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Furulund E, Madebo T, Druckrey-Fiskaaen KT, Vold JH, Nordbotn MH, Dahl E, Dyrstad SM, Lid TG, Fadnes LT. Integrated exercise program in opioid agonist therapy clinics and effect on psychological distress: study protocol for a randomized controlled trial (BAReAktiv). Trials 2024; 25:155. [PMID: 38424609 PMCID: PMC10905828 DOI: 10.1186/s13063-024-07993-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 02/16/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Substance use disorder is associated with unhealthy lifestyle choices, resulting in adverse social and health consequences. People with opioid use disorder receiving opioid agonist therapy, in particular, have high morbidity and reduced quality of life. Physical activity is recommended as an adjunctive treatment for people with substance use disorder, but there is minimal evidence from randomized controlled trials on the effects of this among people with substance use disorder receiving opioid agonist therapy. METHODS BAReAktiv is a multicentre randomized controlled trial. The study aims to recruit 324 patients receiving opioid agonist therapy (parallel groups randomized 1:1 to integrated exercise intervention or control, superiority trial). A 16-week group-based integrated exercise intervention with workouts twice a week. The exercise program consists of endurance and resistance training. The target group will be patients 18 years and older receiving opioid agonist therapy in outpatient clinics in several centers in Western Norway. The primary outcome of the study is the effect on psychological distress measured by Hopkins' symptom checklist with ten items. Secondary outcome measures include physical functioning assessed with a 4-min step test, activity level, fatigue symptoms, quality of life, and changes in inflammation markers. This study will provide improved knowledge on the effects of an integrated exercise program in opioid agonist therapy. DISCUSSION Systematically integrating exercise programs for people receiving opioid agonist therapy could lead to a shift towards a stronger focus on health behaviors in outpatient care. Integrating exercise could benefit patient recovery and reduce disease burden. Further scale-up will be considered if the provided exercise program is safe and effective. TRIAL REGISTRATION ClinicalTrials.gov. NCT05242848. Registered on February 16, 2022.
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Affiliation(s)
- Einar Furulund
- Centre for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway.
- Department of Addiction Medicine, Bergen Addiction Research, Haukeland University Hospital, Bergen, Norway.
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
| | - Tesfaye Madebo
- Department of Addiction Medicine, Bergen Addiction Research, Haukeland University Hospital, Bergen, Norway
- Department of Respiratory Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Karl Trygve Druckrey-Fiskaaen
- Department of Addiction Medicine, Bergen Addiction Research, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Jørn Henrik Vold
- Department of Addiction Medicine, Bergen Addiction Research, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Mette Hegland Nordbotn
- Department of Addiction Medicine, Bergen Addiction Research, Haukeland University Hospital, Bergen, Norway
| | - Eivin Dahl
- Department of Addiction, Stavanger University Hospital, Stavanger, Norway
| | - Sindre M Dyrstad
- Department of Education and Sport Science, University of Stavanger, Stavanger, Norway
| | - Torgeir Gilje Lid
- Centre for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway
- Department of Public Health, University of Stavanger, Stavanger, Norway
| | - Lars T Fadnes
- Department of Addiction Medicine, Bergen Addiction Research, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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Nock NL, Stoutenberg M, Cook DB, Whitworth JW, Janke EA, Gordon AJ. Exercise as Medicine for People with a Substance Use Disorder: An ACSM Call to Action Statement. Curr Sports Med Rep 2024; 23:53-57. [PMID: 38315433 DOI: 10.1249/jsr.0000000000001140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
ABSTRACT Over 20 million Americans are living with a substance use disorder (SUD) and nearly 100,000 die annually from drug overdoses, with a majority involving an opioid. Many people with SUD have co-occurring chronic pain and/or a mental health disorder. Exercise is a frontline treatment for chronic pain and is an effective strategy for reducing depression and anxiety and improving overall mental health. Several studies have shown that exercise improves SUD-related outcomes including abstinence; however, there is limited large-scale randomized clinical trial evidence to inform integration of exercise into practice. In this Call to Action, we aim to raise awareness of the specific issues that should be addressed to advance exercise as medicine in people with SUD including the challenges of co-occurring chronic pain, mental illness, and cardiopulmonary health conditions. In addition, specialized training for exercise professionals and other support staff should be provided on these issues, as well as on the multiple dimensions of stigma that can impair engagement in treatment and overall recovery in people with SUD.
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Affiliation(s)
- Nora L Nock
- Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH
| | - Mark Stoutenberg
- Department of Kinesiology, College of Public Health, Temple University, Philadelphia, PA
| | | | | | - E Amy Janke
- Department of Health Sciences, School of Health Professions, Saint Joseph's University, Philadelphia, PA
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Nock NL, Hernandez E, Robinson D, Hoffer L, Wachholtz A. Barriers, perceived benefits and preferences to exercise in adults with an opioid use disorder in the U.S. Prev Med Rep 2023; 36:102393. [PMID: 37753380 PMCID: PMC10518576 DOI: 10.1016/j.pmedr.2023.102393] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 08/07/2023] [Accepted: 08/28/2023] [Indexed: 09/28/2023] Open
Abstract
Introduction Over 10 million Americans misuse opioids and more than 5 million have been diagnosed with an opioid use disorder (OUD). In 2021, over 100,000 Americans died of a drug overdose and more than 75% of these deaths involved an opioid. Exercise has been shown to increase abstinence and decrease anxiety and depression in people with a substance use disorder. However, only a few small trials have focused on persons with OUD who often experience additional challenges including chronic pain, mental health disorders and cardio-metabolic abnormalities. Methods We aimed to describe the barriers, perceived benefits and preferences to exercise in adults with OUD in residential treatment in the U.S. as part of a larger study. We conducted 33 individually administered, semi-structured interviews and transcribed audiotapes verbatim, conducted coding and thematic analysis using NVivo v12 software (QSR International Inc.). Results Our sample had nearly equal representation of males and females and, was predominantly Caucasian (88%) with a mean of age of 34.5 (s.d. 7.5) years old. Participants stated that exercise helps to reduce drug cravings, anxiety, depression and pain and improve mood, physical health and build "normalcy". Barriers included lack of time, access to resources, fear of poor health and triggering pain. Participants preferred moderate intensity exercise 3 times/week and 30-60 min sessions. Conclusions Our findings indicate that adults with OUD believe exercise is a valuable tool to use in their recovery but they encounter several barriers. Many barriers, however, could be overcome with structured programs offered by residential treatment centers.
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Affiliation(s)
- Nora L. Nock
- Departments of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
- Case Comprehensive Cancer Center, Cleveland, OH, USA
| | | | - Dallas Robinson
- Department of Psychology, University of Colorado at Denver, Denver, CO, USA
| | - Lee Hoffer
- Anthropology, Case Western Reserve University, Cleveland, OH, USA
| | - Amy Wachholtz
- Department of Psychology, University of Colorado at Denver, Denver, CO, USA
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Ingram I, Deane FP, Baker AL, Townsend CJ, Collins CE, Callister R, Chenhall R, Ivers R, Kelly PJ. The health of people attending residential treatment for alcohol and other drug use: Prevalence of and risks for major lifestyle diseases. Drug Alcohol Rev 2023; 42:1723-1732. [PMID: 37715714 DOI: 10.1111/dar.13752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 08/31/2023] [Accepted: 09/01/2023] [Indexed: 09/18/2023]
Abstract
INTRODUCTION Cardiovascular disease and cancers are the leading cause of mortality amongst people accessing treatment for alcohol and other drug use. The current study aimed to examine risk factors for chronic disease amongst people attending residential alcohol and other drug treatment services. METHODS Participants (N = 325) were attending residential alcohol and other drug treatment services across Australia. Diabetes and cardiovascular disease risk scores were calculated using established risk estimation algorithms. Differences in existing health conditions, risk factors for chronic diseases and risk algorithms were calculated for males and females. RESULTS In addition to alcohol and other drug use (including tobacco use), 95% of the sample had at least one other risk factor for chronic disease. Of participants not already diagnosed, 36% were at a high risk of developing type 2 diabetes and 11% had a high risk of developing cardiovascular disease. The heart age of participants was 11 years older than actual age (Mage = 40.63, Mheart age = 52.41). Males had a higher cardiovascular disease risk than females. DISCUSSION AND CONCLUSIONS A large proportion of people accessing residential alcohol and other drug treatment were at risk of chronic disease. Future research is needed that uses objective indicators of physical health. Such research will help to develop our understanding of prevention and intervention initiatives that could be adopted by treatment providers to improve the physical health of their consumers.
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Affiliation(s)
- Isabella Ingram
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
- School of Psychology, University of Wollongong, Wollongong, Australia
| | - Frank P Deane
- School of Psychology, University of Wollongong, Wollongong, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Amanda L Baker
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Camilla J Townsend
- School of Psychology, University of Wollongong, Wollongong, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Clare E Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
- Food and Nutrition Program, Hunter Medical Research Institute, Newcastle, Australia
| | - Robin Callister
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
| | - Richard Chenhall
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Rowena Ivers
- Graduate School of Medicine, University of Wollongong, Wollongong, Australia
| | - Peter J Kelly
- School of Psychology, University of Wollongong, Wollongong, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
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Bichler CS, Niedermeier M, Gufler A, Gálffy M, Sperner-Unterweger B, Kopp M. A case-control study on physical activity preferences, motives, and barriers in patients with psychiatric conditions. Compr Psychiatry 2021; 111:152276. [PMID: 34600310 DOI: 10.1016/j.comppsych.2021.152276] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 08/26/2021] [Accepted: 09/21/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Physical activity in individuals diagnosed with psychiatric conditions (patients) has antidepressant and anxiolytic effects, but levels of physical activity are still low in this population. This study aimed to identify physical activity preferences, motives, and perceived barriers in patients compared to individuals without a diagnosed psychiatric condition (controls). METHODS A total of 230 patients (age = 39.5 ± 14.0 years, 80% female) with major depression (34%), anxiety disorders (38%), or post-traumatic stress disorder (28%) completed a cross-sectional online survey to assess preferences, motives, and perceived barriers to physical activity (measured by the EMI-2). This group consisted of 100 patients with a clinical diagnosis (clinical subset) and 130 with self-reported psychiatric conditions (confirmed by the PHQ-4) from online help forums (online subset). Comparisons between patients of the clinical and the online subsets were performed and are referenced whenever significant. The patients group was compared to a healthy control group matched by sex and age (n = 230, age = 39.4 ± 14.9 years, 80% female). RESULTS More patients reported insufficient physical activity levels and more daily sitting hours (measured by the IPAQ) compared to controls. Patients reported lower preference in more ambitious types of physical activity, such as hiking, cycling, and running. The commonly most preferred type of physical activity in both groups was walking and yoga. Patients had fewer motives and more perceived barriers to physical activity in comparison to the control group. Some differences in motives and perceived barriers to physical activity were also found between patients of the clinical and the online subset. CONCLUSIONS Findings of low physical activity levels in patients are consistent with the literature. Due to the patients' lack of motivation and perception of barriers, health care providers should consider offering different and individualized forms of physical activity. Easier types of physical activity, such as walking and yoga, appear to be the most feasible and provide a good starting point to overcome perceived barriers to physical activity.
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Affiliation(s)
- Carina S Bichler
- Department of Sport Science, University of Innsbruck, Fuerstenweg 176, 6020 Innsbruck, Austria.
| | - Martin Niedermeier
- Department of Sport Science, University of Innsbruck, Fuerstenweg 176, 6020 Innsbruck, Austria
| | - Andrea Gufler
- Department of Sport Science, University of Innsbruck, Fuerstenweg 176, 6020 Innsbruck, Austria
| | - Mátyás Gálffy
- University Hospital of Psychiatry II, Department of Psychiatry, Psychotherapy and Psychosomatics, Innsbruck Medical University, Anichstraße 35, 6020 Innsbruck, Austria
| | - Barbara Sperner-Unterweger
- University Hospital of Psychiatry II, Department of Psychiatry, Psychotherapy and Psychosomatics, Innsbruck Medical University, Anichstraße 35, 6020 Innsbruck, Austria
| | - Martin Kopp
- Department of Sport Science, University of Innsbruck, Fuerstenweg 176, 6020 Innsbruck, Austria
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Fitzgerald C, Barley R, Hunt J, Klasto SP, West R. A Mixed-Method Investigation into Therapeutic Yoga as an Adjunctive Treatment for People Recovering from Substance Use Disorders. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-020-00228-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
AbstractMind Body Connect (MBC) is a charity which uses therapeutic yoga as a vehicle of change for marginalized populations. Alongside MBC, Sheffield Hallam University’s SHU Strength researchers carried out this study aiming to: (1) Gauge the impact of therapeutic yoga classes upon the mood state of people with a Substance Use Disorder (SUD) and (2) Explore the perceived benefits of therapeutic yoga class participation. An adapted shortened Profile of Mood States (POMS) was completed before and after each yoga class. A comparison of means with paired sample T-Test and Cohen’s D was then carried out. Participants who attended 6+ classes were interviewed. Findings were then converged. Before and after measurements of anger, sadness, tiredness, worry, confusion, energy and relaxation were taken, Classes were held at SHU for service users from a Phoenix Future’s (PF) rehabilitation centre. A single yoga class significantly relaxed participants and reduced negative mood states. Interview data covered a range of perceived benefits including the use of yogic down-regulation techniques as daily coping strategies. The MBC yoga programme appears beneficial as an adjunctive therapy for PF residents. Future SHU Strength research shall focus on the mid-long-term exercise habits of the recovery community and the impact of the MBC yoga programme upon the early recovery period of detoxification.
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Alhainen M, Myllyntausta S, Pentti J, Vahtera J, Stenholm S. Concurrent changes in sleep and physical activity during the transition to retirement: a prospective cohort study. Sleep Med 2020; 68:35-41. [PMID: 32028224 DOI: 10.1016/j.sleep.2019.09.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 05/24/2019] [Accepted: 09/17/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND Currently, little is known regarding whether changes in physical activity are associated with changes in sleep in general population. The aim of this study was to examine the association between changes in physical activity and changes in sleep duration and difficulties at retirement transition point. METHODS Data from the prospective Finnish Retirement and Aging study of 2745 retired public sector employees was used. Participants answered questionnaires before and after the retirement with one year interval, in which they reported average weekly hours of physical activity, sleep duration and the frequency of sleep difficulties. The level of physical activity, classified as 'low', 'moderate' or 'high', before and after retirement was used to classify the participants to five physical activity groups. Changes in sleep duration (in minutes) and sleep difficulties (no, moderate, severe) were examined in these physical activity groups. RESULTS Before retirement, high physical activity was associated with longest sleep duration (7 h 8 min) and low physical activity was associated with severe sleep difficulties (OR 1.23, 95% CI 1.06-1.44) in comparison to high physical activity. During retirement transition, sleep duration increased in all physical activity change groups and sleep difficulties decreased significantly in 'stable', 'increase from moderate', 'decrease from moderate' and 'decrease from high' groups. Changes in sleep duration and sleep difficulties were not statistically significantly different between the physical activity change groups. CONCLUSION Sleep duration increases and sleep difficulties decrease after retirement. Changes in sleep during retirement transition seem to be independent of changes in physical activity during the same time period.
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Affiliation(s)
- Maria Alhainen
- Department of Public Health, University of Turku, Turku University Hospital, Turku, Finland; Centre for Population Health Research, University of Turku, Turku University Hospital, Finland
| | - Saana Myllyntausta
- Department of Public Health, University of Turku, Turku University Hospital, Turku, Finland; Centre for Population Health Research, University of Turku, Turku University Hospital, Finland
| | - Jaana Pentti
- Department of Public Health, University of Turku, Turku University Hospital, Turku, Finland; Centre for Population Health Research, University of Turku, Turku University Hospital, Finland; Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jussi Vahtera
- Department of Public Health, University of Turku, Turku University Hospital, Turku, Finland; Centre for Population Health Research, University of Turku, Turku University Hospital, Finland
| | - Sari Stenholm
- Department of Public Health, University of Turku, Turku University Hospital, Turku, Finland; Centre for Population Health Research, University of Turku, Turku University Hospital, Finland.
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Simonton AJ, Young CC, Brown RA. Physical Activity Preferences and Attitudes of Individuals With Substance Use Disorders: A Review of the Literature. Issues Ment Health Nurs 2018; 39:657-666. [PMID: 29505733 DOI: 10.1080/01612840.2018.1429510] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Substance use disorders (SUDs) are prevalent in the United States and costly to society. SUDs contribute significantly to decreased quality of life and overdose deaths. Physical activity (PA) interventions may be one efficacious method to improve recovery and long-term abstinence from substance use; although PA interventions have resulted in positive physical and psychological outcomes, their adherence and attrition rates have been problematic. To address lack of adherence and high attrition rates, it is important to understand the preferences and attitudes for PA among patients in SUD treatment. We, therefore, conducted a literature review to examine preferences and attitudes for PA among adults with SUDs. Five articles met inclusion and exclusion criteria. The findings from this small sample of studies suggest that adults with SUDs are interested in PA. Walking, strength training, and cycling were the activities preferred most frequently. Participants said that they would like to engage in these activities either alone or with small groups and would prefer their exercise options to be located at facilities they already frequented, such as treatment clinics. Nurses are well positioned to assess patient preferences and attitudes and to enhance recovery efforts in this population. Further exploration of this population's unique preferences and attitudes regarding PA may lay the groundwork for efficacious PA interventions with improved adherence and attrition rates, which may lead to improved recovery outcomes.
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Affiliation(s)
- Amanda J Simonton
- a School of Nursing , The University of Texas at Austin , Austin , Texas , USA
| | - Cara C Young
- a School of Nursing , The University of Texas at Austin , Austin , Texas , USA
| | - Richard A Brown
- a School of Nursing , The University of Texas at Austin , Austin , Texas , USA
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Thompson TP, Taylor AH, Wanner A, Husk K, Wei Y, Creanor S, Kandiyali R, Neale J, Sinclair J, Nasser M, Wallace G. Physical activity and the prevention, reduction, and treatment of alcohol and/or substance use across the lifespan (The PHASE review): protocol for a systematic review. Syst Rev 2018; 7:9. [PMID: 29357931 PMCID: PMC5778642 DOI: 10.1186/s13643-018-0674-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 01/04/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Alcohol and substance use results in significant human and economic cost globally and is associated with economic costs of £21 billion and £15billion within the UK, respectively, and trends for use are not improving. Pharmacological interventions are well researched, but relapse rates across interventions for substance and alcohol use disorders are as high as 60-90%. Physical activity may offer an alternative or adjunct approach to reducing rates of alcohol and substance use that is associated with few adverse side effects, is easily accessible, and is potentially cost-effective. Through psychological, behavioural, and physiological mechanisms, physical activity may offer benefits in the prevention, reduction, and treatment of alcohol and substance use across the lifespan. Whilst physical activity is widely advocated as offering benefit, no systematic review exists of physical activity (in all forms) and its effects on all levels of alcohol and substance use across all ages to help inform policymakers, service providers, and commissioners. METHODS The objectives of this mixed methods systematic review are to describe and evaluate the quantitative and qualitative research obtained by a diverse search strategy on the impact of physical activity and its potential to: 1. Reduce the risk of progression to alcohol and/or substance use (PREVENTION) 2. Support individuals to reduce alcohol and/or substance use for harm reduction (REDUCTION), and 3. Promote abstinence and relapse prevention during and after treatment for an alcohol and/or substance use disorder (TREATMENT). With the input of key stakeholders, we aim to assess how what we know can be translated into policy and practice. Quantitative, qualitative, service evaluations, and economic analyses will be brought together in a final narrative synthesis that will describe the potential benefits of physical activity for whom, in what conditions, and in what form. DISCUSSION This review will provide details of what is known about physical activity and the prevention, reduction, and treatment of alcohol and/or substance use. The synthesised findings will be disseminated to policymakers, service providers, and commissioners in the UK. SYSTEMATIC REVIEW REGISTRATION PROSPERO number: CRD42017079322 .
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Affiliation(s)
- Tom P Thompson
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth Science Park, Derriford, Plymouth, PL6 8BX, UK.
| | - Adrian H Taylor
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth Science Park, Derriford, Plymouth, PL6 8BX, UK
| | - Amanda Wanner
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth Science Park, Derriford, Plymouth, PL6 8BX, UK
| | - Kerryn Husk
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth Science Park, Derriford, Plymouth, PL6 8BX, UK
| | - Yinghui Wei
- Centre for Mathematical Sciences, School of Computing, Electronics and Mathematics, Plymouth University, Drake Circus, Plymouth, PL4 8AA, UK
| | - Siobhan Creanor
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth Science Park, Derriford, Plymouth, PL6 8BX, UK
| | - Rebecca Kandiyali
- Bristol Medical School, Bristol University, Oakfield grove, Clifton, Bristol, BS8 2BN, UK
| | - Jo Neale
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Denmark Hill, London, SE5 8BB, UK
| | - Julia Sinclair
- Faculty of Medicine, University of Southampton, 4-12 Terminus Terrace, Southampton, SO14 3DT, UK
| | - Mona Nasser
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth Science Park, Derriford, Plymouth, PL6 8BX, UK
| | - Gary Wallace
- Plymouth City Council, Public Dispensary, Catherine Street, Plymouth, PL1 2AA, UK
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Damian AJ, Mendelson T. Association of Physical Activity with Alcohol Abuse and Dependence in a Nationally-Representative U.S. Sample. Subst Use Misuse 2017; 52:1744-1750. [PMID: 28704120 PMCID: PMC5794006 DOI: 10.1080/10826084.2017.1310245] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Alcohol use is a pervasive and costly public health problem in the United States. Relapse rates from alcohol use disorders are high. Although exercise has been proposed as a strategy to prevent relapse, lifestyle modification is the least studied aspect of relapse prevention programs, especially among racial/ethnic minority populations. OBJECTIVE The current study assessed whether being physically active was associated with remission from alcohol abuse or dependence among Black (African American and Afro Caribbean) adults in the U.S. METHOD We utilized data on Black adult participants (n = 4,828) from the nationally representative National Survey of American Life (NSAL) conducted in 2001-2003. Logistic regression models were estimated to assess the odds of being in 12-month remission or currently meeting DSM-IV criteria for alcohol abuse or dependence based on level of physical activity, adjusting for socio-demographic and neighborhood characteristics. RESULTS People who endorsed being physically active had higher odds of being in 12-month remission from alcohol use problems (OR: 1.67, 95% CI: 1.28, 2.17) than people who were physically inactive, adjusting for individual- and neighborhood-level characteristics. People who were physically active did not differ significantly from those who were inactive with respect to odds of currently meeting DSM-IV criteria for alcohol abuse or dependence. Conclusions/Importance: Physical activity was positively associated with being in 12-month remission from alcohol use problems. Longitudinal studies are needed to establish temporal ordering and to explore exercise as a potential relapse prevention strategy for alcohol use problems.
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Affiliation(s)
- April Joy Damian
- a Mental Health, Bloomberg School of Public Health , Johns Hopkins University , North Broadway, Hampton House, Baltimore , Maryland , USA
| | - Tamar Mendelson
- a Mental Health, Bloomberg School of Public Health , Johns Hopkins University , North Broadway, Hampton House, Baltimore , Maryland , USA
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More A, Jackson B, Dimmock JA, Thornton AL, Colthart A, Furzer BJ. Exercise in the Treatment of Youth Substance Use Disorders: Review and Recommendations. Front Psychol 2017; 8:1839. [PMID: 29089915 PMCID: PMC5651015 DOI: 10.3389/fpsyg.2017.01839] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Accepted: 10/03/2017] [Indexed: 01/26/2023] Open
Abstract
Substance use disorders among youth represent a significant public health concern. It is well established that regular exercise provides important physical and mental health benefits; however, evidence for the role of exercise as an adjunct component within substance use disorder treatment is scarce. In this review, we identify factors associated with the development and persistence of substance use disorders among youth, identify current treatment modalities, and present evidence to support the efficacy of incorporating exercise participation during rehabilitation. We also provide a series of recommendations for future research that explores the feasibility and effectiveness of exercise participation as a complement to substance use disorder treatment among youth.
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Affiliation(s)
- Alissa More
- School of Human Sciences (Exercise & Sport Science), The University of Western Australia, Perth, WA, Australia
| | - Ben Jackson
- School of Human Sciences (Exercise & Sport Science), The University of Western Australia, Perth, WA, Australia
| | - James A Dimmock
- School of Human Sciences (Exercise & Sport Science), The University of Western Australia, Perth, WA, Australia
| | - Ashleigh L Thornton
- School of Human Sciences (Exercise & Sport Science), The University of Western Australia, Perth, WA, Australia
| | - Allan Colthart
- Drug and Alcohol Youth Service, Mental Health Commission and Mission Australia, Perth, WA, Australia
| | - Bonnie J Furzer
- School of Human Sciences (Exercise & Sport Science), The University of Western Australia, Perth, WA, Australia
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Sari S, Muller AE, Roessler KK. Exercising alcohol patients don't lack motivation but struggle with structures, emotions and social context - a qualitative dropout study. BMC FAMILY PRACTICE 2017; 18:45. [PMID: 28330457 PMCID: PMC5363022 DOI: 10.1186/s12875-017-0606-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 02/28/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND Exercise is an important component of a healthy lifestyle, the development of which is a relapse prevention strategy for those with alcohol use disorder. However, it is a challenge to create exercise interventions with a persistent behavioural change. The aim of this qualitative study was to investigate perceived barriers to participation in an exercise intervention among alcohol use disorder patients, who dropped out of the intervention program. Furthermore, this study aims to propose possibilities for a better practice of future intervention studies based on the participants' experiences and suggestions. METHODS Qualitative interviews with 17 patients who dropped out from an exercise intervention in an outpatient treatment centre about their experiences and reasons for dropping out. Social cognitive theory informed the development of the interview guides and systematic text condensation was used for analysis. RESULTS Analysis revealed three central themes: 1) Structural barriers described as the type of exercise and the timing of the intervention, 2) Social barriers described as need for accountability and unsupportive relations, and 3) Emotional barriers described as fear, guilt and shame, and negative affect of the intervention on long term. CONCLUSIONS Future exercise interventions should include socio-psychological support during the first weeks, begin shortly after treatment initiation instead of concurrently, and focus on garnering social support for participants in both the intervention context and among their existing network in order to best reduce barriers to participation. TRIAL REGISTRATION This study was retrospectively registered at Current Controlled Trials ISRCTN74889852 on 11 July 2013.
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Affiliation(s)
- Sengül Sari
- Department of Psychology, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark.,Unit of Clinical Alcohol Research (UCAR), Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Ashley Elizabeth Muller
- Norwegian Centre for Addiction Research (SERAF), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Kirsten K Roessler
- Department of Psychology, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark.
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Weinstock J, Farney MR, Elrod NM, Henderson CE, Weiss EP. Exercise as an Adjunctive Treatment for Substance Use Disorders: Rationale and Intervention Description. J Subst Abuse Treat 2017; 72:40-47. [PMID: 27666958 PMCID: PMC5289308 DOI: 10.1016/j.jsat.2016.09.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 08/25/2016] [Accepted: 09/04/2016] [Indexed: 11/26/2022]
Abstract
Substance use disorders (SUDs) are maladaptive patterns of substance use that are associated with psychiatric comorbidity, unhealthy lifestyle choices, and high rates of relapse. Exercise is associated with a wide range of acute and long-term benefits for both mental and physical health and is presently being investigated as a promising adjunctive treatment for SUD. Despite positive effects of regular physical activity on treatment outcomes and risk factors for relapse, low adherence and high attrition rates limit the benefits derived from exercise interventions. Lack of motivation is one of many perceived barriers to initiating exercise that contributes to poor adherence to interventions. In the present article, we describe the protocol for a novel, integrated exercise intervention that combines motivational interviewing (MI), a client-centered approach designed to enhance intrinsic motivation and resolve ambivalence toward change, and contingency management (CM), a behavioral treatment that provides monetary incentives for the completion of target behaviors. The protocol seeks to address the challenges surrounding initiation and maintenance of an exercise program at a level consistent with public health guidelines, particularly for sedentary patients. We conclude with considerations for the implementation of the intervention in SUD specific clinics.
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Stoutenberg M, Rethorst CD, Lawson O, Read JP. Exercise training - A beneficial intervention in the treatment of alcohol use disorders? Drug Alcohol Depend 2016; 160:2-11. [PMID: 26652900 PMCID: PMC6083864 DOI: 10.1016/j.drugalcdep.2015.11.019] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 11/13/2015] [Accepted: 11/17/2015] [Indexed: 02/08/2023]
Abstract
BACKGROUND A growing body of evidence suggests that exercise training may have multiple beneficial effects in individuals with mental health or substance use disorders. Yet, relatively little knowledge exists regarding the benefits of exercise training to augment treatment for alcohol use disorders (AUDs). PURPOSE The purpose of this narrative review is to present a summary of the growing body of published literature supporting exercise training as a treatment strategy for individuals with AUDs. We will provide evidence on the myriad of ways in which exercise may exert a positive effect on AUD outcomes including stress, anxiety, impulsivity, and depression. Further, we will explore how these mechanisms share common neurobiological pathways. The role of exercise in enhancing the social environment and increasing individual self-efficacy to reduce excess and/or inappropriate alcohol consumption will also be discussed. DISCUSSION We will conclude with a description of completed investigations involving exercise training and provide suggestions for next steps in this innovative field of study.
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Affiliation(s)
- Mark Stoutenberg
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Clinical Research Building, Suite 1008, Miami, FL 33136, USA.
| | - Chad D. Rethorst
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA
| | - Olivia Lawson
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Clinical Research Building, Suite 1008, Miami, FL 33136, USA
| | - Jennifer P. Read
- Department of Psychology, The State University of New York at Buffalo, 213 Park Hall, Buffalo, NY 14260, USA
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15
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Giesen ES, Zimmer P, Bloch W. Effects of an Exercise Program on Physical Activity Level and Quality of Life in Patients with Severe Alcohol Dependence. ALCOHOLISM TREATMENT QUARTERLY 2016. [DOI: 10.1080/07347324.2016.1113109] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Vancampfort D, De Hert M, Stubbs B, Soundy A, De Herdt A, Detraux J, Probst M. A systematic review of physical activity correlates in alcohol use disorders. Arch Psychiatr Nurs 2015; 29:196-201. [PMID: 26165972 DOI: 10.1016/j.apnu.2014.08.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 08/13/2014] [Accepted: 08/20/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Physical activity might promote mental and physical health in persons with alcohol use disorder. Understanding the barriers and facilitators of participation in physical activity in persons with alcohol use disorder is an essential first step in order to devise effective physical activity interventions. OBJECTIVE The present review provides a systematic quantitative review of the correlates of physical activity in people with alcohol use disorder. METHODS Major electronic databases were searched by two independent authors from inception until June 2014. Keywords included 'physical activity' or 'exercise' and 'alcohol dependence' or 'alcohol abuse' or 'alcohol use disorders' or 'alcoholism'. RESULTS Five papers evaluating 14 correlates were included. Three studies reported that alcohol dependence was unrelated to physical activity behavior, while alcohol abuse showed positive associations in 2 studies. No demographic variable was related with physical activity participation. Functional impairments and distress associated with alcohol use disorders including increased smoking rates, obesity, anxiety, depression and a lower self-efficacy may limit one's ability to be physically active. Data on social, environmental and policy related factors are currently lacking. No included study assessed physical activity levels utilizing objective measurements (e.g. pedometers, accelerometers). CONCLUSION Although the literature on physical activity correlates in persons with alcohol use disorder still is equivocal, our varied findings support the hypothesis that the participation in physical activity by people with alcohol use disorder is determined by a range of complex factors.
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Affiliation(s)
- Davy Vancampfort
- KU Leuven Department of Neurosciences, UPC KU Leuven, Kortenberg, Kortenberg, Belgium; KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium.
| | - Marc De Hert
- KU Leuven Department of Neurosciences, UPC KU Leuven, Kortenberg, Kortenberg, Belgium
| | - Brendon Stubbs
- School of Health and Social Care, University of Greenwich, London, UK
| | - Andrew Soundy
- Department of Physiotherapy, University of Birmingham, Birmingham, B15 2TT, UK
| | - Amber De Herdt
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
| | - Johan Detraux
- KU Leuven Department of Neurosciences, UPC KU Leuven, Kortenberg, Kortenberg, Belgium
| | - Michel Probst
- KU Leuven Department of Neurosciences, UPC KU Leuven, Kortenberg, Kortenberg, Belgium; KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
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Linke SE, Noble M, Hurst S, Strong DR, Redwine L, Norman SB, Lindamer LA. An Exercise-Based Program for Veterans with Substance Use Disorders: Formative Research. J Psychoactive Drugs 2015; 47:248-57. [DOI: 10.1080/02791072.2015.1047915] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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18
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Kelly PJ, Baker AL, Deane FP, Callister R, Collins CE, Oldmeadow C, Attia JR, Townsend CJ, Ingram I, Byrne G, Keane CA. Study protocol: a stepped wedge cluster randomised controlled trial of a healthy lifestyle intervention for people attending residential substance abuse treatment. BMC Public Health 2015; 15:465. [PMID: 25935830 PMCID: PMC4433090 DOI: 10.1186/s12889-015-1729-y] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2015] [Accepted: 03/31/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cardiovascular disease and cancer are leading causes of mortality for people with a history of alcohol or other substance use disorders. These chronic diseases share the same four primary behavioural risk factors i.e. excessive alcohol use, smoking, low intake of fruit and vegetables and physical inactivity. In addition to addressing problematic alcohol use, there is the potential for substance abuse treatment services to also address these other behaviours. Healthy Recovery is an 8-session group-based intervention that targets these multiple behavioural health risk factors and was developed specifically for people attending substance abuse treatment. This protocol describes a Cancer Institute NSW funded study that assesses the effectiveness of delivering Healthy Recovery for people who are attending residential alcohol and other substance abuse treatment. METHODS/DESIGN The study uses a stepped wedge randomised controlled design, where randomisation occurs at the service level. Participants will be recruited from residential rehabilitation programs provided by The Australian Salvation Army. All participants who (1) currently smoke tobacco and (2) are expected to be in the residential program for the duration of the 5-week intervention will be asked to participate in the study. Those participants residing at the facilities assigned to the treatment condition will complete Healthy Recovery. The intervention is manual guided and will be delivered over a 5-week period, with participants attending 8 group sessions. All participants will continue to complete The Salvation Army residential program, a predominantly 12-step based, modified therapeutic community. Participants in the control condition will complete treatment as usual. Research staff blind to treatment allocation will complete the primary and secondary outcome assessments at baseline and then at weeks 8, 20 and 32 weeks post intervention. DISCUSSION This study will provide comprehensive data on the effect of delivering a healthy lifestyle intervention (i.e. Healthy Recovery) within a residential substance abuse setting. If shown to be effective, this intervention can be disseminated within other residential substance abuse programs. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Register (ANZCTR): ACTRN12615000165583. Registered 19(th) February 2015.
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Affiliation(s)
- Peter J Kelly
- Illawarra Institute for Mental Health, School of Psychology, University of Wollongong, Northfields Avenue, Wollongong, 2522, Australia.
| | - Amanda L Baker
- School of Medicine and Public Health, Faculty of Medicine, University of Newcastle, University Drive, Callaghan, 2308, Australia.
| | - Frank P Deane
- Illawarra Institute for Mental Health, School of Psychology, University of Wollongong, Northfields Avenue, Wollongong, 2522, Australia.
| | - Robin Callister
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine and Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, University Drive, Callaghan, 2308, Australia.
| | - Clare E Collins
- School of Health Sciences, Faculty of Health and Medicine and Medicine and Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, University Drive, Callaghan, 2308, Australia.
| | - Christopher Oldmeadow
- Clinical Research Design, IT and Statistical Support Unit (CReDITSS), Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, 2305, Australia.
| | - John R Attia
- Clinical Research Design, IT and Statistical Support Unit (CReDITSS), Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, 2305, Australia. .,School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, University Drive, Callaghan, 2308, Australia.
| | - Camilla J Townsend
- Illawarra Institute for Mental Health, School of Psychology, University of Wollongong, Northfields Avenue, Wollongong, 2522, Australia.
| | - Isabella Ingram
- Illawarra Institute for Mental Health, School of Psychology, University of Wollongong, Northfields Avenue, Wollongong, 2522, Australia.
| | - Gerard Byrne
- Recovery Services, Australia Eastern Territory, The Salvation Army, Elizabeth Street, Sydney, 2000, Australia.
| | - Carol A Keane
- Illawarra Institute for Mental Health, School of Psychology, University of Wollongong, Northfields Avenue, Wollongong, 2522, Australia.
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19
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Attitudes and Preferences Towards Exercise Training in Individuals with Alcohol Use Disorders in a Residential Treatment Setting. J Subst Abuse Treat 2015; 49:43-9. [DOI: 10.1016/j.jsat.2014.08.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Revised: 08/08/2014] [Accepted: 08/19/2014] [Indexed: 11/20/2022]
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20
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Linke SE, Ussher M. Exercise-based treatments for substance use disorders: evidence, theory, and practicality. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2015; 41:7-15. [PMID: 25397661 PMCID: PMC4831948 DOI: 10.3109/00952990.2014.976708] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Epidemiological studies reveal that individuals who report risky substance use are generally less likely to meet physical activity guidelines (with the exception of certain population segments, such as adolescents and athletes). A growing body of evidence suggests that individuals with substance use disorders (SUDs) are interested in exercising and that they may derive benefits from regular exercise, in terms of both general health/fitness and SUD recovery. OBJECTIVES The aims of this paper were to: (i) summarize the research examining the effects of exercise-based treatments for SUDs; (ii) discuss the theoretical mechanisms and practical reasons for investigating this topic; (iii) identify the outstanding relevant research questions that warrant further inquiry; and (iv) describe potential implications for practice. METHODS The following databases were searched for peer-reviewed original and review papers on the topic of substance use and exercise: PubMed Central, MEDLINE, EMBASE, PsycINFO, and CINAHL Plus. Reference lists of these publications were subsequently searched for any missed but relevant manuscripts. Identified papers were reviewed and summarized by both authors. RESULTS The limited research conducted suggests that exercise may be an effective adjunctive treatment for SUDs. In contrast to the scarce intervention trials to date, a relative abundance of literature on the theoretical and practical reasons supporting the investigation of this topic has been published. CONCLUSIONS Definitive conclusions are difficult to draw due to diverse study protocols and low adherence to exercise programs, among other problems. Despite the currently limited and inconsistent evidence, numerous theoretical and practical reasons support exercise-based treatments for SUDs, including psychological, behavioral, neurobiological, nearly universal safety profile, and overall positive health effects.
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Affiliation(s)
- Sarah E. Linke
- Department of Family & Preventive Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Michael Ussher
- Division of Population Health Sciences and Education, St George’s, University of London, London, UK
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Weinstock J, Capizzi J, Weber SM, Pescatello LS, Petry NM. Exercise as an intervention for sedentary hazardous drinking college students: A pilot study. Ment Health Phys Act 2014; 7:55-62. [PMID: 24949085 PMCID: PMC4058428 DOI: 10.1016/j.mhpa.2014.02.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Young adults 18-24 years have the highest rates of problems associated with alcohol use among all age groups, and substance use is inversely related to engagement in substance-free activities. This pilot study investigated the promotion of one specific substance-free activity, exercise, on alcohol use in college students. Thirty-one sedentary college students who engaged in hazardous drinking (Alcohol Use Disorders Identification Test scores ≥ 8) were randomized to one of two conditions: (a) one 50-minute session of motivational enhancement therapy (MET) focused on increasing exercise, or (b) one 50-minute session of MET focused on increasing exercise plus 8 weeks of contingency management (CM) for adhering to specific exercise activities. All participants completed evaluations at baseline and post-treatment (2-months later) assessing exercise participation and alcohol use. Results of the pilot study suggest the interventions were well received by participants, the MET+CM condition showed an increased self-reported frequency of exercise in comparison to the MET alone condition, but other indices of exercise, physical fitness, and alcohol use did not differ between the interventions over time. These results suggest that a larger scale trial could better assess efficacy of this well received combined intervention. Investigation in other clinically relevant populations is also warranted.
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Affiliation(s)
- Jeremiah Weinstock
- Department of Psychology, Saint Louis University, St. Louis, MO 63103
- Calhoun Cardiology Center, University of Connecticut Health Center, Farmington, CT 06030-3944
| | - Jeffrey Capizzi
- Department of Kinesiology, Neag School of Education, University of Connecticut, Storrs, CT 06269-1110
| | - Stefanie M. Weber
- Department of Psychology, Saint Louis University, St. Louis, MO 63103
| | - Linda S. Pescatello
- Department of Kinesiology, Neag School of Education, University of Connecticut, Storrs, CT 06269-1110
| | - Nancy M. Petry
- Calhoun Cardiology Center, University of Connecticut Health Center, Farmington, CT 06030-3944
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22
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Caviness CM, Bird JL, Anderson BJ, Abrantes AM, Stein MD. Minimum recommended physical activity, and perceived barriers and benefits of exercise in methadone maintained persons. J Subst Abuse Treat 2012. [PMID: 23199641 DOI: 10.1016/j.jsat.2012.10.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Methadone-maintained persons are at increased risk for many physical and mental health disorders compared to the general population. Increased physical activity could offset these risks. We assessed physical activity level, and perceived benefits and barriers to exercise in a group of 305 methadone-maintained smokers. Mean participant age was 39.9 years, 50.2% were male, 79.7% were non-Hispanic White, and mean body mass index was 29.8. Nearly 45% endorsed fair or poor physical health. Although participants perceived many benefits of exercise and few barriers, only 38% of participants met weekly recommendations for physical activity, and nearly 25% reported no physical activity. Those who met recommended guidelines were significantly more likely to endorse relapse prevention as a benefit of exercise. Motivating MMT patients to increase physical activity could have important physical, mental health, and drug treatment benefits.
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Affiliation(s)
- Celeste M Caviness
- General Medicine Research Unit, Butler Hospital, Providence, RI 02906, USA
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KELLY PETERJ, BAKER AMANDAL, DEANE FRANKP, KAY-LAMBKIN FRANCESJ, BONEVSKI BILLIE, TREGARTHEN JENNA. Prevalence of smoking and other health risk factors in people attending residential substance abuse treatment. Drug Alcohol Rev 2012; 31:638-44. [DOI: 10.1111/j.1465-3362.2012.00465.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Zschucke E, Heinz A, Ströhle A. Exercise and physical activity in the therapy of substance use disorders. ScientificWorldJournal 2012; 2012:901741. [PMID: 22629222 PMCID: PMC3354725 DOI: 10.1100/2012/901741] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2011] [Accepted: 12/08/2011] [Indexed: 11/17/2022] Open
Abstract
Exercise and physical activity are constantly gaining attention as adjuvant treatment for substance use disorders, supplementing classical pharmacological and psychotherapeutic approaches. The present work reviews studies addressing the therapeutic effects of exercise in alcohol abuse/dependence, nicotine abuse/dependence, and illicit drug abuse/dependence. In the field of smoking cessation, evidence is strong for exercise as an effective adjuvant treatment, whereas no generalizable and methodologically strong studies have been published for alcohol and drug treatment so far, allowing only preliminary conclusions about the effectiveness of exercise in these disorders. A couple of potential mechanisms are discussed, by which exercise may act as an effective treatment, as well as future directions for studies investigating exercise as a treatment strategy for substance use disorders.
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Affiliation(s)
- Elisabeth Zschucke
- Klinik für Psychiatrie und Psychotherapie, Charité-Universitätsmedizin Berlin, Charité Campus Mitte, Charitéplatz 1, 101117 Berlin, Germany.
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Evaluation of the Mental Healthiness Aging Initiative: community program to promote awareness about mental health and aging issues. Community Ment Health J 2012; 48:193-201. [PMID: 21234684 DOI: 10.1007/s10597-011-9373-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2009] [Accepted: 01/03/2011] [Indexed: 10/18/2022]
Abstract
The objective of this study is to evaluate the Mental Healthiness Aging Initiative, designed to promote community awareness and knowledge about mental health and aging issues. This study occurred during 2007-2009 in 67 of 120 counties in Kentucky. A rural region (11 counties) received the intervention, consisting of focus groups, Extension Agent training, and television-based social marketing campaign. Partial-intervention counties (29 counties) received only the television-based social marketing campaign. The control counties (27 counties) received no intervention activities. Results indicated that the intervention counties agreed more with being able to assist elder adults with a potential mental illness. Also, the intervention counties understood the risk of consuming alcohol and medications better, but had a poorer recognition of drinking problems in elder adults. These findings need to be considered within study limitations, such as measurement error, degree of intervention exposure, and regional differences across intervention groups. The study demonstrates that community interventions on mental health awareness and knowledge are feasible within majority rural regions, with Extension Agents being gatekeepers, for promoting positive messages about mental health and aging issues.
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Beebe LH, Smith K, Burk R, McIntyre K, Dessieux O, Tavakoli A, Velligan D. Motivational intervention increases exercise in schizophrenia and co-occurring substance use disorders. Schizophr Res 2012; 135:204-5. [PMID: 22260964 DOI: 10.1016/j.schres.2011.12.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2011] [Revised: 12/14/2011] [Accepted: 12/15/2011] [Indexed: 10/14/2022]
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Patients' Improvements Measured With the Pleasant Activities List and the Community Reinforcement Approach Happiness Scale. ADDICTIVE DISORDERS & THEIR TREATMENT 2012. [DOI: 10.1097/adt.0b013e31820bfc67] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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The Role of Physical Activity in Treatment of Substance Use Disorders. ISSUES IN CHILDREN'S AND FAMILIES' LIVES 2012. [DOI: 10.1007/978-1-4614-3606-5_9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Abrantes AM, Battle CL, Strong DR, Ing E, Dubreuil ME, Gordon A, Brown RA. EXERCISE PREFERENCES OF PATIENTS IN SUBSTANCE ABUSE TREATMENT. Ment Health Phys Act 2011; 4:79-87. [PMID: 22125581 PMCID: PMC3224086 DOI: 10.1016/j.mhpa.2011.08.002] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
While emerging studies have demonstrated the benefit of exercise in early recovery from substance use disorders, recruitment and adherence to exercise interventions have been challenging. Tailoring interventions based on patient exercise preferences may address these concerns. Ninety-seven (N=97; age=41.6 years; 44% female) patients were recruited from an intensive substance abuse outpatient program and filled out questionnaires about their exercise preferences. Most (71%) patients were not currently engaged in an exercise program (i.e., exercising less than 20 minutes/day for 3 days/week over the last 6 months). The vast majority (95%) expressed an interest in engaging in an exercise program specifically designed for persons in substance use recovery and 89% reported wanting to initiate an exercise program within the first 3 months of sobriety. Specific exercise preferences regarding type of physical activity, exercise intervention components, and perceived benefits and barriers to exercise differed between males and females. These findings suggest low rates of regular exercise, high level of interest in engaging in exercise during early recovery, and point toward the need to tailor interventions to the unique preferences of individuals.
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Affiliation(s)
- Ana M Abrantes
- Butler Hospital/Alpert Medical School of Brown University Providence, RI 02906
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Pieper B, Templin TN, Kirsner RS, Birk TJ. The impact of vascular leg disorders on physical activity in methadone-maintained adults. Res Nurs Health 2010; 33:426-40. [PMID: 20672307 DOI: 10.1002/nur.20392] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Chronic venous disorders (CVD) and peripheral arterial disease (PAD) may affect diverse physical activity domains. How CVD and PAD and other relevant variables affect physical activity was examined in 569 opioid-addicted adults. Both CVD and PAD were significantly inversely related to daily walking, sports, and active living. Effects remained significant in the latent variable regression after controlling covariates. Overall activity was very low; most participants walked less than a half mile daily and rarely engaged in sports. Motivation for physical activity was the strongest predictor (β = .55) of daily physical activity. Health-care professionals promoting physical activity for injection users should consider the vascular health of their legs and motivational variables in addition to general health.
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Affiliation(s)
- Barbara Pieper
- College of Nursing, Wayne State University, Detroit, MI 48202, USA
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Brown RA, Abrantes AM, Read JP, Marcus BH, Jakicic J, Strong DR, Oakley JR, Ramsey SE, Kahler CW, Stuart GG, Dubreuil ME, Gordon AA. A Pilot Study of Aerobic Exercise as an Adjunctive Treatment for Drug Dependence. Ment Health Phys Act 2010; 3:27-34. [PMID: 20582151 PMCID: PMC2889694 DOI: 10.1016/j.mhpa.2010.03.001] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Intervention to increase exercise in drug dependent patients represents a potentially useful yet unexplored strategy for preventing relapse. However, there are currently no established exercise interventions for use with this population. The purpose of this pilot study was to examine the feasibility of aerobic exercise as an adjunct to substance abuse treatment among drug dependent patients. Participants included 16 (31% female, 38.3 years old) drug dependent patients who participated in a 12-week, moderate-intensity aerobic exercise intervention. Participants attended a mean of 8.6 sessions (out of 12). Participants demonstrated a significant increase in percent days abstinent for both alcohol and drugs at the end of treatment, and those who attended at least 75% of the exercise sessions had significantly better substance use outcomes than those who did not. In addition, participants showed a significant increase in their cardiorespiratory fitness by the end of treatment. While preliminary, this study is one of the first to demonstrate the feasibility of incorporating aerobic exercise during drug abuse treatment. Future randomized control trials are a necessary next step to test the efficacy of a moderate-intensity aerobic exercise intervention as an adjunct to drug abuse treatment in this patient population.
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Affiliation(s)
- Richard A. Brown
- CORRESPONDING AUTHOR: Richard A. Brown, Ph.D., Alpert Medical School of Brown University/Butler Hospital, 345 Blackstone Blvd., Providence, R.I. 02906.
| | | | | | | | | | | | | | - Susan E. Ramsey
- Alpert Medical School of Brown University/Rhode Island Hospital
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Abrantes AM, Strong DR, Cohn A, Cameron AY, Greenberg BD, Mancebo MC, Brown RA. Acute changes in obsessions and compulsions following moderate-intensity aerobic exercise among patients with obsessive-compulsive disorder. J Anxiety Disord 2009; 23:923-7. [PMID: 19616916 DOI: 10.1016/j.janxdis.2009.06.008] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2008] [Revised: 06/02/2009] [Accepted: 06/05/2009] [Indexed: 11/30/2022]
Abstract
Aerobic exercise can acutely influence anxious and depressive mood in both clinical and nonclinical populations. However, there are no existing studies that have examined the acute effect of exercise on mood, anxiety, obsessions, and compulsions in patients with OCD. The primary aim of this study was to examine acute changes in these symptoms after engaging in single exercise sessions during a 12-week exercise intervention for 15 (53% female; mean age=41.9 years) patients with OCD. Participants reported reductions in negative mood, anxiety, and OCD symptoms at the end of each exercise session relative to the beginning. Changes in the magnitude of the effect of exercise in reducing negative mood and anxiety remained fairly stable while levels of self-reported obsessions and compulsions decreased over the duration of the intervention. Results of this study point toward the promising effect of exercise for acute symptom reduction in patients with OCD.
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Affiliation(s)
- Ana M Abrantes
- Butler Hospital/Alpert Medical School of Brown University, Providence, RI 02906, USA.
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Emerson MH, Glovsky E, Amaro H, Nieves R. Unhealthy weight gain during treatment for alcohol and drug use in four residential programs for Latina and African American women. Subst Use Misuse 2009; 44:1553-65. [PMID: 19938931 DOI: 10.1080/10826080802494750] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Weight gain in women (n = 52) in four alcohol and drug user residential treatment programs in Boston, Massachusetts, was studied in 2004 through focus groups (n = 52) and weekly weights (n = 10). Focus group theme analyses revealed that weight gain was primarily attributed to availability of food and lack of exercise. Participants were very interested in improving nutrition, diet, and exercise in the programs. Weight gain (mean = 6.4 pounds) occurred in nine women (n = 10) in the first 12 weeks of treatment. The two-dimensional Food Model Chart and the Yale Physical Activity Survey were used. Limitations are noted and future research is suggested.
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Affiliation(s)
- Margaret H Emerson
- Northeastern University, Bouvé College of Health Sciences, School of Nursing, Boston, Massachusetts 02115, USA.
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The influence of physical activity on alcohol consumption among heavy drinkers participating in an alcohol treatment intervention. Addict Behav 2008; 33:1337-43. [PMID: 18639987 DOI: 10.1016/j.addbeh.2008.06.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2008] [Revised: 04/15/2008] [Accepted: 06/05/2008] [Indexed: 01/25/2023]
Abstract
Researchers have hypothesized that physical activity may be beneficial for individuals attempting to reduce their alcohol consumption, although few studies have actually tested this relationship. The purpose of the present study was to describe the physical activity of 620 male veterans enrolled in a treatment intervention study for heavy drinkers, and to determine whether greater involvement in physical activity was associated with greater reductions in alcohol consumption. Participants endorsed moderate physical activity at the baseline visit (median=1.65 kcal/kg/day expended from physical activity), although physical activity declined during over time, p=.011. The most frequently endorsed activities included walking, gardening/yardwork, calisthenics, biking, swimming, weight lifting, golfing, and dancing. Regression analyses revealed no significant relationships between energy expenditure from physical activity and reductions in alcohol consumption at the six- and 12-month visits. Findings suggest that engaging in physical activity does not enhance treatment outcomes within interventions that do not specifically aim to increase physical activity. However, commonly endorsed activities may be easily incorporated into interventions in which physical activity is a desired component.
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Correia CJ, Benson TA, Carey KB. Decreased substance use following increases in alternative behaviors: a preliminary investigation. Addict Behav 2005; 30:19-27. [PMID: 15561446 DOI: 10.1016/j.addbeh.2004.04.006] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Research derived from behavioral economic theories has demonstrated reciprocal links between substance use and engagement in substance-free activities. The current study used an experimental manipulation to further investigate the relationship between substance use and substance-free behaviors in a nonclinical sample of 133 young adults. Participants completed surveys on substance use and engagement in specific substance-free behaviors (exercise and creative behaviors) on two occasions separated by a 28-day interval. During the 4 weeks separating assessments, the 105 participants who reported recent substance use were randomly assigned to one of three experimental conditions with corresponding behavioral instructions: substance use reduction (SR), activity increase (AI), and a no-change control. Participants assigned to both the SR and AI conditions reported a significant decrease in their substance use behavior. These results are consistent with previous studies in demonstrating that decreases in substance use can be achieved by increasing engagement in substance-free behaviors.
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