Craving among individuals with stimulant use disorder in residential social model-based treatment - Can exercise help?

BACKGROUND: In a randomized controlled 8-week trial, we examined the efficacy of aerobic and resistance exercise in reducing craving for methamphetamine (MA) among individuals with MA-use disorder during residential treatment. METHODS: Individuals with MA use disorder (138) who were newly enrolled in residential treatment volunteered for random assignment to either an 8-week exercise intervention (EX) or health education control (HE), with both conditions meeting 3 times weekly; 3 dropped out of the trial, bringing the analysis sample to 135. The majority of participants were male (80%), and 48% were Latino/Hispanic. The mean age of the sample was 31.7 (SD = 6.9) years. Using multivariate mixed models, differences between conditions were examined in: (1) craving for MA, measured by self-reported ratings on a Visual Analog Scale over the 8-week trial and, (2) MA use, measured by self-report and urine drug screens at baseline and 30 and 60 days after discharge from the 8-week study. RESULTS: Results revealed significantly lower craving scores among the participants in the EX group than those in the HE group over the 8-week trial (median daily craving score for EX = 13.5, for HE = 21.8; p = .009). In addition, participants with less craving during treatment had significantly lower rates of MA use after discharge than participants with high craving measured at 30-days (p = .004) and 60-days post-discharge (p < .001). CONCLUSIONS: Results support the utility of incorporating a structured exercise program for individuals with MA-use disorder to reduce craving and improve MA-use outcomes.

Testing mediational processes of substance use relapse among youth who participated in a mobile texting aftercare project.

BACKGROUND: The goal of this paper is to advance the understanding of mechanisms of action involved in behavioral-driven aftercare interventions for substance use disorders (SUDs) among youth populations. This paper reports data from a study that measured the impact of an aftercare intervention on primary substance use relapse among youth who completed treatment in Los Angeles County for SUDs. The aftercare intervention, Project ESQYIR-Educating and Supporting inQuisitive Youth In Recovery, utilized text messaging to monitor relapse and recovery processes, provide feedback, reminders, support, and education among youth from SUD specialty settings during the initial 3-month period following treatment completion.Method: Mediational modeling informed by Baron and Kenny was used to examine the extent to which select recovery processes including participation in extracurricular activities and self-help, were impacted by the texting intervention, and if such processes helped sustain recovery and prevent primary substance use relapse. The data come from a two-group randomized controlled pilot study testing the initial efficacy of a mobile health texting aftercare intervention among 80 youth (Mage= 20.7, SD = 3.5, range: 14-26 years) who volunteered to participate after completing SUD treatment between 2012 and 2013.Results: Among the two recovery processes examined in the mediational modeling, only involvement in extracurricular activities mediated the effects of the texting aftercare intervention on reductions in primary substance use relapse; not self-help participation.Conclusion: Findings from this pilot study offer greater understanding about potential recovery-related mechanisms of action of mobile aftercare interventions. Mobile texting was found to promote increased engagement in recovery-related behaviors such as participation in extracurricular activities, which mediated the effects of the mobile aftercare intervention on decreasing primary substance use relapse. Findings suggest mobile approaches may be effective for increasing adherence to a wide-array of recovery behavioral regiments among youth populations challenged by complex behavioral issues.