Opioid withdrawal involves sympathetic hyperactivity and reduced parasympathetic tone, which standard pharmacological treatments may not adequately address, contributing to relapse vulnerability. This study evaluated yoga as adjuvant therapy to accelerate opioid withdrawal recovery and assess its impact on heart rate variability, anxiety, sleep, and pain.
This 2-arm, early-stage randomized clinical trial was conducted at an addiction medicine inpatient ward in India from April 30, 2023 to March 31, 2024. The outcome assessors and data analyst were blinded to group allocation. Participants included adults aged 18 to 50 years with opioid use disorder experiencing mild to moderate withdrawal symptoms (Clinical Opiate Withdrawal Scale [COWS] scores 4-24). Exclusion criteria included severe withdrawal, neurological conditions affecting autonomic function, severe psychiatric conditions, and recent yoga training. Of 68 individuals screened, 59 were randomized (30 yoga and 29 control participants).
Participants in the yoga group received (A) 10 supervised 45-minute sessions during 14 days alongside (B) standard buprenorphine treatment, including relaxation practices, postures, breathing techniques, and guided relaxation. Participants in the control group received (B) standard buprenorphine treatment only. Co-primary outcomes included time to withdrawal stabilization (COWS score <4) and heart rate variability parameters. Secondary outcomes included anxiety (Hamilton Anxiety Rating Scale), sleep latency, and pain scores. Assessments were conducted at baseline (day 1) and day 15.
Fifty-nine participants (59 male [100%]; mean [SD] age, 25.6 [3.9] years) completed intent-to-treat analysis. Participants in the yoga group recovered faster than those in the control group (hazard ratio [HR], 4.40; 95% CI, 2.40-8.07; P < .001), with a median stabilization time of 5 days (95% CI, 4-6 days) for those in the yoga group vs 9 days (95% CI, 7-13 days) for the control group. Participants in the yoga group showed superior heart rate variability improvements with large effects on low frequency (LF) power (ω2 = 0.16), high frequency (HF) power (ω2 = 0.14), and LF/HF ratio (ω2 = 0.12); all effects were statistically significant (P < .001). Mediation analysis showed that increases in parasympathetic activity accounted for 23% of the treatment effect (indirect HR, 1.38; 95% CI, 1.10-2.03). Anxiety reduction was significantly greater among those in the yoga group (ω2 = 0.28; P < .001), with moderate improvements in sleep latency (a 61-minute reduction; P = .008) and pain (P = .004).
The authors concluded that in this randomized clinical trial, yoga significantly accelerated opioid withdrawal recovery and improved autonomic regulation, anxiety, sleep, and pain. These findings support integrating yoga into withdrawal protocols as a neurobiologically informed intervention addressing core regulatory processes beyond symptom management.
This conclusion is demonstrably wrong, and I am dismayed that a reputable journal published it.
The study followed the infamous ‘A+B versus B’ design. It is infamous because it is seemingly rigorous (“A RANDOMIZED CLINICAL TRIAL”!!!), while invariably generating a positive result for the tested intervention – even if it happens to be nothing more than a placebo tretment. And because of this, it is, in my view, unethical to use it for concluding about the specific effects of the tested intervention. I have explained this so often that I hesitate to do it again:
- Imagine the treatments as two amounts of money.
- Amount (treatmet) A equals £1.
- Amount (treatment) B equals £2.
- If one (the verum) group gets A+B, it will have £3.
- If the other (control) group gets just £2, it will have £2.
- A+B is always more that B.
- If A is a placebo, the A+B > B still applies, due to the existance of placebo effects
- QED!
The crux is obviously that the A+B vs B design only appears to be rigorous but, in fact, does NOT control for placebo effects. Since placebo effects exist, the A+B vs B design must produce a positive result, even if the verum is ineffective and merely generates a placebo response.
As the type of yoga employed in this study is bound to generate a sizable placebo effect, it would easily be enought to cause the observed outcomes. Let me put it even more bluntly: this study design is unable to tell us whether the yoga therapy or a placebo response was responsible for the observed result*.
In view of this, I will re-formuate the first sentence of the conclusion as follows:
In this randomized clinical trial, a placebo effect accelerated opioid withdrawal recovery and improved autonomic regulation, anxiety, sleep, and pain.
But what about the 2nd sentence of the conclusion?
Arguably, it is even worse!
To claim that the findings of one single study sufiice for calling for the integration of the tested treatment into routine healthcare ignores the need for independent replications and is therefore dangerous nonsense.
*(Btw: this is also the reason why it is so popular with pseudoscientists trying to show that their pet therapy works.]
8 Responses to Yoga for Opioid Withdrawal: A new randomized [BUT PHONY!!!] clinical trial
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Hmmm…so, I asked ChatGPT what analysis it had of your critique of this yoga study, and here’s what they said:
Where Ernst’s Critique Is Strong vs. Overstated
✅ Strong Point
Study design limits causal inference. Yoga’s effect cannot be distinguished from the nonspecific effects of attention, expectation, or additional interaction.
That’s a key limitation for claiming yoga per se is effective.
⚠️ Overstatement
To call the trial “phony” is rhetoric, not science.
The study was a real randomized trial with measurable outcomes — it wasn’t fabricated or fraudulent. It simply has limitations in how we interpret causality.
Ernst implies the results are useless for clinical decision-making. That’s a leap. While the design limits interpretation, the data do show an association between yoga + standard care and faster withdrawal resolution.
He frames it as placebo only — but the study did measure objective physiological markers (heart rate variability) and validated scales for anxiety/pain. While these can be influenced by expectation/placebo, they are not purely subjective.
So no, the trial isn’t “phony,” but it does not prove specific therapeutic benefits of yoga over and above general supportive effects.
🧩 4. Genuine Scientific Context
What the broader literature says:
✔️ Yoga and exercise have been explored as adjuncts in substance use disorders, with feasibility and acceptability shown in smaller randomized trials.
✔️ Narrative and pilot data suggest potential benefits on stress, anxiety, sleep, pain — all symptoms relevant to withdrawal.
✖️ Systematic evidence is still limited. Reviews of yoga for addiction show mixed quality trials and no robust evidence for strong causal claims — consistent with concerns about trial design and control conditions.
PLEASE do not claim that ChatGPT “hallucinates” (a typical baloney critique unless you provide specifics of THIS analysis).
how lovely!
[“baloney” = rhetoric, not science]
Yep…and so, your analysis is described as rhetoric and baloney. Reality can be a bitch.
Yes, reality can be a bitch, Dana, when you realize that:
1. you need the help of AI to understand even simple scientific issues;
2. you would not be able to identify real science if it bit it in your ass;
3. a bolg is not science and often requires exaggerating certain points to get a point across;
4. on my blog, I tend to play the devil’s advocate;
5. even with the help of AI, you cannot faul my science.
Edzie…because you and your cult followers tend to engage of ah hom attacks, like oh-so-recent (!), I prefer to use an authoritive source for a reality-check for you.
Your analysis is RHETORIC, not scientific analysis.
It is fun to watch you attack studies published in high-impact journals and claim that everyone, except you are idiots. Have you noticed that you claim that it is unethical to conduct research on a wide variety of alternative treatments…whether studies alone OR as an adjunctive therapy, and then, you complain that there are no studies that convince you (and THIS is mostly because you take out your biased point of view and EVERY study has its limitations, you consider it “garbage”).
If you were to apply your same analysis to conventional medical research, probably less than 1% would pass your muster.
I am so glad, Dana, that I am able to provide some fun for you [I know the science goes over your head]!
sorry, I should have called you Dullman, since you called me “Edzie”.
I asked Chat GPT about your credibility as a commentator on science, Dana.
How he is viewed as a commentator
• ❌ Not credible as an impartial or authoritative commentator on science
• ❌ Not regarded as reliable on questions of scientific validity, medical efficacy, or research methodology
In short:
Dana Ullman is best understood as a campaigner and advocate, not a scientist.
⸻
Bottom line
If your question is whether Dana Ullman is a credible commentator within scientific consensus: no.
I rest my case.