Exercise as a novel treatment for drug addiction: A neurobiological and stage-dependent hypothesis

Abstract

Physical activity, and specifically exercise, has been suggested as a potential treatment for drug addiction. In this review, we discuss clinical and preclinical evidence for the efficacy of exercise at different phases of the addiction process. Potential neurobiological mechanisms are also discussed focusing on interactions with dopaminergic and glutamatergic signaling and chromatin remodeling in the reward pathway. While exercise generally produces an efficacious response, certain exercise conditions may be either ineffective or lead to detrimental effects depending on the level/type/timing of exercise exposure, the stage of addiction, the drug involved, and the subject population. During drug use initiation and withdrawal, its efficacy may be related to its ability to facilitate dopaminergic transmission, and once addiction develops, its efficacy may be related to its ability to normalize glutamatergic and dopaminergic signaling and reverse drug-induced changes in chromatin via epigenetic interactions with BDNF in the reward pathway. We conclude with future directions, including the development of exercise-based interventions alone or as an adjunct to other strategies for treating drug addiction.

Effect of Exercise Training on Striatal Dopamine D2/D3 Receptors in Methamphetamine Users during Behavioral Treatment

“…Our findings contribute to a growing literature identifying the therapeutic benefits of exercise in health and disease (Hillman et al, 2008), and also in the treatment of substance abuse (Lynch et al, 2013). Exercise is gaining attention as a complement to traditional pharmacological and psychotherapeutic treatments.…”

“…The first relates to the relatively small size of the sample and the fact that findings may not generalize to all methamphetamine users or to those who are not exposed to exercise in a treatment setting. The size of this sample also limits the degree to which potential sex-dependent effects of exercise can be examined in this study (Lynch et al, 2013). Generalizability of the findings may be compromised by exclusion of individuals with Axis I disorders, other than methamphetamine dependence, because such psychiatric comorbidity is common among methamphetamine users.…”

“…Although it has been suggested that exercise can boost dopamine function during early abstinence from drug use (Lynch et al, 2013), the effects of chronic exercise on the dopamine system have not been studied in humans with addictions. In this study, therefore, PET was used with [ 18 F]fallypride as a radioligand for dopamine D2/D3 receptors (Mukherjee et al, 1999) to examine the effect of an 8-week exercise training program on striatal D2/D3 receptor BP ND in individuals undergoing behavioral treatment for methamphetamine addiction in a residential facility.…”

Addiction vs. Creative Activity

“…Since most healthy pleasures, including listening to music 1 as well other creative activities, including physical exercise are associated with dopamine release, 2,3 we have to ask why people need to partake in various substances or addictive behaviors?…”

“…There is evidence that physical and creative activity may reduce our likelihood of addiction. 2,3 What an amazing mechanism it is that colors our life experience. The nature of how we experience our lives depends on how we manage our reward system -or ultimately, how we let it direct us.…”