Exercise has numerous, well-documented health benefits — and may also play a role in preventing and reducing substance misuse and abuse in adolescents.
Investigators from Case Western Reserve University School of Medicine and Cleveland Clinic found support for exercise, particularly assisted exercise, in the prevention and adjunctive treatment of substance-use disorders, including alcohol, marijuana, cocaine, opioids, and heroin.
Investigators explained that adjunctive treatments aid or supplement the primary treatment when tackling a disease. Examples of assisted exercise include the pedaling of a fellow cyclist on a tandem bicycle and a specially designed indoor cycle which provides mechanical assistance to pedal faster.
“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 lead author Nora L. Nock, Ph.D., 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.
The teenage years are often a time when underdeveloped connections, or an “imbalance,” between cognitive and emotional decision-making mechanisms in the brain occur. This natural process of compromised ‘synching’ between the brain regions leads to 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.”
While encouraging exercise in all teens, Nock and co-authors propose assisted exercise as a potentially superior solution for preventing or helping end substance misuse.
They have previously shown that mechanical assistance in pedaling for patients with Parkinson’s disease leads to cycling rates as much as 35 percent faster than unaided cycling, leading to increased activity in select cortical and sub-cortical regions of the brain.
“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 article, 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.”
Investigators acknowledge, however, that 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.”
The review article was recently published in Birth Defects Research.
Source: Case Western Reserve University