Can Exercise Help with Opioid Dependence Recovery?

M.B. is a 39 y/o male who works in marketing, is married with two kids who has been in recovery from opioid addiction for the past 4 years.  When asked about his “secret to success” he explains.  “Four years ago, I hit rock bottom– I was feeling really depressed and ashamed of how my addiction to oxycodone had impacted my relationships with my family and friends.  But, then I enrolled in a Suboxone program and I started to hit the gym every day after work.”

He elaborates, “Lifting weights helped me get my energy and frustrations out. I would come home so much more relaxed and calm. It became my new outlet for doing well in my recovery.”

M.B. is not alone.  J.R., a 33 year old waitress also explains how she used exercise as a way to conquer her addiction to opioids: “Before I started my work day, I would put on my headphones and go for a run and get lost in my thoughts. When I was not in the mood for a jog, I would take my dog for a walk.  It was my ‘me time,’  and it helped me show up for work ready to roll, deal with the daily stresses that life brings, and in a much healthier way than using opioid pills.”

Does exercise really help with managing dependence on opioids?

Yes! Interestingly, exercise is its own medicine and can help patients succeed in their recovery when partnered with evidence-based pharmacological treatments like buprenorphine/naloxone (Suboxone), methadone (Learn more about transitioning from methadone to Suboxone.), and naltrexone.

Exercise actually works similarly to opioids like oxycodone, fentanyl, and vicodin. When you exercise, the body releases natural chemicals called endorphins.  These endorphins bind to the same receptors in the brain as the opioids causing a sense of euphoria and boosting your mood. (1,2)

Liza Hoffman, a Licensed Clinical Social Worker and Director of Behavioral Health at Bicycle Health, a telehealth company that provides buprenorphine/naloxone (Suboxone) to patients with opioid dependence, further explains, “If you have heard of the concept of ‘runner’s high,’ this is what exercise can do for the brain– it boosts your mood, helps you relax, helps you concentrate and sleep better, and even helps improve anxiety and depression. At Bicycle Health, we encourage all our patients to engage in regular exercise to help improve both their mental and physical health.”

Benefits of Exercise for your Brain

Not only is exercise beneficial for the brain and mental health, but it also improves patients’ physical health in numerous ways.

Benefits of Exercise to Your Body

• Weight loss
• Prevents & Improves Diabetes 
• Improves cholesterol 
• Decreases blood pressure
• Decreases risk for certain cancers: breast, colon, prostate
• Decreases risk for osteoporosis (weak bones)
• Decreases risk for falling/ improves mobility
• Improves chronic pain 
• Improves immune function (body’s ability to fight against infection)
• Helps with constipation
• Decreases mortality

So, how much exercise is recommended?

The American College of Sports Medicine and the American Heart Association recommend any of the the following:

Formal Exercise

1- Aerobic activity: 20-60 minutes 5 days/week

Things like:

• running
• brisk walking
• biking
• jumping rope
• swimming
• dancing
• elliptical

→ You should notice your breathing and heart rate increase for it to count!

→ You can do continuous exercise or even interval training (busts of energy followed by resting periods– which can help burn calories more efficiently, improve your aerobic capacity, and can beat any boredom!)

2- Strength training 2-3 times a week of major muscle groups

• weight lifting
• tension bands

3- stretching and toning at least once a week: 

• tai chi
• yoga

Here is a great handout on getting started with some sample routines, put together by Dr. Wayne Altman, a Family Medicine physician in Woburn, MA:

Exercise does not have to be formal– such as “going to the gym” or “going for a run”– to count.  

There are less formal ways to build “getting your steps in” to your everyday life.

People should aim for 10,000 steps a day (which is the equivalent to about 5 miles of walking a day).

Informal Exercise

• Walking your dog
• Walk while talking on the phone
• Yard work
• Golf without a cart
• Park further away and walk into a store/office
• Take the stairs instead of the elevator
• Go for 3 shorter (10 minute) walks per day
• Use your lunch break to walk/ catch up with a colleague
• Hold a “walking meeting” – meetings are actually more productive when people stand or walk than when they sit!

Unfortunately, one-third of people in the U.S. are completely sedentary, one-third do not get enough exercise, and only one-third get enough according to current guidelines. 

To increase regular exercise, people should choose activities they like, start off slow, and change up their routines frequently to keep it interesting.

Dr. Brian Clear, Chief Medical Officer (CMO) at Bicycle Health, explains, “Patients often feel like they have to do things they don’t enjoy doing. Exercise can be different things for different people–whether it’s a rigorous hike or meeting a friend during a lunch break and taking a walk around the block.  When patients make exercise a social activity or find an exercise buddy, they are more likely to enjoy the activity and stick with it.”

He elaborates, “Most importantly is to try to do something EVERY day– consistency matters. It’s all about moving MORE.”

Tracking your steps (on a smart phone or other device) can also help keep you monitor your steps and even “push” you to meet your goal!

Getting Into a Routine 

Researchers say it takes about 66 days to form a new habit.[7] Stick with fitness for two months or so, and it will become an integral part of your life and your recovery.

Follow these five tips to help you make exercise part of your recovery journey: 

1. Find Fitness Options You Love

Maybe you’ve been told that running is the best form of exercise. You know that, but you hate it. Chances are, your knowledge isn’t enough to overcome your dread of pounding the pavement. 

Make your resolutions easier to keep by choosing activities you enjoy. Try swimming, dancing, walking, or video aerobics. 

The more you enjoy the activity, the more likely you’ll be to stick with it. 

2. Set Reasonable Goals 

Don’t tell yourself you’ll lose 20 pounds in two weeks or hit the gym every single day without fail. Overly ambitious goals can trigger a “what-the-hell effect,” allowing you to quit the whole enterprise if you miss one milestone.[8]

Be realistic about what you can and can’t do. And adjust those expectations as needed. Be kind to yourself in recovery.

3. Track Your Progress

Almost any form of physical activity comes with metrics you can measure. Monitoring your workouts with hard data could keep you motivated.[9]

Keep track of your weight, your resting heartbeat, your miles walked, or your time spent in dancer’s pose. When you’re tempted to skip a workout, look over your notes. Seeing your progress could prompt you to keep your promises to yourself. 

4. Mix Things Up

Engaging in the same physical activity every day isn’t just hard on your motivation. Muscles and bones targeted by that exercise could also wear down and grow sore. Variety can keep you healthier and happier.

Add in unexpected forms of exercise when you can. Swap out today’s boxing session for a ride on your bike, or opt out of your yoga class to go swimming with your kids. As long as you’re moving your body, it counts!

Creating Connections Through Exercise 

Exercise is a well-known addition to treatment programs for substance use disorder. 

Don’t be afraid to share your story of recovery with the friends you make at your gym, yoga studio, swimming pool, or running club. If you find a peer, you could deepen your connection by coordinating workouts. Exercise is often more fun with friends. 

If you don’t find sober peers at your exercise facility of choice, ask about the opportunity at your next support group meeting. Some of your friends from Alcoholics Anonymous or Narcotics Anonymous meetings might enjoy working out with you. 

You could even pull together sober running groups or tennis clubs to formalize the exercise options. With accountability, you’re more likely to get moving regularly, and these friendships help to strengthen your support system in recovery.

The bottom line:

Medications like buprenorphine/naloxone (Suboxone), methadone, and naltrexone are considered the gold-standard, evidence-based treatments for opioid dependence– they prevent cravings and withdrawal and decrease mortality rates by over two-thirds.

When these medications are partnered with regular, daily exercise, they can set you up for success in recovery–improving your mental and physical health.

Bicycle Health

Bicycle Health offers buprenorphine/naloxone (Suboxone) exclusively via televisits through either individual prescribing or group-based treatment.  We have a team of Suboxone-prescribing providers and clinical support specialists to help our patients in their recovery journey.

To learn more about the success rates and safety of Bicycle Health’s telemedicine addiction treatment in comparison to other common treatment options, call us at (844) 943-2514 or schedule an appointment here.

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Header Photo by Jonathan Borba on Unsplash