Impact of physical exercise on substance use disorders: a meta-analysis

Exercise Interventions Conducted Among Individuals with Co-occurring HIV and Unhealthy Substance Use: A Systematic Review

Unhealthy substance use and physical inactivity are prevalent co-occurring risk factors for morbidity and mortality among people with HIV (PWH). Evidence-based exercise interventions targeting both risk factors are limited. We conducted a literature search across seven databases for relevant articles published through 05/07/24. Studies qualified if they involved: (a) PWH ≥ 18 years old who engage in unhealthy substance use; (b) randomized controlled trials (RCTs) or quasi-experimental designs; and (c) an exercise intervention. Two researchers independently completed the Cochrane Data Collection Form and Joanna Briggs Institute Critical Appraisal Tool. PROSPERO registry: CRD42023473582. Out of 6916 potentially qualifying studies, 46 underwent full-text review, and 7 studies qualified (6 pilot RCTs & 1 quasi-experimental). Most (k = 6) were conducted in the US. Sample sizes ranged from 16 to 73 participants and retention rates ranged from 42 to 100%. Interventions met at least 1x/week for 6-24 weeks and consisted of supervised progressive overload aerobic/resistance training (k = 3), home-based training with virtual behavioral counseling (k = 1), yoga (k = 2), and tai-chi with cognitive behavioral therapy (k = 1). Despite inconsistent assessment tools and outcomes measured, exercise interventions were significantly (p < 0.05) and positively associated with outcomes relating to improving HIV, substance use, physical activity, strength/fall risk, quality of life/stress, and pain relief. All studies were high quality with low risk of bias, safe, and feasible. Despite small sample sizes and heterogeneity across studies, evidence from this systematic review supports the use of exercise to improve a variety of health outcomes among PWH with unhealthy substance use.

Physical activity and mobile phone addiction among Chinese college students: a chain mediation model of social anxiety and loneliness

Introduction

Mobile phone addiction is increasingly prevalent among college students and can lead to various physical, psychological, and social problems. This study aimed to investigate the relationship between physical activity and mobile phone addiction among Chinese college students and to examine the potential chain mediating effects of social anxiety and loneliness in this relationship.

Methods

A cross-sectional survey was conducted with 268 Chinese college students (62.7% male, mean age = 20.36 years, SD = 1.73) who completed standardized measures including the Physical Activity Rating Scale-3, Social Phobia Inventory, UCLA Loneliness Scale, and Mobile Phone Addiction Tendency Scale. Data were analyzed using Pearson's correlations and PROCESS macro for mediation analyses with bootstrapping.

Results

Physical activity had a significant negative effect on mobile phone addiction (β = -0.11, p < 0.05) with a total effect of β = -0.28 (p < 0.001). Social anxiety [β = -0.12, 95% CI (-0.18, -0.06)] and loneliness [β = -0.03, 95% CI (-0.06, -0.01)] independently mediated this relationship, while a significant chain mediation through both variables was also found [β = -0.02, 95% CI (-0.03, -0.01)], with all indirect effects accounting for 59.68% of the total effect.

Discussion

These findings extend previous research by identifying the psychological mechanisms through which physical activity protects against mobile phone addiction, providing new theoretical insights into the sequential pathway from physical activity to reduced addiction, and practical implications for developing targeted interventions that combine physical activity promotion with strategies to reduce social anxiety and loneliness among college students.

Alcohol consumption and preference in female rats induced by reward downshift reveals sex generality of the modulatory role of physical activity

Increased voluntary consumption of alcohol has been demonstrated in male rats exposed to frustrative reward downshift (the emotional self-medication effect). Access to a wheel for voluntary running abolished this effect in male rats, suggesting an attenuating effect of physical exercise on the negative affect induced by reward downshift and its consequences on drug intake. The present study analyzed this effect in female rats. Sixty-four food-deprived female Wistar rats received 32% sucrose [4% (Experiment 1) or 2% (Experiment 2) in controls] during 10, 5-min preshift sessions followed by 4% (Experiment 1) or 2% (Experiment 2) sucrose during 5 postshift sessions. Immediately after each consummatory session, animals were exposed to a 2-h, two-bottle preference test involving 32% alcohol vs. water. Half of the animals also had access to a running wheel during the preference test. The results showed (a) lower sucrose consumption in the downshifted groups (32-4% and 32-2%) compared to the unshifted controls (4-4% and 2-2%, respectively); (b) higher alcohol preference in downshifted groups without access to a wheel compared with downshifted groups with access to the wheel (Experiments 1 and 2); and (c) increased alcohol intake (g/kg) after experiencing reward downshift in animals without access to the wheel (Experiment 1). Voluntary wheel running thus reduced alcohol intake in female rats experiencing reward downshift. These findings are comparable to previous results reported in male rats and support the usefulness of physical exercise to prevent alcohol self-medication induced by frustrative nonreward.

The impacts of physical activity on domain-specific short video usage behaviors among university students

Short video usage poses risks to the health and academic performance of university students. Physical activity (PA) has been recommended as a potential solution to mitigate excessive short video usage and its associated consequences. However, current research has paid limited attention to the impact of PA on different short video usage behaviors. Therefore, we conducted a cross-sectional survey from April 24 to 30, 2024, to collect data and examine the relationship between PA and short video usage, with depression as a mediator, in domain-specific usage contexts (including short video usage during daytime and nighttime, during study time and leisure time, overall usage, and short video addiction). A total of 1172 students who met the inclusion criteria were included in the analysis. Our structural equation modeling analysis revealed that PA was directly associated only with reduced nighttime short video usage (β = -0.12; p < 0.05). Additionally, PA was indirectly associated with reduced short video usage during nighttime (β = -0.03; p < 0.05), study time (β = -0.03; p < 0.05), and leisure time (β = -0.04; p < 0.05), as well as lower levels of short video addiction (β = -0.06; p < 0.05), mediated by depression. However, no significant total effects were observed between PA and daytime short video usage (β = -0.02; p = 0.52) or overall usage (β = -0.04; p = 0.27). In conclusion, our findings suggest that while PA may improve short video addiction and certain specific short video usage behaviors, its actual effects may be limited due to the small effect sizes observed.

Transcranial direct current stimulation associated with physical exercise can help smokers to quit smoking: a randomized controlled trial

Chronic exposure to nicotine is related to low activity in the prefrontal cortex and insular hyperactivity in smokers. Therefore, addiction has been the target of experimental studies in aerobic exercise (AE) and transcranial direct current stimulation (tDCS). Thus, the objective of this study was to verify the effect of AE and anodal tDCS at F4 and cathodal at T3 on craving, motivation to change smoking behaviour (MCSB) and brain reactivity (BR) in smokers. The sample consisted of 41 chronic smokers distributed into four groups: tDCS (G1), AE (G2), tDCS combined with AE (G3) and sham tDCS combined with AE (G4). All volunteers underwent 5 consecutive sessions of the intended intervention. Before starting the intervention protocol and after the last intervention session, the volunteers answered questionnaires and underwent an electroencephalogram exam, to evaluate the variables investigated. The results demonstrated that AE, when associated with active tDCS, was effective in promoting a reduction in craving (p < 0,05), cigarette consumption (p < 0,05), and BR (p < 0,05) during exposure to smoking cues, in addition to increasing MCSB (p < 0,05). Therefore, only when associated with AE, tDCS was able to modulate positive effects on smoking.

Public interest and engagement in care for brain health in Slovenia: the role of education

Background and objective

Knowledge gap theory posits that individuals with better education have better opportunities to obtain, understand and utilise available information. In a health-related context, this insight could lead to a more effective disease prevention. The aim of our study was to test the hypothesis that knowledge gap underlies differences in behaviour aimed at maintaining brain health.

Methods

We conducted an online survey investigating Slovenian public view on brain, brain research, and science-based recommendations for brain health. The survey was filled out by a total of 2,568 respondents, of whom 2,450 completed it in full. They were divided into two subgroups based on their self-reported brain-related education, i.e., the lay subgroup (n = 1,012) and a topically educated group (n = 1,438), i.e., the educated subgroup. Among the latter, 728 participants reported to have a Bachelor's degree or higher education. We analysed the views of this sample subgroup on brain, neuroscience, and science-based brain health recommendations, and compared them with age- and education-matched lay subgroup (n = 565) from the same survey.

Results

Educated individuals showed greater awareness and adherence to science-based recommendations compared to the lay respondents, specifically in the perceived importance of following a healthy diet, exercising, ensuring time for rest, relaxation and maintenance of social contacts, acquiring new knowledge and skills and using supplements that are considered to improve mental abilities (all p < 0.005), but not in the perceived importance of getting enough sleep, avoiding drugs and alcohol or injuries and performing mentally-challenging activities or cognitive training (all p > 0.10). Educated individuals more frequently reported following a healthy diet, engaging in physical activity and socialising, acquiring new knowledge and skills, performing mental challenges and cognitive training, and using supplements (all p < 0.005), but not getting sufficient sleep, avoiding drugs, alcohol or injury, or ensuring time for rest and relaxation (all p > 0.08). A larger proportion of lay than educated participants (32 and 17%, respectively) identified lack of information as a reason for not engaging in healthy practices (p < 0.001). Educated participants outperformed lay individuals in identifying diseases amenable to lifestyle modification.

Conclusion

Understanding the differences in brain health perceptions between educated and lay individuals is crucial for developing effective public health strategies. Our results highlight a substantial knowledge gap in the Slovenian population and the need for targeted educational interventions that account for varying degrees of knowledge in different population segments which could lead to better adherence to healthy lifestyle practices.

Comparative effects of Health Qigong and closed motor exercise on the physical and mental health of female drug rehabilitation participants: a randomized controlled trial

BACKGROUND

Drug rehabilitation is a challenging process that impacts both the physical and mental health of individuals. Traditional martial arts, such as Health Qigong, and closed motor exercises, such as power cycling, have shown potential benefits in improving health outcomes. This study aims to compare the effects of Health Qigong, closed motor exercises, and their combination on the physical and mental health of female drug rehabilitation participants.

METHODS

In this randomized controlled trial, female participants from the Jilin Province Women's Compulsory Isolation Drug Rehabilitation Center were randomly assigned to three groups: Health Qigong (QigongG), Closed Motor Exercise (ClosedG), and Combined Health Qigong and Closed Motor Exercise (CombinedG). Measurements were taken at baseline, mid-intervention, and post-intervention and included resting heart rate, vital capacity, choice reaction time, sleep quality, and relapse tendency.

RESULTS

At the study's conclusion, the ClosedG group showed significant improvements in relapse tendency, vital capacity, and sleep quality compared to baseline. The QigongG showed significant improvements in relapse tendency, sleep quality, and choice reaction compared to baseline. The CombinedG group demonstrated significant improvements in relapse tendency, vital capacity, sleep quality, and choice reaction time, outperforming the ClosedG groups in reaction time, and outperforming QigongG groups in vital capacity. The CombinedG group exhibited the most notable overall improvements.

CONCLUSION

The combined intervention of Health Qigong and closed motor exercises is more effective in improving physical and mental health metrics among female drug rehabilitation participants than either intervention alone. These findings suggest that incorporating a combination of traditional martial arts and closed motor exercises could enhance rehabilitation programs for drug rehabilitation.

TRIAL REGISTRATION

ClinicalTrials.gov NCT06454565. The date of registration is 2024.07.11 (Retrospectively registered).

Exploring exercise interventions in substance abuse treatment: A comprehensive bibliometric analysis

This study aims to comprehensively evaluate the research landscape related to exercise and substance abuse over the past 2 decades. A systemic bibliometric analysis was conducted using 2 powerful tools, the Bibliometrix package for R and VOSviewer software. The analysis covered a corpus of literature indexed in the Web of Science's core collection. The publication counts related to exercise interventions within the context of substance abuse from 2004 to 2023, key journals extensively publishing research on this topic, institutional affiliations contributing significantly to this field, frequently co-occurring keywords to highlight research focal areas, and citation patterns for these studies were examined. The analysis identified a total of 2110 articles during the specified period. Notably, there has been a discernible upward trend in publication volume within this field over the past 2 decades. Prominent journals featuring extensive research on this topic include Drug and Alcohol Dependence, Frontiers in Psychiatry, and International Journal of Environmental Research and Public Health. Among the notable contributors to the field are researchers Greer TL and Trivedi MH. The University of California's system has also emerged as a leading institution, fostering collaborations with diverse research entities. The most frequently recurring keywords were exercise, substance abuse, substance use disorders, mental health, and depression, among others, highlighting the research focus. This study offers insights and recommendations for future research in the area of exercise in substance abuse, emphasizing the need to explore physiological mechanisms and psychological comorbidities to optimize exercise as a therapeutic intervention.

Physical activity and its benefits on adolescents' mental health through self-esteem

Background

Since the onset of the COVID-19 pandemic, the scientific community has been concerned about the high rates of psychological distress among adolescents. The pandemic not only tested adolescents' adaptation, but also disrupted key areas of their development. This demonstrates the need to study their psychological adjustment over time during this critical period to better guide services.

Objective

This study sought to explore the extent to which physical activity and its association with self-esteem in the first months of the pandemic impacted adolescents' psychological distress, six months later.

Methods

Two hundred and ninety-four adolescents (73% girls) between the ages of 12 and 17 participated in a longitudinal study launched at the start of the COVID-19 pandemic. The number of hours spent engaging in physical activity (HPA) in the past week and self-esteem were measured at Time 1 (T1; summer 2020). Psychological distress was measured at T1 and Time 2 (T2; winter 2021).

Results

More HPA in the past week were related to greater self-esteem at T1. Greater self-esteem at T1 was related to lower psychological distress, six months later (T2). Lastly, HPA in the past week was not directly linked to psychological distress at T2, which confirms a fully indirect model.

Conclusion

Results suggest that physical activity is a key factor in promoting better mental health adjustment through its benefits in terms of self-esteem, even during times of turmoil. Findings reinforce the recommendation of promoting the practice of sports and athletic activity in difficult times.

The association between medical fitness facility attendance and incident mental disorders

OBJECTIVE

This study examined the effects of medical fitness facility (MFF) attendance, a proxy for exercise, on the incidence of mental disorders.

METHODS

This retrospective cohort study linked members at two MFFs in Winnipeg, Canada, to health administrative databases held at the Manitoba Centre for Health Policy population research data repository. Adults aged ≥ 18 years were assigned an index date at MFF membership enrollment between January 1, 2005, and December 31, 2015, and matched to controls based on propensity score weighting. Cox proportional hazards models generated hazard ratios (HR) comparing the MFF group to controls on incident mental disorders (mood and anxiety disorders, substance use disorders, dementia, personality disorders, schizophrenia, and psychotic disorders).

RESULTS

There were 15,407 MFF members and 507,400 controls. Attendance at a MFF was associated with a reduced hazards risk of incident substance use disorders (HR = 0.67, 95% confidence interval (CI) 0.62-0.67), psychotic disorders (HR = 0.69, 95% CI 0.60-0.79), personality disorders (HR = 0.63, 95% CI 0.50-0.78), schizophrenia (HR = 0.69, 95% CI 0.52-0.93), and dementia (HR = 0.69, 95% CI 0.64-0.75).

CONCLUSION

Attending a medical fitness facility was associated with a reduced risk of incident mental disorders. Further research in MFFs as preventive initiatives for mental illness is warranted.

Impact of structured exercise interventions on health outcomes in drug rehabilitation patients: a comparative study of open and closed exercises

BACKGROUND

This study investigates the effects of open and closed exercise interventions on the physical and mental health of individuals undergoing substance use disorder (SUD). We examined changes in tendency of recurrence of use, vital capacity (VC), resting heart rate (RHR), sleep quality, and choice reaction time.

METHODS

Conducted over six months at the drug rehabilitation center, 95 participants were randomly assigned to closed exercise, open exercise, or control group. Outcome measures were taken at baseline, three months, and six months.

RESULTS

Both exercise groups showed significant improvements in reduction of return-to-use risk and VC compared to baseline. Open exercise groups showed earlier significant improvements in risk of return to use at three months. No significant changes were observed in RHR. Both exercise groups showed significant improvements in sleep quality, with the open exercise group also showing significant improvements in choice reaction time. At six months, both exercise groups showed significant improvements over the control group in tendency of recurrence of use, VC, and sleep quality, with no significant differences between the exercise groups.

CONCLUSIONS

Both exercise interventions led to significant improvements in reducing the risk of return to substance use, VC, sleep quality, and choice reaction time, with the open exercise group showing the most pronounced effects in choice reaction time.

A Narrative Review of Old and Emerging Treatment Modalities for Substance Use Disorders

Substance use disorders (SUDs) represent one of the leading causes of preventable death in the setting of overdose and comorbidities leading to mortality. A multi-database literature search limited to peer-reviewed articles within the last 10 years was conducted to compare treatment modalities used to treat SUDs. This literature review aims to provide a concise yet comprehensive summary of the various treatment modalities that exist to address these disorders in clinical practice. Healthcare professionals in multiple disciplines are encouraged to continue exploring the modalities outlined in this review to competently and holistically address the various factors that contribute to these disorders. This literature review also serves as an important reminder of the ongoing evolution and range of treatments for SUDs.

Recovery Horizons: Nature-Based Activities as Adjunctive Treatments for Co-Occurring Post-Traumatic Stress Disorder and Substance Use Disorders

Posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) frequently co-occur, and individuals with co-occurring PTSD and SUD often experience more complex treatment challenges and poorer outcomes compared to those with either condition alone. Integrative treatment approaches that simultaneously address both PTSD and SUD are considered the most effective and include both pharmacological and non-pharmacological strategies. In recent years, complementary interventions have garnered increased attention due to their broad appeal and potential therapeutic benefits in enhancing existing treatments for PTSD and SUD. This review explores the existing literature on the use of nature-based activities, such as hiking, camping, sailing, and surfing in treating individuals with co-occurring PTSD and SUD. Nature-based activities offer promising adjunctive benefits, including the reduction of PTSD symptoms and craving levels. While evidence supports the therapeutic value of nature-based activities, current research remains limited. Further research is needed to better understand their therapeutic role and to refine their implementation in clinical practice.

A study to explore the role of a low threshold, fitness focussed physical rehabilitation intervention with protein supplementation to target physical function and frailty in people with problematic substance use and homelessness: protocol for a single-arm pre-post intervention study

Background

People who are homeless are more likely to experience poor mental health and addiction as well as suffering from non-communicable diseases. There is evidence of frailty and accelerated physical ageing among people experiencing homelessness. Appropriate physical rehabilitation and nutritional supplementation strategies can stabilise or reverse frailty and general physical decline, but it is not known how this type of intervention would work in practice in this population.

Aim

To evaluate the feasibility and pre-post intervention impact of a low threshold physical rehabilitation intervention with protein supplementation to target physical functioning and frailty in people with problematic substance use who are experiencing homelessness.

Methods

The intervention will consist of a 12-week low threshold rehabilitation programme with protein supplementation. Participants will be service users of the Ballyfermot Advance Project, a day services centre for people with addiction issues and experiencing homelessness. Primary outcomes will be feasibility including numbers recruited, retention of participants and adherence to the exercise intervention and protein supplement. Any adverse events will be recorded. Secondary outcomes will be strength and muscular mass, physical performance and lower extremity physical function, pain, frailty and nutritional status.

Discussion

An immediate impact may be simply a distraction from difficult circumstances and potentially an improvement of physical health of participants, which can be a conduit for the emergence of other positive behaviours and recovery. Longer term, this study will generate preliminary data on which to inform the design of a definitive randomised controlled trial of physical rehabilitation and protein supplementation, if indicated.

Ethics and dissemination

Ethical approval was granted by the Faculty of Health Sciences Research Ethics Committee in TCD. Study findings will be disseminated through publication into an international peer-reviewed journal and presented at national and international conferences.

Dopamine in Sports: A Narrative Review on the Genetic and Epigenetic Factors Shaping Personality and Athletic Performance

This narrative review examines the relationship between dopamine-related genetic polymorphisms, personality traits, and athletic success. Advances in sports genetics have identified specific single nucleotide polymorphisms (SNPs) in dopamine-related genes linked to personality traits crucial for athletic performance, such as motivation, cognitive function, and emotional resilience. This review clarifies how genetic variations can influence athletic predisposition through dopaminergic pathways and environmental interactions. Key findings reveal associations between specific SNPs and enhanced performance in various sports. For example, polymorphisms such as COMT Val158Met rs4680 and BDNF Val66Met rs6265 are associated with traits that could benefit performance, such as increased focus, stress resilience and conscientiousness, especially in martial arts. DRD3 rs167771 is associated with higher agreeableness, benefiting teamwork in sports like football. This synthesis underscores the multidimensional role of genetics in shaping athletic ability and advocates for integrating genetic profiling into personalized training to optimize performance and well-being. However, research gaps remain, including the need for standardized training protocols and exploring gene-environment interactions in diverse populations. Future studies should focus on how genetic and epigenetic factors can inform tailored interventions to enhance both physical and psychological aspects of athletic performance. By bridging genetics, personality psychology, and exercise science, this review paves the way for innovative training and performance optimization strategies.

The Effect of 6 weeks Physical Activity on Cognitive Control and Trait Impulsivity in Multi-problem Young Adults: First Findings of an RCT-study

This study aimed to report the effect of a 6-week light-active versus moderate-active physical activity intervention embedded in a multimodal day treatment program on selected measures of cognitive control (i.e., response inhibition, error processing, and cognitive interference) and trait impulsivity. A randomized controlled design was implemented, including male multi-problem young adults (aged 18-27) assigned to either light-active (N = 12) or moderate-active physical activity lessons (N = 11). A repeated measures design was used to examine treatment effects between the two groups over time on response inhibition, error processing, and cognitive interference (measured respectively with a Go/NoGo task, a Flanker task, and the Stroop) and trait impulsivity (measured with the Dutch Baratt Impulsiveness Scale). Cognitive control, but not trait impulsivity, improved over time. Specifically, enhancements in inhibition and reduced cognitive interference were observed after 6 weeks. Error processing did not improve, but we did observe improved performance on an error-processing task. No interaction with physical activity intensity was found, suggesting similar treatment effects regardless of intensity. Results should be interpreted with caution due to several limitations, including the small sample size. Overall, due to current limitations (i.e., physical activity embedded in a larger treatment program, small sample size at follow-up, and low intervention adherence), it is not possible to draw any definite conclusions. However, the current findings contribute to a growing body of evidence suggesting potential benefits of physical activity (embedded in a multi-modal day treatment program) in the enhancement of cognitive control deficits in at-risk populations, independent of exercise intensity.

How life events may confer vulnerability to addiction: the role of epigenetics

Substance use disorder (SUD) represents a large and growing global health problem. Despite the strong addictive potency of drugs of abuse, only a minority of those exposed develop SUDs. While certain life experiences (e.g., childhood trauma) may increase subsequent vulnerability to SUDs, mechanisms underlying these effects are not yet well understood. Given the chronic and relapsing nature of SUDs, and the length of time that can elapse between prior life events and subsequent drug exposure, changes in SUD vulnerability almost certainly involve long-term epigenetic dysregulation. To validate this idea, functional effects of specific epigenetic modifications in brain regions mediating reinforcement learning (e.g., nucleus accumbens, prefrontal cortex) have been investigated in a variety of animal models of SUDs. In addition, the effects of epigenetic modifications produced by prior life experiences on subsequent SUD vulnerability have been studied, but mostly in a correlational manner. Here, we review how epigenetic mechanisms impact SUD-related behavior in animal models and summarize our understanding of the relationships among life experiences, epigenetic regulation, and future vulnerability to SUDs. Despite variations in study design, epigenetic modifications that most consistently affect SUD-related behavior are those that produce predominantly unidirectional effects on gene regulation, such as DNA methylation and histone phosphorylation. Evidence explicitly linking environmentally induced epigenetic modifications to subsequent SUD-related behavior is surprisingly sparse. We conclude by offering several directions for future research to begin to address this critical research gap.

A Systematic Review of the Benefits of Physical Exercise on Mental Health and Quality of Life in Patients With Substance Use Disorders

Physical exercise is increasingly recognized for its potential therapeutic effects in individuals with substance use disorders (SUDs), particularly in terms of relapse prevention, mental health improvement, and enhanced quality of life (QoL). This systematic review aimed to statistically summarize findings from numerous randomized controlled trials (RCTs) on the effects of physical exercise on mental health outcomes, QoL, abstinence-related outcomes, and cravings among SUD patients. A systematic search was conducted across PubMed, Web of Science, and Scopus databases, resulting in the inclusion of 15 studies, comprising RCTs, cohort studies, observational studies, and quasi-experimental designs. The review revealed a significant reduction in stress and depression, with a standardized mean difference (SMD) of 0.63, indicating a moderate effect size. Patients engaging in physical exercise reported a higher QoL across various domains, although the trend toward reduced cravings was not statistically significant, suggesting a need for further research in this area. The findings suggest that physical exercise can positively contribute to the treatment of SUD patients by enhancing mental health and QoL.

The Nexus of Aging and Substance Use: A Scoping Review of Therapeutic Modalities for Geriatric Substance Use Disorders

The insidious grip of substance use disorders (SUDs) manifests as a ubiquitous public health crisis, indiscriminately affecting individuals across the spectrum of age, gender, and socioeconomic status. While advancements in treatment offer a glimmer of hope, millions continue to grapple with the debilitating physical, psychological, and social consequences of addiction, particularly those involving alcohol and opioids. This crisis is further exacerbated by the alarming rise of SUDs among older adults. As the global population undergoes a process of demographic senescence, the escalating prevalence of SUDs in this demographic underscores the urgent need for nuanced interventions. This review explores the therapeutic landscape for managing SUDs in older adults, evaluating pharmacological and non-pharmacological treatment modalities. A detailed literature search was conducted using databases like PubMed, Google Scholar, and Scopus, and studies were selected based on their relevance to therapeutic interventions for older adults with SUDs, encompassing pharmacological and non-pharmacological modalities. The synthesized results provide an extensive overview of contemporary therapeutic approaches. The findings indicate that pharmacological interventions demonstrate varied effectiveness in managing opioid and alcohol use disorders, with each drug offering distinct benefits and limitations regarding safety, tolerability, and patient adherence. Non-pharmacological interventions provide critical psychological and social support, often requiring adaptations to meet elderly patients' needs effectively. Integrated care models, which combine pharmacological and non-pharmacological treatments, emerge as the most effective approach, addressing the comprehensive needs of elderly patients by leveraging multidisciplinary teams, centralized service access, and coordinated, patient-centered care. Implementing these models, however, requires overcoming significant resource and coordination challenges. Indeed, the confluence of a burgeoning geriatric population and escalating rates of SUDs necessitates the development and implementation of granular and integrated care protocols specifically designed for older adults. By employing such a targeted approach, optimism can be cultivated and the quality of life enhanced for this vulnerable and often overlooked segment of society. This ensures the fight against addiction extends its reach, leaving no one behind.

Strengthening Neuroplasticity in Substance Use Recovery Through Lifestyle Intervention

The incidence of substance use and behavioral addictions continues to increase throughout the world. The Global Burden of Disease Study shows a growing impact in disability-adjusted life years due to substance use. Substance use impacts families, communities, health care, and legal systems; yet, the vast majority of individuals with substance use disorders do not seek treatment. Within the United States, new legislation has attempted to increase the availability of buprenorphine, but the impact of substance use continues. Although medications and group support therapy have been the mainstay of treatment for substance use, lifestyle medicine offers a valuable adjunct therapy that may help strengthen substance use recovery through healthy neuroplastic changes.

Effect of Tai Chi Compared to Running on Drug Cravings, Attention Bias, and Physical Fitness in Men with Methamphetamine Use Disorder

BACKGROUND

Methamphetamine use disorder (MUD) is a global health problem. Studies have shown Tai Chi is a potential treatment for MUD. We aimed to explore the effectiveness of Tai Chi in improving drug cravings, attention bias, and physical fitness in men with MUD compared with aerobic exercise.

METHODS

A total of forty-eight participants (mean age 39.1 ± 8.7 years) were randomly assigned to either the Tai Chi group (TC) or the running group (RG). The TC performed 60 min of moderate-intensity (65-75% HRmax) Tai Chi exercise three times a week. The RG performed 60 min of moderate-intensity (65-75% HRmax) running on a treadmill three times a week. Before and after the intervention, drug cravings, attention bias, and physical fitness were evaluated.

RESULTS

After 12 weeks, we found the TC significantly improved in attention bias (F (1, 43) = 6.023, p = 0.019, d = -0.42) and reaction time (F (1, 43) = 6.181, p = 0.017, d = -0.72). No significant improvement was found in other variables in the TC, compared to the RG (p > 0.05).

CONCLUSIONS

The 12-week Tai Chi intervention improved attention bias and reaction time, compared to RG. Tai Chi exercise might be a potential auxiliary method for the rehabilitation for men with MUD.

Voluntary Exercise Ameliorates Chronic Ethanol Withdrawal-Induced Adaptations of Opioid Receptor Expression in the Nucleus Accumbens, Dopamine Release, and Ethanol Consumption

Exercise has increasingly been recognized as an adjunctive therapy for alcohol-use disorder (AUD), yet our understanding of its underlying neurological mechanisms remains limited. This knowledge gap impedes the development of evidence-based exercise guidelines for AUD treatment. Chronic ethanol (EtOH) exposure has been shown to upregulate and sensitize kappa opioid receptors (KORs) in the nucleus accumbens (NAc), which is innervated by dopamine (DA) neurons in the midbrain ventral tegmental area (VTA), which may contribute to AUD-related behaviors. In this study, we investigated the impact of voluntary exercise in EtOH-dependent mice on EtOH consumption, KOR and delta opioid receptor (DOR) expression in the NAc and VTA, and functional effects on EtOH-induced alterations in DA release in the NAc. Our findings reveal that voluntary exercise reduces EtOH consumption, reduces KOR and enhances DOR expression in the NAc, and modifies EtOH-induced adaptations in DA release, suggesting a competitive interaction between exercise-induced and EtOH-induced alterations in KOR expression. We also found changes to DOR expression in the NAc and VTA with voluntary exercise but no significant changes to DA release. These findings elucidate the complex interplay of AUD-related neurobiological processes, highlighting the potential for exercise as a therapeutic intervention for AUD.

Implications of Physical Activity in Reducing Alcohol Use for Women Veterans: A Narrative Review

Women veterans (WV) are a fast-growing population in the United States with concerning health disparities. Reports of increased risks of cardiovascular disease (CVD) and poorer health are evident in WV compared with their civilian counterparts. The transition from active duty to veteran poses additional life stressors, causing changes in health behaviors such as unhealthy alcohol consumption and decreased physical activity, which may explain health disparities in WV. The changes in these two health risk behaviors may be influenced by each other, and emerging evidence suggests that physical activity aids in managing alcohol consumption during alcohol use treatment. In this general narrative review, we summarized findings from studies involving WV on (1) the associations between alcohol consumption and physical activity and (2) the effect of physical activity on reducing alcohol use. We also discussed the clinical consideration of adding physical activity to alcohol use interventions for WV. Most of the literature included in this review has been based on predominantly veteran men populations. This knowledge gap highlights the importance of continued efforts and research studies targeting WV to eliminate health disparities among them.

Using a Smartwatch App to Understand Young Adult Substance Use: Mixed Methods Feasibility Study

BACKGROUND

Young adults in the United States exhibit some of the highest rates of substance use compared to other age groups. Heavy and frequent substance use can be associated with a host of acute and chronic health and mental health concerns. Recent advances in ubiquitous technologies have prompted interest and innovation in using technology-based data collection instruments to understand substance use and associated harms. Existing methods for collecting granular, real-world data primarily rely on the use of smartphones to study and understand substance use in young adults. Wearable devices, such as smartwatches, show significant potential as platforms for data collection in this domain but remain underused.

OBJECTIVE

This study aims to describe the design and user evaluation of a smartwatch-based data collection app, which uses ecological momentary assessments to examine young adult substance use in daily life.

METHODS

This study used a 2-phase iterative design and acceptability evaluation process with young adults (aged 18-25 y) reporting recent alcohol or cannabis use. In phase 1, participants (8/15, 53%) used the data collection app for 14 days on their Apple Watches to report their substance use patterns, social contexts of substance use, and psychosocial risk factors (eg, affect). After this 14-day deployment, the participants completed a user experience survey and a semistructured interview to record their perspectives and experiences of using the app. Formative feedback from this phase informed feature modification and refinement of the app. In phase 2, an additional cohort (7/15, 47%) used the modified app for 14 days and provided feedback through surveys and interviews conducted after the app use period.

RESULTS

Analyses of overall app use patterns indicated high, consistent use of the app, with participants using the app for an average of 11.73 (SD 2.60) days out of 14 days of data collection. Participants reported 67 instances of substance use throughout the study, and our analysis indicates that participants were able to respond to ecological momentary assessment prompts in diverse temporal and situational contexts. Our findings from the user experience survey indicate that participants found the app usable and functional. Comparisons of app use metrics and user evaluation scores indicate that the iterative app design had a measurable and positive impact on users' experience. Qualitative data from the participant interviews highlighted the value of recording substance use patterns, low disruption to daily life, minimal overall burden, preference of platforms (smartphones vs smartwatches), and perspectives relating to privacy and app use in social contexts.

CONCLUSIONS

This study demonstrated the acceptability of using a smartwatch-based app to collect intensive, longitudinal substance use data among young adults. The findings document the utility of smartwatches as a novel platform to understand sensitive and often-stigmatized behaviors such as substance use with minimal burden.

PEAK Mood, Mind, and Marks: a pilot study of an intervention to support university students' mental and cognitive health through physical exercise

Introduction

Regular exercise has the potential to enhance university students' mental and cognitive health. The PEAK Mood, Mind and Marks program (i.e., PEAK) is a neuroscience-informed intervention developed using the Behaviour Change Wheel to support students to exercise three or more times per week to benefit their mental and cognitive health. This pilot study assessed the impact of PEAK on exercise, mental and cognitive health, and implementation outcomes.

Methods

PEAK was delivered to 115 undergraduate university students throughout a 12-week university semester. The primary outcome was weekly exercise frequency. Secondary outcomes were: time spent engaged in moderate-vigorous exercise, sedentary behaviour and perceived mental health and cognitive health. All were measured via online self-report questionnaires. Qualitative interviews with 15 students investigated influences on engagement, the acceptability and appropriateness of PEAK, and its mechanisms of behaviour change. Paired t-tests, Wilcoxon Signed-Rank tests and template analysis were used to analyse quantitative and qualitative data, respectively.

Results

On average, 48.4% of students engaged in the recommended frequency of three or more exercise sessions per week. This proportion decreased towards the end of PEAK. Sedentary behaviour significantly decreased from baseline to end-point, and moderate-vigorous exercise significantly increased among students' who were non-exercisers. Mental wellbeing, stress, loneliness, and sense of belonging to the university significantly improved. There were no significant changes in psychological distress. Concentration, memory, and productivity significantly improved. Sixty-eight percent of students remained engaged in one or more components of PEAK at end-point. Qualitative data indicated students found PEAK to be acceptable and appropriate, and that it improved aspects of their capability, opportunity, and motivation to exercise.

Conclusions

Students are receptive to an exercise-based program to support their mental and cognitive health. Students exercise frequency decreased; however, these figures are likely a conservative estimate of students exercise engagement. Students valued the neuroscience-informed approach to motivational and educational content and that the program's goals aligned with their academic goals. Students identified numerous areas PEAK's content and implementation can be optimised, including use of a single digital delivery platform, more opportunities to connect with peers and to expand the content's cultural inclusivity.

Longitudinal description and prediction of physical inactivity among patients with borderline personality disorder and personality-disordered comparison subjects

BACKGROUND

The physical and psychological benefits of physical activity are well-known, and physical activity has been proven to be a helpful adjunct to psychotherapeutic treatment for many symptomatic disorders, including mood and anxiety disorders. The current study explores physical inactivity levels in patients with borderline personality disorder (BPD). The first aim of this study is to describe the 12-year course of physical inactivity in patients with BPD. The second aim is to examine predictors of physical inactivity, including adversity experiences, comorbid symptomatic (formerly axis I) disorders, medical disorders, and demographic factors.

METHODS

Two hundred and forty-five patients with BPD were interviewed seven times over 12-years of prospective follow-up as part of the McLean Study of Adult Development (MSAD). Patients were categorized as ever-recovered (i.e., patient had experienced a symptomatic and psychosocial recovery from BPD) or never-recovered. At each follow-up, patients reported physical activity levels (minutes of exercise per week) via a semi-structured interview- the Medical History and Services Utilization Interview (MHSUI). Data was collected from June 1992 to December 2018.

RESULTS

Never-recovered patients with BPD were significantly more inactive than their ever-recovered counterparts (p < 0.001). These rates of inactivity remained stable over time for both groups. Two significant multivariate predictors of inactivity were found: obesity (p = 0.003) and PTSD (p < 0.001).

CONCLUSIONS

Non-recovered BPD patients are more likely to be inactive than patients who have recovered. Both clinical and medical factors appear to contribute to inactivity levels in patients with BPD.

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.

A qualitative study of experiences with physical activity among people receiving opioid agonist therapy

BACKGROUND

Physical or mental health comorbidities are common among people with substance use disorders undergoing opioid agonist therapy. As both a preventive and treatment strategy, exercise offers various health benefits for several conditions. Exercise interventions to people with substance use disorders receiving opioid agonist therapy are limited. This study aims to explore experiences with physical activity, perceived barriers, and facilitators among people receiving opioid agonist therapy.

METHOD

Fourteen qualitative interviews were conducted with individuals receiving opioid agonist therapy in outpatient clinics in Western Norway.

RESULTS

Most were males in the age range 30 to 60 years. Participants had diverse and long-term substance use histories, and most received buprenorphine-based opioid agonist therapy. The identified themes were (1) Physical limitations: Participants experienced health-related problems like breathing difficulties, pain, and reduced physical function. (2) Social dynamics: Social support was essential for participating in physical activities and many argued for group exercises, but some were concerned about the possibility of meeting persons influenced by substances in a group setting, fearing temptations to use substances. (3) Shift in focus: As participants felt the weight of the health burden, their preference for activities shifted from sports aiming for "adrenaline" to a health promoting focus. (4) COVID-19's impact on exercise: because of the pandemic, group activities were suspended, and participants described it as challenging to resume. (5) Implementation preferences in clinics: Not interfering with opioid medication routines was reported to be essential.

CONCLUSION

This study offers valuable insights for the development of customized exercise interventions aimed at enhancing the health and well-being of patients undergoing opioid agonist therapy. These findings underscore the significance of addressing social dynamics, overcoming physical limitations, and implementing a practical and effective exercise regimen.

Understanding physical exercise among individuals with substance use disorders using an integrated theoretical perspective of the health action process approach and theory of planned behavior

Introduction

Physical exercise is considered a useful non-pharmacological adjunctive treatment for promoting recovery from substance use disorders (SUD). However, adherence to physical exercise treatments is low, and little is known about what factors are associated with the initiation and maintenance of physical exercise behaviors. The aim of this study was to explore the psychosocial factors underlying these behaviors in individuals with SUD using an integrated theoretical model based on the health action process approach (HAPA) and the theory of planned behavior (TPB).

Methods

A total of 1,197 individuals with SUDs (aged 37.20 ± 8.62 years) were recruited from 10 compulsory isolation drug rehabilitation centers in Zhejiang Province via convenience sampling according to a set of inclusion criteria. Self-reported data were collected to assess task self-efficacy (TSE), maintenance self-efficacy (MSE), recovery self-efficacy (RSE), outcome expectations (OE), action planning (AP), coping planning (CP), social support (SS), subjective norms (SN), attitude behavior (AB), behavioral intention (BI), perceived behavioral control (PBC), risk perception (RP), exercise stage, and exercise behavior in this integrated model. ANOVA and structural equation modeling (SEM) were used to evaluate this model.

Results

One-way ANOVA revealed that the majority of the moderating variables were significantly different in the exercise phase. Further SEM showed that the model fit the data and revealed several important relationships. TSE, RP, SS, AB, and SN were indirectly associated with physical exercise behavior in individuals with SUD through the BI in the SUD initiation stage. In addition, PBC was directly related to physical exercise behavior in individuals with SUD. In the maintenance stage, MSE, AP, CP and exercise behavior were significantly related. Moreover, AP and CP were mediators of BI and MSE.

Conclusion

This study is the first attempt to integrate patterns of physical exercise behavior in individuals with SUD. The HAPA-TPB integration model provides a useful framework for identifying determinants of physical exercise behavioral intentions and behaviors in individuals with SUD and for explaining and predicting the initiation and maintenance of physical exercise behaviors in these individuals. Moreover, the model provides scientific guidance for the enhancement of physical exercise adherence in individuals with SUD.

Acute effects of different Tai Chi practice protocols on cardiac autonomic modulation

Tai Chi serves as an effective exercise modality for enhancing autonomic regulation. However, a majority of existing studies have employed the single routine (SR) protocol as the basis for health interventions. The extent to which the gong routine application (GRA) protocol achieves similar levels of exercise load stimulation as traditional single practice routines remains uncertain. Therefore, this study the distinct characteristics of autonomic load stimulation in these different protocols, thus providing a biological foundation to support the development of Tai Chi health promotion intervention programs. we recruited a cohort of forty-five university students to participate in the 15 min GRA protocol and SR protocol. We collected heart rate and heart rate variability indicators during periods of rest, GRA protocol, and SR protocol utilizing the Polar Scale. Additionally, we assessed the mental state of the participants using the BFS State of Mind Scale. In summary, the autonomic load is lower in the GRA protocol compared to the SR protocol, with lower sympathetic activity but higher parasympathetic activity in the former. Results are specific to college students, additional research is necessary to extend support for frail older adults. It is advised to incorporate GRA protocol alongside SR protocol in Tai Chi instruction. This approach is likely to enhance Tai Chi skills and yield greater health benefits.

Integrated exercise program in opioid agonist therapy clinics and effect on psychological distress: study protocol for a randomized controlled trial (BAReAktiv)

BACKGROUND

Substance use disorder is associated with unhealthy lifestyle choices, resulting in adverse social and health consequences. People with opioid use disorder receiving opioid agonist therapy, in particular, have high morbidity and reduced quality of life. Physical activity is recommended as an adjunctive treatment for people with substance use disorder, but there is minimal evidence from randomized controlled trials on the effects of this among people with substance use disorder receiving opioid agonist therapy.

METHODS

BAReAktiv is a multicentre randomized controlled trial. The study aims to recruit 324 patients receiving opioid agonist therapy (parallel groups randomized 1:1 to integrated exercise intervention or control, superiority trial). A 16-week group-based integrated exercise intervention with workouts twice a week. The exercise program consists of endurance and resistance training. The target group will be patients 18 years and older receiving opioid agonist therapy in outpatient clinics in several centers in Western Norway. The primary outcome of the study is the effect on psychological distress measured by Hopkins' symptom checklist with ten items. Secondary outcome measures include physical functioning assessed with a 4-min step test, activity level, fatigue symptoms, quality of life, and changes in inflammation markers. This study will provide improved knowledge on the effects of an integrated exercise program in opioid agonist therapy.

DISCUSSION

Systematically integrating exercise programs for people receiving opioid agonist therapy could lead to a shift towards a stronger focus on health behaviors in outpatient care. Integrating exercise could benefit patient recovery and reduce disease burden. Further scale-up will be considered if the provided exercise program is safe and effective.

TRIAL REGISTRATION

ClinicalTrials.gov. NCT05242848. Registered on February 16, 2022.

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.

Effects of a Two-Month Exercise Training Program on Concurrent Non-Opiate Substance Use in Opioid-Dependent Patients during Substitution Treatment

BACKGROUND

This randomized controlled trial aimed to evaluate the effects of a two-month exercise intervention on the concurrent non-opiate substance use (alcohol, cocaine, cannabis, and benzodiazepines) in opioid users during their medication treatment.

METHODS

Ninety opioid users (41 females) in methadone and buprenorphine medication treatment were randomly divided into four groups: (a) buprenorphine experimental (BEX; n = 26, aged 41.9 ± 6.1 yrs); (b) buprenorphine control (BCON; n = 25, aged 41.9 ± 5.6 yrs); (c) methadone experimental (MEX; n = 20, aged 46.7 ± 6.6 yrs); and (d) methadone control (MCON; n = 19, aged 46.1 ± 7.5 yrs). The experimental groups (BEX and MEX) followed an aerobic exercise training program on a treadmill for 20 min at 70% HRmax, 3 days/week for 8 weeks. Socio-demographic, anthropometric, and clinical characteristics, as well as non-opioid drug use in days and quantity per week, were assessed before and after the intervention period.

RESULTS

Following the exercise training, the weekly non-opioid substance consumption (days) decreased (p < 0.05) in both exercise groups and was lower in BEX compared to MEX, while no differences were observed (p > 0.05) between the control groups (BCON vs. MCON) or compared to their baseline levels. Similarly, the daily amount of non-opiate substance intake was reduced (p < 0.05) post-training in BEX and MEX, whereas it did not differ (p > 0.05) in BCON and MCON compared to the baseline.

CONCLUSIONS

The two-month exercise intervention reduced the non-opioid drug use in both the methadone and buprenorphine substitution groups compared to the controls, suggesting that aerobic exercise training may be an effective strategy for treating patients with OUDs.

Exercise as Medicine for People with a Substance Use Disorder: An ACSM Call to Action Statement

ABSTRACT

Over 20 million Americans are living with a substance use disorder (SUD) and nearly 100,000 die annually from drug overdoses, with a majority involving an opioid. Many people with SUD have co-occurring chronic pain and/or a mental health disorder. Exercise is a frontline treatment for chronic pain and is an effective strategy for reducing depression and anxiety and improving overall mental health. Several studies have shown that exercise improves SUD-related outcomes including abstinence; however, there is limited large-scale randomized clinical trial evidence to inform integration of exercise into practice. In this Call to Action, we aim to raise awareness of the specific issues that should be addressed to advance exercise as medicine in people with SUD including the challenges of co-occurring chronic pain, mental illness, and cardiopulmonary health conditions. In addition, specialized training for exercise professionals and other support staff should be provided on these issues, as well as on the multiple dimensions of stigma that can impair engagement in treatment and overall recovery in people with SUD.

The effects of virtual reality environmental enrichments on craving to food in healthy volunteers

RATIONALE

Environmental enrichment (EE) is a non-pharmacological approach that has been shown to be effective in reducing food-taking in rats. Studies in human volunteers are still in their infancy, given the difficulty to translate the complexity of EE in clinical practice. Virtual reality (VR) is a promising methodological approach, but no study has yet applied it to model and test EE in humans.

OBJECTIVES

The present study is the first to assess the effects of virtual EE on craving for palatable food.

METHODS

Eighty-one healthy volunteers (43 women) were divided into three groups: (i) exposure to a virtual EE (VR-EE), (ii) exposure to a virtual neutral environment (VR-NoEE), and (iii) without exposure to VR (No VR). Craving for palatable food at basal level and evoked by neutral and palatable food images was assessed before and after the VR simulation. Behavior during VR exposure and subjective measures related to the experience were also collected.

RESULTS

VR-EE group showed a significantly greater decrease in pre-post craving difference compared to No VR for all assessments and at basal level compared to VR-NoEE. Interestingly, an inverse correlation between craving and deambulation in the VR simulation emerged in VR-EE group only.

CONCLUSIONS

The study highlighted the feasibility of exposing human subjects to an EE as a virtual simulation. Virtual EE induced effects on basal craving for food that suggest the potential for further improvements of the protocol to extend its efficacy to palatable food cues.

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.

Effects of Aerobic Exercise Combined With Attentional Bias Modification in the Care of Male Patients With a Methamphetamine Use Disorder

OBJECTIVE

It remains unclear which individual or combined strategies are most beneficial for methamphetamine use disorders (MUDs). We compared the effects of aerobic exercise, attentional bias modification, and combined intervention on male patients with MUD.

METHOD

One hundred male patients with MUD were randomly assigned to combined intervention, aerobic exercise, attentional bias modification, or control groups (25 patients per group). The 8-week intervention protocol included three 60-minute sessions of aerobic exercises per week. Primary outcomes included high- and low-frequency heart rate variability, executive function, and cardiorespiratory fitness measured by customized software, computerized tests, and the Harvard step test, respectively. Secondary outcomes included psychiatric symptoms, drug craving, training acceptability, and persistence.

RESULTS

Participant characteristics were matched between groups at baseline. Executive function, heart rate variability, cardiorespiratory fitness, drug craving, and most psychiatric symptoms had significant time-group interactions at posttest (p < .05, η2 = .08-.28). Compared with the attentional bias modification and control groups, the combined intervention and aerobic exercise groups improved significantly in executive function, heart rate variability, cardiorespiratory fitness, and most secondary outcomes. In addition, high-frequency heart rate variability and cardiorespiratory fitness in the aerobic exercise group were significantly higher than those in the combined intervention group.

CONCLUSIONS

Combination strategies showed comparable efficacy to aerobic exercise alone in improving executive function, psychiatric symptoms, and drug craving and significantly exceeded other conditions. For heart rate variability and cardiorespiratory fitness, aerobic exercise alone was the most effective. For acceptability and persistence, combination strategies were preferred over single-domain training and health education intervention.

Exploring the Nexus between Moderate-to-Vigorous Physical Activity, Self-Disclosure, Social Anxiety, and Adolescent Social Avoidance: Insights from a Cross-Sectional Study in Central China

Objectives: Psychological issues among adolescents represent a prevalent challenge in today's society. The purpose of this study is to explore the associations among moderate-to-vigorous physical activity, self-disclosure, social anxiety, and social avoidance in adolescents. Methods: This study collected cross-sectional data from 427 students in eight provincial key junior and senior high schools in the central China region of three provinces using snowball sampling and convenience sampling from July to August 2023. A structural equation model was employed to investigate the relationship between moderate-to-vigorous physical activity and social avoidance among adolescents. Results: The findings indicate that moderate-to-vigorous physical activity is negatively correlated with social anxiety (standardized coefficient = -0.219, p < 0.001) and positively correlated with self-disclosure (standardized coefficient = 0.454, p < 0.001). Social anxiety is negatively correlated with self-disclosure (standardized coefficient = -0.220, p < 0.001). Social avoidance is positively correlated with social anxiety (standardized coefficient = 0.461, p < 0.001) and negatively correlated with self-disclosure (standardized coefficient = -0.331, p < 0.001). Conclusions: The chain-mediated dual-path model between moderate-to-vigorous physical activity and social avoidance is facilitated by social anxiety and self-disclosure. In other words, adolescents who engage in more moderate to high-intensity physical activities exhibit lower levels of social anxiety, and those who have a stronger inclination for self-disclosure tend to demonstrate lower levels of social avoidance. In light of these findings, it is recommended that the government, society, schools, and families collaborate synergistically to promote the holistic well-being of adolescents and advance the development of a healthier China.

High intensity interval training exercise increases dopamine D2 levels and modulates brain dopamine signaling

Background

Previous research has outlined the health benefits of exercise including its therapeutic potential for substance use disorders (SUD). These data have already been utilized and it is now common to find exercise as part of SUD treatment and relapse prevention programs. However, we need to better understand different exercise regimens and determine which would be the most beneficial for SUDs. Recently, high intensity interval training (HIIT) has gained attention in comparison with aerobic and resistance exercise. Little is known regarding the neurobiological mechanisms of HIIT, including its effects on dopamine signaling and receptor levels in the brain. The present study examined the effects of chronic HIIT exercise on dopamine signaling as measured by dopamine type 1-like receptor (D1R)-like, dopamine type 2-like receptor (D2R)-like, and tyrosine hydroxylase (TH) quantification in the brains of male and female rats as measured by [3H] SCH 23390 and [3H] spiperone autoradiography, and TH-immunoreactive optical density values.

Methods

Rats were separated in two groups: sedentary and HIIT exercise. Exercise was on a treadmill for 30 min daily (10 3 min cycles) for six weeks with progressive speed increased up to 0.8 mph (21.5 m/min).

Results

Results showed for D2R-like binding, a significant effect across the ventral caudate putamen (V CPU) between sexes, such that mean D2R-like binding was 14% greater for males than females. In the nucleus accumbens shell (Nac Shell), the HIIT Exercise rats showed 16% greater D2R-like binding as compared to the sedentary rats. No significant effects of HIIT exercise were found across groups for brain D1R-like binding levels or TH expression.

Conclusion

These results suggest that HIIT exercise can modulate dopamine signaling by way of increased D2R. These findings support the premise that HIIT exercise plays an important role in dopamine signaling and, may provide a potential mechanism for how HIIT exercise can impact the brain and behavior.

Barriers, perceived benefits and preferences to exercise in adults with an opioid use disorder in the U.S

Introduction

Over 10 million Americans misuse opioids and more than 5 million have been diagnosed with an opioid use disorder (OUD). In 2021, over 100,000 Americans died of a drug overdose and more than 75% of these deaths involved an opioid. Exercise has been shown to increase abstinence and decrease anxiety and depression in people with a substance use disorder. However, only a few small trials have focused on persons with OUD who often experience additional challenges including chronic pain, mental health disorders and cardio-metabolic abnormalities.

Methods

We aimed to describe the barriers, perceived benefits and preferences to exercise in adults with OUD in residential treatment in the U.S. as part of a larger study. We conducted 33 individually administered, semi-structured interviews and transcribed audiotapes verbatim, conducted coding and thematic analysis using NVivo v12 software (QSR International Inc.).

Results

Our sample had nearly equal representation of males and females and, was predominantly Caucasian (88%) with a mean of age of 34.5 (s.d. 7.5) years old. Participants stated that exercise helps to reduce drug cravings, anxiety, depression and pain and improve mood, physical health and build "normalcy". Barriers included lack of time, access to resources, fear of poor health and triggering pain. Participants preferred moderate intensity exercise 3 times/week and 30-60 min sessions.

Conclusions

Our findings indicate that adults with OUD believe exercise is a valuable tool to use in their recovery but they encounter several barriers. Many barriers, however, could be overcome with structured programs offered by residential treatment centers.

Effects of traditional Chinese exercise on sleep quality: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND

The efficacy of traditional Chinese exercise (TCE)-based interventions in the improvement of sleep quality is controversial. In this systematic review, we aimed to summarize randomized controlled trials (RCTs) that outline the effects of TCE on sleep quality.

METHODS

Five databases (Web of Science, Embase, PubMed, Medline, and China National Knowledge Infrastructure) were searched for literature published before July 2022. RCTs examining TCE interventions were included. The treatment effects were estimated using a random-effect meta-analysis model with mean differences (MDs). There were 2 outcome scales for sleep quality; however, because they were extremely contrastive to be analyzed by standard MD, the scales were analyzed separately to ensure the accuracy of the results. This review was registered in the International Prospective Register of Systematic Reviews (identifier CRD42023421314).

RESULTS

Twenty studies were included for analysis at last. The outcome was calculated using the Verran and Snyder-Halpern Sleep Scale (MD: 344.17, 95% confidence interval: 316.95 to 371.39, P < .00001) and Pittsburgh Sleep Quality Index to measure sleep quality (MD: -2.24, 95% confidence interval: -3.05 to -1.43, P < .00001), both showed improvement effect. In subgroup analysis, for patients with fibromyalgia, normal older adults, and non-Hodgkin lymphoma, chronic fatigue syndrome-like illness, knee osteoarthritis, nasopharyngeal carcinoma, pausimenia, insomnia, TCE could improve sleep quality. However, there was no significant improvement in stroke patients, breast cancer patients, normal college students, and episodic migraine patients. Tai Chi had greater effects in improving sleep quality than Qigong. In addition, the participants practice site, duration, and age did not influence the effects of TCE.

CONCLUSION

TCE can improve sleep quality in specific populations in specific populations clinical applications. Tai chi should be considered first to improve sleep quality. However, further extensive trials and rigorous study designs should be conducted to strengthen the findings of this study. In addition, considering the large heterogeneity, the findings of our study should be interpreted cautiously.

The health of people attending residential treatment for alcohol and other drug use: Prevalence of and risks for major lifestyle diseases

INTRODUCTION

Cardiovascular disease and cancers are the leading cause of mortality amongst people accessing treatment for alcohol and other drug use. The current study aimed to examine risk factors for chronic disease amongst people attending residential alcohol and other drug treatment services.

METHODS

Participants (N = 325) were attending residential alcohol and other drug treatment services across Australia. Diabetes and cardiovascular disease risk scores were calculated using established risk estimation algorithms. Differences in existing health conditions, risk factors for chronic diseases and risk algorithms were calculated for males and females.

RESULTS

In addition to alcohol and other drug use (including tobacco use), 95% of the sample had at least one other risk factor for chronic disease. Of participants not already diagnosed, 36% were at a high risk of developing type 2 diabetes and 11% had a high risk of developing cardiovascular disease. The heart age of participants was 11 years older than actual age (Mage = 40.63, Mheart age = 52.41). Males had a higher cardiovascular disease risk than females.

DISCUSSION AND CONCLUSIONS

A large proportion of people accessing residential alcohol and other drug treatment were at risk of chronic disease. Future research is needed that uses objective indicators of physical health. Such research will help to develop our understanding of prevention and intervention initiatives that could be adopted by treatment providers to improve the physical health of their consumers.

Prevalence of food addiction and its association with lifestyle factors in undergraduate students from Northwest Mexico

Background: The aim of this study was to determine the prevalence of food addiction (FA) in undergraduate students from Northwest Mexico and to examine its association with lifestyle factors, eating behaviors and food consumption.Methods: This cross-sectional study included a total of 326 undergraduate students, both sexes, between 18 and 25 years of age, who were enrolled in a bachelor's degree program at a public or private university in the city of Tijuana, Baja California, Mexico. FA was assessed using the modified Yale Food Addiction Scale Version 2.0 (mYFAS 2.0). Lifestyle (sleep patterns, physical exercise, alcohol intake, and smoking) and nutritional information (eating behaviors and food frequency consumption) was obtained through a clinical history. A multivariate logistic regression model was fitted to assess the factors associated with FA.Results: The whole prevalence of FA was 12.9%. In general, mild FA was the most frequent (5.2%), followed by severe (4.3%) and moderate (3.4%) categories. In the multivariate model, insomnia conferred a higher risk for FA (OR = 2.08, 95% CI, 1.04-4.17, p = 0.040), while the habitual consumption of fruits showed a protective effect (OR = 0.50, 95% CI, 0.25-0.98, p = 0.046). Overall, the model predicted FA in 12% (R2=0.12, p = 0.011).Conclusion: The prevalence of FA is 12.9% among undergraduate students from Northwest Mexico. Although caution should be exercised, insomnia seems to increase the risk of FA, while the habitual consumption of fruits appears to have a protective role. Additional studies are needed to validate these results.

Effectiveness of physical activity interventions for improving depression, anxiety and distress: an overview of systematic reviews

OBJECTIVE

To synthesise the evidence on the effects of physical activity on symptoms of depression, anxiety and psychological distress in adult populations.

DESIGN

Umbrella review.

DATA SOURCES

Twelve electronic databases were searched for eligible studies published from inception to 1 January 2022.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Systematic reviews with meta-analyses of randomised controlled trials designed to increase physical activity in an adult population and that assessed depression, anxiety or psychological distress were eligible. Study selection was undertaken in duplicate by two independent reviewers.

RESULTS

Ninety-seven reviews (1039 trials and 128 119 participants) were included. Populations included healthy adults, people with mental health disorders and people with various chronic diseases. Most reviews (n=77) had a critically low A MeaSurement Tool to Assess systematic Reviews score. Physical activity had medium effects on depression (median effect size=-0.43, IQR=-0.66 to -0.27), anxiety (median effect size=-0.42, IQR=-0.66 to -0.26) and psychological distress (effect size=-0.60, 95% CI -0.78 to -0.42), compared with usual care across all populations. The largest benefits were seen in people with depression, HIV and kidney disease, in pregnant and postpartum women, and in healthy individuals. Higher intensity physical activity was associated with greater improvements in symptoms. Effectiveness of physical activity interventions diminished with longer duration interventions.

CONCLUSION AND RELEVANCE

Physical activity is highly beneficial for improving symptoms of depression, anxiety and distress across a wide range of adult populations, including the general population, people with diagnosed mental health disorders and people with chronic disease. Physical activity should be a mainstay approach in the management of depression, anxiety and psychological distress.

PROSPERO REGISTRATION NUMBER

CRD42021292710.

"Students Moving Together", Tailored Exercise for Students Facing Mental Health Challenges-A Pilot Feasibility Study

An increasing number of university students are facing mental health challenges. The primary aim of this study was to determine the feasibility of 10 weeks of supervised tailored group exercise for 60 min twice a week delivered by the student health service for students facing mental health challenges. Secondary aims were to explore changes in mental health and physical fitness from pre- to post-test. Feasibility was assessed in terms of recruitment, drop-outs, attendance, and adverse events. The secondary outcomes included symptoms of depression and anxiety, wellbeing, satisfaction with life, cardiorespiratory fitness, and muscular endurance/strength. A total of 13 university students with self-reported mental health challenges, aged 20-39 years, were recruited during a four-week period. Ten (77%) of these completed the intervention and post-test as planned, and no adverse events occurred. There was a significant average reduction of 20% in symptoms of depression and anxiety (p = 0.008), and non-significant improvements of 21% in well-being and 16% in satisfaction with life were found. On average, cardiorespiratory fitness (p = 0.01) and muscular strength (push-ups test, p = 0.01, and sit-ups test, p = 0.02) increased. In conclusion, a 10-week tailored exercise intervention delivered by the student mental health service was found to be feasible, and beneficial for mental health and physical fitness in students facing mental health challenges.

Testing the causal relationships of physical activity and sedentary behaviour with mental health and substance use disorders: a Mendelian randomisation study

Observational studies suggest that physical activity can reduce the risk of mental health and substance use disorders. However, it is unclear whether this relationship is causal or explained by confounding bias (e.g., common underlying causes or reverse causality). We investigated the bidirectional causal relationship of physical activity (PA) and sedentary behaviour (SB) with ten mental health and substance use disorders, applying two-sample Mendelian Randomisation (MR). Genetic instruments for the exposures and outcomes were derived from the largest available, non-overlapping genome-wide association studies (GWAS). Summary-level data for objectively assessed PA (accelerometer-based average activity, moderate activity, and walking) and SB and self-reported moderate-to-vigorous PA were obtained from the UK Biobank. Data for mental health/substance use disorders were obtained from the Psychiatric Genomics Consortium and the GWAS and Sequencing Consortium of Alcohol and Nicotine Use. MR estimates were combined using inverse variance weighted meta-analysis (IVW). Sensitivity analyses were conducted to assess the robustness of the results. Accelerometer-based average PA was associated with a lower risk of depression (b = -0.043, 95% CI: -0.071 to -0.016, effect size[OR] = 0.957) and cigarette smoking (b = -0.026; 95% CI: -0.035 to -0.017, effect size[β] = -0.022). Accelerometer-based SB decreased the risk of anorexia (b = -0.341, 95% CI: -0.530 to -0.152, effect size[OR] = 0.711) and schizophrenia (b = -0.230; 95% CI: -0.285 to -0.175, effect size[OR] = 0.795). However, we found evidence of reverse causality in the relationship between SB and schizophrenia. Further, PTSD, bipolar disorder, anorexia, and ADHD were all associated with increased PA. This study provides evidence consistent with a causal protective effect of objectively assessed but not self-reported PA on reduced depression and cigarette smoking. Objectively assessed SB had a protective relationship with anorexia. Enhancing PA may be an effective intervention strategy to reduce depressive symptoms and addictive behaviours, while promoting sedentary or light physical activities may help to reduce the risk of anorexia in at-risk individuals.

Primary Care at the Intersection of Lifestyle Interventions and Unhealthy Substance Use

Primary care physicians are well-positioned to integrate lifestyle interventions into the management of patients with unhealthy substance use, who may also have mental and physical chronic health comorbidities. However, the COVID-19 pandemic exacerbated the U.S.'s poor state of health, revealing that its current approach to chronic disease management is neither effective nor sustainable. Today's full spectrum comprehensive care model requires an expanded toolkit. Lifestyle interventions broaden current treatment approaches and may enhance Addiction Medicine care. Primary care providers have the potential to have the greatest impact on unhealthy substance use care because they are experts in chronic disease management and their frontline accessibility minimizes healthcare barriers. Individuals with unhealthy substance use are at an increased risk of chronic physical conditions. Incorporating lifestyle interventions with unhealthy substance use care at every level of medicine, from medical school through practice, normalizes both as part of the standard care of medicine and will drive evidence-based best practices to support patients through prevention, treatment, and reversal of chronic diseases.

Associations of sport participation with subjective well-being: a study consisting of a sample of Chinese school-attending students

Purpose

Past studies have illustrated that the impact of sports participation on school-attending students' well-being plays a significant role in the life course of adolescence, which is a golden period for developing sound psychological qualities. However, the relationship between sports participation and subjective well-being is not clear, particularly in Chinese primary and middle schools. Therefore, the current study was aimed to explore the relationship between sports participation and subjective well-being in elementary and middle schools in China.

Method

All involved children and adolescents were asked to conduct a self-report of their sociodemographic factors (e.g., sex, grade, and age), independence, and outcomes. The survey involved a two-stage sampling design (district school). Besides, in order to examine the relationship between participation in sports and subjective well-being, a self-report questionnaire was used. Logistic regression with 95% confidence interval and odds ratios (ORs), was conducted to investigate the relationship between sports participation and subjective well-being.

Results

A total of 67,281 participants in total provided complete data for the final analysis of the current study. The percentage of boys and girls was 51.9% and 48.1%, namely. The current study found that compared with children who never participate in sports, those children who participated sports in 1-3 times a month, 1-2 times a week, and 3 times a week and above were more likely to enjoy better well-being. Compared with children who never participate in sports, those children who in every grade participated sports in 1-3 times a month, 1-2 times a week, and 3 times a week and above were more likely to achieve better well-being.

Conclusion

Our current study offered the positive effect of sports participation on children and adolescents' subjective well-being. For schools and governments, further studies are needed to focus on sports participation and positive feedback on adolescents' mental health, and the three parties' endeavors should be intervened.

Clinical guidelines for the use of lifestyle-based mental health care in major depressive disorder: World Federation of Societies for Biological Psychiatry (WFSBP) and Australasian Society of Lifestyle Medicine (ASLM) taskforce

OBJECTIVES

The primary objectives of these international guidelines were to provide a global audience of clinicians with (a) a series of evidence-based recommendations for the provision of lifestyle-based mental health care in clinical practice for adults with Major Depressive Disorder (MDD) and (b) a series of implementation considerations that may be applicable across a range of settings.

METHODS

Recommendations and associated evidence-based gradings were based on a series of systematic literature searches of published research as well as the clinical expertise of taskforce members. The focus of the guidelines was eight lifestyle domains: physical activity and exercise, smoking cessation, work-directed interventions, mindfulness-based and stress management therapies, diet, sleep, loneliness and social support, and green space interaction. The following electronic bibliographic databases were searched for articles published prior to June 2020: PubMed, EMBASE, The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Methodology Register), CINAHL, PsycINFO. Evidence grading was based on the level of evidence specific to MDD and risk of bias, in accordance with the World Federation of Societies for Biological Psychiatry criteria.

RESULTS

Nine recommendations were formed. The recommendations with the highest ratings to improve MDD were the use of physical activity and exercise, relaxation techniques, work-directed interventions, sleep, and mindfulness-based therapies (Grade 2). Interventions related to diet and green space were recommended, but with a lower strength of evidence (Grade 3). Recommendations regarding smoking cessation and loneliness and social support were based on expert opinion. Key implementation considerations included the need for input from allied health professionals and support networks to implement this type of approach, the importance of partnering such recommendations with behaviour change support, and the need to deliver interventions using a biopsychosocial-cultural framework.

CONCLUSIONS

Lifestyle-based interventions are recommended as a foundational component of mental health care in clinical practice for adults with Major Depressive Disorder, where other evidence-based therapies can be added or used in combination. The findings and recommendations of these guidelines support the need for further research to address existing gaps in efficacy and implementation research, especially for emerging lifestyle-based approaches (e.g. green space, loneliness and social support interventions) where data are limited. Further work is also needed to develop innovative approaches for delivery and models of care, and to support the training of health professionals regarding lifestyle-based mental health care.

Effects of exercise of different intensities on withdrawal symptoms among people with substance use disorder: a systematic review and meta-analysis

Background: Exercise can effectively attenuate withdrawal symptoms and reduce relapse, but it is unknown whether exercise of different intensities produces different results. This study aimed to systematically review the effects of different exercise intensities on withdrawal symptoms among people with substance use disorder (SUD). Methods: Systematic searches for randomized controlled trials (RCTs) on exercise, SUD, and abstinence symptoms were conducted via electronic databases, including PubMed, up to June 2022. Study quality was evaluated using the Cochrane Risk of Bias tool (RoB 2.0) for assessment of risk of bias in randomized trials. The meta-analysis was performed by calculating the standard mean difference (SMD) in outcomes of interventions involving light-, moderate-, and high-intensity exercise for each individual study using Review Manager version 5.3 (RevMan 5.3). Results: In total, 22 RCTs (n = 1,537) were included. Overall, exercise interventions had significant effects on withdrawal symptoms, but the effect size varied with exercise intensity and by outcome measure (i.e., for different negative emotions). Light-, moderate-, and high-intensity exercise reduced cravings after the intervention [SMD = -0.71, 95% CI = (-0.90, -0.52)], and there were no statistical differences between the subgroups (p > 0.05). Light-, moderate-, and high-intensity exercise reduced depression after the intervention [light, SMD = -0.33, 95% CI = (-0.57, -0.09); moderate, SMD = -0.64, 95% CI = (-0.85, -0.42); high, SMD = -0.25, 95% CI = (-0.44, -0.05)], with moderate-intensity exercise producing the best effect (p < 0.05). Only light- and moderate-intensity exercise relieved anxiety after the intervention [light, SMD = -0.48, 95% CI = (-0.71, -0.26); moderate, SMD = -0.58, 95% CI = (-0.85, -0.31)]. Only high-intensity exercise worked in alleviating stress [SMD = -1.13, 95% CI = (-2.22, -0.04)]. Both irritability and restlessness could be improved by light- and moderate-intensity exercise [irritability, SMD = -0.74, 95% CI = (-0.98, -0.50); restless, SMD = -0.72, 95% CI = (-0.98, -0.47)], and there were no statistical differences between the subgroups (p > 0.05). Moderate- and high-intensity exercise decreased withdrawal syndrome after the intervention [moderate, SMD = -0.30, 95% CI = (-0.55, -0.05); high, SMD = -1.33, 95% CI = (-1.90, -0.76)], with high-intensity exercise producing the best effects (p < 0.01). Conclusion: Overall, exercise leads to improvements in withdrawal symptoms in individuals with SUD, but these effects vary significantly between the exercise of different intensities and according to the type of withdrawal symptoms. Moderate-intensity exercise has the greatest benefits in improving depression and anxiety; high-intensity exercise has the greatest benefits in improving withdrawal syndrome. Systematic Review Registration: www.crd.york.ac.uk/PROSPERO/, identifier, CRD42022343791.