Addiction changes the brain, body, and behavior. Persistent insomnia, craving, depression, anhedonia, and anxiety may continue for months after sobriety, often leading to relapse. While we search for medications and treatments to set the clock back to pre-addiction, researchers have shown that regular exercise is a major plus. But many people, even doctors, don’t realize exercise helps considerably with addiction recovery, as well as anxiety and depression. For example, research reveals that actively exercising only 10 to 20 minutes a day reduces powerful nicotine cravings and withdrawal symptoms immediately. Exercise has also shown promise for aiding in cocaine and methamphetamine stimulant use disorders. For alcohol use disorder, researchers have found that exercise reduces craving and withdrawal severity.
Preclinical lab studies from Professor Panayotis “Peter” K. Thanos, PhD, senior research scientist in the Department of Pharmacology and Toxicology at the Jacobs School of Medicine and Biomedical Sciences in Buffalo, New York, have provided compelling evidence that aerobic exercise is effective as an adjunctive, relapse-preventive intervention in addiction. Exercise helps normalize dopamine and physiological and behavioral stress responses and reduces stress hormones while easing withdrawal-related anxiety and negative affect. Exercise helps reset the brain’s pleasure system, reversing anhedonia (lack of emotion), improving sleep, controlling anxiety and depression, and reducing addictive cravings.
Emerging clinical research increasingly focuses on personalizing exercise prescriptions, understanding sex-based differences, and elucidating neurophysiological underpinnings. Exercise also improves depression and many other serious health problems.
In a critical new systematic review and dose-response meta-analysis published in the August Lancet, Professor Ding Ding from the University of Sydney found that walking benefits accelerated steeply between 5,000 to 7,000 steps/day. Even increasing from 2,000 to 4,000 steps/day reduced the risk of death for many by over one‑third. Ding et al. reviewed 57 studies and a meta-analysis of 31 studies including 160,000+ adults, uncovering an inverse association for all-cause mortality, cardiovascular incidence, dementia, and falls. Seven thousand steps per day was associated with a 25 percent lower risk of cardiovascular disease incidence, a 47 percent lower risk of cardiovascular disease mortality, and a 47 percent lower risk of all-cause mortality.
Exercise and Addiction
Intense exercise appears capable of resetting the brain to pre-addiction health levels. What happens is addiction induces a shift in the brain’s reward setpoint, often called hedonic adaptation. This means the “normal” state for the addicted person is reduced pleasure, which then drives compulsive use.
Addiction induces brain changes and a reduced response to drugs of abuse, also called tolerance—users need higher doses or more frequent use to achieve pleasure, because the former level of drug-taking is now insufficient. Addiction is a trap because, without breaking the cycle, tolerance continues to increase, meaning ever higher doses/more frequent use.
Exercise helps reset reward pleasure sensitivity, reduces cravings, and improves mood; however, it should be positioned as a structured adjunct—not a stand-alone therapy—for substance abuse.
Eminem
After his near-fatal overdose in 2007, rapper Eminem began running to cope with sobriety-induced insomnia. He told Men’s Journal that running helped him sleep and manage opioid withdrawal symptoms. In addition to running, he used at‑home fitness programs to rebuild strength and fitness. At one point, Eminem was running up to 17 miles per day to support his abstinence and recovery. Running offers a method of restoring endorphin function, being with nature, a daily routine, or a structure that promotes healing and connections. Research findings support the anecdotal conclusions, suggesting that running may offer an alternative for substance users and recovering addicts.
Eminem openly described replacing one addiction with another—exercise being a far healthier alternative than drugs. Eminem’s sobriety began on April 20, 2008, after his overdose in December 2007. He credits that date as the pivotal moment of recovery. On April 20, 2024, he publicly celebrated 16 years sober by sharing a photo of his Alcoholics Anonymous sobriety chip engraved with “Unity,” “Service,” and “Recovery.” He attends AA when not on tour. Eminem has now been sober for 17+ years. Exercise works best when part of a comprehensive addiction recovery program.
Exercise and Depression
Exercise for depression rivals antidepressant medications and other treatments for many patients. Walking/jogging, yoga, and strength training perform best in improving depressive symptoms. It’s best to start with 30 to 40 minutes of moderate-intensity aerobic activity (like brisk walking), three to four days/week, for at least nine weeks.
Exercise and Anxiety
Exercise provides moderate improvements in anxiety, with greater benefits at higher intensities; effects are observed across many adult populations. For situational anxiety, even a single 20- to 30-minute workout often provides short-term relief.
Summary
The message is clear: Even moderate daily walking confers meaningful, broad health benefits, especially to the person trying to recover from an addiction. But can it be that easy? Bite your tongue! Exercise is hard work, especially for a recently very sedentary person. But the payoff is high: reduced craving, depression, risk for relapse, and insomnia, and decreased anxiety. Consequently, physical activity should be a mainstay approach in the management of addiction recovery, along with NA, AA, medications, and therapy aimed at reacquiring mental and physical health. The most recent research suggests 7,000 daily steps can be a meaningful goal to achieve better medical and psychological health outcomes.