Chiropractor’s Review on Exercise for Treatment of Opioid-Dependent Patients

McKinney Chiropractor Best Practices;

Research Commentary

Exercise for Treatment of Opioid-Dependent Patients

A review of

Psarianos A, Chryssanthopoulos C, Theocharis A, Paparrigopoulos T, Philippou A. Effects of a Two-Month Exercise Training Program on Concurrent Non-Opiate Substance Use in Opioid-Dependent Patients during Substitution Treatment. Journal of Clinical Medicine. 2024; 13(4):941. https://doi.org/10.3390/jcm13040941

Reviewed by Dr. Justin Thompson

Exercise for Treatment of Opioid Patients

A Summarized Review of the Conclusion

When looking at the solution to problems like addiction, many times there will be instances where the user will just be prescribed a substitution drug. It is important that we examine the usefulness of non drug approaches especially in this population. Physical exercise is a useful non-pharmaceutical intervention for the improvement of numerous variables related to the recovery of opioid-dependent patients. The findings of this study confirm the value of aerobic exercise of moderate intensity for being integrated in the clinical practice for the treatment of concurrent non-opiate substance use in opioid-dependent patients under substitution treatment. It is a low-cost, feasible, and non-stigmatizing intervention that is not associated with any side effects and that can help abusers of multiple addictive substances to improve their physical and mental health.

Quotes from the Article

“Moreover, the continuous and repeated use of addictive substances may cause adaptive, morphological, and functional alterations in the brain’s reward system and also in the system that selects the behaviors to satisfy the individual’s drives and desires, eventually forming an endophenotype vulnerable to both addiction and other risky behaviors”

“In particular, aerobic exercise can restore synaptic deficits caused by cocaine, thereby reducing drug-seeking behavior”

“Our main findings were that after the two-month exercise training in opioid users during maintenance treatment, the parallel non-opiate drug (alcohol, cocaine, cannabis, and benzodiazepines) use decreased significantly in the exercise groups of both methadone and buprenorphine substitution compared to the controls.”

“Regular aerobic exercise could modulate a variety of psychological symptoms in addicts, such as anxiety, depression, paranoia, hostility, or compulsion, and thus could effectively improve the physical condition, emotional state, and mental health of addicts, as well as reduce their drug addiction”

Introduction to the Research

Non-opioid polysubstance abuse is common among patients with OUDs seeking treatment. It is usually observed during the early phases of medication for opioid use disorders and is enhanced by the experience of withdrawal and craving. Specifically, the rates of this pattern of use are high (~65%) in patients receiving methadone or buprenorphine treatment, which is of concern due to its potential complications. Such concerns are associated with the interaction of non-opioid substances with the treatment medication and the risk that may act as substitutes. Specifically, they potentially lead to increased (non-opioid) use, while they might also escalate the risk of substitution-substance use. Consequently, the effect of drug therapy is compromised, and the risk of relapse increases. Exercise appears to be an ideal complementary strategy and, together with psychotherapeutic interventions, can have a positive effect on abstinence from alcohol use. In particular, aerobic exercise can restore synaptic deficits caused by cocaine, thereby reducing drug-seeking behavior. Moreover, physical exercise is a powerful activator of the endocannabinoid system, and, thus, it could be a very effective intervention for stopping cannabis use, reducing psychosomatic withdrawal, regulating stress management, and mitigating the desire for drug use. In addition, exercise, acting as a stress management regulator, can help control panic symptoms, which is the key for a successful, gradual withdrawal from long-term benzodiazepine use.

Research Methodology

This is a randomized controlled trial conducted in adult patients, men and women, with OUDs (Opiate use disorder). The 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.

Research Findings

Our main findings were that after the two-month exercise training in opioid users during maintenance treatment, the parallel non-opiate drug (alcohol, cocaine, cannabis, and benzodiazepines) use decreased significantly in the exercise groups of both methadone and buprenorphine substitution compared to the controls. 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.

Reference

As always with these reviews, these are my takeaways from the article and I encourage you to read the article in its entirety.  The references used in this article by the authors of this article are listed here.

Our Message

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