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Alcoholics by All Means Should Avoid Stress During Early Abstinence

ntil exhaustion (considered a highly reproducible and reliable form of stress). The alcoholics were tested at three time points: four, six and eight weeks after alcohol withdrawal. The controls were tested only once.

Results indicate an only slight ACTH/cortisol response to physical exercise among alcoholics after four weeks of abstinence, returning to near-normal levels at eight weeks.

This means, said Coiro, that not only did his group establish a time course of HPA failure during abstinence, but they also found that physical exercise among abstinent alcoholics may not always be a good thing.

"Guidelines for recovery from alcoholism attribute an important role to physical activity and sport," he said. "Exercise is included in many rehabilitation programs, because it produces physical and emotional effects that benefit the alcohol-dependent subjects during early abstinence. However, in the absence of HPA reactivity, exercise until exhaustion may produce stressful deleterious effects, because alcohol-dependent subjects are more vulnerable to relapse during early abstinence."

"Given that the HPA axis remains ‘stunned’ for at least one month from withdrawal, with a full functional recovery only after two months," said Di Gennaro, "caution is to be recommended for patients in rehabilitation programs that include stressful physical exercise. However, since physical activity has been found to be an important therapeutic tool for early alcohol-withdrawing patients, it should be included in treatment even during the first eight weeks of abstinence, albeit mild at the beginning, with a slight progressive increase of physical activity during the first and the second month of abstinence."

"From a research perspective," said Coiro, these results help us to understand entity and time of the effects of alcohol in the central nervous system as ACTH/cortisol measurements represent a ‘window’ through which we can evalua
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