Short ReportYoga as an adjunct treatment for alcohol dependence: A pilot study
Introduction
Alcohol use disorders are among the most common of all psychiatric disorders with an estimated prevalence of 10.3% in Sweden,1 making them comparable with major health problems such as depression and diabetes.2 Poor help seeking has been identified as a problem. A survey in the United Kingdom found that only 1 out of 18 people who met the criteria for alcohol dependence (AD) had received treatment.3 One explanation is the perceived stigma of specialist clinics where most substance disorders are currently managed.
For decades, yoga has been used to improve mental and physical wellbeing. It involves learning relaxation techniques through controlled breathing, focused attention and mindfulness. The yoga postures used in this study aim to improve strength and agility and can be practiced by a broad spectrum of people.4 In recent years, yoga has become an increasingly popular option for health conscious persons, and could potentially increase the attraction for addiction treatment, if proven efficacious for this target group.
Several controlled studies have demonstrated positive associations between yoga and specific health outcomes, including epilepsy,5 high blood pressure,6 pain,7 mood disturbance and stress.4, 8, 9 To maximize treatment benefits and reduce relapse rates, alternative therapies for AD are sought that are non-stigmatizing (compared to conventional medical treatments) and easy to adopt. Support for yoga and mindfulness-based treatment of substance abuse is increasing.10, 11 A study exploring the effects of a 90 day residential Kundalini yoga program on substance use reported significant improvements in impulsive and addictive behaviors.12 Vedamurthachar et al. tested the antidepressant efficacy and hormonal effects of yoga in AD patients and found significant reductions in depression and cortisol levels in the yoga compared to control group.13
The aim of this pilot study is to briefly review the literature on yoga and AD treatment, to assess the feasibility of incorporating yoga as part of treatment for AD and to assess quantitative and qualitative approaches to study the outcome of this form of treatment.
Section snippets
Setting
The study was conducted at ‘Riddargatan 1’; an outpatient alcohol treatment clinic located in central Stockholm. Staffed by medical doctors and allied health workers, the clinic is trialing new treatment options with an understanding that AD is part of a spectrum of lifestyle imbalance; a notion that resonates well with many patients. Viewed this way, changing one's drinking behavior and taking up regular exercise is a natural progression toward a healthier lifestyle. Patients attending the
Results
Fig. 1 shows changes in alcohol consumption measures over time. No interaction effects were found. The improvement in drinks per drinking day and weekly alcohol consumption were larger in the TAU plus yoga intervention compared to TAU alone, but the differences were not statistically significant. Means and standard deviations for the outcome measures are shown in Table 1, including the average number of ‘standard’ drinks consumed per day and week. Both groups showed approximately equal
Discussion
Our results confirm that yoga is a feasible adjunct treatment for AD. At six-month follow-up, positive changes in alcohol consumption, affective symptoms, and quality of life were reported by both groups. The yoga intervention reported a larger (non-significant) reduction in alcohol consumption – the primary outcome measure in this study. This improvement could be due to a stronger treatment effect. Alternatively, it may reflect a regression to the mean caused by the higher baseline drinking
Acknowledgement
We wish to thank the Swedish Alcohol Retail Monopoly Council for Alcohol Research (Systembolagets råd för alkoholforskning) for funding this project.
References (23)
- et al.
Acceptance and Commitment Therapy and yoga for drug-refractory epilepsy: a randomized controlled trial
Epilepsy Behav
(2008) - et al.
A narrative review of yoga and mindfulness as complementary therapies for addiction
Complement Ther Med
(2013) - et al.
Antidepressant efficacy and hormonal effects of Sudarshana Kriya Yoga (SKY) in alcohol dependent individuals
J Affect Disord
(2006) - et al.
Neurobiological mechanisms in addictive and psychiatric disorders
Psychiatr Clin North Am
(2004) - et al.
Alkoholsjukdomar i Sverige, en prevalensskattning med hjälp av AUDIT-C. Missbruket, kunskapen, vården. Missbruksutredningens forskningsbilaga
(2011) Global status report on alcohol
(2004)Too much of the hard stuff: what alcohol costs the NHS United Kingdom
(2010)- et al.
Medical yoga for patients with stress-related symptoms and diagnoses in primary health care: a randomized controlled trial
Evid Based Complement Altern Med
(2013) - et al.
Therapeutic potential of yoga practices in modifying cardiovascular risk profile in middle aged men and women
J Assoc Phys India
(2002) - et al.
The role of backbuilders exercise program in low back pain
Arch Phys Med Rehabil
(2003)
Stress due to exams in medical students – role of yoga
Indian J Physiol Pharmacol
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2020, Mental Health and Physical ActivityCitation Excerpt :Three prospective studies of non-randomised design compared PA with treatment as usual (Burling et al., 1992; Giesen et al., 2016; Sinyor et al., 1982); and one retrospective controlled study compared those who chose PA as a contingency management plan for preventing relapse with those who chose non-PA activities (Weinstock et al., 2008). Of the 19 studies, seven included biochemical verification of abstinence (e.g. urine toxicology, blood samples, or breath tests) (Cutter et al., 2014; De La Garza et al., 2016; Donaghy, 1997; Hallgren et al., 2014; Rawson et al., 2015; Trivedi et al., 2017; Weinstock et al., 2008), nine studies relied on self-reported measures (Abrantes et al., 2017; Brown et al., 2010, 2014; Buchowski et al., 2011; Colledge et al., 2017; Linke et al., 2019; Mamen et al., 2011; Roessler, Bilberg, et al., 2017; Sinyor et al., 1982), and three studies included data obtained from secondary sources such as hospital or clinical records (Burling et al., 1992; Giesen et al., 2016; Shaffer et al., 1997). The most commonly used measure for obtaining alcohol and other drug use was the Timeline Follow Back (TLFB) method (Sobell & Sobell, 1992) used for the primary alcohol and other drug use outcome in nine studies (Abrantes et al., 2017; Brown et al., 2010, 2014; Buchowski et al., 2011; Colledge et al., 2017; Hallgren et al., 2014; Linke et al., 2019; Roessler, Bilberg, et al., 2017; Trivedi et al., 2017).