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

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 VO2 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