Objectives Physical exercise has been shown to benefit diverse medical and behavioral conditions. This study assesses the feasibility and efficacy of an 8-week endurance and resistance training program on fitness measures in individuals undergoing residential treatment for methamphetamine (MA) dependence. Methods A total of 39 MA-dependent individuals were randomized to 3 days/week of exercise training (ET, n=15) or health education without training (EA, n=14) over 8 weeks. Aerobic performance (VO2max) was measured by indirect calorimetry, body composition by skinfolds, muscle strength by 1-repetition maximum (1-RM) and endurance at 85% of 1-RM for both leg press (LP) and chest press (CP). Results A total of 29 individuals completed the study for a 74% adherence rate. Baseline characteristics (mean±SD) were balanced between groups: age 31±7 years; height=1.74±0.07 m; weight 82.0±15.0 kg. The ET group significantly improved VO2max by 0.63±0.22 L/min (+21%), LP strength by 24.4±5.6 kg (+40%) and CP strength by 20.6±5.7 kg (+49%). The ET group increased LP and CP endurance by 120% and 96%, respectively and showed significant reductions in body weight of 1.7±2.4 kg (−2%), % body fat of 2.8±1.3% (−15%) and fat weight 2.8±1.8 kg (−18%). All changes were significant (P<0.001) for ET, and no changes were seen for the EA group. Conclusions Individuals recovering from methamphetamine dependence showed substantial improvements in aerobic exercise performance, muscle strength and endurance, and body composition with exercise training. These findings demonstrate the feasibility of an exercise training intervention in these participants and also show excellent responsiveness to the exercise stimulus resulting in physiological changes that might enhance recovery from drug dependency.

Methamphetamine use disorder is associated with striatal dopaminergic deficits that have been linked to poor treatment outcomes, identifying these deficits as an important therapeutic target. Exercise attenuates methamphetamine-induced neurochemical damage in the rat brain, and a preliminary observation suggests that exercise increases striatal D2/D3 receptor availability (measured as nondisplaceable binding potential (BP ND )) in patients with Parkinson's disease. The goal of this study was to evaluate whether adding an exercise training program to an inpatient behavioral intervention for methamphetamine use disorder reverses deficits in striatal D2/D3 receptors. Participants were adult men and women who met DSM-IV criteria for methamphetamine dependence and were enrolled in a residential facility, where they maintained abstinence from illicit drugs of abuse and received behavioral therapy for their addiction. They were randomized to a group that received 1 h supervised exercise training (n = 10) or one that received equal-time health education training (n = 9), 3 days/week for 8 weeks. They came to an academic research center for positron emission tomography (PET) using [ 18 F]fallypride to determine the effects of the 8-week interventions on striatal D2/D3 receptor BP ND . At baseline, striatal D2/D3 BP ND did not differ between groups. However, after 8 weeks, participants in the exercise group displayed a significant increase in striatal D2/D3 BP ND , whereas those in the education group did not. There were no changes in D2/D3 BP ND in extrastriatal regions in either group. These findings suggest that structured exercise training can ameliorate striatal D2/D3 receptor deficits in methamphetamine users, and warrants further evaluation as an adjunctive treatment for stimulant dependence.

Background This paper reports data from a study designed to determine the impact of an 8-week exercise program on depression and anxiety symptoms among newly abstinent methamphetamine (MA)-dependent individuals in residential treatment. Methods One hundred thirty-five MA-dependent individuals, newly enrolled in residential treatment, were randomly assigned to receive either a 3-times-per-week, 60-minute structured exercise program for 8 weeks (24 sessions) or an equivalent number of health education sessions. Using mixed-modeling repeated-measures regression, we examined changes in weekly total depression and anxiety scores as measured by the Beck Depression Inventory and Beck Anxiety Inventory over the 8-week study period. Results Mean age of participants was 31.7 (SD = 6.9); 70.4% were male and 48% Latino. Analyses indicate a significant effect of exercise on reducing depression (β = −0.63, P = 0.001) and anxiety (β = −0.95, P = 0.001) symptoms (total scores) over the 8-week period compared to a health education control group. A significant dose interaction effect between session attendance and exercise was found as well on reducing depression (β = −0.61, P < 0.001) and anxiety symptoms (β = −0.22, P = 0.009) over time compared to the control group. Conclusions Results support the role of a structured exercise program as an effective intervention for improving symptoms of depression and anxiety associated with MA abstinence.

The primary aim of this study was to determine whether different durations of contingency management (CM) in conjunction with psychosocial treatment produced different rates of abstinence among methamphetamine dependent individuals. Participants were randomized to one of four 16-week treatment conditions: standard psychosocial treatment or psychosocial treatment plus one of three durations of CM (one-month, two-month, or four-month). A total of 118 participants were randomized to the four treatment conditions. There were significant differences across treatment conditions for number of consecutive days of methamphetamine abstinence (p < 0.05). These differences were in the hypothesized direction, as participants were more likely to remain abstinent through the 16-week trial as CM duration increased. A significant effect of treatment condition (p < 0.05) and time (p < 0.05) on abstinence over time was also found. Longer durations of CM were more effective for maintaining methamphetamine abstinence.

Purpose Heart rate variability (HRV) reflects a healthy autonomic nervous system and is increased with physical training. Methamphetamine dependence (MD) causes autonomic dysfunction and diminished HRV. We compared recently abstinent MD participants with age-matched, drug free controls (DF) and also investigated whether HRV can be improved with exercise training in the MD participants. Methods In 50 participants (MD=28; DF=22) resting heart rate (R-R intervals) was recorded over 5 min while seated using a monitor affixed to a chest strap. Previously reported time-domain (SDNN, RMSSD, pNN50) and frequency-domain (LFnu, HFnu, LF/HF) parameters of HRV were calculated with customized software. MD were randomized to thrice weekly exercise training (ME=14) or equal attention without training (MC=14) over 8 weeks. Groups were compared using paired and unpaired t-tests. Statistical significance was set at P≤0.05. Results Participant characteristics were matched between groups: age 33±6 years; body mass 82.7±12 kg, BMI 26.8±4.1 kg•min−2, mean±SD. Compared with DF, the MD group had significantly higher resting heart rate (P<0.05), LFnu, and LF/HF (P<0.001) as well as lower SDNN, RMSSD, pNN50 and HFnu (all P<0.001). At randomization, HRV indices were similar between ME and MC groups. However, after training, the ME group significantly (all P<0.001) increased SDNN (+14.7±2.0 ms, +34%), RMSSD (+19.6±4.2 ms, +63%), pNN50 (+22.6±2.7%, +173%), HFnu (+14.2±1.9, +60%) and decreased HR (−5.2±1.1 beats·min−1, −7%), LFnu (−9.6±1.5, −16%) and LF/HF (−0.7±0.3, −19%). These measures did not change from baseline in the MC group. Conclusion HRV, based on several conventional indices, was diminished in recently abstinent, methamphetamine dependent individuals. Moreover, physical training yielded a marked increase of HRV representing increased vagal modulation or improved autonomic balance.