Physical activity is a viable alternative therapy for easing the effects of substance use disorder, a global problem that has detrimental health effects. A new study, which excludes studies concentrating on tobacco use, attempts to characterize the physical activity therapies in the literature and evaluate their impact throughout therapy for adults with drug use disorders.
Physical activity (PA), defined as any body movement requiring energetic expenditure, has been recently considered a therapeutic tool for people with serious mental illness (e.g., schizophrenia, major depressive disorder, bipolar disorder), considering its numerous benefits.
Compared to the control group, it was discovered to increase cardiorespiratory fitness, quality of life, and depressive symptoms without causing negative side effects. The only definite outcome for someone with SUD is the abatement of craving symptoms in tobacco users after brief bursts of physical activity.
Scientists reviewed all psychoactive substances except for studies that exclusively looked at tobacco, given the substantial body of knowledge on this substance, in this study’s systematic evaluation of PA treatments for people receiving SUD treatment.
The following two research questions were the study’s direction: 1. What traits distinguish PA strategies used in SUD treatment? 2. What are the social, psychological, and physical advantages of PA treatments during SUD treatment?
An evaluation of bias was done after conducting a systematic search of seven databases for articles that included a physical activity intervention during treatment for substance use disorder.
A total of 43 articles, including 3135 participants, were identified. Most studies were randomized controlled trials (81%), followed by pre-post design (14%) and cohort studies (5%).
The most common physical activity intervention identified was of moderate intensity, three times per week ( 1 hour) for 13 weeks. Cessation/reduction of substance use was the most studied outcome (21 studies, 49%), and 75% showed a decrease in substance use following physical activity intervention. Aerobic capacity was the second most studied effect (14 studies, 33%), with more than 71% of studies showing improvement. Twelve studies (28%) reported a decrease in depressive symptoms.
Scientists noted, “The most reported intensities were moderate and/or vigorous, which may be explained by the fact that persons with SUD reported a preference towards moderate-intensity PA, followed closely by high-intensity exercise. For the type, we found jogging and resistance exercise as the most common activities; a systematic review found that persons with SUD enjoy activities such as walking, resistance exercise, and cycling.”
“We observed that cycling was used in 10 studies. We believe it is because of the availability of equipment in the facility or hospital along with a low risk of injury.”
Also, yoga and tai chi were also figured in nine studies. Given the literature shows that this activity attracts more women than men, it may be necessary to consider the gender balance ratio in a facility for adherence to the activity.
As regards the second objective, three categories of outcomes were identified: physical, psychological, and life domains. The mechanisms by which PA could decrease substance use are complex and operate at different levels.
At a physical level, increased awareness of one’s body, health, and fitness may be a mechanism to help reduce alcohol and drug use. Regarding the psychological outcomes, depressive symptoms and the presence of anxiety symptoms were the two most studied. The literature reveals that major depressive disorder or generalized anxiety disorder is very common in persons with SUD and that PA is recommended to alleviate symptoms of depression and anxiety in the general population and SUD for nicotine users.
Regarding life outcomes, substance use was the most studied outcome, and it is because that abstinence or reduced consumption is often a major goal of treatment. Most studies reported a reduction in substance use at the end of the treatment when PA was performed, regardless of the substance.
Scientists noted, “Our systematic review explores PA interventions during treatment for persons with SUD. Results suggest that there is promising evidence indicating that PA can be beneficial for these patients. We conclude, too, that future researchers should better describe their interventions. We also maintain that it is important to consider including participants with mental comorbidities and to monitor PA adherence during the intervention and mention it in the results. This will help reduce methodological bias and allow for clear results that can be generalized.”
- Piche’ F, Daneau C, Plourde C, Girard S, Romain AJ (2023) Characteristics and impact of physical activity interventions during substance use disorder treatment excluding tobacco: A systematic review. PLoS ONE 18(4): e0283861. DOI: 10.1371/journal.pone.0283861