Drug addicts are regulars in emergency rooms and clinics. Despite this, there is hardly any research on the physical health of drug users, says Grete Flemmen. She has mapped the general health of drug addicts starting treatment and the effects of exercise on this particular group of patients. She drew the following conclusions:
The general health of a substance-dependent person is, on average, the same as that of a drug-free person who is 20 to 25 years older.
An 8-week course of structured, effective exercise can get drug users into almost the same shape as an average member of the population.
As a result of Flemmen’s research, high-intensity training is now part of the treatment plan offered by the Clinic for Drug and Addiction Medicine at St. Olav’s Hospital in Trondheim, Norway.
Drug users are keen to be involved
For those patients who agreed to have the state of their physical health assessed, it was important for them to know that they had the opportunity to support groundbreaking research. “They were happy to be involved in improving future drug treatment,” Flemmen says.
As part of her study, she examined the patients’ cardiac capacity as well as their muscle strength. “Muscle strength and stamina actually tell you more about how long you will live than other factors, such as high blood pressure, smoking or obesity,” she explains.
The statistics show that the life expectancy of drug addicts is 20 to 25 years less than that of the rest of the population. Most users do not die of drug use itself but as a result of cardiovascular diseases, infections and diabetes. “We see that, by the same token, the addicts’ poor physical health is due to inactivity rather than to the substance, as such,” Flemmen states.
The statistics show that the life expectancy of drug addicts is 20 to 25 years less than that of the rest of the population.
There is no pill for improving staying power and physical strength, however. The only way to get into better physical shape is through exercise. High-intensity training has been proven to be most effective. For those in Flemmen’s study, this took the form of endurance training with high heart rates, combined with heavyweight training for strength.
Enthusiasm is required
Today, the Clinic for Drug and Addiction Medicine at St. Olav’s Hospital offers exercise as part of its treatment plans for both inpatients and outpatients. Inpatients take part in three workout sessions per week: these are mandatory and are a part of the treatment plan that is just as important as sessions with psychologists and therapists. The exercise component was introduced on New Year’s Day. Patients who are not admitted are offered exercise as a non-mandatory part of their treatment and active users are not offered exercise.
Many patients at St.Olav’s drug clinic are ashamed of their body and their physical condition. Most of them are men who have never exercised. Many also think that they have completely destroyed their bodies by using drugs.
“Our investigations show that they actually respond really well to exercise,” says Flemmen. “And you don’t have to keep interval-exercising three times a week for the rest of your life, either. After the 8-week program, it is really about maintaining a level of fitness. However, some of our patients are getting really keen about exercising,” she smiles.
Those who have reservations about the program are advised by Flemmen to give themselves two weeks to try it out. “During this time, they will realize that exercise really works,” she says, “and then they will be motivated to continue.”
The path to better health
It has not been easy to get the new treatment method put into practice.
“Structuring the exercise sessions as part of the existing framework was met with some resistance within the organization. Physical activity is often associated with things that are satisfying, fun and social,” Flemmen explains. “Many feared that these aspects would be lost if the training sessions were so structured. But the exercise program had to be effective in order to make any difference. And the feedback from our patients has been positive.”
Flemmen emphasises the social impact of physical exercise: “If individuals achieve a reasonable level of physical fitness, the threshold to participate in other activities on offer also becomes much lower. It’s not great to cycle in the countryside with your friends if you have the cardiac capacity of a 70-year-old,” she says.
Flemmen plans to further investigate the potential positive effects of physical activity on drug treatment itself. “We’d like to look into whether exercise can help our patients get back into work, and if it can affect their need for medication and the like.”
How the study was conducted
This is how the study on the effects of exercise on drug addicts was carried out:
One group received high-intensity interval training sessions three times a week over the course of 8 weeks. A second group received the same number of sessions but did strength training. A control group participated in the regular activities offered by the clinic.
Both study groups responded well to the training sessions. Over the course of the 8 weeks, they almost reached the fitness level of the healthy population; that is to say, that they became the equivalent of 20 to 25 years younger through exercise.
Seventy-five percent of the participants completed the 8-week program. That is the same level of completion as in any healthy group of people undertaking an exercise program.
Exercise chases away fear
Raymond Midtsand was in a lousy physical state after years of drug use. But now he is finally able give his kids piggyback rides.
“I had never exercised before. Now I do it almost every day,” Midtsand says. He has just finished exercising on a treadmill, where he has been sweating it out with three other addiction patients for half an hour. He towels off and takes a note of his daily times.
Midtsand says that he has used drugs all his life. He arrived at Lade Treatment Centre in mid-April, where it took him a month to get clean. He accepted the offer of a place in the exercise program at the Clinic for Drug and Addiction Medicine at St. Olav’s Hospital as part of his treatment and has not regretted his decision.
“It’s really great! Both my physical and my mental strength have improved a lot. Initially, I had planned to take Sobril in addition to Suboxon after the detox,” he says. “But I’ve completely rejected that. The exercise program helps so well with my anxiety problems that I no longer need this type of medication.
“I’ve noticed a big difference in what I’m able to do on the treadmill. When I first started, it was set to a 5 percent [uphill] incline, and I increased that over time. Now I can do 15 percent. My legs are also much stronger. Staff here have worked out that the strength of my legs has increased by 120 percent.”
Midtsand has had a lot of trouble with his back because of his lifestyle, he admits. “Life as a drug addict involved a lot of lying down. Now that I’ve built up the muscles in my back, I can carry my kids on piggyback. That means a lot to me,” says the father of four with a smile.
Courtesy INSP / Sorgenfri (Norway)
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