Exploring exercise in recovery from substance use disorder: A qualitative study


Background: Many individuals in Canada struggle with substance use disorder (SUD) and over a quarter of these individuals are struggling with additional mental health disorders (i.e., polysubstance use disorder, or psychiatric comorbidity). There is a need for non-invasive, inexpensive and scalable interventions to assist in recovery. A possible adjunct intervention that warrants exploration is exercise. However, little is known about the acceptability of exercise in residential SUD treatment facilities. Methods: Semi-structured interviews were conducted with in-patients (n=15). The interviews were based on the Theoretical Domains Framework and included questions regarding physical activity knowledge, exercise preferences, and barriers/facilitators to exercise participation. A thematic analysis was conducted. Results: Four main themes were identified. First, there was a lack of knowledge regarding the recommended amounts of physical activity. Further, the participants lacked confidence in doing more difficult modalities of exercise (e.g., proper weight lifting form). Second, many environmental resources (e.g., cost, equipment and full schedule) were considered barriers to exercise participation both inside and outside the treatment facility. Third, technology (e.g., activity trackers/mobile phone applications) and social accountability were considered key to continued exercise participation. Finally, emotional and mood regulation seems to play an essential role as a facilitator for exercise (e.g., craving reduction, the alleviation of depression, the release of uncomfortable feelings). However, feeling anxious before exercise and self-conscious during exercise emerged as prominent barriers. Implications: The results from this work may inform future interventions in residential treatment facilities for SUD.