According to Gram Research analysis of 633 addiction patients, methamphetamine users have significantly lower folate levels and higher deficiency rates than other substance users, with alcohol and opioid users also showing substantial folate problems. Folate supplementation and improved nutrition may support recovery in these populations.
A Gram Research analysis of 633 people with alcohol or drug use disorders found that folate—a B vitamin crucial for brain and cell health—is often dangerously low. The study compared four groups: people using alcohol, cannabis, methamphetamine, and opiates. Methamphetamine users had the lowest folate levels and the highest rates of deficiency. Alcohol and opiate users also showed significant folate problems. These findings suggest that adding folate supplements and improving nutrition could help people recovering from addiction feel better and support their healing process.
Key Statistics
A 2026 cross-sectional study of 633 patients with substance use disorders found that methamphetamine users had significantly lower mean folate levels compared to alcohol and cannabis users (p < 0.0083).
In the same 2026 study of 633 addiction patients, possible folate deficiency was significantly higher in the methamphetamine group compared to cannabis users (p < 0.0083).
A 2026 analysis of 633 patients with alcohol or drug use disorders found that folate deficiency status differed significantly across substance types, with methamphetamine, alcohol, and opioid users showing higher deficiency rates than cannabis users (p < 0.001).
Among 633 patients reviewed in a 2026 study, the methamphetamine group (n=296) showed the most severe folate deficiency patterns, suggesting this substance may be particularly damaging to the body’s folate status.
The Quick Take
- What they studied: Whether people with alcohol or drug addictions have lower levels of folate (a B vitamin) and whether the type of drug used affects folate levels differently.
- Who participated: 633 patients with alcohol or substance use disorders divided into four groups: 217 alcohol users, 71 cannabis users, 296 methamphetamine users, and 49 opioid users. This was a retrospective study, meaning researchers reviewed existing medical records.
- Key finding: Methamphetamine users had significantly lower folate levels and higher rates of folate deficiency compared to other groups. Alcohol and opioid users also showed high rates of deficiency, while cannabis users had better folate levels overall.
- What it means for you: If you or someone you know is struggling with addiction, getting folate levels checked and taking supplements may help support recovery and overall health. This is especially important for people using methamphetamine, alcohol, or opioids. Talk to a doctor before starting any supplements.
The Research Details
Researchers reviewed medical records of 633 patients who had been treated for alcohol or drug use disorders. They organized patients into four groups based on what substance they primarily used: alcohol, cannabis, methamphetamine, or opioids. They then compared folate blood levels and deficiency rates across these groups using statistical tests. This type of study is called a retrospective cross-sectional study because researchers looked backward at existing data rather than following people forward over time.
This approach is important because it shows real-world patterns in actual patients seeking treatment. By comparing different substance groups, the researchers could identify which addictions are most likely to cause folate problems. This helps doctors know which patients need folate screening and supplementation most urgently.
The study’s main strength is its large sample size of 633 patients, which makes the findings more reliable. However, because it’s a retrospective review of medical records, researchers couldn’t control all the factors that might affect folate levels (like diet quality or other health conditions). The study was published in 2026 in a peer-reviewed journal focused on substance use research.
What the Results Show
The study found clear differences in folate levels depending on the drug used. Methamphetamine users had the lowest average folate levels and the highest rate of folate deficiency—meaning their bodies weren’t getting enough of this essential vitamin. When researchers compared the groups statistically, these differences were highly significant (p < 0.001), meaning they’re very unlikely to have happened by chance.
Alcohol users and opioid users also showed high rates of folate deficiency, though not quite as severe as the methamphetamine group. Cannabis users had the best folate levels of all four groups, with significantly lower deficiency rates. This suggests that different drugs affect the body’s ability to absorb, store, or use folate in different ways.
The researchers also found that folate deficiency status varied significantly across the groups (p < 0.001). This means the type of substance someone uses is a strong predictor of whether they’ll have folate problems.
The study looked at sociodemographic data (age, gender, background information) across the groups, though specific details weren’t emphasized in the abstract. The researchers noted that nutritional disorders in general are common in people with addiction, and folate deficiency is just one example of how substance use can harm the body’s ability to maintain proper nutrition.
This research builds on existing knowledge that addiction often causes vitamin deficiencies. Previous studies have shown that alcohol use particularly damages the body’s ability to absorb B vitamins like folate. This study extends that understanding by showing that methamphetamine may be even more damaging to folate levels than alcohol, and that different drugs affect folate differently. The findings support the growing recognition that nutritional support should be part of addiction treatment.
Because this was a retrospective study using existing medical records, researchers couldn’t control for other factors that might affect folate levels, such as diet quality, other health conditions, medications, or how long someone had been using the substance. The study didn’t measure whether folate supplementation actually helped patients recover better. The sample sizes for some groups (especially cannabis and opioid users) were smaller than others, which could affect the reliability of comparisons. Finally, the study only included people who sought treatment, so it may not represent all people with addiction.
The Bottom Line
People with alcohol, methamphetamine, or opioid use disorders should have their folate levels checked as part of their medical care (high confidence). Folate supplementation may help support recovery and overall health in these populations (moderate confidence, pending more research). Cannabis users appear to have lower folate deficiency risk but should still maintain good nutrition (moderate confidence). Anyone considering supplements should discuss this with their doctor first, as folate interacts with some medications.
This research is most relevant for people struggling with alcohol, methamphetamine, or opioid addiction and their healthcare providers. It’s also important for addiction treatment programs, nutritionists, and public health officials designing recovery support services. People using cannabis recreationally don’t appear to face the same folate risk based on this study.
Folate deficiency can develop over months to years of substance use. Folate supplementation typically takes 2-4 weeks to raise blood levels noticeably, though feeling better from improved nutrition may take longer. Recovery is a long-term process, and nutritional support is just one piece of comprehensive addiction treatment.
Frequently Asked Questions
What is folate and why do drug users have low levels?
Folate is a B vitamin your body needs for cell growth and brain function. Drugs like methamphetamine, alcohol, and opioids damage the digestive system’s ability to absorb folate from food and may increase how quickly your body uses it up.
Does methamphetamine cause worse folate deficiency than other drugs?
Yes. A 2026 study of 633 addiction patients found methamphetamine users had the lowest folate levels and highest deficiency rates of all substance groups studied, suggesting it’s particularly damaging to folate status.
Can folate supplements help people recovering from addiction?
Folate supplementation may support recovery by improving energy, mood, and brain function, though more research is needed. This study suggests it could be helpful, especially for methamphetamine, alcohol, and opioid users. Always consult your doctor first.
Is cannabis use as bad for folate levels as other drugs?
No. The 2026 study found cannabis users had significantly better folate levels and lower deficiency rates compared to methamphetamine, alcohol, and opioid users, suggesting cannabis poses less folate risk.
How long does it take for folate supplements to work?
Blood folate levels typically improve within 2-4 weeks of supplementation. However, feeling better from improved nutrition and overall recovery takes longer and depends on many factors including overall health and treatment quality.
Want to Apply This Research?
- Log folate-rich foods daily (leafy greens, legumes, fortified grains) and track any folate supplements taken. Set a reminder for weekly folate level check-ins if your doctor recommends monitoring.
- Add one folate-rich food to each meal: spinach in breakfast eggs, lentil soup for lunch, or broccoli with dinner. If prescribed folate supplements, set a daily alarm to take them at the same time each day.
- Track energy levels, mood, and cognitive clarity weekly as potential indicators of improving folate status. Schedule blood work every 3 months with your doctor to monitor actual folate levels and adjust supplementation as needed.
This research provides important information about folate deficiency in people with addiction, but it should not replace professional medical advice. If you or someone you know struggles with substance use, please consult with a healthcare provider or addiction specialist for personalized evaluation and treatment. Folate supplementation should only be started under medical supervision, as it can interact with certain medications and medical conditions. This study was observational and cannot prove that folate supplements will improve recovery outcomes—more research is needed. If you’re experiencing a substance use crisis, contact SAMHSA’s National Helpline at 1-800-662-4357 (free, confidential, 24/7).
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.