Research Progress on the Intervention Effects and Mechanisms of Various Exercise Modalities in Patients with Drug Addiction

Zhuolin  Wu; Yanmei  Chen

doi:10.54691/e73m0p16

Authors

Zhuolin Wu
Yanmei Chen

DOI:

https://doi.org/10.54691/e73m0p16

Keywords:

Drug addiction; Exercise intervention; Intervention effect; Mechanism.

Abstract

Drug addiction seriously endangers human physical and mental health. Recent studies have shown that exercise therapy, as a non-pharmaceutical intervention, has a significant effect on patients addicted to drugs. This article systematically analyzes the intervention effects of different types of exercise (aerobic exercise, resistance training, and combined exercise). The results show that exercise can effectively suppress drug craving, improve emotional state, enhance physical fitness, and alleviate withdrawal symptoms and the risk of relapse. However, the intervention effects vary with different exercise intensities. At present, the research on the mechanism of exercise intervention is still in the development stage. This article focuses on exploring the regulatory effects of exercise on neurotransmitters (dopamine, glutamic acid, endogenous opioid peptides), brain-derived neurotrophic factor (BDNF), and the immune system, revealing that it improves addiction symptoms through pathways such as dopaminergic reward pathway remodeling, BDNF-mediated neural plasticity repair, and inflammation inhibition. Future research should focus on the design of personalized exercise programs, deepen the empirical study of the dose-effect of exercise intensity, and deeply explore the interaction mechanisms of multiple systems to optimize the application of exercise therapy in the treatment of drug addiction.

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References

[1] Yang Liu, Zhu Wenjing, Luo Xue, et al. Research Progress on Biological Mechanisms Related to Drug addiction [J]. Chinese Journal of Drug Dependence, 2024, 33(1): 7-11.

[2] UNODC World Drug Report 2025: Global instability compounding social, economic and security costs of the world drug problem[EB/OL]. [2025-06-27]. //www.unodc.org/ unodc/en/ press/ releases/2025/June/unodc-world-drug-report-2025_-global-instability-compounding-social--e conomic-and-security-costs-of-the-world-drug-problem.html.

[3] Full Text of the "2023 China Drug Situation Report" - China Anti-Drug Network [EB/OL]. [2025-06-27]. http://www.nncc626.com/20240619/d1a1ffb1f3fb4c93bb05f6e73fb50414/c.html.

[4] Lu Zehui, Tao Weiji, Xiao Jiaojiao, et al. Dose-effect of resistance exercise of different intensities on improving craving and executive function in heroin addicts [J]. China Sports Science and Technology, 2021, 57(6): 23-30.

[5] Peng Bo, Chen Jiachen, Su Rui, et al. The influence of resistance exercise on the psychological craving and inducing factors of methamphetamine drug addicts and its dose effect [J]. Chinese Journal of Sports Medicine, 2021, 40(1): 46-54.

[6] Wang Dongshi, Zhu Ting The Effect of aerobic Exercise on physical Fitness, craving and emotional State of methamphetamine-dependent Individuals [J]. Sports Science, 2017, 37(7): 50-59.

[7] Rawson R A, Chudzynski J, Gonzales R, et al. The Impact of Exercise On Depression and Anxiety Symptoms Among Abstinent Methamphetamine-Dependent Individuals in A Residential Treatment Setting[J]. Journal of Substance Abuse Treatment, 2015, 57: 36-40.

[8] Wang D, Zhou C, Chang Y K. Acute exercise ameliorates craving and inhibitory deficits in methamphetamine: An ERP study[J]. Physiology & Behavior, 2015, 147: 38-46.

[9] Ellingsen M M, Johannesen S L, Martinsen E W, et al. Effects of Acute Exercise on Drug Craving, Self-Esteem, Mood, and Affect in Adults with Polysubstance Use Disorder: Protocol for a Multicenter Randomized Controlled Trial[J]. JMIR research protocols, 2020, 9(10): e18553.

[10] Zhao Qi, Liu Jianing, Lu Yingzhi, et al. Long-term aerobic exercise improves methamphetamine addicts' craving for drugs - Evidence from alpha Waves [J]. Chinese Journal of Sports Medicine, 2020, 39(10): 804-809.

[11] Zhao Q, Wang X, Lu Y, et al. Effects of chronic exercise on temporal discounting among persons with methamphetamine use disorder[J]. Mental Health and Physical Activity, 2020, 19: 100350.

[12] Rong Hao, Liu Jianing, Liu Xudong, et al. Research on the Brain Mechanism of Aerobic Exercise Improving Executive Control Ability in Methamphetamine Addicts [J] Journal of Physical Education, 2019, 26(3): 138-144.

[13] Chen Yifan, Zhou Yu, Wang Jiakuan, et al. The cognitive regulatory effect of acute aerobic exercise intensity on drug craving in methamphetamine withdrawal patients [J]. Chinese Journal of Drug Dependence, 2019, 28(5): 371-378.

[14] Li X, Zhou Y, Zhang G, et al. Behavioral and Brain Reactivity Associated With Drug-Related and Non-Drug-Related Emotional Stimuli in Methamphetamine Addicts[J]. Frontiers in Human Neuroscience, 2022, 16: 894911.

[15] Damghani F, Bigdeli I, Miladi-Gorji H, et al. Swimming exercise attenuates psychological dependence and voluntary methamphetamine consumption in methamphetamine withdrawn rats[J]. Iranian Journal of Basic Medical Sciences, 2016, 19(6): 594-600.

[16] Boecker H, Henriksen G, Sprenger T, et al. Positron emission tomography ligand activation studies in the sports sciences: measuring neurochemistry in vivo[J]. Methods (San Diego, Calif.), 2008, 45(4): 307-318.

[17] Meeusen R. Exercise and the brain: insight in new therapeutic modalities[J]. Annals of Transplantation, 2005, 10(4): 49-51.

[18] The Influence of Aerobic Exercise on the Rehabilitation Effect of Drug Rehabilitation Personnel - Zhao Zhenhu [Z]

[19] Geng Jingjing, Zhu Dong, Xu Ding. The rehabilitation effect of Tai Chi rehabilitation exercises on female drug addicts under compulsory isolation [J]. Chinese Journal of Sports Medicine, 2016, 35(11): 1048-1051.

[20] Yuan Rongqin, Huang Huafeng, Liu Dade, et al. Research on the Physical Rehabilitation Effect of Progressive Exercise Training on Drug Addicts [J]. Chinese Journal of Drug Abuse Prevention and Control, 2018, 24(4): 200-204, 235.

[21] Brown R A, Abrantes A M, Read J P, et al. A Pilot Study of Aerobic Exercise as an Adjunctive Treatment for Drug Dependence[J]. Mental Health and Physical Activity, 2010, 3(1): 27-34.

[22] Liu Xudong, Zhou Chenglin, Lu Yingzhi. Brain activity characteristics of the impact of neuromuscular Training on the emotional state of methamphetamine addicts [J] China Sports Science and Technology, 2021, 57(6): 8-15.

[23] Li Kefeng, Yan Qian, Ding Lijie, et al. The effect of moderate-intensity resistance training on brain functional connectivity in methamphetamine addicts [J]. Sports Science, 2021, 41(3): 25-33.

[24] Nutt D, King L A, Saulsbury W, et al. Development of a rational scale to assess the harm of drugs of potential misuse[J]. Lancet (London, England), 2007, 369(9566): 1047-1053.

[25] Dolezal B A, Chudzynski J, Storer T W, et al. Eight weeks of exercise training improves fitness measures in methamphetamine-dependent individuals in residential treatment[J]. Journal of Addiction Medicine, 2013, 7(2): 122-128.

[26] Li H, Wang C, Huang X, et al. Chan-Chuang and resistance exercise for drug rehabilitation: a randomized controlled trial among Chinese male methamphetamine users[J]. Frontiers in Public Health, 2023, 11.

[27] He Q, Wu J, Wang X, et al. Exercise intervention can reduce the degree of drug dependence of patients with amphetamines/addiction by improving dopamine level and immunity and reducing negative emotions[J]. American Journal of Translational Research, 2021, 13(3): 1779-1788.

[28] Lu Chunxia, Mi Hao, He Jian, et al. The influence of moderate-intensity exercise on Negative emotions and monoamine neurotransmitters in methamphetamine addicts with Anxiety symptoms [J]. Chinese Journal of Rehabilitation Medicine, 2023, 38(11): 1550-1557.

[29] Li Songyang Research on the Impact of Aerobic Exercise Combined with Resistance Training on the Physical and Mental Rehabilitation of Methamphetamine Addicts [J] Chinese Journal of Drug Dependence, 2022, 31(3): 188-193.

[30] Wang J, Lu C, Zheng L, et al. Peripheral Inflammatory Biomarkers of Methamphetamine Withdrawal Patients Based on the Neuro-Inflammation Hypothesis: The Possible Improvement Effect of Exercise[J]. Frontiers in Psychiatry, 2021, 12: 795073.

[31] Gong Dan, Qin Liping, Zhu Ting, et al. The effects of short-term aerobic Exercise on craving, Emotional State and Neurotransmitters in methamphetamine-dependent individuals [J]. China Sports Science and Technology, 2019, 55(5): 56-64.

[32] Goekint M, Bos I, Heyman E, et al. Acute running stimulates hippocampal dopaminergic neurotransmission in rats, but has no influence on brain-derived neurotrophic factor[J]. Journal of Applied Physiology (Bethesda, Md.: 1985), 2012, 112(4): 535-541.

[33] Greenwood B N, Foley T E, Le T V, 等. Long-term voluntary wheel running is rewarding and produces plasticity in the mesolimbic reward pathway[J]. Behavioural Brain Research, 2011, 217(2): 354-362.

[34] Robison L S, Swenson S, Hamilton J, et al. Exercise Reduces Dopamine D1R and Increases D2R in Rats: Implications for Addiction[J]. Medicine and Science in Sports and Exercise, 2018, 50(8): 1596-1602.

[35] Robertson C L, Ishibashi K, Chudzynski J, et al. Effect of Exercise Training on Striatal Dopamine D2/D3 Receptors in Methamphetamine Users during Behavioral Treatment[J]. Neuropsy chopharmacology: Official Publication of the American College of Neuropsy chopharm acology, 2016, 41(6): 1629-1636.

[36] Mongi-Bragato B, Avalos M P, Guzman A S et al. Endogenous enkephalin is necessary for cocaine-induced alteration in glutamate transmission within the nucleus accumbens[J]. The European Journal of Neuroscience, 2021, 53(5): 1441-1449.

[37] Ke Yuting, Zhou Wenhua. Research progress on the neurobiological mechanism of drug dependence in exercise intervention [J]. Chinese Journal of Pharmacology and Toxicology, 2015, 29(4): 599-606.

[38] Shi Kaixuan, Liu Xiaoli, Qiao Decai. Exercise improves the behavior of PD model rats by regulating the plasticity of functional connectivity in the cord-striatum pathway [J]. Sports Science, 2020, 40(6): 49-58.

[39] Han Yumei, Zhang Ziwei, Liang Jiarun, et al. 4-week high-intensity interval training regulates lactate-mediated synaptic plasticity to improve depressive-like behaviors in CUMS rats [J]. Advances in Biochemistry and Biophysics, 2025.

[40] Real C C, Ferreira A F B, Hernandes S, et al. Exercise-induced plasticity of AMPA-type glutamate receptor subunits in the rat brain[J]. Brain Research, 2010, 1363: 63-71.

[41] He Y, Madeo G, Liang Y, et al. A red nucleus-VTA glutamate pathway underlies exercise reward and the therapeutic effect of exercise on cocaine use[J]. Science Advances, 2022, 8(35): eabo1440.

[42] Ahmadi S, Radahmadi M, Alaei H, et al. Effect of Aerobic Exercise on Morphine Self-administration and Pain Modulation in Rats[J]. Advanced Biomedical Research, 2018, 7:70.

[43] Sun Luyue, Zhou Yuehui. Exercise intervention Drug Addiction Circuit: Research Progress on the Regulatory Role of Endorphins [J]. Chinese Journal of Sports Medicine, 2021, 40(4): 298-305.

[44] Zhao Feiyi, Zhou Chenglin, Liu Tianze. The neurobiological mechanism by which exercise inhibits Psychological Craving and relapse behavior in drug addicts: Based on the Regulatory Effects of Exercise on Neurotransmitters, Hormones and Peptide Substances [J]. Sports Science, 2018, 38(7): 33-41.

[45] Shi J, Li S xia, Zhang X li, et al. Time-dependent neuroendocrine alterations and drug craving during the first month of abstinence in heroin addicts[J]. The American Journal of Drug and Alcohol Abuse, 2009, 35(5): 267-272.

[46] Malinowski K, Shock E J, Rochelle P, et al. Plasma beta-endorphin, cortisol and immune responses to acute exercise are altered by age and exercise training in horses[J]. Equine Veterinary Journal. Supplement, 2006(36): 267-273.

[47] Yu Dongzhen, Chen Peijie. The effects of aerobic swimming training on conditioned positional preference and endopeptide levels in the hippocampus of rats [J]. Chinese Journal of Pharmacology, 2010, 26(7): 978-979.

[48] Zhang Dingfang, Wang Liangchun, Wang Bubiao. Study on the Changes of Plasma β -Endorphin and Blood Lactate during Constant Load Exercise of Different Intensities [J] Sports Science, 1996, 16(1): 62-67.

[49] Hughes L, Patterson S D. The effect of blood flow restriction exercise on exercise-induced hypoalgesia and endogenous opioid and endocannabinoid mechanisms of pain modulation[J]. Journal of Applied Physiology (Bethesda, Md.: 1985), 2020, 128(4): 914-924.

[50] Heyman E, Gamelin F X, Goekint M, et al. Intense exercise increases circulating endocannabinoid and BDNF levels in humans--possible implications for reward and depression[J]. Psychoneuroen docrinology, 2012, 37(6): 844-851.

[51] Wang Xiaoge, Bao Jinyu, Yang Shuai, et al. Treadmill exercise upregulates the BDNF/TrkB-CREB pathway and improves anxiety-like behavior in rat models of neuropathic pain [J]. Chinese Journal of Laboratory Animal Science, 2024, 32(9): 1149-1159.

[52] Xiong J Y, Li S C, Sun Y X, et al. Long-term treadmill exercise improves spatial memory of male APPswe/PS1dE9 mice by regulation of BDNF expression and microglia activation[J]. Biology of Sport, 2015, 32(4): 295-300.

[53] Morais A P D, Pita I R, Fontes‐Ribeiro C A, et al. The neurobiological mechanisms of physical exercise in methamphetamine addiction[J]. CNS Neuroscience & Therapeutics, 2018, 24(2): 85-97.

[54] Guo Yi, Zhang Liancheng, Tao Yingying, et al. Is BDNF the biological mechanism by which exercise promotes cognition? Evidence, Challenges and Prospects [J]. Advances in Psychological Science, 2025, 33(3): 465-476.

[55] Plein L M, Rittner H L. Opioids and the immune system - friend or foe[J]. British Journal of Pharmacology, 2018, 175(14): 2717-2725.

[56] Mohamed H M, Mahmoud A M. Chronic exposure to the opioid tramadol induces oxidative damage, inflammation and apoptosis, and alters cerebral monoamine neurotransmitters in rats[J]. Biomedicine & Pharmacotherapy = Biomedecine & Pharmacotherapie, 2019, 110: 239-247.

[57] Shi Haiwang, Li Jie, Wu Chongyun, et al. Research Progress on Exercise Improving Immune Dysfunction in Drug-Dependent Individuals [J]. Chinese Journal of Sports Science and Technology, 2021, 57(6): 38-45.

[58] Lu Chunxia, Dong Weixin, Zheng LAN, et al. The influence of exercise intervention activating immune stress and dopamine levels on the mental health of amphetamine-addicted individuals under compulsory isolation for detoxification [J]. Chinese Journal of Sports Medicine, 2019, 38(9): 762-770.

[59] Scheffer D da L, Latini A. Exercise-induced immune system response: Anti-inflammatory status on peripheral and central organs[J]. Biochimica Et Biophysica Acta. Molecular Basis of Disease, 2020, 1866(10): 165823.

[60] Wan Wenjun, Hao Xuanming The influence of exercise training on immune function and the effect of immune regulation [J]. Journal of Physical Education, 2012, 19(4): 140-144.