An integrative overview of physical activity for people with opioid use disorder

People with and in recovery from opioid use disorder face a burden of poor physical and mental health. However, an emergent and growing body of evidence shows that physical activity has a multidimensional therapeutic potential to help people with opioid use disorders during recovery. We conducted a narrative review that incorporated a broad range of quantitative and qualitative evidence, in addition to key review evidence, to offer an overview of the benefits of physical activity on (i) abstinence and related outcomes, (ii) other mental health and cognitive outcomes, (iii) physical health outcomes, (iv) social health and wellbeing outcomes. We also discuss the evidence for (v) physical activity levels and behaviour in people with opioid use disorder, (vi) and, key factors of influences on physical activity behaviour among people with opioid use disorder. The article concludes with key recommendations for future research and practice. A limited body of evidence exists for using physical activity to improve outcomes of abstinence, improved physical health, mental health and social health among people with opioid use disorder. To date, such interventions are somewhat limited in quality and scale, and few have examined effects beyond light and moderate intensity, including high intensity PA and resistance exercise intervention. People with opioid use disorder appear to have nuanced physical activity behaviours that are influenced by a plethora of individual, interpersonal and environmental factors. Such populations also typically have low levels of physical activity, but more research is required to understand this. There is an apparent need for integrated efforts to improve opportunities for physical activity as part of treatment for opioid use disorders. There is also a need for the inclusion of people with opioid use disorder in PA implementation research. •People with opioid use disorders may experience abstinence, physical, mental and social health benefit from physical activity.•The evidence for effectiveness is limited due to limited good quality experimental research.•People with opioid use disorder have nuanced physical activity behaviours, influenced by individual, interpersonal and environmental factors.•There is a need for integrated physical activity as part of treatment for opioid use disorder.