Randomised controlled trial (RCT) of daily aerobic exercise for inpatient cannabis withdrawal: A study protocol

Abstract Background and aims Cannabis withdrawal is thought to be a major contributor to relapse to cannabis use and is now included in the DSM-5. Aerobic exercise relieves withdrawal symptoms from tobacco and other drugs, but has yet to be tested in cannabis users. Methods A prospective, single blind, parallel-group RCT comparing daily aerobic exercise to a control stretching intervention. Setting A seven-day inpatient hospital admission, with follow-up at 28 days’ post-discharge. Participants The study population will be 80 cannabis dependent adults seeking assistance with cannabis withdrawal. Intervention and comparator Participants in the Intervention group will undergo 35 min of aerobic exercise daily, at 60% of their VO 2 Max, on an exercise bicycle. The Control group will participate in a structured non-aerobic daily stretching routine for 35 min daily. Both groups receive treatment as usual in the withdrawal management unit of the hospital. Measurements The primary outcome measure is the severity of cannabis withdrawal symptoms assessed daily using the Cannabis Withdrawal Scale and the Marijuana Cravings Questionnaire – pre and post exercise, across the week. Mechanisms by which exercise may affect cannabis withdrawal will be assessed by analysis of endogenous cannabinoids, and plasma and urine cannabinoid levels. Discussion This is the first RCT of aerobic exercise for cannabis dependence that has a valid control group to aid in interpretation of findings. Should the intervention prove effective, it would give empirical support to an inexpensive and accessible treatment approach for drug withdrawal management.