APRIL 8, 2026
A recent randomized clinical trial, conducted at India’s National Institute of Mental Health and Neurosciences (NIMHANS) and published by JAMA Psychiatry (2026 Jan 7. doi:10.1001/jamapsychiatry.2025.3863) found that yoga interventions can speed up recovery for patients with opioid use disorder (OUD) by directly reducing underlying symptoms that increase patients’ risk for relapse.
OUD is increasingly prevalent, with global rates increasing by nearly 50% between 1990 and 2021.
A recent randomized clinical trial, conducted at India’s National Institute of Mental Health and Neurosciences (NIMHANS) and published by JAMA Psychiatry (2026 Jan 7. doi:10.1001/jamapsychiatry.2025.3863) found that yoga interventions can speed up recovery for patients with opioid use disorder (OUD) by directly reducing underlying symptoms that increase patients’ risk for relapse.
OUD is increasingly prevalent, with global rates increasing by nearly 50% between 1990 and 2021. However, the pharmacologic treatments typically prescribed for opioid withdrawal are limited by the fact that they don’t address the autonomic dysregulation patients experience during withdrawal. “The current treatments are more controlling the patient’s craving,” explained lead author Suddala Goutham, a researcher at NIMHANS.
When a patient stops taking an opioid, it causes hyperarousal of the sympathetic nervous system and reduced parasympathetic tone, leading to a cascade of autonomic symptoms such as increased heart rate, difficulty sleeping, anxiety, and agitation. Because autonomic dysregulation is associated with more severe cravings that make patients vulnerable to relapse, not addressing these symptoms can worsen patients’ recovery outcomes.
Because research has shown that yoga increases activity in the parasympathetic nervous system while decreasing it in the sympathetic nervous system, Goutham’s team decided to investigate how offering a yoga intervention to patients experiencing opioid withdrawal might affect their recovery.
The study was conducted with 59 male patients who were hospitalized for mild to moderate opioid withdrawal symptoms at the Institute’s Centre for Addiction Medicine, in Bengaluru, India. While a control group of 29 participants was treated only with buprenorphine, the other 30 participants received both buprenorphine and a yoga training consisting of ten 45-minute sessions over the course of two weeks. The exercises used in the training came from a validated yoga module developed by researchers at NIMHANS, which included guided relaxation, postures, and breathing exercises.
Throughout the study period, researchers measured participants’ withdrawal symptoms using the Clinical Opiate Withdrawal Scale (COWS). They found that participants in the yoga intervention group reached withdrawal stabilization, measured as a COWS score of less than 4, after a median of five days, compared with an average of nine days in the control group, indicating that yoga training can significantly accelerate recovery.
This has major implications for recovery. “[Yoga] can actually reduce the amount of time [patients] are suffering with the withdrawal symptoms,” Goutham explained. Shortening this withdrawal period, when patients are at greatest risk for relapse, could lead to better long-term outcomes by reducing patient dropout rates. This change could also significantly reduce patients’ hospital stays, reducing the burden on healthcare systems.
The study found that this accelerated recovery may be caused by reduced autonomic dysregulation. On the first and last days of the intervention, researchers measured yoga intervention participants’ heart rate variability while they engaged in an exercise involving 10 minutes of rest, 10 minutes of breathing techniques, and then another 10 minutes of rest. Patients’ low-frequency/high-frequency (LF/HF) ratio, a measure indicating the sympathetic nervous system’s dominance compared with the parasympathetic nervous system, increased each time participants engaged in breathing exercises, before decreasing again when they returned to a resting state.
This routine activation and relaxation of the sympathetic nervous system can help to strengthen participants’ autonomic regulation. Researchers observed this in yoga intervention participants, whose baseline LF/HF ratio, measured during the resting phase at the beginning of sessions, decreased significantly between the first and last days of the intervention, suggesting reduced dominance of the sympathetic nervous system during resting states.
Participants from the control group, meanwhile, were asked to engage in a similar practice on the intervention’s first and last days, with breathing techniques replaced by quiet breath observation. Unlike the yoga intervention group, these participants’ LF/HF ratio remained stable throughout the exercise, and their average baseline did not change significantly over the two weeks.
The yoga intervention group also had significantly greater improvements in anxiety than those in the control group, an important finding given that anxiety is linked with relapse and cravings during the recovery process. Similar improvements were observed for pain perception and sleep latency in the yoga intervention group but not in the control group.
Because the study was conducted over a short period of time, longitudinal studies are still needed to better understand yoga’s long-term potential for patients with OUD. “We have to see, when a person gets better from the withdrawal phase,” said Goutham, “if he continues yoga in the long run, are there changes?”
Even so, the current study’s findings offer a promising way forward for treating OUD, demonstrating how interventions like yoga training can improve outcomes by addressing the underlying arousal and anxiety that make withdrawal onerous.
“These are all withdrawal symptoms,” Goutham said. “It’s not just the craving we should work upon.”
—Zoe Cunliffe
