Madde Bağımlılığı Tedavisinde Egzersiz

Year 2021, Volume: 2 Issue: 2, 51 - 62, 24.06.2021

Ertuğrul Demirdel , Beyza Gül Aşkın , Buse Çıtlak , Fatıma Zehra Zorlu

Abstract

Bağımlılık, genel tabirle bir şeyi arzulama durumudur. Alınan zevk verici maddeye karşı oluşan bağlanmaya da “Madde Bağımlılığı” denir. Dünya Sağlık Örgütü’nün verilerine göre hem bağımlılık yapan madde çeşitlerinin hem de madde bağımlıları sayısının artmasıyla birlikte mortalite ve morbidite oranları yükselmiş, bu durum uluslararası bir problem haline gelmiştir.
Morbidite oranlarının artmasıyla, madde bağımlısı kişilerde bozukluk, özür ve engellilik meydana gelmektedir. Bunlar; duyu-algı bozuklukları, kas-iskelet sistemi problemleri, denge ve fonksiyonel güçlükler ve günlük yaşamlarında karşılaştıkları problemlerdir. Bu durum yaşam kalitesi, iş gücü ve sosyal rollerdeki aktifliğin azalması ile kanıtlanmıştır. Bağımlılıkla mücadelede birçok tedavi yöntemi geliştirilmekte ve uygulanmaktadır. Madde bağımlılığının fizyolojisi göz önüne alındığında egzersiz yaklaşımları her evrede bireylerin bozukluk, özür ve engellilik durumlarında iyileşme sağladığı için uygulanabilir ve sürdürülebilir bir tedavi yöntemidir. Literatürde aerobik-anaerobik egzersizler, dirençli egzersizler, denge egzersizleri, grup egzersizleri, Yoga ve Tai-Chi gibi birçok egzersiz çeşidi önerilmektedir. Bunlardan üzerine en çok çalışma yapılmış olanları aerobik egzersizlerdir. Fakat ülkemizde, egzersiz yaklaşımlarının Madde Bağımlılığı üzerine etkisini inceleyen çalışmalar yetersizdir. Bu çalışmanın amacı, uluslararası literatürü inceleyerek bağımlılıkla mücadele kapsamında uygulanan egzersizleri derlemek, bu konuda ülkemizde yapılacak çalışmalara rehberlik etmektir.

Keywords

Denge, Egzersiz, Madde Bağımlılığı

Exercise in Substance Abuse Treatment

Abstract

In general, addiction is defined as a strong craving for something. "Substance Addiction" refers to the connection that develops against the pleasurable substance consumed. According to World Health Organization data, the rates of mortality and morbidity have increased as the variety of addictive substances and the number of substance abusers has increased, and this has become an international problem. Disorder, impairment, and disability emerge among substance users as morbidity rates rise. Sensory-perception disorders, musculoskeletal system problems, balance, and functional difficulties, and barriers they face in their daily lives are among the issues they face. Reduced activity in quality of life, workforce and social roles are signs of this. In the fight against addiction, many treatment options are being developed and used. Given the physiology of substance abuse, exercise programs are a realistic and long-term therapy option since they improve persons' disorders, impairment, and disability at all stages. Many forms of exercises are advised in the literature, including aerobic-anaerobic exercises, resistance exercises, balance exercises, group activities, Yoga, and Tai-Chi. Aerobic exercises are the most researched. However, there isn't enough research in our country looking at the impact of exercise on substance abuse. This research intends to analyze the literature and gather the exercises used in the fight against addiction to influence future research in our country.

Keywords

Balance, Exercise, Substance Abuse

References

• Türkiye Uyuşturucu Raporu: Eğitimler ve Gelişmeler (2020), T.C. İçişleri Bakanlığı Emniyet Genel Müdürlüğü, Narkotik Suçlarla Mücadele Daire Başkanlığı http://www.narkotik.pol.tr/kurumlar/narkotik.pol.tr/TUB%C4%B0M/TU%CC%88RKI%CC%87YE-UYUS%CC%A7TURUCU-RAPORU_26-HAZI%CC%87RAN-FI%CC%87NAL-_1_.pdf (Erişim Tarihi 09.05.2021) .
• Avrupa Uyuşturucu Raporu: Temel Sorunlar (2020), Avrupa Uyuşturucu ve Uyuşturucu Bağımlılığını İzleme Merkezi (EMCDDA) https://www.emcdda.europa.eu/system/files/publications/13238/TD0420439TRN.pdf (Erişim Tarihi 09.05.2021).
• Laudet A.B. What does recovery mean to you? Lessons from the recovery experience for research and practice. J. Subst Abuse Treat. 2007;33:243–256.
• Örken, C.,& Tavşanlı, M. E. Madde bağımlılığının nörolojik etkileri. Okmeydanı Tıp Dergisi, 2014;30(2), 110-114.
• Valencia-Martín JL, Galán I, Rodríguez-Artalejo F. The association between alcohol consumption patterns and adherence to food consumption guidelines. Alcoholism: Clin Experim Res 2011;35:2075–2081.
• Harrop EN, Marlatt GA. The comorbidity of substance use disorders and eating disorders in women: prevalence, etiology, and treatment. Addict Behav 2010;35:392–398.
• Best D, Lehmann P, Gossop M, Harris J, Noble A, Strang J. Eating too little, smoking and drinking too much: wider lifestyle problems among methadone maintenance patients. Addict Res Theory 1998;6:489–498.
• Laudet A.B. What does recovery mean to you? Lessons from the recovery experience for research and practice. J. Subst Abuse Treat. 2007;33:243–256. doi: 10.1016/j.jsat.2007.04.014.
• Dilbaz, N. Madde bağımlılığında korunma ve tedavi ilkeleri. İrfan. Şencan (Ed.), Madde bağımlılığı tanı ve tedavi kılavuzu el kitabı 2011;47-49. Ankara: T.C Sağlık Bakanlığı Sağlık Hizmetleri Genel Müdürlüğü.
• Smith PJ, Blumenthal JA, Hoffman BM, Cooper H, Strauman TA, Welsh-Bohmer K, Browndyke JN, Sherwood A. Aerobic exercise and neurocognitive performance: a meta-analytic review of randomized controlled trials. Psychosom Med. 2010;72:239–252.
• Ströhle A, Höfler M, Pfister H, Müller AG, Hoyer J, et al. Physical activity and prevalence and incidence of mental disorders in adolescents and young adults. Psychological medicine 2007;37: 1657–1666.
• Korhonen T, Kujala UM, Rose RJ, Kaprio J Physical activity in adolescence as a predictor of alcohol and illicit drug use in early adulthood: a longitudinal population-based twin study. Twin Research and Human Genetics 2009;12: 261–268.
• Cabrera, I. Role of exercise in managing substance use disorders. Prescriber, 2020;31(5), 15-19.
• Weinstock J., Barry D., Petry N.M. Exercise-related activities are associated with positive outcome in contingency management treatment for substance use disorders. Addict Behav. 2008;33:1072–1075.
• Agarwal R.P., Kumar A., Lewis J.E. A pilot feasibility and acceptability study of yoga/meditation on the quality of life and markers of stress in persons living with HIV who also use crack cocaine. J. Altern. Complement Med. 2015;21:152–158.
• Rawson R.A., Chudzynski J., Gonzales R., Mooney L., Dickerson D., Ang A., Dolezal B., Cooper C.B. The impact of exercise on depression and anxiety symptoms among abstinent methamphetamine-dependent individuals in a residential treatment setting. J. Subst. Abuse Treat. 2015;57:36–40. doi: 10.1016/j.jsat.2015.04.007.
• Flemmen G., Unhjem R., Wang E. High-intensity interval training in patients with substance use disorder. Biomed. Res. Int. 2014;1:1–8.
• Morris L., Stander J., Ebrahim W., Eksteen S., Meaden O.A., Ras A., Wessels A. Effect of exercise versus cognitive behavioural therapy or no intervention on anxiety, depression, fitness and quality of life in adults with previous methamphetamine dependency: A systematic review. Addict. Sci. Clin. Pract. 2018;13:1–12.
• Buchowski M.S., Meade N.N., Charboneau E., Park S., Dietrich M.S., Cowan R.L., Martin P.R. Aerobic exercise training reduces cannabis craving and use in non-treatment seeking cannabis-dependent adults. PLoS ONE. 2011;6:e17465.
• Boecker H, Sprenger T, Spilker ME, Henriksen G, Koppenhoefer M, Wagner KJ, Valet M, et al. The runner’s high: opioidergic mechanisms in the human brain. Cerebral Cortex 2008;18:2523–2531.
• Greenwood BN, Fleshner M. Exercise, stress resistance, and central serotonergic systems. Exercise Sport Sci Rev 2011;39:140–149.
• Lynch WJ, et al. Exercise as a novel treatment for drug addiction: a neurobiological and stage‐dependent hypothesis. Neurosci Biobehav Rev 2013;37(8):1622–44.
• Smith MA, Pitts EG. Access to a running wheel inhibits the acquisition of cocaine self‐administration. Pharmacol Biochem Behav 2011;100(2):237–43.
• Cabrera, I. Role of exercise in managing substance use disorders. Prescriber, 2020;31(5), 15-19.
• Greenwood BN, et al. Long‐term voluntary wheel running is rewarding and produces plasticity in the mesolimbic reward pathway. Behav Brain Res 2011;217(2):354–62.
• Schmidt HD, Pierce RC. Cocaine‐induced neuroadaptations in glutamate transmission: potential therapeutic targets for craving and addiction. Ann New York Acad Sci 2010;1187:35.
• Schmidt HD, et al. Epigenetics and psychostimulant addiction. Cold Spring Harb Perspect Med 2013;3(3):a012047.
• Linke, S. E.,& Ussher, M. (2015). Exercise-based treatments for substance use disorders: evidence, theory, and practicality. The American journal of drug and alcohol abuse, 41(1), 7-15.
• Giménez-Meseguer, J., Tortosa-Martínez, J., & Cortell-Tormo, J. M. (2020). The benefits of physical exercise on mental disorders and quality of life in substance use disorders patients. Systematic review and meta-analysis. International Journal of Environmental Research and Public Health, 17(10), 3680.
• Linke, S. E.,& Ussher, M. Exercise-based treatments for substance use disorders: evidence, theory, and practicality. The American journal of drug and alcohol abuse, 2015;41(1).
• Wang, D., Wang, Y., Wang, Y., Li, R., & Zhou, C. Impact of physical exercise on substance use disorders: a meta-analysis. PloS one, 2014;9(10), e110728. doi:10.1371/ journal.pone.0110728.
• Huang, He, et al. "Influence of aerobic training on recovery of herion sddicts." Chinese Journal of Physical Therapy 23 (2000): 267-270.
• Kirsten Kaya Roessler, Exercise treatment for drug abuse - A Danish pilot study, Volume: 38 issue: 6, page(s): 664-669, Article first published online: June 7, 2010; Issue published: August 1, 2010.
• Nioka S, Moser D, Lech G, Evengelisti M, Verde T, Chance B, et al., Muscle Deoxygenation in aerobic and anaerobic exercise. In Hudetz AG, Bruley DF, editors. Oxygen Transport to Tissue. Boston, MA: Springer (1998). p. 63–70. doi: 10.1007/978-1-4615-4863-8_8.
• Londeree BR. Effect of training on lactate/ventilatory thresholds: a meta-analysis. Med Sci Sports Exerc. (1997) 29:837–43. doi: 10.1097/00005768-199706000-00016.
• Martin L, Whyte GP. Comparison of critical swimming velocity and velocity at lactate threshold in elite triathletes. Int J Sports Med. (2000) 21:366–8. doi: 10.1055/s-2000-3786).
• Safinaz A. Yıldız , Aerobik ve Anaerobik Kapasitenin Anlamı Nedir?, İstanbul Üniversitesi İstanbul Tıp Fakültesi, Spor Hekimliği AD, İstanbul, 2012 Türkiye Solunum Araştırmaları Derneği (TÜSAD) Solunum 2012;14:1–8 (Ek / Supplement).
• Wang D, Zhou C, Zhao M, Wu X, Chang YK. Dose-response relationships between exercise intensity, cravings, and inhibitory control in methamphetamine dependence: an ERPs study. Drug Alcohol Depend. (2016) 161:331–9. doi: 10.1016/j.drugalcdep.2016.02.023.
• Gbiri C, Akınpetu A, Odole A, Effect of exercise on balance, gait-speed and quality of life of substance abuse patients, Journal of Clinical Medicine Research, 2011.
• Vingren J, Levitt D, Curtis J, Duplanty D,Adding resistance training to the Standard of care for inpatient substance abuse treatment in men with human immunodeficiency virus improves skeletal muscle health without altering concentrations,Journal of Strength and Conditioning Research, 32(1)/76–82,2017.
• Güçray S, Çolakkadıoğlu O, Çekici F, Grup Uygulamalarında aktiviteler/egzersizler; amaçları, çeşitleri ve uygulama örnekleri, Ç.Ü. Sosyal Bilimler Enstitüsü Dergisi, Cilt 18, Sayı 2, 2009, Sayfa 194-208.
• Muller A, Clausen T, Group exercise to improve quality of life among substance use disorders patients, Scandinavian Journal of Public Health, 2015; 43: 146–152.
• Wang D, Su R, Peng B,Zhu T, Tao W, Effects of a Group-Based Aerobic Exercise Program on the Cognitive Functions and Emotions of Substance Use Disorder Patients: a Randomized Controlled Trial, International Journal of Mental Health and Addiction, 2021.
• Zhu D, Jiang M, Xu D, Long-Term Effects of Mind-BodyExercises on the Physical Fitnessand Quality of Life of Individuals WithSubstance Use Disorder—ARandomized Trial, Frontiers in Psychiatry, 2020.
• Kuppili PP, Parmar A, Gupta A, Balhara YPS. Role of Yoga in Management of Substance-use Disorders: A Narrative Review. J Neurosci Rural Pract. 2018 Jan-Mar;9(1):117-122.
• Galantino ML, Turetzkin S, Lawlor S, Jones L, Brooks JC. Community-Based Yoga for Women Undergoing Substance Use Disorder Treatment: A Descriptive Study. Int J Yoga. 2021 Jan-Apr;14(1):50-59.
• Witkiewitz K, Bowen S. Depression, craving, and substance use following a randomized trial of mindfulness-based relapse prevention. J Consult Clin Psychol. 2010 Jun;78(3):362-374.
• Cutter CJ, Schottenfeld RS, Moore BA, Ball SA, Beitel M, Savant JD, Stults-Kolehmainen MA, Doucette C, Barry DT. A pilot trial of a videogame-based exercise program for methadone maintained patients. J Subst Abuse Treat. 2014 Oct;47(4):299-305.
• Mustafaoglu R, Demir R, Demirci AC, Yigit Z. Effects of core stabilization exercises on pulmonary function, respiratory muscle strength, and functional capacity in adolescents with substance use disorder: Randomized controlled trial. Pediatr Pulmonol. 2019 Jul;54(7):1002-1011.