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.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA027615-05
Application #
8516483
Study Section
Special Emphasis Panel (ZDA1-GXM-A (05))
Program Officer
Aklin, Will
Project Start
2009-09-30
Project End
2014-08-31
Budget Start
2013-09-01
Budget End
2014-08-31
Support Year
5
Fiscal Year
2013
Total Cost
$560,445
Indirect Cost
$170,642
Name
University of Connecticut
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
022254226
City
Farmington
State
CT
Country
United States
Zip Code
06030
Walter, Kimberly N; Petry, Nancy M (2016) Lifetime suicide attempt history, quality of life, and objective functioning among HIV/AIDS patients with alcohol and illicit substance use disorders. Int J STD AIDS 27:476-85
Rash, Carla J; Burki, Madison; Montezuma-Rusca, Jairo M et al. (2016) A retrospective and prospective analysis of trading sex for drugs or money in women substance abuse treatment patients. Drug Alcohol Depend 162:182-9
Petry, Nancy M; Alessi, Sheila M; Byrne, Shannon et al. (2015) Reinforcing adherence to antihypertensive medications. J Clin Hypertens (Greenwich) 17:33-8
Walter, Kimberly N; Petry, Nancy M (2015) Patients with diabetes respond well to contingency management treatment targeting alcohol and substance use. Psychol Health Med 20:916-26
Rash, Carla J; Petry, Nancy M (2015) Contingency management treatments are equally efficacious for both sexes in intensive outpatient settings. Exp Clin Psychopharmacol 23:369-76
Meredith, Steven E; Alessi, Sheila M; Petry, Nancy M (2015) Smartphone applications to reduce alcohol consumption and help patients with alcohol use disorder: a state-of-the-art review. Adv Health Care Technol 1:47-54
Burch, Ashley E; Rash, Carla J; Petry, Nancy M (2015) Sex effects in cocaine-using methadone patients randomized to contingency management interventions. Exp Clin Psychopharmacol 23:284-90
Burch, Ashley E; Morasco, Benjamin J; Petry, Nancy M (2015) Patients Undergoing Substance Abuse Treatment and Receiving Financial Assistance for a Physical Disability Respond Well to Contingency Management Treatment. J Subst Abuse Treat 58:67-71
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
Blanco, Carlos; Hanania, Joan; Petry, Nancy M et al. (2015) Towards a comprehensive developmental model of pathological gambling. Addiction 110:1340-51

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