The effects of exercise interventions on substance-use outcomes: A meta-analytic and systematic review.

A number of studies have been conducted to assess the efficacy of exercise-based interventions for substance-use disorders. Nicotine use has been overrepresented in prior meta-analytic and systematic reviews, potentially obscuring the effects of exercise on outcomes related to other drugs. The aim of this meta-analysis and systematic review was to offer an updated account of the impact of exercise on substance-use outcomes for drugs other than nicotine. Eligible studies included peer reviewed articles published before August 2023 describing randomized controlled trials or clinical trials involving adults in which exercise served as the primary treatment intervention and substance use and/or craving outcomes were assessed for drugs other than nicotine. In addition to omnibus effects, meta-regression models were conducted to assess study design (within vs. between), data collection (acute vs. long-term), and outcome measure (drug craving vs. drug use) as potential moderating variables. A total of 19 articles describing 17 unique studies were selected for analysis, including data from 1,363 individual participants. An omnibus robust variance estimation meta-analysis indicated a significant reduction in substance-use outcomes following exercise intervention. The moderator analysis additionally indicated a significant effect of design type such that between-subject designs displayed smaller magnitude reductions than within-subject designs. Other potential moderators were not significant. These findings indicate that a variety of exercise-based interventions produce moderate improvements in substance use and craving for people using nonmedical drugs and corroborate prior reports that exercise is effective as an adjunctive or standalone treatment for substance-use disorder. (PsycInfo Database Record (c) 2025 APA, all rights reserved).