Journal
JOURNAL OF CLINICAL PSYCHIATRY
Volume 78, Issue 8, Pages 1075-1082Publisher
PHYSICIANS POSTGRADUATE PRESS
DOI: 10.4088/JCP.15m10591
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Funding
- National Institute on Drug Abuse of the National Institutes of Health [U10 DA020024, UG1DA020024, U10 DA013727, U10 DA013035, U10 DA013720, U10 DA013732, HHSN271200900034C]
- NIDA [K24 DA022412]
- NIMH [K01 MH097847]
- NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES [KL2TR000461] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF MENTAL HEALTH [K01MH097847] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE ON DRUG ABUSE [UG1DA013720, U10DA013732, UG1DA020024, K24DA022412, U10DA020024, U10DA013720, U10DA013727, U10DA013035, UG1DA013727] Funding Source: NIH RePORTER
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Objective: To evaluate exercise as a treatment for stimulant use disorders. Methods: The STimulant Reduction Intervention using Dosed Exercise (STRIDE) study was a randomized clinical trial conducted in 9 residential addiction treatment programs across the United States from July 2010 to February 2013. Of 497 adults referred to the study, 302 met all eligibility criteria, including DSM-IV criteria for stimulant abuse and/or dependence, and were randomized to either a dosed exercise intervention (Exercise) or a health education intervention (Health Education) control, both augmenting treatment as usual and conducted thrice weekly for 12 weeks. The primary outcome of percent stimulant abstinent days during study weeks 4 to 12 was estimated using a novel algorithm adjustment incorporating self-reported Timeline Followback (TLFB) stimulant use and urine drug screen (UDS) data. Results: Mean percent of abstinent days based on TLFB was 90.8% (SD = 16.4%) for Exercise and 91.6% (SD = 14.7%) for Health Education participants. Percent of abstinent days using the eliminate contradiction (ELCON) algorithm was 75.6% (SD = 27.4%) for Exercise and 77.3% (SD = 25.1%) for Health Education. The primary intent-to-treat analysis, using a mixed model controlling for site and the ELCON algorithm, produced no treatment effect (P = .60). In post hoc analyses controlling for treatment adherence and baseline stimulant use, Exercise participants had a 4.8% higher abstinence rate (78.7%) compared to Health Education participants (73.9%) (P = .03, number needed to treat = 7.2). Conclusions: The primary analysis indicated no significant difference between exercise and health education. Adjustment for intervention adherence showed modestly but significantly higher percent of abstinent days in the exercise group, suggesting that exercise may improve outcomes for stimulant users who have better adherence to an exercise dose. (C) Copyright 2017 Physicians Postgraduate Press, Inc.
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