Substance Use to Exercise: Are We Moving 3/17/2021 from One Addiction to Another? Wellness and Recovery in the Addiction Profession Part Two: Substance Use to Exercise: Are We Moving from One Addiction to Another? Presented by: Stephanie F. Rose, DSW, LCSW, AADC, CS and Duston Morris, PhD, MS, CHES 1 Jessica O’Brien, LCSW, CASAC Training Organizer • Training & Professional Development Content Manager • NAADAC, the Association for Addiction Professionals • www.naadac.org • [email protected] 2 2 PRODUCED BY NAADAC, the Association for Addiction Professionals 3 3 Presented by: Stephanie F. Rose, DSW, LCSW, AADC, CS and Duston Morris, PhD, MS, CHES 1 Substance Use to Exercise: Are We Moving 3/17/2021 from One Addiction to Another? www.naadac.org/certificate-for-wellness-and-recovery- online-training-series 4 4 4 www.naadac.org/substance-use-to-exercise-webinar CE Hours Available: 1.5 CEs CE Certificate : $25 If you complete all six parts in the series, you can apply for the Certificate of Achievement for Wellness & Recovery in the Addiction Profession 5 5 Using GoToWebinar (Live participants only) Control Panel Asking Questions Handouts Audio (phone option) Polling Questions 6 6 Presented by: Stephanie F. Rose, DSW, LCSW, AADC, CS and Duston Morris, PhD, MS, CHES 2 Substance Use to Exercise: Are We Moving 3/17/2021 from One Addiction to Another? Training Presenter • Duston Morris, PhD, MS, CHES • University of Central Arkansas 7 7 Training Presenter • Stephanie F. Rose, DSW, LCSW, AADC, CS • University of Central Arkansas 8 8 Substance Use to Exercise: Are We Moving From One Addiction to Another? STEPHANIE ROSE, DSW, LCSW, AADC, CS, DCC, ASSISTANT PROFESSOR DUSTON MORRIS, PHD, MS, CHES, ASSOCIATE PROFESSOR 9 9 Presented by: Stephanie F. Rose, DSW, LCSW, AADC, CS and Duston Morris, PhD, MS, CHES 3 Substance Use to Exercise: Are We Moving 3/17/2021 from One Addiction to Another? Study overview Very little evidence addresses the relationship between substance use and exercise addiction among college students. A phenomenon referred to as “switching addictions” or substitute addictions is the substitution of one addictive behavioral pattern for another. A total of 824 college students completed a 36-item survey regarding substance use and views of exercise. 10 10 Physical activity and recovery Substance abuse disorders are among those with the highest mortality rates (Franko, Dorer, Keel, Jackson, Manzo, & Herzog, 2005). For chronic abusers, their health has generally taken a back seat to their addiction. Therefore, many treatment facilities also address nutrition and physical activity. Physical activity is often promoted in treatment for alcohol use disorder not only because it is at little cost, but it does not need insurance approval or a trained provider (Read, Brown, Marcus, Kahler, Ramsey, Dubreuil, Jakicic, & Francione, 2001). 11 11 POLL QUESTION #1 Which of the 1. Exercise can effectively following are increase the abstinence accurate rate statements 2. Exercise can ease concerning the withdrawal symptoms relationship 3. Exercise can reduce between physical anxiety and depression exercise and 4. All the above substance abuse? 12 Presented by: Stephanie F. Rose, DSW, LCSW, AADC, CS and Duston Morris, PhD, MS, CHES 4 Substance Use to Exercise: Are We Moving 3/17/2021 from One Addiction to Another? What are the concerns? Possible benefits from physical activity as part of recovery include, achieving a pleasurable state without use of drugs, improving mood, increasing self-efficacy, participating in group activity and social support, providing a positive non-drinking alternative, decreasing stress reactivity and improving coping skills (Read JP, Brown RA, 2003). While this sounds promising, there is little research evaluating if individuals in treatment for substance abuse, who are susceptible to addiction, are potentially being lead to another addiction. 13 13 Making the connection Similarities Societal norms Linked behaviors Individuals that are For example, individuals addicted to physical addicted to exercise and activity and exercise have individuals addicted to some characteristics drugs and/or alcohol similar to individuals that generally have low self- have a substance abuse esteem and both use disorder. either exercise or a chemical as a way of “managing and/or manipulating psychological states” 14 14 Substitute addictions Substitute addictions can involve a transition from a chemical addiction to a behavioral or process addiction. In some situations when an individual is able to terminate one addictive behavior, such as alcohol abuse, they may engage in a pattern of addictive eating, exercise, or sexual behaviors. The process of substitute or “switching addictions” involves process-overlaps between obtaining pleasure and distorted rewards, while experiencing withdrawal symptoms (Sussman S, Black, DS, 2008). Ultimately, switching from one addition to another leads to similar negative health outcomes. 15 15 Presented by: Stephanie F. Rose, DSW, LCSW, AADC, CS and Duston Morris, PhD, MS, CHES 5 Substance Use to Exercise: Are We Moving 3/17/2021 from One Addiction to Another? POLL QUESTION #2 Researchers 1. Chemicals released that believe that in create a since of part, exercise pleasure or reward addiction may be 2. Specific positive exercise based on? attitudes 3. A family history of exercise addiction 4. Coping mechanism for other behaviors 16 Alcohol use and physical activity There is an association between alcohol use and increased physical activity (Dodge & Clarke, 2018). Among college students, for example, a correlation exists between risk for exercise addiction and alcohol use. Some research also demonstrated a link between problematic alcohol use and those considered at risk for exercise addiction. 17 17 Exercise addiction Exercise addiction involves psychophysiological symptoms that can manifest in compulsive and/or dependent behaviors (Yong-Seok, Eun, 2018). Exercise addiction renders consequential behaviors, similar to other addictive behaviors, including a lack of control despite negative consequences. 18 18 Presented by: Stephanie F. Rose, DSW, LCSW, AADC, CS and Duston Morris, PhD, MS, CHES 6 Substance Use to Exercise: Are We Moving 3/17/2021 from One Addiction to Another? Additional consequences of exercise addiction Musculoskeletal injuries and weakened immune systems (Yong-Seok & Eun, 2018). Similar to other addictions, including, alcohol abuse and gambling, an individual with exercise addiction presents with psychological inflexibility. Obligatory exercise is a compulsive pattern of exercise behavior where thoughts of needing to exercise or actual exercise behavior begins to dominate daily life requirements, and where the lack of exercise begins to produce withdrawal symptoms (Rodgers, Blanchard, & Munroe, 2001). Individuals recovering from alcohol or drug addiction may perceive obligatory exercise as a healthy alternative due to the general social acceptance surrounding excessive exercise; however this is not always the case. 19 19 Griffiths (1997) six components of exercise addiction Salience Mood modification Tolerance Withdrawal Conflict Relapse 20 20 POLL QUESTION #3 It is estimated that 1. 5% _____% of people who are addicted 2. 10% to exercise might also be addicted 3. 15% to tobacco, alcohol, and 4. 20% other drugs. 21 Presented by: Stephanie F. Rose, DSW, LCSW, AADC, CS and Duston Morris, PhD, MS, CHES 7 Substance Use to Exercise: Are We Moving 3/17/2021 from One Addiction to Another? Exercise addiction contributors Feelings of guilt and shame are two primary emotions associated with personal motive for behavioral change concerning heavy alcohol consumption and a desire to engage in restorative- health efforts (Dodge & Clarke, 2018). In relation to guilt and shame, those struggling with exercise addiction also struggle with poor body image (Berczik, Szabo, Griffiths, Kurimay, Kun, Urban, & Demetrovics, 2012). 22 22 Association with social constructs Social constructs The bellybutton challenge Exercise trends Exercise addiction is often Current social constructs that overlooked as a concern due to promote, sensationalize, and the positive view of physical glamorize only the fit images activity and sports within our as healthy people can make social construct. This extreme the average person feel guilty level of acceptance can result or shameful about their own in rationalizing dysfunctional exercise efforts and/or body behavior (Nogueira, Molinero, image. Salguerro, & Marquez, 2018), which can lead to the disruption of normal, healthy lifestyle patterns. 23 23 POLL QUESTION #4 Exercisers at high 1. True risk of exercise addiction 2. False reported the same level of support for exercise from relatives as those at low risk of exercise addiction. 24 Presented by: Stephanie F. Rose, DSW, LCSW, AADC, CS and Duston Morris, PhD, MS, CHES 8 Substance Use to Exercise: Are We Moving 3/17/2021 from One Addiction to Another? Other contributing factors Among undergraduate college students, more women reported increased weight as a concern in regard to alcohol consumption (Reilly, Dmochowski, Schaumberg, Earleywne, & Anderson, 2016). There is a high prevalence of co- occurring diagnoses with exercise addiction and eating disorders (Berczik, Szabo, Griffiths, Kurimay, Kun, Urban, & Demetrovics, 2012). Furthermore, there is research that suggests that guilt related to drinking can be a mediator for increased exercise as a way to address the additional caloric consumption. Individuals