Physical activity during treatment for substance use disorder: What a systematic review tells us

Background: Substance use disorder is a worldwide issue that entails negative health outcomes. Over the last years, physical activity has been considered as an alternative therapy in the management of substance use disorder and its consequences. Objective: To characterize physical activity interventions offered in the literature and explore their effects during treatment.

Methods: Systematic search of seven databases (CINAHL, Cochrane Library, PsycINFO, Medline, SCOPUS, SPORTDiscus and Google Scholar) of physical activity interventions during a treatment for substance use disorder was done. Only adults following a treatment for SUD related to psychoactive substances, including alcohol and drugs such as methamphetamine, heroin, cocaine and cannabis were included. Studies on tobacco use disorders were excluded given there is already extensive published research on this topic.

Results: A total of 32 articles including 2550 participants were identified. Most studies were randomized controlled trial (78%), followed by pre-post design (16%) and cohort studies (6%). The most common physical activity intervention identified was a moderate intensity, 3 times per week (≈ 1 hour) for 12 weeks. Cessation/reduction of substance use was the most studied outcome (13 studies, 41%), 70% of which showed a decrease in substance use following physical activity intervention. Aerobic capacity was the second most studied effect (12 studies, 38%), with more than 70% of studies showing improvement. Nine studies reported a decrease of depressive symptoms (56% significantly) and five studies for anxiety (60 % significantly). The main limitation of included studies was their heterogeneity in terms of the type of physical activity, outcome and population.

Conclusion: Considering its beneficial effects, including physical activity in treatment (detoxication, residential, outpatient) for substance use disorder seems to be a promising and safe practice, but more methodologically rigorous scientific studies are needed to have clearer recommendations.