Effect Of Exercise Training On Alcohol And Substitute Use In Opioid-dependent Patients During Substitution Treatment

There has been a growing interest in the role of exercise as an adjunctive therapeutic intervention in treating opioid dependence using substitution. PURPOSE: This study aimed to evaluate the alcohol use in days and quantity per week and the substitute dosage on the last day of each week during a 2-month exercise training in opioid-addicted patients on a methadone and buprenorphine substitution program. METHODS: Ninety opioid users (41 females) in methadone and buprenorphine substitution treatment were randomly divided into four groups: a) buprenorphine experimental (BEX) (n = 26; age (yrs): 41.9 ± 6.1), b) buprenorphine control (BCON) (n = 25; age: 41.9 ± 5.6), c) methadone experimental (MEX) (n = 20; age: 46.7 ± 6.6) and d) methadone control (MCON) (n = 19; age: 46.1 ± 7.5) (mean ± SD). The experimental groups (BEX & MEX) followed an exercise program on a treadmill for 20 minutes at 70% HRmax, 3 days/week for 8 weeks. RESULTS: After exercise intervention, weekly alcohol consumption (days) decreased (p < 0.05) in both exercise groups and was lower in BEX (before: 2.62 ± 1.63 Vs. after: 1.42 ± 1.36) compared to MEX (before: 4.5 ± 1.67 after: 2.15 ± 1.6), while it was not different (p > 0.05) in the control groups compared to baseline levels, or between BCON (before: 2.80 ± 1.58 Vs. after: 2.64 ± 1.5) and MCON (before: 4.21 ± 1.44 Vs. after: 4.21 ± 1.58). Similarly, daily amount of alcohol intake (drinks) was reduced (p < 0.05) post-intervention in BEX (before: 2.88 ± 1.8 Vs. after: 1.58 ± 1.17) and MEX (before: 4.30 ± 1.66 Vs. after: 2.75 ± 1.45), whereas did not differ (p > 0.05) in BCON (before: 3.32 ± 1.31 Vs. after: 3.24 ± 1.16) and MCON (before: 4.89 ± 1.29 Vs after: 4.79 ± 1.23). During the last 2 weeks (7th and 8th) of intervention, the dosage of the substitute (mg) on the last day of the week in BCON (7th: 9.6 ± 1.41; 8th: 8.96 ± 1.31) was higher (p < 0.022) compared to BEX (7th: 8.31 ± 1.76; BEX 8th:7.92 ± 1.92), while in MEX and MCON no differences were found throughout the 8-weeks. CONCLUSION: The 2-month exercise program reduced the alcohol use in both methadone and buprenorphine substitution intervention groups compared to controls. The substitute dosage was reduced during the last 2 weeks only in the buprenorphine substitution exercise group. Our results suggest that exercise training may be an effective strategy for treating opioid addicted patients.