Yoga for Addiction and Substance Use Recovery: Evidence

If you or someone you know is in danger or has severe withdrawal symptoms, get urgent help first: in the US call 911, and if you are thinking about harming yourself call 988. The NHS tells people in the UK to call 999 for severe alcohol withdrawal symptoms such as hallucinations, severe tremors or seizures.[1] For treatment and support options, see Substance Use Support and Urgent Help.

This page is about one narrow question: does adding yoga to recovery care help? It does not suggest yoga as a way to treat addiction on its own. Stopping alcohol suddenly can be dangerous for some people. The NHS says that if you are physically dependent and need to stop drinking completely, stopping overnight could be harmful and you should get advice first.[1] Yoga is not a substitute for that advice, for medicines such as opioid substitution therapy, or for counseling.

What the research found

1. Yoga for adults with substance use disorder

   Promising but limited

   A 2021 systematic review included eight randomized trials in people using tobacco, alcohol or opioids, excluding studies where yoga was combined with other interventions.[2] The authors called the results encouraging but said larger trials are needed.

2. Yoga for substance use in women

   Insufficient evidence

   A review of ten trials, of which two focused on women, said most were small to medium with methodological flaws.[3] It found few results specific to women's needs.

3. NCCIH summary

   Promising but limited

   The NCCIH says yoga may be a helpful addition to treatment programs for substance use disorders and describes a 2021 review of 8 studies in which 7 showed benefits such as reduced substance use or less pain, stress or anxiety.[4]

4. Impulsivity in conditions that include substance use

   No good evidence of benefit in that review

   A review of placebo-controlled trials found no significant improvement from yoga versus placebo.[5]

5. Yoga plus physical therapy for chronic back pain and opioid use disorder

   Proper evidence not found (results not read)

   A trial protocol describes randomizing 345 people to yoga, physical therapy or usual care.[6] We read only the protocol, so no results are reported here.

What "encouraging" means here

In the 2021 review, most of the trials were scored as low concern for bias, and two had some concerns.[2] Seven of eight reported improvements in outcomes such as anxiety, pain or substance use, and the review says these positive outcomes came with yoga used alongside other treatment such as opioid substitution therapy.[2] The practices tested included hatha yoga, Sudarshan Kriya yoga, breathing exercises and meditation, so "yoga" meant different things in different trials.[2]

The review of women-focused research described most trials as small to medium-sized, with flaws in methods and analysis. It found results favorable or equivalent to control or usual treatment, mainly with hatha yoga, as an add-on to usual care.[3] "Equivalent" does not mean better.

Limits to keep in mind:

• Small trials and mixed definitions of yoga make it hard to say which part helps, if any.
• Trials of yoga cannot hide which group a person is in. A review of yoga and body image listed lack of blinding as a weakness, and the same limit applies here.[7]
• Reviews look at symptoms such as anxiety and craving. Proper evidence not found in the abstracts we read for yoga preventing relapse over the long term. We searched PubMed for yoga and substance use or alcohol and opioid trials.

Sensible ways to use this information

• Ask your treatment team whether a gentle class fits your recovery plan. Do not skip appointments or medicines to attend.
• The NCCIH advises a qualified instructor, since yoga is considered generally safe when done properly with one.[4]

Related pages

Yoga for Depression, Yoga for PTSD and Trauma and Yoga Compared With Medication and Therapy cover conditions that often overlap with addiction.