Does physical activity impact substance use disorder treatment?

In a recent study published in the PLOS ONE Journal, researchers reviewed existing studies on physical activity interventions for treating substance use disorders excluding studies that focused solely on tobacco use.

Study: Characteristics and impact of physical activity interventions during substance use disorder treatment excluding tobacco: A systematic review. Image Credit: agny_illustration/Shutterstock.comStudy: Characteristics and impact of physical activity interventions during substance use disorder treatment excluding tobacco: A systematic review. Image Credit: agny_illustration/


Substance use disorder is the problematic use of substances such as cannabis, alcohol, phencyclidine, hallucinogens, hypnotics, sedatives, inhalants, stimulants, opioids, anxiolytics, and other similar substances despite experiencing serious physical, behavioral, and cognitive symptoms.

The misuse of substances causing overdose or intoxication has short and long-term impacts on mental and physical health, including anxiety disorder, depression, asthma, heart disease, and cancer.

The treatment options for substance use disorders generally include residential and outpatient facilities that offer detoxification, but these have a significant relapse rate and low adherence.

Physical activity involving movement requiring energy expenditure has recently gained interest as a therapeutic tool in treating mental illnesses such as bipolar disorder, major depressive disorder, and schizophrenia.

Besides improving cardiovascular health and reducing depressive symptoms, physical activity has also decreased craving symptoms in tobacco users.

However, a shortage of reviews have focused on substance use disorders other than tobacco use, and many of the reviews have focused on a single substance. A large number of individuals with substance use disorders often misuse multiple substances.

Therefore, it is important to examine studies that include poly users of substances other than tobacco to understand the impact of physical activity in treating substance use disorder.

About the study

In the present review, the researchers included studies involving adults above the age of 18 who were treated for substance use disorders related to various psychoactive substances such as cannabis, alcohol, phencyclidine, hallucinogens, opioids, inhalants, sedatives, stimulants, hypnotics, and anxiolytics, while excluding studies that focused on tobacco alone.

The studies also involved chronic physical activity interventions offered during residential or detoxification treatments, including group or individual exercises and sports.

The examined outcomes included flexibility, aerobic capacity, other body composition and physical fitness outcomes, psychological outcomes such as changes in depressive symptoms, and life outcomes related to the social environment and behavior. The review only considered observational and experimental studies.


The results reported that 43 studies fit the eligibility criteria for the review and covered 3,135 participants. A large number (81%) of the studies were randomized controlled trials, followed by pre-post design and cohort studies (14% and 5%, respectively).

Physical activity of moderate intensity, spanning approximately 13 weeks with three sessions a week of about an hour each, was the most common intervention found in most studies.

The most examined outcome was the reduction or cessation of substance use, with 49% of the studies reporting a 75% reduction in substance use after the physical activity intervention.

The second most examined outcome was aerobic capacity, reported by 14 out of the 43 studies (33%), and 71% of these studies reported improvement in aerobic capacity after the intervention. Furthermore, 28% (12) of the studies also reported improvements in depressive symptoms.

The life outcomes examined by most studies covered quality of sleep and overall quality of life, and most studies reported improvements in both parameters after the initiation of physical activity interventions.

Cycling, walking, resistance exercises, and jogging were the most commonly preferred activities. Some studies also reported the use of tai chi and yoga.

The review discussed the mechanisms through which physical activity interventions could benefit substance use disorder patients. The increased physical awareness of the body, fitness, and health is thought to reduce dependence on drugs or alcohol.

Furthermore, changes in depressive symptoms were also associated with changes in anxiety disorder symptoms, indicating a concomitance between the two symptoms.


To summarize, the review examined studies that investigated the application of physical activity interventions in treating substance use disorders, not including tobacco use alone.

Overall, the findings reported that physical activity interventions were associated with improvements in physical, psychological, and life outcomes.

Moderate levels of physical activity involving cycling, jogging, resistance exercises, walking, yoga, and tai chi were the preferred activities for most patients, and improvements were observed in aerobic capacity, depressive and anxiety disorder symptoms, and overall quality of life.

However, the authors believe that while physical activity interventions seem promising in treating substance abuse disorders, more rigorous and extensive research is required in the field.

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