Physical activity and the prevention, reduction, and treatment of alcohol and other drug use across the lifespan (The PHASE review): A systematic review

Abstract

The aim of this review is to systematically describe and quantify the effects of PA interventions on alcohol and other drug use outcomes, and to identify any apparent effect of PA dose and type, possible mechanisms of effect, and any other aspect of intervention delivery (e.g. key behaviour change processes), within a framework to inform the design and evaluation of future interventions. Systematic searches were designed to identify published and grey literature on the role of PA for reducing the risk of progression to alcohol and other drug use (PREVENTION), supporting individuals to reduce alcohol and other drug use for harm reduction (REDUCTION), and promote abstinence and relapse prevention during and after treatment of alcohol and other drug use (TREATMENT). Searches identified 49,518 records, with 49,342 excluded on title and abstract. We screened 176 full text articles from which we included 32 studies in 32 papers with quantitative results of relevance to this review. Meta-analysis of two studies showed a significant effect of PA on prevention of alcohol initiation (risk ratio [RR]: 0.72, 95%CI: 0.61 to 0.85). Meta-analysis of four studies showed no clear evidence for an effect of PA on alcohol consumption (Standardised Mean Difference [SMD]: 0.19, 95%, Confidence Interval −0.57 to 0.18). We were unable to quantitatively examine the effects of PA interventions on other drug use alone, or in combination with alcohol use, for prevention, reduction or treatment. Among the 19 treatment studies with an alcohol and other drug use outcome, there was a trend for promising short-term effect but with limited information about intervention fidelity and exercise dose, there was a moderate to high risk of bias. We identified no studies reporting the cost-effectiveness of interventions. More rigorous and well-designed research is needed. Our novel approach to the review provides a clearer guide to achieve this in future research questions addressed to inform policy and practice for different populations and settings.

Behavior change techniques in physical activity interventions for adults with substance use disorders: A systematic review.

“…However, findings regarding its effects on substance use and psychological functioning were mixed (Colledge et al, 2018;Giménez-Meseguer et al, 2020;Linke & Ussher, 2015). These mixed results extend to reviews about the use of PA in the treatment of specific SUDs including alcohol use disorder (AUD; Gür & Can Gür, 2020;Hallgren et al, 2017;Thompson et al, 2020) and tobacco use disorder (Klinsophon et al, 2017;Ussher et al, 2014;Zschucke et al, 2012). Further, there were high dropout rates (25%-40%) across studies (e.g., Gür & Can Gür, 2020;Hallgren et al, 2017).…”

The Influence of Moderate Physical Activity on Brain Monoaminergic Responses to Binge-Patterned Alcohol Ingestion in Female Mice

“…Moreover, mounting evidence from rodent models of drug abuse also suggests that exercise therapy may aid in recovery from cocaine, morphine, and methamphetamine dependence (Cosgrove et al, 2002 ; Miladi-Gorji et al, 2012 ; Engelmann et al, 2014 ). However, the impact of physical activity status on alcohol abuse, in particular, remains less clear, as reports with human subjects and rodent models have demonstrated varied outcomes (Giesen et al, 2015 ; Leasure et al, 2015 ; Manthou et al, 2016 ; Horrell et al, 2020 ). Yet still, regular exercise can promote adaptations in mood regulation and reward neuropathways that also overlap with the motivation to ingest excessive amounts of alcohol (Werme et al, 2002b ; Greenwood et al, 2011 ; Herrera et al, 2016 ; Robison et al, 2018 ).…”

Physical health programs and interventions with women during incarceration: a scoping review

“…It seems worth remarking that one frequent argument in the more robust body of interventional research that addresses the physical health of incarcerated men is that improving physical health is a foundation for (rather than an embellishment on or a supplement to) addressing both substance abuse and mental health conditions (Sanchez-Lastra et al , 2019; Papa et al , 2021; O’Toole et al , 2018). Increasing physical activity as a basis for improving the all-round health of persons who are incarcerated has been a focus of numerous international studies, many conducted in countries falling under mandates of international bodies requiring access to exercise (Brosens et al , 2017) Some of these include studies in Australia, Canada, England, Ireland, Italy, Spain and Wales (Thompson et al , 2020; Cashin et al , 2008; Elwood Martin et al , 2013; Meek and Lewis, 2012; Mannocci et al , 2015; Pérez-Moreno et al , 2007). Internationally, the research suggests that increasing physical activity and improving sleep and nutrition may be important for tackling other, ostensibly more urgent problems of substance abuse and mental health.…”