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Exercise Regulates the Metabolic Homeostasis of Methamphetamine Dependence

Physical exercise is effective in enhancing cognitive function, reducing anxiety and depressive symptoms, reducing cravings, and improving quality of life in methamphetamine (METH) addiction. However, little is known about the effect of exercise on metabolic profiles. We performed LC/MS-based targeted metabolic profiling on serum samples to investigate the metabolic characteristics of METH dependence and find the differences between METH-dependent individuals and nonusers and evaluated the metabolomic profiles of individuals with METH dependence following aerobic exercise training. We identified a total of 201 metabolites, among which 115 were differentially expressed under METH use. Among the differentially regulated metabolites, 72 were selected as potential biomarkers. Further analysis identified 19 pathways, among which glyoxylate and dicarboxylate metabolism; alanine, aspartate, and glutamate metabolism; and citrate cycle were most significantly affected by METH. The aerobic exercise intervention differentially regulated 55 metabolites, of which 51 were selected as potential biomarkers and were mainly enriched in 10 pathways. Interestingly, alanine, aspartate, and glutamate metabolism and nitrogen metabolism were the remarkably affected pathways. Furthermore, METH increased the serum levels of glutamate and decreased GABA, whereas exercise decreased the serum levels of glutamate and increased GABA. Results suggested that METH dependency disturbed normal metabolic homeostasis, whereas exercise restored metabolism.

Effect of Physical Activity on Drug Craving of Women With Substance Use Disorder in Compulsory Isolation: Mediating Effect of Internal Inhibition

Background

Women with substance use disorder has attracted widespread attention as a prominent social issue. According to reports, physical exercise can improve the internal inhibition, effectively reduce the substance user's drug graving, and improve withdrawal symptoms, however, the specific mechanism of internal inhibition should be further considered. This study was designed to determine the critical role of internal inhibition in the path of physical exertion affecting the drug cravings of women drug users.

Methods

By means of Physical Activity Rating Scale (PARS-3), internal Inhibition Scale and Drug Craving Scale, this study investigated the individuals with substance use disorder under rehabilitation in the women compulsory isolation rehabilitation center in Chongqing, China.

Results

(1) Women with traditional drug users had the strongest internal inhibition and new drug use disorder had the highest drug craving. The longer the duration of drug abuse, the lower the internal inhibition and the higher the drug craving. Women with moderate-intensity activity had the strongest internal inhibition and the lowest drug craving. (2) The physical activity intensity was negatively correlated with drug craving, positively correlated with intrinsic inhibition, and negatively correlated with drug craving. (3) Internal inhibition played a partial mediating effect between physical activity intensity and drug craving.

Conclusion

Physical activity has a positive effect on inhibiting drug craving among drug addicts, while moderate-intensity activity seems to be more conducive to enhancing the internal inhibition of addicts, to improving their resistance to drugs, and thus more conducive to reducing drug craving.

Incarcerated women develop a nutrition and fitness program: participatory research

PURPOSE

Women in prison throughout the world experience higher rates of mental and physical illness compared with the general population and compared with men in prison. The paper finds no published studies that report on men or women in prison engaging in participatory health research to address their concerns about nutrition and fitness. The purpose of this paper is to describe a pilot nutrition and fitness program, which resulted from a unique prison participatory health research project.

DESIGN/METHODOLOGY/APPROACH

Women in prison designed, led, and evaluated a six-week pilot fitness program in a minimum/medium security women's prison. Pre- and post-program assessments included a self-administered questionnaire and body measures. Open-ended questionnaire responses illuminated the quantitative findings.

FINDINGS

Sixteen women in prison completed the program evaluation. Weight, body mass index, waist-to-hip ratio, and chest measurements decreased, and energy, sleep, and stress levels improved by the end of the program.

RESEARCH LIMITATIONS/IMPLICATIONS

As a component of a participatory research project, incarcerated women designed and led a nutrition and fitness program, which resulted in improved body measures and self-reported health benefits. ORIGINALITY VALUE: Incarceration provides opportunities to engage women in designing their own health programs with consequent potential long-term "healing" benefits.

Clinical exercise interventions in alcohol use disorders: a systematic review

The therapeutic impact of exercise interventions in psychiatric diseases such as depression, anxiety and schizophrenia has already been proven through several reviews whereas substance use disorders such as alcohol use disorders (AUD) have so far less frequently been a matter of investigation. Although several publications have summarized studies focusing on physical activities in substance use disorders, no systematic review exists summarizing the evidence of exercise interventions in AUD. A total of 14 studies using the Medline Database, CCMed, Cochrane Library and PsychINFO were identified and met the inclusion criteria. In order to evaluate the evidence, we used the evaluation system of the Oxford Centre for Evidence-Based Medicine (2011). Due to methodological flaws the overall evidence of the studies is rated level "3" but primarily findings confirm that exercise interventions as a complementary treatment component in AUD are feasible and safe. No adverse events were reported. This systematic review indicates that exercise may have beneficial effects on certain domains of physical functioning including VO2max, basal heart rate, physical activity level and strength. Inconsistent effects with a slight trend towards a positive effect on anxiety, mood management, craving, and drinking behavior have been shown and need to be verified. Results must be interpreted cautiously due to the numerous methodological flaws and the heterogeneity of the interventions and measures. However, according to preclinical studies several mechanisms of action are conceivable, especially as to alcohol-related outcomes and additionally seem to be promising. RCTs with high methodological quality are urgently needed in future research to establish evidence-based exercise recommendations for the treatment of AUD.

A systematic review of the effectiveness and cost-effectiveness of peer-based interventions to maintain and improve offender health in prison settings

Background

Offender health is deemed a priority issue by the Department of Health. Peer support is an established feature of prison life in England and Wales; however, more needs to be known about the effectiveness of peer-based interventions to maintain and improve health in prison settings.

Objectives

The study aimed to synthesise the evidence on peer-based interventions in prison settings by carrying out a systematic review and holding an expert symposium. Review questions were (1) what are the effects of peer-based interventions on prisoner health and the determinants of prisoner health?, (2) what are the positive and negative impacts on health services within prison settings of delivering peer-based interventions?, (3) how do the effects of peer-based approaches compare with those of professionally led approaches? and (4) what are the costs and cost-effectiveness of peer-based interventions in prison settings?

Data sources

For the systematic review, 20 electronic databases including MEDLINE, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature and EMBASE were searched from 1985. Grey literature and relevant websites were also searched. To supplement the review findings 58 delegates, representing a variety of organisations, attended an expert symposium, which provided contextual information.

Review methods

Two reviewers independently selected studies using the following inclusion criteria: population – prisoners resident in prisons and young offender institutions; intervention – peer-based interventions; comparators: review questions 3 and 4 compared peer-led and professionally led approaches; outcomes – prisoner health or determinants of health, organisational/process outcomes or views of prison populations; study design: quantitative, qualitative and mixed-methods evaluations. Two reviewers extracted data and assessed validity using piloted electronic forms and validity assessment criteria based on published checklists. Results from quantitative studies were combined using narrative summary and meta-analysis when appropriate; results from qualitative studies were combined using thematic synthesis.

Results

A total of 15,320 potentially relevant papers were identified of which 57 studies were included in the effectiveness review and one study was included in the cost-effectiveness review; most were of poor methodological quality. A typology of peer-based interventions was developed. Evidence suggested that peer education interventions are effective at reducing risky behaviours and that peer support services provide an acceptable source of help within the prison environment and have a positive effect on recipients; the strongest evidence came from the Listener scheme. Consistent evidence from many predominantly qualitative studies suggested that being a peer deliverer was associated with positive effects across all intervention types. There was limited evidence about recruitment of peer deliverers. Recurring themes were the importance of prison managerial and staff support for schemes to operate successfully, and risk management. There was little evidence on the cost-effectiveness of peer-based interventions. An economic model, developed from the results of the effectiveness review, although based on data of variable quality and a number of assumptions, showed the cost-effectiveness of peer-led over professionally led education in prison for the prevention of human immunodeficiency virus (HIV) infection.

Limitations

The 58 included studies were, on the whole, of poor methodological quality.

Conclusions

There is consistent evidence from a large number of studies that being a peer worker is associated with positive health. Peer support services can also provide an acceptable source of help within the prison environment and can have a positive effect on recipients. This was confirmed by expert evidence. Research into cost-effectiveness is sparse but a limited HIV-specific economic model, although based on a number of assumptions and evidence of variable quality, showed that peer interventions were cost-effective compared with professionally led interventions. Well-designed intervention studies are needed to provide robust evidence including assessing outcomes for the target population, economic analysis of cost-effectiveness and impacts on prison health services. More research is needed to examine issues of reach, utilisation and acceptability from the perspective of recipients and those who choose not to receive peer support.

Study registration

This study was registered as PROSPERO CRD42012002349.

Funding

The National Institute for Health Research Health Services and Delivery Research programme.

Access to a running wheel decreases cocaine-primed and cue-induced reinstatement in male and female rats

BACKGROUND

Relapse to drug use after a period of abstinence is a persistent problem in the treatment of cocaine dependence. Physical activity decreases cocaine self-administration in laboratory animals and is associated with a positive prognosis in human substance-abusing populations. The purpose of this study was to examine the effects of long-term access to a running wheel on drug-primed and cue-induced reinstatement of cocaine-seeking behavior in male and female rats. methods: Long-Evans rats were obtained at weaning and assigned to sedentary (no wheel) and exercising (access to wheel) groups for the duration of the study. After 6 weeks, rats were implanted with intravenous catheters and trained to self-administer cocaine for 14 days. After training, saline was substituted for cocaine and responding was allowed to extinguish, after which cocaine-primed reinstatement was examined in both groups. Following this test, cocaine self-administration was re-established in both groups for a 5-day period. Next, a second period of abstinence occurred in which both cocaine and the cocaine-associated cues were withheld. After 5 days of abstinence, cue-induced reinstatement was examined in both groups.

RESULTS

Sedentary and exercising rats exhibited similar levels of cocaine self-administration, but exercising rats responded less than sedentary rats during extinction. In tests of cocaine-primed and cue-induced reinstatement, exercising rats responded less than sedentary rats, and this effect was apparent in both males and females.

CONCLUSIONS

These data indicate that long-term access to a running wheel decreases drug-primed and cue-induced reinstatement, and that physical activity may be effective at preventing relapse in substance-abusing populations.

Aerobic exercise for alcohol recovery: rationale, program description, and preliminary findings

Alcohol use disorders are a major public health concern. Despite the demonstrated efficacy of a number of different treatments for alcohol dependence, relapse remains a major problem. Healthy lifestyle changes may contribute to long-term maintenance of recovery, and interventions targeting physical activity, in particular, may be especially valuable as an adjunct to alcohol treatment. In this article, the authors discuss the rationale and review potential mechanisms of action whereby exercise might benefit alcohol dependent patients in recovery. They then describe the development of a 12-week moderate-intensity aerobic exercise program as an adjunctive intervention for alcohol dependent patients in recovery. Preliminary data from a pilot study (N=19) are presented, and the overall significance of this research effort is discussed.

Aerobic exercise decreases the positive-reinforcing effects of cocaine

Aerobic exercise can serve as an alternative, non-drug reinforcer in laboratory animals and has been recommended as a potential intervention for substance abusing populations. Unfortunately, relatively little empirical data have been collected that specifically address the possible protective effects of voluntary, long-term exercise on measures of drug self-administration. The purpose of the present study was to examine the effects of chronic exercise on sensitivity to the positive-reinforcing effects of cocaine in the drug self-administration procedure. Female rats were obtained at weaning and immediately divided into two groups. Sedentary rats were housed individually in standard laboratory cages that permitted no exercise beyond normal cage ambulation; exercising rats were housed individually in modified cages equipped with a running wheel. After 6 weeks under these conditions, rats were surgically implanted with venous catheters and trained to self-administer cocaine on a fixed-ratio schedule of reinforcement. Once self-administration was acquired, cocaine was made available on a progressive ratio schedule and breakpoints were obtained for various doses of cocaine. Sedentary and exercising rats did not differ in the time to acquire cocaine self-administration or responding on the fixed-ratio schedule of reinforcement. However, on the progressive ratio schedule, breakpoints were significantly lower in exercising rats than sedentary rats when responding was maintained by both low (0.3mg/kg/infusion) and high (1.0mg/kg/infusion) doses of cocaine. In exercising rats, greater exercise output prior to catheter implantation was associated with lower breakpoints at the high dose of cocaine. These data indicate that chronic exercise decreases the positive-reinforcing effects of cocaine and support the possibility that exercise may be an effective intervention in drug abuse prevention and treatment programs.

Exercise attitudes and behaviors among persons in treatment for alcohol use disorders

The present study investigated self-reported exercise behaviors and exercise-related attitudes in a sample (N = 105) of adults in treatment for alcohol use disorders (AUD) (abuse or dependence). Slightly less than half (47%) of participants reported engaging in regular physical exercise (3 times per week or more). Level of alcohol dependence was not significantly associated with level of physical exercise activity. Level of nicotine dependence was significantly and negatively associated with physical activity level. Nicotine dependence and level of depressive symptoms were both significantly negatively associated with self-efficacy for physical exercise (SPE). Exercise self-efficacy mediated the relationship between nicotine dependence and physical activity level. Tension and stress reduction were among the most strongly endorsed of the perceived benefits of physical activity. Other perceived benefits included more positive outlook and increased self-esteem. Financial costs associated with exercise, lack of motivation, and time constraints were among the most common perceived barriers to exercise in this sample. Together, these preliminary data indicate that exercise-based interventions are may be well-received by those early in recovery from AUDs.

Accountability in public short-term adult AOD residential treatment. Fontainebleau Treatment Center

Fontainebleau Treatment Center provides short-term public residential AOD treatment and primary health care to a lower-socioeconomic adult population. The multimodal focus of treatment includes interactive group therapy, behavioral contracting, relapse prevention, and 12-step involvement. Research funded by the National Institute on Drug Abuse indicated both positive treatment outcome and significant cost efficacy. These results may be in some contrast to prevailing assumptions about public sector, government-operated behavioral health-care delivery to high-risk populations. Multiple variables for consideration in future outcome research are discussed, with potential for database inclusion toward standardization of treatment and cost protocols.