Efficacy and Clinical Application of Physical Activity in Substance Use Disorder Rehabilitation: A Review on Mechanism and Benefits

Background: Substance Use Disorders (SUDs) are chronic conditions characterized by high relapse rates and significant psychological, physical, and social complications. Despite the availability of traditional pharmacological and psychotherapeutic interventions, many individuals struggle to maintain abstinence. Recently, physical activity (PA) has emerged as a promising complementary intervention. This review aims to examine the existing evidence on the effects of PA in individuals with SUDs, with a particular focus on neurobiological mechanisms. Methods: A narrative review was conducted on 30 September 2024, searching relevant keywords on PubMed, Web of Science, Google Scholar, and Scopus. Randomized clinical trials, cohort studies, reviews, and meta-analyses published between 1988 and 2024 were considered. Results: Fifty studies were included. Key themes included the role of PA in inducing neuroadaptation in individuals with SUDs, which is crucial for relapse prevention and impulse control, and the effects of PA depending on the type of PA and the specific SUD. Neurobiological modifications related to PA are of particular interest in the search for potential biomarkers. Additionally, studies explored the effects of PA on cravings, mental health, and quality of life. The review overall discusses the psychological changes induced by PA during SUD rehabilitation, identifies barriers to participation in PA programs, and suggests clinical and organizational strategies to enhance adherence. Conclusions: Physical activity is a promising adjunctive therapy for the management of Substance Use Disorders. Long-time longitudinal studies and meta-analyses are needed to sustain scientific evidence of efficacy. The success of PA programs moreover depends on overcoming barriers to adherence, including physical, psychological, and logistical challenges.