Aerobic exercise training reduces cannabis craving and use in non-treatment seeking cannabis-dependent adults

Maciej S Buchowski, Natalie N Meade, Evonne Charboneau, Sohee Park, Mary S Dietrich, Ronald L Cowan, Peter R Martin, Maciej S Buchowski, Natalie N Meade, Evonne Charboneau, Sohee Park, Mary S Dietrich, Ronald L Cowan, Peter R Martin

Abstract

Background: Cannabis dependence is a significant public health problem. Because there are no approved medications for this condition, treatment must rely on behavioral approaches empirically complemented by such lifestyle change as exercise.

Aims: To examine the effects of moderate aerobic exercise on cannabis craving and use in cannabis dependent adults under normal living conditions.

Design: Participants attended 10 supervised 30-min treadmill exercise sessions standardized using heart rate (HR) monitoring (60-70% HR reserve) over 2 weeks. Exercise sessions were conducted by exercise physiologists under medical oversight.

Participants: Sedentary or minimally active non-treatment seeking cannabis-dependent adults (n = 12, age 25±3 years, 8 females) met criteria for primary cannabis dependence using the Substance Abuse module of the Structured Clinical Interview for DSM-IV (SCID).

Measurements: Self-reported drug use was assessed for 1-week before, during, and 2-weeks after the study. Participants viewed visual cannabis cues before and after exercise in conjunction with assessment of subjective cannabis craving using the Marijuana Craving Questionnaire (MCQ-SF).

Findings: Daily cannabis use within the run-in period was 5.9 joints per day (SD = 3.1, range 1.8-10.9). Average cannabis use levels within the exercise (2.8 joints, SD = 1.6, range 0.9-5.4) and follow-up (4.1 joints, SD = 2.5, range 1.1-9.5) periods were lower than during the run-in period (both P<.005). Average MCQ factor scores for the pre- and post-exercise craving assessments were reduced for compulsivity (P = .006), emotionality (P = .002), expectancy (P = .002), and purposefulness (P = .002).

Conclusions: The findings of this pilot study warrant larger, adequately powered controlled trials to test the efficacy of prescribed moderate aerobic exercise as a component of cannabis dependence treatment. The neurobiological mechanisms that account for these beneficial effects on cannabis use may lead to understanding of the physical and emotional underpinnings of cannabis dependence and recovery from this disorder.

Trial registration: ClinicalTrials.gov NCT00838448].

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. Experimental design.
Figure 1. Experimental design.
The study included Run-In (1 week), Exercise intervention (10 daily 30-minute treadmill sessions in ∼2 weeks), and Follow-Up (2 weeks) periods. Cannabis, other drug, caffeine and tobacco use were assessed from self-reports during all study periods. Cannabis craving was assessed pre- and-post each exercise session after viewing cannabis-related visual cues.
Figure 2. Cannabis use during the study.
Figure 2. Cannabis use during the study.
Mean (± 2 SEM) daily cannabis use (standard joints) during Run-In (1 week), Exercise Intervention (10 daily 30-minute treadmill sessions in ∼2 weeks), and Follow-Up (2 weeks). Cannabis use was calculated as “standard joints” where 1 joint equals 0.5 g of dry cannabis, 5 hits (deep inhalations) from a joint or a bowl, or 0.5 bowl. * - Decrease from Run-In period (P = 0.002). ** - Decrease in daily use from period onset (P = 0.006). *** - Increase in daily use from period onset (P = 0.003).
Figure 3. Cannabis craving during the exercise…
Figure 3. Cannabis craving during the exercise sessions.
Box plots represent aggregated cannabis craving factor scores elicited by cannabis cues viewed before and after the standardized exercise sessions during Exercise Intervention (10 daily 30-minute treadmill sessions in ∼2 weeks). The cannabis craving factor scores were obtained from the cannabis-craving questionnaire (MCQ-SF) . Changes in the cannabis craving factor scores from pre-to-post exercise were assessed using Wilcoxon Signed Ranks Tests. Each box represents middle 50% of results and horizontal line inside each box represents median for the score. *- Significant decrease from pre-exercise sessions (P

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