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How running can help people with substance use disorder fight addiction

Running helps increase neuroplasticity of the brain, improving cognitive function, and mood, particularly important for people who have a dual diagnosis of a substance use disorder and mental illness.

Louis Knight (middle) with members of Back on My Feet.
Louis Knight (middle) with members of Back on My Feet.Read moreCourtesy of Louis Knight

After an accident many years ago, Louis Knight was prescribed narcotics for his pain. Eventually, he started abusing them and, ultimately, turned to heroin when he could no longer get prescription pills. To keep up with his drug habit, Knight committed burglaries and spent time in prison. He was living in a recovery house after his release when someone gave him a pair of running shoes — a small gesture that helped change his life.

“At the end of the day, [running is] better than trying to run and get a bag” of heroin said Knight, 43, of Philadelphia. “We know where that takes you. Why not try something different?”

A volunteer for a nonprofit called Back on My Feet was the one who offered Knight a pair of running shoes. The mission of the program is to promote self-sufficiency in people who are experiencing homelessness and/or addiction by first getting them to commit to early-morning runs three times a week for 30 days. If they have 90 percent attendance, they become eligible for the program’s other perks, such as housing assistance and job training, funded through relationships with corporate partners. “The running is the tool for giving people goals and helping people build confidence and self-esteem,” said Back on My Feet CEO Katy Sherratt.

Now Knight has his own apartment and works as a carpenter at the recovery house where he used to live. “When you think about running, it’s a lot deeper than just the health aspect,” said Knight, who has been in recovery for more than five years. “It’s really about being committed to yourself.”

Running, in particular, but really any intense exercise, offers several health benefits that help people fight addiction, said Alexis Tingan, assistant professor of physical medicine and rehabilitation at the University of Pennsylvania. Smoking or injecting drugs becomes habitual, but so can running, giving people an alternative addiction. Running also helps increase neuroplasticity of the brain, improving cognitive function and mood, which is particularly important for people who have a dual diagnosis of a substance use disorder and mental illness. Research shows that exercise, as well as medication and/or cognitive behavioral therapy, reduces depression for some people.

In 2011, Vanderbilt researchers discovered that after just a few runs, heavy marijuana users saw a significant decrease in their cravings and use. Hormones produced by the brain during a run act on the same receptors that opioids and other narcotics do, leading to the “runner’s high,” or sense of euphoria that can kick in as quickly as 10 minutes into a run and last for a couple of hours. “It gives you the sense of literally being high but not from a dangerous substance,” Tingan said.

Charles Giannasio, an addiction psychiatrist and psychoanalyst in Blue Bell, said some of his clients work out religiously and attribute their recovery in part to that. “Some people [exercise] first thing in the morning, and they feel like they’ve accomplished something,” Giannasio said. “It gets them in a position to concentrate better and do their job better.”

Although Giannasio said he does not always prescribe exercise to patients with substance use disorder or depression, he certainly talks about it with them. “With people who are depressed, you need to keep moving,” because depression tends to slow people down when what they really need is increased activity and involvement in the world, Giannasio said.

Another important aspect of exercise as a tool for recovery is the community-building, addiction experts said. This has certainly proven true with the Boston Bulldogs Running Club, started by Mike Ferullo, 70, and his wife, Shelley, which aims to help people recover through running.

“One of the key reasons AA works or the Bulldogs work is because of the social component,” said Ferullo, otherwise known as “Coach Mike.” In recovery about 40 years from opioid use, Ferullo is a psychotherapist in private practice who specializes in treating addiction.

“Addicts tend to isolate, and isolation is one of the main triggers that result in relapse,” Ferullo said. “It’s very, very important to be engaged in the community, like with the Bulldogs, to show up and hold yourself accountable to yourself and others.”

One of his proteges, Meaghan O’Sullivan, program coordinator for the Bulldogs, has been in recovery, after several relapses, for about a year. She said that running, especially with others, has been key in her effort to give up alcohol and other substances.

“We’re the only ones who are going to be accountable for our actions and to do things we don’t want to do,” O’Sullivan said. “What ends up happening is that we set these attainable goals, and the self-esteem starts to build. … Then that naturally starts to bleed out into other areas of your life.”

Shelley Leone, a former Pennsylvanian who now lives in Ohio, agrees.

“In the beginning, I don’t always want to go out and run in the bitter cold, but it’s the feeling I get afterward of accomplishment,” said Leone, 46, who has struggled with alcoholism for 20 years. “You have that discipline to go out there day after day – it’s a small victory. Nothing can take that away from you.”

After a recent relapse, Leone is more than five months sober, in part, she said, because she runs 16 to 18 miles a week. She is training for a half-marathon in April.

“You feel better about yourself,” Leone said. “Running helps you discover your worth. … It quiets your mind and puts you in a better state. It allows me to pick myself up and not stay stuck and wallow in self-pity.”

Running is not a substitute for 12-step programs, counseling, and medication-assisted treatment, considered the gold standard for opioid addiction. But it can certainly help, said Paul Allegretto, 33.

Allegretto suffers from anxiety and an opioid use disorder. When he was in long-term rehab at the Kirkbride Center in West Philly, he heard about Back on My Feet. “It sounded interesting, and it sounded like a way to challenge myself,” Allegretto said. “So I just started to run.”

Since those first few paces in West Philly, Allegretto has run the Philadelphia Marathon and been accepted to the Community College of Philadelphia. He is also more than a year sober. And he still runs. “I don’t really plan to stop,” he said.

“It takes a special person to run,” said Knight, who has completed several races with comrades from Back on My Feet. “I’m not running for competition. I’m running for the love of it. Running is just you and the ground.”