Yoga Speeds Up Opioid Withdrawal, Boosts Heart Health: JAMA Study
India: Researchers have reported that adding yoga to standard medical treatment can significantly accelerate recovery from opioid withdrawal while improving both physiological and psychological outcomes. In a randomized clinical trial, yoga shortened the time required for withdrawal stabilization and enhanced autonomic regulation, while also reducing anxiety, improving sleep, and alleviating pain. The findings suggest that yoga may serve as a neurobiologically informed adjunct to conventional withdrawal care.
The study, published in JAMA Psychiatry, was led by Suddala Goutham from the Department of Integrative Medicine, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, and colleagues. Opioid withdrawal is characterized by sympathetic overactivity and diminished parasympathetic tone, which standard pharmacological treatments may not fully address. This autonomic imbalance contributes to distress during withdrawal and increases vulnerability to relapse, highlighting the need for complementary interventions.
The early-stage, two-arm randomized clinical trial was conducted in an inpatient addiction medicine ward in India between April 2023 and March 2024. Adults aged 18 to 50 years with opioid use disorder and mild to moderate withdrawal symptoms were eligible for inclusion. Of 68 individuals screened, 59 male participants were randomized to receive either yoga alongside standard buprenorphine treatment or buprenorphine treatment alone. Outcome assessors and data analysts were blinded to group allocation.
Participants in the yoga group underwent ten supervised 45-minute sessions over 14 days, including relaxation, postures, breathing exercises, and guided relaxation. Primary outcomes were time to withdrawal stabilization (Clinical Opiate Withdrawal Scale score <4) and heart rate variability, while secondary outcomes included anxiety, sleep latency, and pain, assessed at baseline and day 15.
The study led to the following findings:
- Patients who received yoga alongside standard treatment recovered significantly faster than those in the control group.
- The median time to withdrawal stabilization was five days in the yoga group compared with nine days in the control group.
- Yoga increased the likelihood of achieving faster withdrawal recovery by more than fourfold.
- Heart rate variability analysis showed significant improvements in autonomic balance among participants practicing yoga.
- Increased parasympathetic activity accounted for nearly one-quarter of the overall treatment effect.
- Participants in the yoga group experienced greater reductions in anxiety compared with controls.
- Moderate but statistically significant improvements were observed in sleep and pain outcomes among yoga participants.
- Sleep onset time was reduced by approximately one hour in the yoga group.
- Pain scores showed meaningful declines following the yoga intervention.
The authors acknowledged several limitations, including the single-center design, short intervention duration, and exclusive inclusion of male participants, which restrict generalizability. Although most participants misused tapentadol, the underlying autonomic disturbances observed during withdrawal are common across opioid types, suggesting broader relevance.
Overall, the study indicates that yoga can enhance opioid withdrawal management by addressing core autonomic dysregulation rather than focusing solely on symptom relief. The authors conclude that integrating yoga into withdrawal protocols may strengthen standard care and reduce relapse vulnerability. Larger, multisite trials involving diverse populations and longer follow-up are needed to confirm these findings and guide clinical implementation.
Reference:
Goutham S, Bhargav H, Holla B, et al. Yoga for Opioid Withdrawal and Autonomic Regulation: A Randomized Clinical Trial. JAMA Psychiatry. Published online January 07, 2026. doi:10.1001/jamapsychiatry.2025.3863
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