A Systematic Review of Exercise Intervention Program for People With Substance Use Disorder

Enhancing Substance Use Disorder Recovery through Integrated Physical Activity and Behavioral Interventions: A Comprehensive Approach to Treatment and Prevention

The global issue of substance abuse demands ongoing initiatives aligned with the United Nations Sustainable Development Goals. With drug use remaining prevalent worldwide, interventions are critical to addressing the associated health challenges and societal implications. Exercise and physical activities have emerged as integral components of substance use disorder (SUD) treatment, offering promising avenues for prevention, intervention, and recovery. Recent research underscores the efficacy of exercise in reducing substance cravings, promoting abstinence, and improving overall well-being. However, integrating exercise into SUD recovery programs presents challenges such as dropout rates and cultural considerations. This paper synthesizes existing literature on exercise integration into SUD recovery, highlighting strategies for enhancing treatment outcomes and addressing barriers to exercise adherence. Drawing on cognitive-behavioral therapy, experiential learning, motivational interviewing, and goal-setting techniques, the holistic approach outlined in this paper aims to empower individuals both mentally and physically, fostering resilience and supporting long-term recovery. In conclusion, new initiatives need to be taken by advocating for inclusive policies, promoting community engagement, and fostering collaborations across sectors. By doing so, stakeholders can optimize the effectiveness of exercise programs and contribute to sustainable rehabilitation efforts for individuals with SUD.

Effect of physical exercise on the emotional and cognitive levels of patients with substance use disorder: a meta-analysis

Introduction

This study investigated the impact of different modes of physical exercise on the emotional and cognitive levels of patients with Substance Use Disorder (SUD). By exploring the most effective intervention types, cycle, frequency, and duration, we aimed to provide evidence-based recommendations for the adjunctive treatment of SUD.

Methods

We conducted a systematic search in five databases, including PubMed, Web of Science, The Cochrane Library, ScienceDirect, and EBSCO, from database inception up to May 2023, and identified 4,255 randomized controlled trials addressing the influence of physical exercise on the emotional and cognitive levels of SUD patients. Data extraction and analysis were performed using Review Manager 5.4 software, focusing on 11 studies that met the inclusion criteria and included 895 participants. Subsequently, a meta-analysis was conducted using Stata 16.0 software, presenting the results in the form of standardized mean differences (SMD) and 95% confidence intervals (CI).

Results

Our findings indicate that physical exercise significantly alleviates anxiety and depression in SUD patients while improving their cognitive function. Specifically, physical exercise was found to reduce anxiety (SMD = -0.726 [-1.349, -0.103], p < 0.05) and depression (SMD = -0.666 [-1.077, -0.255], p < 0.05) and enhance cognitive levels (SMD = -0.523 [-0.887, -0.159], p < 0.05) among patients. Subgroup analysis further revealed that SUD patients benefitted most from physical exercise when engaging in aerobic exercises lasting over 12 weeks, with a frequency exceeding 40 sessions and each session lasting more than 60 min.

Discussion

In conclusion, our study affirms that physical exercise mitigates anxiety and depression while enhancing cognitive function in SUD patients, making it an effective measure for adjunctive clinical treatment.

The Role of Estrogen Signaling and Exercise in Drug Abuse: A Review

BACKGROUND

Discovering how sex differences impact the efficacy of exercise regimens used for treating drug addiction is becoming increasingly important. Estrogen is a hormone believed to explain a large portion of sex differences observed during drug addiction, and why certain exercise regimens are not equally effective between sexes in treatment. Addiction is currently a global hindrance to millions, many of whom are suffering under the influence of their brain's intrinsic reward system coupled with external environmental factors. Substance abuse disorders in the U.S. alone cost billions of dollars annually.

REVIEW SUMMARY

Studies involving the manipulation of estrogen levels in female rodents, primarily via ovariectomy, highlight its impact regarding drug addiction. More specifically, female rodents with higher estrogen levels during the estrus phase increase cocaine consumption, whereas those in the non-estrus phase (low estrogen levels) decrease cocaine consumption. If estrogen is reintroduced, self-administration increases once again. Exercise has been proven to decrease relapse tendency, but its effect on estrogen levels is not fully understood.

CONCLUSIONS

Such findings and results discussed in this review suggest that estrogen influences the susceptibility of females to relapse. Therefore, to improve drug-abuse-related treatment, exercise regimens for females should be generated based on key sex differences with respect to males.

Physical Exercise to Redynamize Interoception in Substance use Disorders

Physical exercise is considered a promising medication-free and cost-effective adjunct treatment for substance use disorders (SUD). Nevertheless, evidence regarding the effectiveness of these interventions is currently limited, thereby signaling the need to better understand the mechanisms underlying their impact on SUD, in order to reframe and optimize them. Here we advance that physical exercise could be re-conceptualized as an "interoception booster", namely as a way to help people with SUD to better decode and interpret bodily-related signals associated with transient states of homeostatic imbalances that usually trigger consumption. We first discuss how mismatches between current and desired bodily states influence the formation of reward-seeking states in SUD, in light of the insular cortex brain networks. Next, we detail effort perception during physical exercise and discuss how it can be used as a relevant framework for re-dynamizing interoception in SUD. We conclude by providing perspectives and methodological considerations for applying the proposed approach to mixed-design neurocognitive research on SUD.

The Role of Physical Exercise in Opioid Substitution Therapy: Mechanisms of Sequential Effects

It is generally accepted that chronic opioid use is associated with structural and functional changes in the human brain that lead to an enhancement of impulsive behavior for immediate satisfaction. Interestingly, in recent years, physical exercise interventions have been used as an adjunctive treatment for patients with opioid use disorders (OUDs). Indeed, exercise has positive effects on both the biological and psychosocial basis of addiction, modifying neural circuits such as the reward, inhibition, and stress systems, and thus causing behavioral changes. This review focuses on the possible mechanisms that contribute to the beneficial effects of exercise on the treatment of OUDs, with emphasis placed on the description of a sequential consolidation of these mechanisms. Exercise is thought to act initially as a factor of internal activation and self-regulation and eventually as a factor of commitment. This approach suggests a sequential (temporal) consolidation of the functions of exercise in favor of gradual disengagement from addiction. Particularly, the sequence in which the exercise-induced mechanisms are consolidated follows the pattern of internal activation-self-regulation-commitment, eventually resulting in stimulation of the endocannabinoid and endogenous opioid systems. Additionally, this is accompanied by modification of molecular and behavioral aspects of opioid addiction. Overall, the neurobiological actions of exercise in combination with certain psychological mechanisms appear to promote its beneficial effects. Given the positive effects of exercise on both physical and mental health, exercise prescription is recommended as a complement to conventional therapy for patients on opioid maintenance treatment.