Effects of acute exercise on drug craving in adults with poly-substance use disorder. A randomized controlled trial

Objectives: To examine the short-term effects of exercise on drug craving in poly-drug-dependent inpatients, duration of effects, differences between exercise types, explore the relationship between craving and mood, and possible moderators. Design: Multicenter randomized control trial (RCT) with a crossover design. Methods: 38 (25 completed) inpatients (37.3 +/- 6.4 years; 84 % male) from three treatment centers participated in soccer, circuit training and control condition in random order for 45-min. Craving was assessed with a self-rated visual analog scale (VAS), mood with Feeling scale (FS), immediately before and after each condition and 1, 2, and 4 h post interventions. Ratings of perceived exertion (RPE) and heart rate were assessed. Intervention effects were assessed using linear mixed effects model, including moderator analyses. Results: Exercise sessions were perceived as "somewhat hard" to "hard". Compared to control, there was an immediate reduction in craving after soccer and circuit training (beta =-1.35, 95 %CI: 1.96,-0.75, p = 0.000; beta =-1.44, 95 %CI: 2.06,-0.83, p = 0.000) that persisted for 4 h (beta =-1.11, 95 %CI: 1.72,-0.49, p = 0.000; beta =-0.85, 95 %CI: 1.49,-0.22, p = 0.008). Elevations in mood after soccer (beta = 1.08, 95 %CI: 0.41, 1.76, p = 0.002) and circuit training (beta = 0.99, 95 %CI: 0.32, 1.67, p = 0.004) were significantly larger than control. Depressive disorder and primary drug of use might moderate the effect. Conclusion: Reduced drug cravings and elevated mood following soccer and circuit training were observed in people with poly-SUDs. Single exercise sessions can be an effective strategy to alleviate craving and potentially prevent relapse and treatment drop-out.