Inside the Rehab Swapping Drug Addiction for Extreme Exercise

If you believe that you'll always be an addict, is your best option to swap one dependancy for another?

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18 December 2018, 11:22pm

Illustration by Ash Goodall

By the time Imran was 28, he’d already spent more than a quarter of his life as a drug addict. At first, he only dabbled with methamphetamines recreationally, taking drugs at parties for an adrenaline kick. Years later, the Sydneysider started using drugs at work to enhance his performance and deal with stress. Meth made him feel invincible: he could work longer hours without needing to sleep, perform to a better standard, and make more money.

It took eight years for drugs to destroy Imran’s career, bank account, personal relationships, and health. But it only took four months of cognitive behavioural therapy paired with triathlon training for him to morph from drug addict to “clean” athlete.

The transformation took place at The Cabin, a Thai rehabilitation clinic. Reflecting on his time there Imran told VICE: “The way things eventuated for me, I should be rightfully in a psych ward or dead...But somehow I find myself in Chiang Mai with a real sense of hope for the future.”

Imran had previously tried to get clean through Australian rehab clinics, but nothing worked. Then after spending a week in a psychiatric ward due to a drug-induced psychosis, he turned to his dad, desperate for help.

“Dad said ‘no problems. Pack your bags because you’ll be leaving for Thailand tomorrow’. And here I am, at The Cabin.”

While you're here, check out our documentary on the role of poppers in the LGBTQ+ community.

The Cabin is a resort-style addiction treatment facility that employs a long-term holistic program to get clients clean, concentrating on their physical, emotional and mental health. Set in the mountains of Chiang Mai, addicts like Imran first go through a medically supervised detox process at the on-site hospital. After their body is free of all addictive substances, they move into accommodation where they will live for around four months.

Young men are housed in a section called The Edge where they undergo an intensive program of counselling, nutrition therapy and physical activities involving triathlon, Muay Thai boxing, yoga and meditation. The facility has chosen to make sport a cornerstone of their treatment, reasoning that addicts can replace the high found in drugs with a natural high from exercise.

For Imran, triathlon training played a huge role in his transformation from a paranoid addict to a calm and considered young man. “I came into The Cabin weighing 92 kilos and was extremely overweight and out of shape. I couldn’t even run 500 metres, and now I’m competing in triathlons…. Just today I’ve run 20 kilometres.”

Continuing, he explains how the intensity of exercise helps suppress any physical cravings he experiences during the rehabilitation process. “It also helps to [control] anxiety or if you feel slightly depressed. The physical activity for me, personally, just sets me up for the day.”

Additionally, the treatment program also uses sports psychology to encourage young men to break old habits, create positive behavioural patterns, learn discipline, and heal. Imran continues: “Through rehabilitation and triathlon, they show you there’s another way to live. When you have a drug addiction, all you know is the drugs. You don’t know there’s a whole life out there.”

But while Imran’s rehabilitation is impressive, the substitution of drugs for extreme exercise raises questions around replacing one dependency with another. A 2014 Israeli research review on exercise addiction, published in the medical journal Current Pharmaceutical Design, identified that substance use and exercise addiction may be co-occurring disorders. They detailed how genetic studies have suggested that genes controlling the preference for drugs may also control a preference for naturally rewarding behaviours like exercise.

The relationship between high intensity sport and drug use is most commonly demonstrated through a “runner’s high.” This refers to how exercise can activate the dopamine reward system in the brain to releases endorphins and cannabinoids, which produce euphoric feelings.

This observation mirrors the experience of John*, another former drug addict-turned-triathlete who now works full-time training young men at The Edge to compete in triathlons. He explains that although it’s been ages since he’s used drugs, in his mind, he’ll always be an addict.

But what addiction in any form is problematic, he argues his fanatic dedication to triathlon keeps him healthy and clean—serving as the healthier choice between two dependent behaviours.

Additionally, he points out the role his Attention-Deficit Hyperactivity Disorder (ADHD) plays in all this: he feels a constant need to keep his brain stimulated and be physically active. Before he started running, he turned to drugs to deliver the buzz his disorder demanded. “I’m no longer using but I’ll always be an addict,” he stresses. “I do triathlon now and I train others to be triathletes. So in a way, I am addicted to triathlon.”

Mike Miller, the Cabin’s clinical lead and a former addict himself, also observes that even when clean former addicts may become dependant on other naturally rewarding behaviours like exercise. “If you have a genetic predisposition to become an addict, you have a reward system that’s basically deficient,” Miller comments. “Because your brain is unrewarded, when you try ice, you will get a sudden flood of dopamine. When you introduce something that enhances [your brain] and gives you a reward, you may become addicted.”

While agreeing addiction can be a genetic predisposition, Associate Professor at Curtin University’s National Drug Research Institute, Nicole Lee, stresses that addiction has many parts: “There are many other risk factors for drug use and dependence like having a family history of drug use, experiencing trauma quite early in life, an early introduction to drugs and having mental health problems,” says Lee. “The more risk factors you have, the more likely you are to become dependent.”

Concluding, “The big difference between excessive enthusiasm and being dependant on something is whether it adds to or takes away from your life. So if you are excessively exercising and you miss work, school or social events because you are so obsessed with it, then that is a problem.

“But replacing an unhealthy dependence with a healthy one is a reasonable thing to do. It doesn’t matter if it the sport you are doing is excessive. If it adds to your life, then go for it.”

*Names have been changed

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