The effect of daily aerobic cycling exercise on cannabis withdrawal: An inpatient randomised controlled trial

Aerobic exercise can reduce withdrawal symptoms from tobacco and other drugs but its potential to alleviate cannabis withdrawal remains unexplored. This study investigated whether aerobic exercise can reduce the severity of cannabis withdrawal. Forty-six adults were randomised to (i) 35 min of aerobic cycling exercise (n=24), or (ii) stretching (n=22) each day for seven days. Withdrawal, cravings, exertion, free-fatty acids, triglycerides, and cannabinoids were measured during sessions. We hypothesised that exercise would cause release of THC from fat stores and reduce withdrawal in this way. Self-reported withdrawal and plasma cannabinoids decreased across the inpatient stay, however there were no significant differences between the cycling and stretching groups in withdrawal symptoms, cannabis craving, or plasma cannabinoids, despite significantly greater objective and perceived exertion in the cycling group. Exercise did not increase plasma cannabinoid concentrations despite a slight increase in free-fatty acid and triglycerides. Cannabis use was greatly reduced post-trial, with a third of participants remaining abstinent throughout the 28-day post-treatment period. The absence of between-group differences in withdrawal prevents us from concluding that aerobic exercise confers benefits for individuals undergoing inpatient cannabis withdrawal. Mild stretching exercises are easily integrated into clinical services and self-guided withdrawal attempts and may have beneficial effects. Trial Registration: Australian New Zealand Clinical Trials Registry (ACTRN12615000211561) https://www.anzctr.org.au.