NUTRITIONAL ASSESSMENT OF DRUG-ADDICTS

Objective: To discern if factors such as organic pathology, sex, durat ion and/or intensity of drug addiction, alcohol abuse, hepatitis B inf ection, anorexia with poor food and drink consumption, or disturbance of social and familial networks, are related to an impaired nutritiona l status in hospitalized drug addicts. Design: Cross-sectional prospec tive study. Setting: Detoxication unit and internal medicine unit of a university hospital. Patients: 140 drug addicts without acute organic pathology and 18 with acute organic pathology related to drug addicti on. The immunological study was compared with a control group composed of 50 healthy and well-nourished individuals (26 women and 24 men), a ge-matched with our patients. Results: Drug addicts without organic pa thology were under-nourished: 92.4% weighed under the mean weight for the population and 55.7% had had a weight loss above 5%. The distribut ion of mid-upper arm circumference (MUAC), triceps skinfold (TSF) meas urement and mid-arm muscle area (MAMA) compared with the percentiles f or the population showed a shift towards lower values. We found a high percentage of patients with a high lymphocyte count (55%). Despite th e high lymphocyte count, delayed hypersensitivity was depressed in our patients. Of our patients, 66.4% exhibited anorexia at admission. The mean calorific intake was 978 +/- 89 kcal/day in females and 1265 +/- 64 kcal/day in males. However, in most cases, malnutrition (usually m arasmus-like malnutrition) was not very severe; only 30% of the drug a ddicts weighed less than 80% of the mean weight for the population, or admitted to a weight loss above 10%, and by subjective nutritional as sessment, only 18% were deeply malnourished. Otherwise, the nutritiona l status was very poor in drug addicts with acute organic pathology. W e also found a worse nutritional status in our patients related to fem ale sex, intensity of drug addiction, anorexia with poor food and drin k consumption, and disturbance of the social and familial networks. Co nclusions: Many drug addicts suffer from calorie and protein malnutrit ion. This malnutrition is related to female sex, intensity of drug add iction, anorexia and poor food and drink consumption, and disturbance of the social and familial links. Acute organic pathology leads to a s ignificant worsening of the nutritional status of drug addicts.