Does Yoga Therapy Have a Place in Addition Therapy?

At Minded, we have continuously evaluated the effects of the COVID-19 pandemic on mental health conditions such as anxiety, however addiction remains a major public health problem, and the complex nature of addictions & the suffering that those caught in the cycle endure, is well known. We were interested to explore the relationship between yoga therapy & addiction therapy.

According to the Centres for Disease Control and Prevention, as of June 2020, 13% of those in the United States reported starting or increasing substance use as a means of coping with COVID-19-related stress.

On an individual level, the problematic use of substances, known as substance use disorder (SUD) alters neurochemical pathways and behavioural patterns which can have negative effects on physical and mental health, from poor sleep & nutrition to concurrent disease [2]. Research into SUD has uncovered that post-treatment relapse rates are as high as 60% in the year following treatment and those with greater severity of substance-related problems & concurrent disorders experience the highest rates of relapse & comorbidity [1].

How Can Yoga Help?

It is well known that the use of complementary and alternative medicine (CAM) such as yoga, for treating SUD has been on the increase in recent years, with yoga as the third most common alternative health approach amongst adults (National Health Interview Survey, 2012).

As SUD is often related to lifestyle-related factors including the high levels of stress most of us experience within the modern world, particularly considering the pandemic, it is reasonable to suggest that yoga may be beneficial for those with SUD. Yoga has profound associations with reducing stress and addictive behaviours, whilst simultaneously improving perceived levels of self-esteem, personal empowerment, and self-control [5].

The Research

We came across a recent study by Petker et al (2021), which evaluated the within-treatment effects of an adjunctive yoga intervention in residential addiction treatment. They found that whilst usual treatment significantly improved craving, psychiatric symptoms, self-efficacy, impulsivity & mindfulness; the addition of yoga significantly improved range of motion and premeditation (i.e., ability to consider consequences prior to acting).

This kind of premeditation is seen a lot in the literature with regards to yoga’s ability to increase self-regulation (the ability to manage your emotions & behaviour in accordance with the demands of the situation) and the impacts of this on conditions such as SUD.

A further study by Walia et al (2021) highlighted yoga’s beneficial effects on SUD regarding stress reduction and increased self-regulation, concluding that the use of yoga as an adjunct treatment for SUD may help to lower the rising healthcare costs, due to the relative low-cost and easy-to-access nature of yoga [2].

Method: Mantra Meditation

Neurologically, one of the ways yoga may have a beneficial effect on SUD is the use of mantra within meditation. Mantra involves a short phrase, usually in the ancient Sanskrit language, which is repeated continuously either out loud or internally. When sound is used in this way, it supports concentration through repetition and creates a memory in the areas of the brain which encode language [9].

When this memory is made, sound current then has the potential to play by itself, and if this is happening, some of the ordinary mind activity, such as rumination can be interrupted [9]. This is a fascinating finding as rumination can cause a person to become anxious, depressed and/or irritable, which may lead them the seek an escape from their thoughts, reinforcing the cycle of addiction.

Non-Attachment

“From craving arises sorrow and from craving arises fear. If a man is free from craving, he is free from fear and sorrow”

– (Dhummupudu,197,216).

Within Patanjali’s Yoga Sutras, five yamas are listed. A yama (literally meaning ‘to reign in’) is a moral restraint, which specifically apply to how you behave outwardly toward other beings [7]. It’s easy to think of them as a sort of ‘moral code’ by which to live.

One of the yamas is aparigraha –

‘Parigraha’ means to cling to, to grasp, to hold.

And the prefix ‘A’ means the opposite of.

Which gives the word the loose translation ‘non-attachment’ which corresponds to the idea of ‘letting go’.

Focusing on non-attachment through yoga, mindfulness, and meditation, increases awareness and openness, therefore lessoning this attached thought. These findings are conducive to improved executive control (high-order regulation of both thoughts & behaviours) and a decrease in thought suppression [8]. This has the potential to regulate cue-reactivity, meaning individuals can overtime, become disengaged from substance cues [8] which would usually trigger consumption (i.e., they become less attached to the substance as an outcome of a trigger cue).

Insights

With marked rise in mental health conditions, including SUD considering the COVID-19 pandemic, it is important that yoga & healthcare professionals consider the impact of yoga as a low-cost and widely accessible conjunctive treatment for improving health.

At Minded, our wider mission is to bring yoga into healthcare, and in support of this mission, Shaura Hall has an upcoming 5-day Yoga Therapy for Addictions Online Course in February & March 2022.

Shaura is also running a half-day introductory course on the 18^th November 2021 for those interested in the of yoga therapy & addiction therapy.

References

1. Petker, T., Yanke, C., Rahman, L., Whalen, L., Demaline, K., Whitelaw, K., … & MacKillop, J. (2021). Naturalistic Evaluation of an Adjunctive Yoga Program for Women with Substance Use Disorders in Inpatient Treatment: Within-Treatment Effects on Cravings, Self-efficacy, Psychiatric Symptoms, Impulsivity, and Mindfulness. Substance abuse: research and treatment, 15, 11782218211026651.
2. Walia, N., Matas, J., Turner, A., Gonzalez, S., & Zoorob, R. (2021). Yoga for Substance Use: A Systematic Review. The Journal of the American Board of Family Medicine, 34(5), 964-973.
3. Kiseleva, N., & Kiselev, S. (2021). Impact of body-oriented therapy on executive abilities in children with computer game addiction. European Psychiatry, 64(S1), S568-S568.
4. Centers for Disease Control and Prevention (June, 2020). https://www.google.com/search?client=safari&rls=en&q=addiction+statistics+covid+19&ie=UTF-8&oe=UTF-8
5. Gelderloos P, Walton KG, Orme-Johnson DW, Alexander CN. Effectiveness of the Transcendental Meditation program in preventing and treating substance misuse: a review. Int J Addict. 1991 Mar;26(3):293-325. doi: 10.3109/10826089109058887. PMID: 1889927.
6. Groves, P., & Farmer, R. (1994). Buddhism and addictions.Addiction Research, 2(2), 183-194.
7. Reverend Jaganath Carrera (20060. Inside The Yoga Sutras: A Comprehensive Sourcebook for The Study and Practice of Patanjali’s Yoga Sutras. Intergral Yoga Publications,
8. Cheng, F. K. (2016). How can meditation be salutary in dealing with alcohol use disorder.Mental Health and Addiction Research, 1(3), 55-58.
9. https://www.healthflix.online/lesson/brief-interventions-for-addictive-behaviours-developing-embodied-practices-to-support-present-moment-awareness/