Medical professionals everywhere are fully supporting the benefits of exercise. The American College of Sports Medicine and American Diabetes Association state aerobic exercise and resistance training together can efficiently lower body weight, decrease cardiovascular risk factors, reduce disease progression, improve mood and so much more.

It is a cornerstone of patient self-treatment for many acute and chronic disease processes across the spectrum. However, a new and up-and-coming theorem is that exercise can decrease addiction, substance abuse, and therefore prevent imminent bad outcomes. A study published in Drug and Alcohol Review looked at the effects of acute exercise on drug cravings, mood, and self-esteem, and presented preliminary findings. The study concluded that football, circuit training, and walking are feasible therapeutic activities for inpatients with poly-substance dependence.1 One big limitation of this study was that it was performed in a select group of patients, and further randomized controlled studies would have to be performed to determine long-term effects.

In addition to risk reduction, aerobic exercises such as running and weight lifting have shown to improve psychological imbalances.2 Increased intensity aerobic exercises decrease down-regulation of activity in the prefrontal cortex. This area is often up-regulated in anxiety and depression. Many nicotine users state they use tobacco products to curb the effects of their anxiety. Exercise has been shown to decreased nicotine withdrawal and cravings with increased levels of exercise. When comparing steady-state running and anaerobic sprint training, the latter has been found to increase levels of dopamine and brain-derived neurotropic factor (BDNF).2 Findings from preclinical studies have hypothesized that BDNF is increased by exercise and serves as a substitute reward for drug intake by increasing dopaminergic activity.2

Evidence shows aerobic exercise can change the mesolimbic pathway, altering seeking and addiction behaviors in substance users.3 This alteration is theorized to be mediated by decreased binding of the dopamine type 1-like and dopamine type 2-like receptors.3

The evidence regarding use of forms of exercise and impact on drug cravings and substance use disorders is limited. Given the limited evidence available, further exploration in this theory may impact the lives of many in a multifactorial way. Exercise improves psychological, behavioral, neurobiological, and overall health of patients. The overall safety profile of this treatment does more benefits than harm in most cases.4 This provides pharmacist and other health care professionals another opportunity to provide counseling regarding this possibility as this approach may have a multifactorial impact.


REFERENCES
  1. Ellingsen MM, Johannesen SL, Martinsen EW et al. Effects of acute exercise on drug craving, self-esteem, mood and affect in adults with poly‚Äźsubstance dependence: Feasibility and preliminary findings. Drug and Alcohol Review. Volume 37, Issue 6. 04 June 2018. doi.org/10.1111/dar.12818
  2. Colledge F, Gerber M, Ludyga S et al. Anaerobic Exercise Training in the Therapy of Substance Use Disorders: A Systematic Review. Front. Psychiatry. 04 December 2018. doi.org/10.3389/fpsyt.2018.00644
  3. Robison LS, Swenson S, Hamilton J et al. Exercise Reduces Dopamine D1R and Increases D2R in Rats: Implications for Addiction. Medicine and Science in Sports and Exercise. 01 Aug 2018, 50(8):1596-1602.
  4. Linke SE, Ussher M. Exercise-based treatments for substance use disorders: evidence, theory, and practicality. The American Journal of Drug and Alcohol Abuse. Volume 41, 2015, Issue 1. 14 Nov 2014.