Effect of exercise on cravings levels in individuals with drug dependency: A systematic review

Objective

This systematic review aims to assess the feasibility, acceptability, and efficacy of exercise-based interventions in reducing craving levels among individuals with drug dependency.

Methods

This study included randomized controlled trials that investigated the effects of exercise on craving levels in individuals with drug dependence. We searched for relevant literature in PubMed, Web of Science, EMbase, The Cochrane Library, CNKI, China Biomedicine, Wanfang, and VIP databases from their inception until July 2024. Two researchers independently reviewed the literature. The quality of the studies was assessed using the PEDro scale, and the GRADE profiler software was utilized to evaluate the strength of the evidence. A qualitative synthesis was performed to describe the findings.

Results

We included 26 studies involving a total of 1381 participants, with 787 in the experimental group and 594 in the control group. These studies were mainly conducted in China, the United States, and the United Kingdom, and were published mostly after 2018. The participants had typically been dependent on drugs for more than 5 years. The review found that exercise interventions were feasible and well-accepted, and effectively reduced drug cravings. Among the 26 studies, 22 showed positive outcomes in reducing cravings. The type of exercise appears to be a crucial factor. Aerobic exercises were more effective than resistance exercises. Out of 18 studies that included aerobic exercises, 17 reported significant reductions in cravings. In contrast, among the 4 studies that included resistance exercises, 3 did not find a significant impact on cravings.

Conclusion

Exercise is highly feasible and acceptable, significantly contributing to the reduction of drug cravings among individuals with drug dependency. The specific type of exercise appears to be a key determinant of the intervention's effectiveness. Aerobic exercises were more effective than resistance exercises. The evidence supporting these findings is of high quality, with an average score of 6.92 on the PEDro scale.

Others

The research was supported by the Shanghai Key Laboratory of Human Performance, with the project number 11DZ2261100. Registration details can be found on PROSPEO under the number CRD42024525700 at www.crd.york.ac.uk.