Physical activity has known positive effects with respect to improving health and reducing depression. While exercise also has some putative benefits for decreasing smoking, its effects on illicit drug use are relatively untested. Exercise may serve as a healthy substitute behavior for drug use. However, the majority of substance abusers are sedentary, and few individuals successfully initiate or maintain exercise regimens. Contingency management (CM) interventions are highly efficacious in reducing drug use, and growing evidence suggests these treatments can be adapted to alter a number of behaviors, including physical activity or exercise. We have pilot data suggesting that substance abusing patients who engage in exercise to earn reinforcement have improved drug abuse treatment outcomes compared to those who do not engage in exercise during CM treatments. Further, we have developed a CM-based exercise intervention, and our pilot data suggest that patients respond favorably to this intervention and begin exercising regularly. In this study, we plan to evaluate the efficacy of this exercise-based CM intervention. A total of 120 cocaine abusing patients in intensive outpatient treatment will be randomly assigned to one of two conditions: (a) standard care plus CM for completing goal-related activities not related to exercising (e.g., improving work, family, or transportation issues), or (b) standard care plus CM for completing exercise- related activities. Each intervention will consist of one weekly individual therapy session for 16 weeks, and patients in both conditions will earn the chance to win prizes for completing activities. All participants will provide urine and breath specimens 1-2 times weekly that will be tested for stimulants, opioids, marijuana and alcohol. Physical activity levels, drug use, psychological symptoms, and subjective and objective indicators of health (body mass index, waist circumference, blood pressure) will be measured pre-treatment and at months 2 and 4 (post-treatment), as well as at 6-,9- and 12-month follow-up evaluations. Compared to those receiving goal-related CM activity contracting, we expect that those in the exercise CM condition will participate in more physical activities and develop greater strength and flexibility, decrease drug use to a greater extent, reduce depressive symptoms, and improve health indices.

Public Health Relevance

Few substance abusers engage in regular physical activity, and exercise is closely linked with physical fitness and emotional well being. By utilizing contingency management procedures to increase adherence to exercise regimes, we expect that cocaine abusers will begin exercising regularly. Exercising should improve physical fitness, reduce drug use, decrease psychological symptoms, and improve indices of health in cocaine abusing patients.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Research Project (R01)
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Special Emphasis Panel (ZDA1-GXM-A (05))
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Aklin, Will
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University of Connecticut
Internal Medicine/Medicine
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United States
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Petry, Nancy M; Alessi, Sheila M; Byrne, Shannon et al. (2015) Reinforcing adherence to antihypertensive medications. J Clin Hypertens (Greenwich) 17:33-8
Petry, Nancy M; Alessi, Sheila M; Barry, Danielle et al. (2015) Standard magnitude prize reinforcers can be as efficacious as larger magnitude reinforcers in cocaine-dependent methadone patients. J Consult Clin Psychol 83:464-72
Andrade, Leonardo F; Petry, Nancy M (2014) White problem gamblers discount delayed rewards less steeply than their African American and Hispanic counterparts. Psychol Addict Behav 28:599-606
Andrade, Leonardo F; Barry, Danielle; Litt, Mark D et al. (2014) Maintaining high activity levels in sedentary adults with a reinforcement-thinning schedule. J Appl Behav Anal 47:523-36
Alessi, Sheila M; Petry, Nancy M (2014) Smoking reductions and increased self-efficacy in a randomized controlled trial of smoking abstinence-contingent incentives in residential substance abuse treatment patients. Nicotine Tob Res 16:1436-45
Weiss, Lindsay M; Petry, Nancy M (2014) Substance abuse treatment patients with early onset cocaine use respond as well to contingency management interventions as those with later onset cocaine use. J Subst Abuse Treat 47:146-50
Andrade, Leonardo F; Riven, Levi; Petry, Nancy M (2014) Associations between Antisocial Personality Disorder and Sex on Discounting Rates. Psychol Rec 64:639-644
Petry, Nancy M; Andrade, Leonardo F; Rash, Carla J et al. (2014) Engaging in job-related activities is associated with reductions in employment problems and improvements in quality of life in substance abusing patients. Psychol Addict Behav 28:268-75
Andrade, Leonardo F; Carroll, Kathleen M; Petry, Nancy M (2013) Marijuana use is associated with risky sexual behaviors in treatment-seeking polysubstance abusers. Am J Drug Alcohol Abuse 39:266-71
Petry, Nancy M; Alessi, Sheila M; Rash, Carla J (2013) Contingency management treatments decrease psychiatric symptoms. J Consult Clin Psychol 81:926-31

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