by Helen Freeman
Sitting is the new smoking, they say, so much so that busy executives across the globe are taking breaks every few minutes to run up and down a flight of steps or complete a short in-office workout, all in the name of staving off obesity, heart disease and Type II diabetes. The benefits of physical activity extend beyond mere physical fitness and disease prevention, however, with research showing that sport can be an important component in any addiction recovery programme.
There are many ways that sport and physical activity in general can make the path towards recovery a little less taxing. For one, research has shown that exercise helps to lower levels of stress hormones such as cortisol and adrenalin. Addicts undergoing recovery are forced to face highly stressful situations and cravings, and anxiety can act as a trigger for relapse or heavier drug use. One important study, published in Frontiers in Psychiatry (Mark Smith et al, 2011) showed that exercise cuts drug use during the stages of initiation and maintenance. It basically stops drug use from escalating and lowers the likelihood of bingeing on drugs. The findings are vital, since a rapid transition from initial drug use to regular drug use, and bingeing on drugs, are linked to a higher rate of overdose deaths.
Researchers have noted that there are many psychological reasons why exercise can help combat addiction. For one, physical activity has powerful effects on our wellbeing and self-confidence. Secondly, it reduces the reinforcing power of drugs. Finally, since exercise promotes a more relaxed mental state, it reduces the risk for abuse and relapse.
Even extremely powerful addictions, such as an addiction to methamphetamines, can benefit from a good workout. In the case of methamphetamine addiction, there are no substitution medications in existence (Suboxone and methadone, so efficient at quelling opioid cravings, are unfortunately powerless against methamphetamine cravings). Thus far, ‘gold standard’ treatments for methamphetamine addiction include cognitive behavioral therapy (CBT) and contingency management. In CBT, recovering addicts are encouraged to understand the extent to which they way they think, feel, and behave, are interrelated. A therapist works alongside the patient to set up a strategy which involves changing their behaviour in one sphere of their lives, of instance, and observing the profound effect this change can have on the way they think and feel about an issue, situation or person. In contingency management, the key is to provide rewards for positive behaviour.
Despite the fact that these therapies are commonly used, both CBT and contingency management have a high dropout rate during the first month of treatment, and patients who have relied on these therapies have a high relapse rate, for two reasons: firstly, those who have been in an inpatient setting can find it very hard to resist triggers when they are released into the real world, where temptations abound. Secondly, those in recovery can have powerful memories of using drugs that can trigger a relapse.
Some of the most promising therapies for addiction include mindfulness meditation (its focus on remaining ‘in the here and now’, and on ‘riding out a craving’ instead of trying to push thoughts of drug taking out of one’s mind have proven successful in limited settings). Exercise, too, has proven to be effective in recent studies on methamphetamine addiction. Research has shown that exercise quells depression and anxiety. One study showed that meth users with ‘lower severity’ of use (i.e. those who used meth for 18 days or less) benefitted particularly well from exercise. One interesting study showed that meth users who exercised, had positive brain changes in brain imaging scans, while those who did not exercise suffered more detrimental brain changes.
Naturally, one of the biggest challenges for health professionals and therapists is to help those in recovery find the motivation to exercise. Often, these patients have not engaged in physical activity in a long time, and their fitness and motivation levels can be low. Therefore, patients should begin with a gentle type of exercise such as yoga, which can be adapted to all fitness levels and which has a strong mindfulness component. Yoga also focuses on breathing, which together with the performance of yoga poses, has been proven to lower stress levels and increase energy and motivation.