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RESEARCH PRODUCT

Exercise as an Adjuvant Intervention in Opiate Dependence

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We read with interest the article by Weinstock et al. in whichthe authors propose exercise as an adjuvant intervention inopiate agonist treatment based on current research findings(1).The use of an opiate agonist, such as buprenorphine, butmainly, methadone, for the treatment of opiate dependenceis currently an effective therapy for this type of addiction.The main benefits of this treatment occur through a relieffrom craving narcotic drugs, a temporally suppression ofwithdrawal symptoms, and by blocking the euphoric effectsof opiates (2). Unfortunately, patients needing treatment foropiatedependenceoftenfaceavarietyofco-occurringissues,suchashepatitisBandCvirusesorhumanimmunodeficiencyvirus (HIV) (3); psychiatric disorders, such as major depres-sion and additional substance abuse disorders (4); and poorquality of life (5). In this regard, Weinstock and colleaguesrecommend exercise as an adjuvant treatment in opiate de-pendence. The authors suggest several potential mechanismsof action based essentially on psychological and sociologi-cal effects. In addition, they consider that exercise could be acompatible substitute for drug abuse, since endogenous opi-ates are similar to opiate drugs such as heroin and morphine.Although the mechanisms by which endogenous (exer-cise) and exogenous (drugs) opiates produce addiction atphysiological level are well known, new pathways shouldbe investigated. One of the most important regulators of ad-diction depends on the transcription factor cyclic adenosinemonophosphate (cAMP) response element–binding protein(CREB), which, depending on the brain section, can produce