Chapter 5 - Exercise for Alcohol Use Disorders

Abstract

Alcohol use disorders (AUDs) are highly prevalent yet often go untreated. In 2014, the 12-month and lifetime prevalence of AUDs in the United States were 13.9% and 29.1%, respectively, making it comparable with other major health problems such as depression and diabetes. Current treatment options (counseling, medication, group support, and so on) are effective for some but not all patients, and relapse is common. Of importance, psychiatric and somatic comorbidity is highly prevalent in AUDs, highlighting the need for treatments that address problematic drinking and related health problems synergistically. Structured exercise (a subset of physical activity) is a safe and feasible treatment option that is likely to improve comorbid health problems and may reduce heavy drinking. Currently, studies show that regular exercise can reduce the heightened cardiometabolic risks associated with AUDs, lower depression, and improve physical fitness. However, additional trials are needed to strengthen the case for prescribing exercise to reduce alcohol consumption per se. Based on current evidence, we recommend that light to moderate exercise is initially prescribed for AUDs, and that patients should select their preferred type of physical training. Exercise should be performed at least three times per week with the additional aim of increasing total daily physical activity levels. Finally, we recommend that exercise prescriptions should be closely monitored to identify obstacles to participation and, where possible, regimes should be prescribed by qualified personnel with training in exercise prescription.