Exercise as a Treatment for Substance Use Disorders Protocol

Not Applicable

Completed

Interventions: Other: Health Education Intervention
Other: Vigorous Intensity High Dose Exercise

Brief Summary: The purpose of this study is to investigate if health interventions (intensive exercise or health education) can be used to help improve substance abuse treatment. The primary objective of this protocol is to compare percent days of abstinence between Vigorous Intensity High Dose exercise (VIHD) and Health Education Intervention (HEI) groups based on stimulant (i.e., cocaine, methamphetamine, amphetamine, or other stimulant, excluding caffeine and nicotine) use during a 12-week acute phase.

Detailed Description: This study is designed as a two-group, randomized controlled trial to test the effectiveness of the addition of exercise and health education to treatment as usual in improving drug treatment outcomes in 330 eligible and interested participants who provide informed consent at 8-10 sites across the nation. These participants will be randomized to one of two treatment arms: (1) Vigorous Intensity High Dose Exercise Augmentation (VIHD): Usual Care Augmented with Vigorous Intensity High Dose Exercise or (2) Health Education Intervention Augmentation (HEI): Usual Care Augmented with Health Education. This study will include individuals diagnosed with stimulant abuse or dependence (cocaine, methamphetamine, amphetamine or other stimulant, except caffeine or nicotine) who begin treatment while in a residential setting.

Recruitment & Eligibility

Inclusion Criteria

Male or female age 18-65.
Admitted to residential setting and receiving substance use treatment.
Ability to understand and willingness to provide written informed consent.
Agree to remain in facility for authorized treatment of about 21-30 days.
Willing to provide contact information.
Self-reported use of stimulant drug (cocaine, methamphetamine, amphetamine, or other stimulant, excluding caffeine and nicotine) within the 30 days prior to admission for treatment.
Meets DSM-IV criteria for substance abuse or dependence for stimulants (cocaine, methamphetamine, amphetamine, or other stimulant, excluding caffeine and nicotine) within the last 12 months.
Medical clearance with protocol-defined stress testing (in accordance with American College of Sports Medicine (ACSM) guidelines) from protocol approved medical personnel. Details of guidelines and related testing protocol are provided in the study Manual of Procedures.
Body mass index (BMI)≤40 kg/m2 or BMI 40 >kg/m2 and cleared by medical personnel to exercise.
Able to comprehend and communicate in English.

Exclusion Criteria

Evidence of general medical condition or other abnormality that contraindicates use of exercise, based on the Medical Screening Visit.
Current opiate dependence.
Currently considered a high suicide risk and/or high risk for being unable to complete the study due to the need for psychiatric hospitalization, suicide attempts or suicidality, significant self-mutilation, or other self-injurious or destructive behavior based on the judgment of the site PI, medical personnel, or designee.
Pregnancy.
Significant physical activity, defined as aerobic exercise more than 3 times per week for 20 minutes or more, completed consistently for the three months prior to study enrollment.
Current psychotic disorder. Other comorbid psychiatric diagnosis that, in the investigator's judgment, will pose a safety issue or make it difficult for the participant to understand or complete the intervention.
Concomitant treatments: beta blockers; methadone, buprenorphine, or any other opioid replacement therapies.

Arm && Interventions

Group	Intervention	Description
Health Education Intervention	Health Education Intervention	Health Education Intervention
Vigorous Intensity High Dose Exercise	Vigorous Intensity High Dose Exercise	Usual Care Augmented with Vigorous Intensity High Dose Exercise

Primary Outcome Measures

Name	Time	Method
Percent Days Abstinent	single value calculated based on TLFB data during days 22-84	Percent days of abstinence based on stimulant (i.e., cocaine, methamphetamine, amphetamine, or other stimulant, excluding caffeine and nicotine) use during the 12-week acute phase. Days of abstinence will be measured during days 22-84, since it is anticipated that most individuals will be in a highly structured environment during the first 21 days of the study, and therefore would have little opportunity to use substances (i.e., the groups are not likely to differ during this time period). Measured by the Timeline Follow Back (TLFB) and aided by urine drug screen collected three times/week.

Secondary Outcome Measures

Name	Time	Method
Time to Relapse (Defined as Second Positive Urine Test [for Stimulants] and Use of Drugs Established by TLFB)	12 weeks
Time to Dropout From Substance Abuse Treatment	12 weeks
Withdrawal Symptoms as Measured by the Stimulant Selective Severity Assessment (SSSA) and Craving as Measured by the Stimulant Craving Questionnaire-Brief (STCQ-Brief)	12 weeks
Drug Use and Related Outcomes During the Entire Course of the Study (i.e., Randomization to 9 Months)	9 months
Drug Use and Related Outcomes for All Substances (Categorized as Alcohol, Cannabinoids, Nicotine, Opioids, or Sedative/Hypnotic/Anxiolytics)	12 weeks
Examination of Additional Health Benefits (in Sleep, Cognitive Function, Mood, Quality of Life and Anhedonia, and Weight Gain)	9 months

Locations (9): Gateway Community Services
🇺🇸
Jacksonville, Florida, United States
Gibson Recovery Center, Inc.
🇺🇸
Cape Girardeau, Missouri, United States
St. Luke's-Roosevelt
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New York, New York, United States
Charleston VAMC
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Charleston, South Carolina, United States
Arapahoe House
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Denver, Colorado, United States
Penn Presbyterian
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Philadelphia, Pennsylvania, United States
Morris Village
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Columbia, South Carolina, United States
Nexus Recovery, Inc.
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Dallas, Texas, United States
Memorial Hermann
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Houston, Texas, United States