The feasibility and efficacy of exercise as an adjunctive treatment for reducing craving levels among inpatients with Alcohol Use Disorders

Open-ended study investigating the feasibility and efficacy of exercise as an adjunctive treatment to reduce craving levels in patients with alcohol use disorders.
Background: Alcohol use disorders affect nearly twenty per cent of Australians, and nearly four percent of Australians are classified as alcohol dependent. Alcohol dependency is associated with a range of comorbidities leading to premature mortality. Individuals living with an alcohol use disorder suffer from poorer physical health, increasing the risk of developing cardiometabolic disease and other chronic diseases. The use of structured physical activity may assist individuals affected by substance use disorders. Although limited, previous research has demonstrated that physical activity and structured exercise may decrease levels of substance use and increase duration of abstinence. There is a lack of research investigating of the effect of exercise on alcohol urges among inpatient populations. This study aimed to assess the feasibility and efficacy of an exercise intervention to reduce alcohol craving levels among inpatients with a diagnosis of alcohol dependency.
Methods: A prospective 14-day intervention study was conducted among 40 (65% males) participants with a DSM-5 diagnosis of alcohol dependency. Participants were inpatients receiving usual care treatment at St John of God Hospital Richmond, Sydney aged 18 – 65 years and medically cleared to participate in an exercise program. Outcomes were assessed at multiple time-points (baseline, pre-/post exercise sessions, and discharge) and included alcohol dependency, alcohol urge questionnaire, mood, physical activity and sleep behaviour. An individualised 6-session exercise program was delivered by an accredited exercise physiologist.
Results: There were statistically significant reductions in post exercise alcohol cravings (p < 0.001), in positive and negative affect post exercise following each exercise session (p < 0.01). Post exercise reductions for measures of depression were also found (all p < 0.001). A significant increase in positive affect post exercise was also demonstrated (p < 0.001). Significant improvements were observed in physical measures, including the submaximal aerobic capacity test, strength tests and self-reported physical activity (p < 0.001). Improved sleep quality was also statistically significantly (p < 0.001). There was a trend for improvements in cardiovascular endurance or strength to be correlated with the overall changes in alcohol urge or mood, whilst statistically significant correlation between improvement in strength and positive affect were observed. Conclusion: Data shows a significant immediate effect were observed for exercise when combined with usual care for reducing alcohol urge and improving state mood. Data also suggest that exercise may be a promising adjunctive treatment for inpatients with alcohol dependence. This studies greatest limitation is the inability to determine the independent effect of exercise as there was no control sample. Future studies should include larger patient cohorts and a longer duration of follow-up.