Assisted exercise can help to prevent and treat substance- use disorders such as alcohol, marijuana, cocaine, opioids, and heroin explores a research team from Case Western Reserve University School of Medicine and Cleveland Clinic. Assisted exercise includes the pedaling of a fellow cyclist on a tandem bicycle and a specially designed indoor cycle which provides mechanical assistance to pedal faster. The findings are published in the journal Birth Defects Research .
"Although use-rates for most substances have remained relatively stable, the frequency of marijuana use and the perception that regular marijuana use is not harmful has increased in adolescents," said the piece's lead author, Nora L. Nock, PhD, associate professor of population and quantitative health sciences at Case Western Reserve University's School of Medicine. "In addition, nonmedical use of opioids has increased in teens, particularly in the South, Midwest, and rural low-income communities."
A chief reason for teen substance use is that risk-taking behaviors accelerate during these years, with a goal and subsequent feeling of reward. Underdeveloped connections, or an "imbalance," between cognitive and emotional decision-making mechanisms in the brain are present in all adolescents as a natural process, resulting in impulsive or risky behaviors. "We think that substance use, which may cause adverse structural and functional brain changes, may exacerbate this imbalance, potentially leading to substance-use disorders as well as other behavioral problems," said Nock. "Exercise may help to reinforce these underdeveloped connections between reward and regulatory processes and offset reward-seeking from substance use in adolescents."
"Our team has shown that assisted exercise can improve central motor control processing and other functioning in Parkinson's disease patients," said Alberts. "This new work shows forced exercise also may also provide particular benefits to substance use disorder patients, especially those with dopamine deficits - which can result from drug use, poor nutrition, stress, and lack of sleep, and result in depression, fatigue, apathy, and mood swings."
Drawing on this and other research, the authors hypothesize that assisted exercise may provide particular benefits to substance-use disorder patients. "We believe," they write in the piece, that "exercise (and, potentially assisted exercise) should be included as an adjunctive component to existing substance use treatment programs and should be offered as a preventative measure to adolescents at high risk for substance abuse based on their family history, mental health, genetic and neurocognitive profiles and other risk factors."
Given the shortage of randomized trials in adolescents, additional studies are needed to determine which dose (frequency, intensity, duration, length), type (aerobic, resistance training) and format (assisted, standard) of exercise is most effective. More broadly, the authors write that "assisted exercise ... might be more beneficial than standard [exercise] for a variety of diseases and conditions, [such as] ... obesity and neurological diseases including Parkinson's."
Their next steps include formally testing, via a randomized trial, assisted cycling vs. standard cycling as an adjunctive treatment in substance-abuse disease.