MENTAL HEALTH
ACTIVE DUTY
T here is a wellestablished link between substance use and mental health. According to Office for Health Improvement and Disparities figures for 2024 to 2025, almost three-quarters of adults starting treatment stated they had a mental health treatment need. However, over one-fifth of people with a mental health need were not receiving any treatment for it.
Last year, the Royal College of Psychiatrists warned that people with co-occurring substance use and mental health conditions were being failed by NHS services that were not designed to meet their needs. The college added that people who had mental health conditions
When it comes to genuinely holistic treatment, exercise and physical activity should be more than just an add-on, says Nat Travis
and substance use problems experienced overall poorer health, poorer engagement with work, and higher mortality and suicide rates.
Turning Point has long recognised this issue, originally publishing our dual-diagnosis toolkit in 2004. In 2021 we published a revised and refreshed substance use mental health resource pack, enabling services to provide better support to people presenting with multiple issues – it’ s available on the report section of the Turning Point website. In the same year, we established a dedicated substance use and mental health team in Leicester to better integrate substance use and mental health treatment for people.
POWERFUL EFFECTS We take a holistic approach to tailoring treatment programmes to the people we support, and research has shown the powerful effect that exercise and physical activity can have on a person’ s mental wellbeing.
‘ We know that addiction pathways can lead to changes in chemical responses in the brain and the way it responds to normal stimulus,’ says Dr Yvonne Musgrove, clinical lead at Turning Point Wakefield Inspiring Recovery – effectively‘ hijacking’ the‘ feel-good’ hormone dopamine response in a person’ s brain.‘ In people that use substances, the substance hijacks the dopamine reward pathway and they find that other things in life do not give them that reward. It’ s only the substance that provides the reward, which is why it takes quite a long time to recover and why people can be vulnerable to relapsing.’
Studies have shown that instead of a simple, pleasurable surge of dopamine, many drugs – including opioids, cocaine and nicotine – cause dopamine to flood the reward pathway ten times more than with a natural reward. The brain remembers this surge and associates it with the substance.
However, with chronic use of the substance the brain’ s circuits adapt over time and become less sensitive to dopamine. Achieving that pleasurable sensation becomes increasingly important, but at the same time people build tolerance and need more and more of the substance to generate the level of high they crave.
NATURAL SUBSTITUTE As part of the treatment and recovery journey, it’ s important for people to find activities that can rebalance the dopamine response. Exercise acts as a natural, healthy substitute for substance use by activating the brain’ s reward system, increasing dopamine, and repairing dopamine receptors damaged by substance use. Regular exercise of just 20 to 30 minutes a day can reverse the low-dopamine state caused by substance use, reducing cravings and improving motivation.
‘ It’ s very much accepted that exercise has beneficial effects on physical health and mental
16 • DRINK AND DRUGS NEWS • MAY 2026 WWW. DRINKANDDRUGSNEWS. COM