of ARFID, ARFID would not be the appropriate diagnosis since substance use triggers their symptoms.
Stimulants, for example, have a reputation for decreasing someone’s appetite and making them less interested in consuming food. Because of this, a person using cocaine, amphetamines or other stimulants including caffeine or nicotine may have a decreased desire to eat, leading to weight loss.
So, while it is possible for a person with ARFID to have a stimulant use disorder, it is not possible for the stimulant addiction to cause ARFID. The individual and the treatment team will need to understand the progression of symptoms to accurately identify their root.
Another point that separates ARFID from substance use is that ARFID continues with consistency for an extended period of time while stimulant use often follows a “binge and crash” cycle. A binge is when a person consumes large amounts of stimulants. The crash comes when use ends and the individual experiences increased appetite and weight gain.
Does ARFID Lead to Drug Abuse?
It is possible for many mental health issues to lead to drug abuse, and avoidant restrictive food intake disorder is no exception. Substance use, for many, is a coping skill that aims to manage unwanted feelings or deal with stressful situations. Surely, people with mental health disorders experience a range of uncomfortable feelings and find themselves in distressing environments.
People with ARFID may abuse drugs to escape the reality of their mental health challenges or drink alcohol because its calories help them maintain low body weight. Either situation can lead to detrimental effects of physical and mental health.
To complicate matters, people with ARFID frequently have other mental health conditions. These people may live with a number of co-occurring conditions, like:
- Anxiety disorders, such as generalized anxiety disorder, phobias, social anxiety disorder and panic disorder
- Obsessive-compulsive disorder (OCD)
- Autism spectrum disorder
- Attention-deficit hyperactivity disorder (ADHD)
- Intellectual disabilities
Co-occurring conditions can increase the risk of substance use in an individual with ARFID. A person with ARFID and anxiety may use a substance like marijuana because they believe it aids with relaxation in social situations. Of course, they believe it is making symptoms better, while it can actually exacerbate them over time.
Treating ARFID and Co-Occurring Substance Use Disorders
Since ARFID commonly co-occurs with various mental health conditions, it is essential for treatment to address all disorders concurrently. By only tending to ARFID or substance use, there is an increased risk of some symptoms worsening while other symptoms improve. To decrease all symptoms, treatment providers must employ a comprehensive approach.
Even though ARFID is a newer mental health condition, experts have already found several effective treatment styles. One study found a combination of physical health monitoring, family therapy, cognitive behavioral therapy (CBT) and medications helpful.
One specific type of CBT called exposure and response prevention (ERP) may be useful in treatment for ARFID as well. This treatment involves exposing a person to a stressful situation while making it impossible for the person to use their unhealthy coping skills. ERP can also be beneficial for several disorders, so if a person has ARFID and anxiety or ARFID and OCD, this one treatment could tackle both conditions. A person should always consult with their treatment team about the best ARFID treatments available.
If your life has been affected by ARFID and a substance use disorder, you may benefit from treatment plans at The Recovery Village. When you call and speak to a knowledgeable representative, you can begin the journey towards recovery and wellness. Reach out today for more information.
American Psychiatric Association. “Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition.” 2013. National Eating Disorder Association. “Avoidant Restrictive Food Intake Disorder (ARFID).” Accessed May 28, 2019. Spettigue, Wendy, Norris, Mark L., Santos, Alexandre, Obeid, Nicole. “Treatment of Children and Adolescents with Avoidant/ Restrictive Food Intake Disorder: A Case Series Examining the Feasibility of Family Therapy and Adjunctive Treatments.” Journal of Eating Disorders, August 3, 2018. Accessed May 28, 2019.
American Psychiatric Association. “Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition.” 2013.
National Eating Disorder Association. “Avoidant Restrictive Food Intake Disorder (ARFID).” Accessed May 28, 2019.
Spettigue, Wendy, Norris, Mark L., Santos, Alexandre, Obeid, Nicole. “Treatment of Children and Adolescents with Avoidant/ Restrictive Food Intake Disorder: A Case Series Examining the Feasibility of Family Therapy and Adjunctive Treatments.” Journal of Eating Disorders, August 3, 2018. Accessed May 28, 2019.