Craving among individuals with stimulant use disorder in residential social model-based treatment - Can exercise help?

BACKGROUND: In a randomized controlled 8-week trial, we examined the efficacy of aerobic and resistance exercise in reducing craving for methamphetamine (MA) among individuals with MA-use disorder during residential treatment. METHODS: Individuals with MA use disorder (138) who were newly enrolled in residential treatment volunteered for random assignment to either an 8-week exercise intervention (EX) or health education control (HE), with both conditions meeting 3 times weekly; 3 dropped out of the trial, bringing the analysis sample to 135. The majority of participants were male (80%), and 48% were Latino/Hispanic. The mean age of the sample was 31.7 (SD = 6.9) years. Using multivariate mixed models, differences between conditions were examined in: (1) craving for MA, measured by self-reported ratings on a Visual Analog Scale over the 8-week trial and, (2) MA use, measured by self-report and urine drug screens at baseline and 30 and 60 days after discharge from the 8-week study. RESULTS: Results revealed significantly lower craving scores among the participants in the EX group than those in the HE group over the 8-week trial (median daily craving score for EX = 13.5, for HE = 21.8; p = .009). In addition, participants with less craving during treatment had significantly lower rates of MA use after discharge than participants with high craving measured at 30-days (p = .004) and 60-days post-discharge (p < .001). CONCLUSIONS: Results support the utility of incorporating a structured exercise program for individuals with MA-use disorder to reduce craving and improve MA-use outcomes.

Impact of an exercise intervention on methamphetamine use outcomes post-residential treatment care.

BACKGROUND: We examined the efficacy of an 8-week exercise intervention on posttreatment methamphetamine (MA) use among MA-dependent individuals following residential treatment. METHODS: 135 individuals newly enrolled in treatment were randomly assigned to a structured 8-week exercise intervention or health education control group. Approximately 1 week after completion of the intervention, participants were discharged to the community. Interview data and urine samples were collected at 1-, 3-, and 6-months post-residential care. Of the sample, 54.8% were classified as higher severity users (using MA more than 18 days in the month before admission) and 45.2% as lower severity users (using MA for up to 18 days in the month before admission). Group differences in MA use outcomes were examined over the 3 timepoints using mixed-multivariate modeling. RESULTS: While fewer exercise participants returned to MA use compared to education participants at 1-, 3- and 6-months post-discharge, differences were not statistically significant. A significant interaction for self-reported MA use and MA urine drug test results by condition and MA severity was found: lower severity users in the exercise group reported using MA significantly fewer days at the three post-discharge timepoints than lower severity users in the education group. Lower severity users in the exercise group also had a lower percentage of positive urine results at the three timepoints than lower severity users in the education group. These relationships were not present in the comparison of the higher severity conditions. CONCLUSION: Results support the value of exercise as a treatment component for individuals using MA 18 or fewer days/month.

Exercise for methamphetamine dependence: rationale, design, and methodology.

BACKGROUND: Effective pharmacotherapies to treat methamphetamine (MA) dependence have not been identified, and behavioral therapies are marginally effective. Based on behavioral studies demonstrating the potential efficacy of aerobic exercise for improving depressive symptoms, anxiety, cognitive deficits, and substance use outcomes, the study described here is examining exercise as a potential treatment for MA-dependent individuals. METHODS: This study is randomizing 150 participants with MA dependence at a residential treatment facility for addictive disorders to receive either a thrice-weekly structured aerobic and resistance exercise intervention or a health education condition. Recruitment commenced in March, 2010. Enrollment and follow-up phases are ongoing, and recruitment is exceeding targeted enrollment rates. CONCLUSIONS: Seeking evidence for a possibly effective adjunct to traditional behavioral approaches for treatment of MA dependence, this study is assessing the ability of an 8-week aerobic and resistance exercise protocol to reduce relapse to MA use during a 12-week follow-up period after discharge from residential-based treatment. The study also is evaluating improvements in health and functional outcomes during and after the protocol. This paper describes the design and methods of the study.

Eight weeks of exercise training improves fitness measures in methamphetamine-dependent individuals in residential treatment.

OBJECTIVES: Physical exercise has been shown to benefit diverse medical and behavioral conditions. This study assesses the feasibility and efficacy of an 8-week endurance and resistance training program on fitness measures in individuals undergoing residential treatment for methamphetamine (MA) dependence. METHODS: A total of 39 MA-dependent individuals were randomized to 3 days/week of exercise training (ET, n = 15) or health education without training (equal attention [EA], n = 14) over 8 weeks. Aerobic performance ((Equation is included in full-text article.)VO2max) was measured by indirect calorimetry, body composition by skinfolds, muscle strength by 1-repetition maximum (1-RM), and endurance at 85% of 1-RM for both leg press (LP) and chest press (CP). RESULTS: A total of 29 individuals completed the study for a 74% adherence rate. Baseline characteristics (mean ± SD) were balanced between groups: age 31 ± 7 years; height = 1.74 ± 0.07 m; weight 82.0 ± 15.0 kg. The ET group significantly improved (Equation is included in full-text article.)O2max by 0.63 ± 0.22 L/min (+21%), LP strength by 24.4 ± 5.6 kg (+40%), and CP strength by 20.6 ± 5.7 kg (+49%). The ET group increased LP and CP endurance by 120% and 96%, respectively and showed significant reductions in body weight of 1.7 ± 2.4 kg (-2%), % body fat of 2.8 ± 1.3% (-15%), and fat weight 2.8 ± 1.8 kg (-18%). All changes were significant (P < 0.001) for ET, and no changes were seen for the EA group. CONCLUSIONS: Individuals recovering from MA dependence showed substantial improvements in aerobic exercise performance, muscle strength and endurance, and body composition with ET. These findings demonstrate the feasibility of an ET intervention in these participants and also show excellent responsiveness to the exercise stimulus resulting in physiological changes that might enhance recovery from drug dependency.

Estudio citológico e histométrico de la mucosa bronquial en bronquíticos / Citological and histometrical study of the bronchial mucosa in bronchitic patients

Para realizar nuestro estudio, se tuvieron en cuenta una serie de irritantes capaces de lesionar la mucosa bronquial, asi como de provocar en la misma alteraciones morfológicas. Se establecieron proporciones volumétricas que caracterizan a las estructuras mas afectadas en los bronquíticos y sitio de localización donde estos prevalecen, además de conocer la población celular y sus modificaciones en este tipo de lesión inflamatoria. Se tomaron dos grupos: controles y bronquiticos, obteniendo cortes de ambos bronquios. Se procesaron, estudiaron con planimetría directa y un método de cuantificación celular. Se encontró que fueron en el bronquio derecho y las glándulas del área y estructura respectivamente, las más susceptibles de modificarse en bronquiticos. El conteo de células demostró un aumento de la población celular en esta entidad, y aun cuando la proporción de mastocitos es baja con respecto a la celularidad total, se ve incrementada estadísticamente en los bronquíticos

Estudio citológico e histométrico de la mucosa bronquial en bronquíticos / Citological and histometrical study of the bronchial mucosa in bronchitic patients

Para realizar nuestro estudio, se tuvieron en cuenta una serie de irritantes capaces de lesionar la mucosa bronquial, asi como de provocar en la misma alteraciones morfológicas. Se establecieron proporciones volumétricas que caracterizan a las estructuras mas afectadas en los bronquíticos y sitio de localización donde estos prevalecen, además de conocer la población celular y sus modificaciones en este tipo de lesión inflamatoria. Se tomaron dos grupos: controles y bronquiticos, obteniendo cortes de ambos bronquios. Se procesaron, estudiaron con planimetría directa y un método de cuantificación celular. Se encontró que fueron en el bronquio derecho y las glándulas del área y estructura respectivamente, las más susceptibles de modificarse en bronquiticos. El conteo de células demostró un aumento de la población celular en esta entidad, y aun cuando la proporción de mastocitos es baja con respecto a la celularidad total, se ve incrementada estadísticamente en los bronquíticos(AU)