The Role of Exercise in Recovery

Promising research studying the impact of regular physical exercise on recovery strongly suggests it’s a beneficial, supplementary treatment alongside traditional drug replacement therapy. A sophisticated meta-analysis combining the results from 22 high-quality studies found that physical exercise significantly increased abstinence rates among a variety of substance abusers.

These encouraging clinical trials identify the underlying neurobiological mechanisms responsible for this positive effect. Moreover, researchers seek to identify which exercises better target different kinds of substance use. For example, they examine which types of exercise benefits people in recovery from nicotine addiction vs. which types benefit people in recovery from heroin addiction.

Physical Exercise Improves Abstinence Rates

In order to synthesize data from over 20 years and perform a legitimate meta-analysis, researchers selected studies wherein the physical exercises included met guidelines set by the American College of Sports Medicine. Among the factors they analyzed for common and consistent effects were:

  • Intensity of exercise
  • Type of exercise.

The findings reveal that low, moderate, and high-intensity physical exercise all positively impact abstinence rates. Researchers also found no significant differences in the types of exercise. In other words, a gentle yoga practice can be as beneficial to improving abstinence rates as training for a marathon.

Researchers were further able to break out three different classes of substance use disorders (SUDs):

  • Nicotine (tobacco) use disorder
  • Alcohol use disorder
  • Illicit drug use disorder (cocaine, marijuana, morphine, heroin, etc.)

While all classes of individuals with substance use disorders benefitted from physical exercise, researchers found a slightly more robust boost for recovery from illicit drugs. Researchers measured this positive effect across four factors relevant to recovery:

  • Abstinence rate
  • Withdrawal symptoms
  • Anxiety
  • Depression

Among these four factors, the increase of abstinence rate individuals with SUDs was considered the primary one. As such, physical exercise appears to support recovery for each class of SUDs studied. Researchers also found some interesting differences in the impact of physical exercise across the other three dimensions. Most notably, physical exercise improved symptoms of depression among individuals recovering from illicit drug use but not those recovering from nicotine and alcohol use.

Further Directions

While this meta-analysis confirms previous studies suggesting the positive benefits of exercise on recovery, the researchers point to two important questions that require future study.

First, more work needs to be done to better identify why physical exercise has a noticeably higher benefit on illicit drug use compared to nicotine and alcohol use. Part of that research will likely involve animal studies that identify the specific neurobiological pathways involved in alcohol addiction compared to nicotine or opioid addiction, for example.

Second, women prove to have a more difficult time recovering from SUDs compared to men. Biological differences between women and men suggest that gender-specific study of the effect of physical exercise on SUD recovery is warranted. Some of the same researchers undertaking this meta-analysis have published a review article – serving as important preliminary work – for identifying how these biological differences impact the effect of exercise on recovery. One goal of future research will be establishing criteria to determine not only which types of exercise best support specific types of SUD, but also which types of exercise best support women in recovery from SUDs.

The current research, however, strongly endorses incorporating all types of physical exercise into treatment plans.