Exercise as a Sex-Specific Treatment for Substance Use Disorder

Curr Addict Rep. 2017 Dec;4(4):467-481. doi: 10.1007/s40429-017-0177-4. Epub 2017 Oct 23.

Abstract

Purpose of review: Exercise is a promising treatment for substance use disorder that may reduce withdrawal symptoms and prevent relapse. In this review, we discuss recent evidence from clinical and preclinical studies for its efficacy, from a behavioral to a molecular level, in order to understand the exercise conditions that lead to beneficial effects. We also highlight the few recent findings of sex-specific differences.

Recent findings: Clinical and preclinical findings show that exercise decreases withdrawal symptoms, including craving, in both males and females. Evidence from clinical studies support the efficacy of exercise to prevent relapse to smoking, although further research is needed to examine sex differences, establish long-term efficacy, and to determine if effects extend to other substance use disorders. Preclinical findings also support the potential utility of exercise to prevent relapse with evidence suggesting that its efficacy is enhanced in males, and mediated by blocking drug-induced adaptations that occur during early abstinence.

Summary: Sex differences and timing of exercise availability during abstinence should be considered in future studies examining exercise as an intervention for relapse. A better understanding of the neurobiological mechanisms underlying the efficacy of exercise to reduce withdrawal symptoms and prevent relapse is needed to guide its development as a sex-specific treatment.

Keywords: addiction; animal models; biological mechanisms; clinical; drug-craving; drug-seeking; exercise; gender differences; gonadal hormones; intervention; neurobiology; physical activity; preclinical; relapse; sex differences; sex-specific; substance use disorder; treatment.