Abstract
AimsExercise is increasingly being studied as treatment for alcohol use disorder (AUD). We examined the effects of an acute bout of exercise on alcohol craving, heterogeneity of response, and factors associated with reductions in craving. MethodsWithin the context of a randomized controlled trial, we conducted an exploratory, single-arm study. In total, 117 adults with AUD (52.7 years; SD = 12.3; 68.4% female) and indications of alcohol craving (Desire for Alcohol Questionnaire, DAQ-short version total score >8) were included. The intervention was a 12-min sub-maximal fitness test performed on a cycle ergometer. We examined changes in participant's self-rated desire for alcohol immediately before and after exercise. Personal, clinical, and exercise-related factors associated with reductions (≥0.5 SD) in craving were identified using hierarchical logistic regression. ResultsIn the total sample craving reduced from pre-to post-exercise (p < 0.001, g = 0.60 [0.40–0.79]). Three groups were observed: those whose craving decreased (70.1%; p < 0.001, g = 1.12 [0.85–1.40]), increased (16.2%; p < 0.001, g = 1.08 [0.51–1.64]), or did not change (13.7%). Forty percent experienced clinically meaningful reductions in craving (≥0.5 SD). In fully adjusted models, two factors were associated with these reductions: higher pre-exercise cravings (OR = 1.15 [1.07–1.23], p < 0.001) and lower cardiorespiratory fitness (OR = 0.88 [0.79–1.00], p = 0.043). ConclusionsIn most adults with AUD, short bouts of moderately intense aerobic exercise helps reduce cravings for alcohol. Those with higher cravings and lower cardiorespiratory fitness are most likely to benefit.
Highlights
The estimated 12-month prevalence of alcohol use disorder (AUD) in Sweden is 11% (Lundin et al, 2015) and 12.7% in the United States (Grant et al, 2015)
Comparable magnitude as sociations were found for each of these subscales with the DSM5 total score. This is the first study to demonstrate that an acute bout of aerobic exercise has differential effects on craving in those with alcohol use disorder (AUD)
Consistent with previous investigations (Brown et al, 2016; Ussher et al, 2004) we found that a short bout of moderately intense exercise elicited moderate reductions in craving among most participants, with 40% of participants experiencing a clinically mean ingful reduction
Summary
The estimated 12-month prevalence of alcohol use disorder (AUD) in Sweden is 11% (Lundin et al, 2015) and 12.7% in the United States (Grant et al, 2015). Treatments for AUD include supportive counselling, psy chosocial and behavioural therapy, and pharmacotherapy (Andreasson et al, 2013b); where the latter is often prescribed to help reduce cravings. Studies demonstrate that these interventions are effective, yet relapse is common, ranging between 30 and 80% one year following treatment (Sliedrecht et al, 2019). Given the relationship between alcohol craving and relapse (Stohs et al, 2019), this information could help explain previous, equivocal findings on the effect of exercise on alcohol outcomes and, in turn, identify those most likely to respond to exercise-based treatments for AUD
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