Controlled Breathing May Help Reduce substance Addiction, Cravings: Study

A new study published in the journal of Addiction showed that for those who use alcohol, nicotine, or other substances, regulated breathing techniques, such as heart rate variability biofeedback, may help lessen cravings.

Globally, substance use disorders (SUDs) are a significant cause of disease, disability, and early mortality. Even while well-known therapies like cognitive behavioral therapy can be successful, they might need a significant investment of time, resources, and expertise. One very easy intervention that may affect the body's stress-response systems and enhance self-regulation is controlled breathing. One type of regulated breathing that uses physiological input to assist individuals in controlling autonomic nervous system activity is heart rate variability biofeedback. Therefore, this study methodically assessed whether biofeedback on heart rate variability and regulated breathing may enhance outcomes related to drug use.

The last search was carried out in November 2025 and involved searching Web of Science, PsycINFO, MEDLINE, CINAHL, EMBASE, PubMed, Scopus, and the Cochrane Library. Quantitative studies that assessed regulated breathing as the main intervention and involved individuals who used alcohol, nicotine, or other substances were included in the review. Twenty of the 3,502 papers that were found satisfied the inclusion requirements, and fifteen of them offered enough information for a meta-analysis. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards were adhered to in this study. Pooled effects were estimated using a random-effects model.

20 of the 3502 studies that were found satisfied the inclusion requirements, and fifteen of those were suitable for meta-analyses. With a minor but statistically significant and persistent impact, breathing-based therapies reduced cravings compared to controls [Hedge's g = 0.30, 95% confidence interval (CI) = 0.12–0.48, heterogeneity (I2) = 23.5%, 12 trials, 696 individuals].

When compared to controls, the effects on withdrawal symptoms were unclear (g = 0.46, 95% CI = −0.28 to 1.19, I2 = 89.7%, 4 trials, 289 participants), while the effects on drug dependence were greater (g = 0.85, 95% CI = 0.21–1.48, I2 = 70.9%, 2 studies, 144 individuals). The kind of breathing intervention (HRVB vs. other) did not vary in the desired result [Q between (1) = 0.17, P = 0.68].

Overall, among people with drug and nicotine use problems, breathing-based therapies consistently and significantly reduced desire. The overall results support the incorporation of affordable, scalable, and easily accessible breathing-based strategies into addiction treatment frameworks, even though there is still conflicting and little data for other outcomes.

Source:

Roxburgh, A. D., Rowland, B., Lubman, D. I., Kaur Bains, S., Pek, M. A., Tso, B., Manning, V., & Arunogiri, S. (2026). Controlled breathing and heart rate variability biofeedback for substance use-related outcomes: A systematic review and meta-analysis. Addiction (Abingdon, England), add.70542. https://doi.org/10.1111/add.70542