At Boston Medical Center, patients recovering from addiction are getting healthier one slab, stick and cube at a time.
For years, the hospital has offered cooking classes tailored to specific medical conditions such as heart disease and diabetes, and it runs a food pantry for low-income patients who are prescribed fresh food as part of their treatments. The newest class is "Cooking for Recovery" and is part of a growing trend toward taking a more comprehensive approach to treating addiction.
"Good health care is about more than just direct clinical services," said Michael Botticelli, executive director of the medical center's Grayken Center for Addiction and former director of the White House Office of National Drug Control Policy. "Recovery is not just about stopping the use of alcohol and drugs, it's about how do we return people to a sense of wellness and a sense of well-being."
On a recent Thursday, dietitian and chef Tracy Burg kept up a steady stream of advice while guiding participants through a chicken, pasta and vegetable dish. Felicha Young joined her behind the demonstration kitchen's cooktop, making quick work of a zucchini following Burg's instructions to slice it first into slabs, followed by stick shapes and finally crisp, cross-cut cubes. One end of the counter was piled with "mood enhancers" -- vegetables and whole grains -- while the other sported a sign listing "mood depressors" such as candy, soda and fried food.
"You don't want to be living on French fries," Burg said.
While addiction can leave bodies depleted of vital nutrients, self-care and good nutrition often are overlooked during recovery, Burg said. And many crave sweets that activate the same areas of the brain targeted by drugs, she said, which can lead to rising and falling blood sugar levels, weight gain, depression and possible relapse.
"It's a vicious cycle," she said.
One cooking class participant told Burg she ate two bags of cotton candy every day, plus a third at night to "help her sleep." Burg's goal is to nudge participants into making healthy choices, such as brown rice or whole grains that make them feel fuller longer while also delivering healing nutrients.
"A lot of people who are getting over alcoholism or drug addiction, their gut is a wreck because all their healthy bacteria has been destroyed," she said. "But eating fiber is actually feeding the healthy bacteria in the gut ... and it helps to bring back that healthy microbiome. So nutrition plays many roles in the healing process."
Young, who has been in recovery for about a year and a half, heard about the cooking class from her doctor.
"I'm pretty familiar with the kitchen, but I wanted to go there to get more tips on how to bring out flavor," she said. "As long as I get to participate, I enjoy it. Just sitting there watching would be boring for me."
Young said the hospital's addiction treatment program has helped her get her life back on track, but until she attended the class, she hadn't given much thought to how healthy eating could impact that.
"I didn't even know that it could be part of recovery," she said.
Though some addiction treatment centers employ dietitians and include nutrition programs for patients, officials at Boston Medical Center said they did not know of similar cooking classes at other medical centers. But their approach has caught the attention of New Hampshire's Dartmouth-Hitchcock Medical Center, where the Perinatal Addiction Treatment Program clinic for pregnant women and mothers includes a food pantry, "grab and go" snack bags of fruit and vegetables and casseroles for patients to take home after recovery group meetings.
The food pantry is run by Upper Valley Haven, a non-profit organization in nearby Vermont that offers food, shelter and other support to people struggling with poverty. Officials there visited the Boston test kitchen and food pantry for inspiration. Daisy Goodman, an advance practice nurse at Dartmouth-Hitchcock, said women often show up at the clinic with a doughnut or high-sugar coffee drink in hand.
"It's obvious they're not eating a lot of nutritious food," she said. "So we've really started to focus on providing food that's immediately and readily available because women come in hungry."
Rather than offer cooking classes, Dartmouth-Hitchcock is working with patients to compile a cookbook of healthy recipes, Goodman said. But she said the basic principles guide both the Boston and New Hampshire programs.
"I think the key question we always have to ask when we think that we're providing a service for patients, is that service truly accessible?" she said. "That's the really the benefit of comprehensive programs that provide multiple services at one location."