Table 2.

Pathology of SUD and potential targeted benefits of KD.

Pathology of SUD	Substance	Potential targeted benefits of KD
Sugar consumption↑	Opiate (37); Heroin (38); Methadone (39); Cocaine (41); Alcohol (42, 43)	Carbohydrates intake↓ (May improve the neural circuits that encode reward)
Neurotransmitter imbalances (Glutamate/GABAergic system dysfunction)	Cocaine (83–85); Heroin (86); Nicotine (87); Alcohol (88–90); Methamphetamine (234)	Glutamate↓, GABA↑ (95–98, 101, 102)
Brain glucose metabolism↓; Acetate uptake↑	Alcohol (28, 30–32, 103); Opiate (107); Methadone (108); Cocaine (109); Nicotine (110); Methamphetamine (111–113)	Ketone metabolism↑ (15, 16)
Neuronal damage	Heroin (119, 120); Methamphetamine (121, 122, 124); Cocaine (123)	Neuroprotection (mitochondrial function↑; ROS↓; oxidative stress↓) (125, 126, 129–136)
Inflammation↑	Alcohol (138); Morphine (139); Cocaine (140); Methamphetamine (147); Heroin (235); Methadone (236)	Inflammation↓ (148–151, 153, 154)
Glial cell dysfunction	Alcohol (167, 168); Morphine (169, 180, 181); Cocaine (170, 171); Methamphetamine (142); Heroin (237)	Glia cell inflammatory activation↓ (135, 182–188)
Gut microbiota disorders	Alcohol (138, 167, 196–198, 211, 213–215, 217, 221, 222); Methadone (199); Morphine (200, 219); Heroin (201); Cocaine (202); Methamphetamine (203, 204, 212, 216)	Modulate gut microbiota (206, 223–228)

↑: increased; ↓: decreased; SUD, substance use disorders; KD, ketogenic diet; GABA, γ-aminobutyric acid; ROS, reactive oxygen species.