Something as old – and easy – as yoga might help something far more challenging: opioid withdrawal.
In a randomized clinical trial appearing online this week in JAMA Psychiatry, researchers report that adding structured yoga sessions to standard medication dramatically accelerated recovery from opioid withdrawal. The intervention also appeared to help with anxiety symptoms, improved sleep, curbed pain, and ultimately helped restore balance to the autonomic nervous system.
Methodology
The study followed nearly five dozen hospitalized men in India with opioid use disorder. All of them reported mild to moderate symptoms of opioid withdrawal. The researchers administered buprenorphine to every participant.
The study’s authors also assigned half of the participants to a two-week yoga program that included ten supervised, 45-minute sessions blending gentle postures, breathing exercises, relaxation practices, and guided meditation.
Startling Results
The results exceeded even the most optimistic expectations. Patients in the yoga group stabilized more than four times faster than those who simply received medication. Patients who practiced yoga stabilized in a median of five days, compared with nine days in the control group. Both groups received similar doses of buprenorphine.
Beyond symptom relief, the researchers wanted to know what else was going on. Opioid withdrawal remains a period of intense physiological stress, exacerbated by overactivation of the sympathetic “fight-or-flight” system and suppression of parasympathetic calming signals. Standard medications blunt some of the usual cravings and symptoms , but don’t do much to address this imbalance. And that could help explain why relapse risk is highest in the earliest days of treatment.
To probe that mechanism, investigators measured heart rate variability (HRV). By day 15, the yoga group showed large improvements in HRV, including higher parasympathetic activity and a healthier balance between sympathetic and parasympathetic tone. Mediation analyses suggested that roughly one-quarter of yoga’s benefit in speeding withdrawal recovery could be explained by the boost in parasympathetic regulation.
Benefits Beyond Withdrawal Relief
Clinical improvements extended beyond withdrawal scores. Compared with controls, participants practicing yoga showed far greater drops in anxiety, fell asleep about an hour faster on average, and reported less pain. These effects are especially helpful during withdrawal, when discomfort and emotional distress often drive patients back to the drugs.
Researchers ensured that the yoga sessions themselves were deliberately low-threshold. Clinicians conducted the sessions bedside when necessary and designed them to remain feasible even during the worst of the withdrawal symptoms, when concentration wanes and distress is highest.
While some breathing techniques produced short-term sympathetic activation, the pattern consistently resolved into stronger parasympathetic rebound over time, suggesting a process of autonomic “rehabilitation.”
Caveats – and Next Steps
The authors warn, however, that the trial was a small one. It didn’t take much time, took place at a single center, and included only male participants. While this reflected local patterns of opioid use, it did limit wider applicability.
The study also lacked an active behavioral control, making it impossible to rule out nonspecific effects such as additional attention or structure.
Still, the objective physiological changes and clear differences in recovery time argue against a simple placebo effect.
If larger and more diverse trials can confirm the results of this study, it could uncover a simple but effective supplement to existing care. By targeting the biological stress systems that medications often miss, yoga could help patients move through the most vulnerable phase of opioid treatment more quickly. It might also offer a bit more physiological breathing room, too.
Further Reading
Prenatal Opioids Might Not Drive Autism, ADHD Risk
