Alcohol Took My Life; Yoga gave it back�: A Case Study of Yoga�s Therapeutic Potential in Addictions

Abstract

Most drug and alcohol addiction treatment services in the UK lack emphasis on supporting patients after their successful discharge from treatment. However this is unfortunate as addiction being a chronic condition, most patients need on-going support. Through this case report we illustrate how yoga can be a beneficial intervention for recovering addicts, and its benefits in preventing relapses. We call for more addiction treatment services to offer yoga, through integrating it into addicts� aftercare packages.

Keywords: Addictions; Relapse; Recovery; Yoga

Introduction

Given the existing �culture� in addiction (alcohol and/or drugs) treatment services in the UK of targets, performance monitoring and payment by results, there is excessive emphasis on getting patients into and successfully through treatment (also called through put) [1]. However, inadequate attention is paid to those addicts who successfully exit treatment. Or in other words, there is much less emphasis on their on-going care after �formal� discharge from treatment services. Patients are often left to rely on their own resilience or are expected to seek out and mobilise their own sources of on-going support such as peer support groups to maintain their recovery from addictions. This is unfortunate as addiction more often than not, is a chronic relapsing condition [2] that requires long-term support. It is a chronic illness with its ups and downs, and addicts even in recovery need on-going support to prevent relapse. It is time we moved away from a purely pharmacological model and saw an addict/ ex-addict as a �whole� person. For addicts in recovery, it is important that their overall well-being (physical and psychological) is addressed and improved. A successful episode of treatment and discharge from a short spell in treatment doesn�t always equate to sustained long-term recovery. It is merely seen as the stepping stone towards the start of an addict�s recovery journey. And this road to recovery can be bumpy: Often cited triggers for relapses include negative mood states such as anxiety and depression, boredom, stressors in day to day life, inadequate coping strategies, etc.

This is where yoga has a vital therapeutic role to play � i.e. in supporting recovering addicts stay in recovery and not to relapse. Yoga is a holistic intervention that originated in India several thousand years ago and in its true forms it has immense health benefits. Yoga�s therapeutic potential in psychiatric conditions such as depression has been studied extensively but their benefit in addictive disorders is yet to be systematically explored. Preliminary findings from studies in the field of yoga and psychiatry indicate changes in neurophysiological, neuroimmunological and neuroimaging measures, thus establishing a scientific basis for yoga treatment [3].

Through this case report, I illustrate the therapeutic benefits of yoga to an addict in recovery. In the sections below I include a brief account by the patient herself as to how yoga benefitted her in her recovery and a discussion around how yoga helps her in her recovery journey. I make a call for addiction services to incorporate yoga into their aftercare support provision: Yoga can be offered in conjunction with other psychosocial support packages of care to addicts after their discharge from �formal� treatment services.

Case Report

In this section I include: an account of how yoga benefitted this patient (in her own words), her scores on a yoga impact rating scale, a brief description of how this yoga class is run, and some of the ways in which yoga helps addicts.

Lucy is a Caucasian lady in her sixties. She lives with her husband of more than 40 years and is retired. She has two children in their forties and is a grandmother to three. She was an alcoholic for twenty years and has now been in recovery for 2 years. She is not on any pharmacological treatment for her alcoholism. Lucy comes to yoga class every week without fail. She says it�s a �little treat� for herself.

�I do believe that going to yoga classes has helped me stay in recovery for over two years. In the past, when I felt stressed, I would drink heavily, thinking this would solve my problem or make it go away. When I become stressed and anxious now, deep abdominal breathing helps clear my mind and relieves the tension within my body, enabling me to put things into perspective and where possible, deal with it. Giving up alcohol has given me my life back- freedom to choose and make decisions with a clear mind. Yoga has enabled me to hold onto that freedom by using my mind and body instead of alcohol, which was only a temporary solution. A big problem in people�s life today is stress and anxiety. There are yogic techniques that you can use anytime and anywhere to help you manage a situation. I was surprised at how long it took for me to learn how to clear my mind of thoughts and overwhelming sounds, but definitely well worth the wait. I have also had the opportunity to meet different people and make new friends. I am learning that yoga is a discipline for all people. Yoga is giving me life. Alcohol was taking it away.�

Given here is Lucy�s own rating of the impact of yoga on various aspects of her life. The questions in this self-administered �yoga impact questionnaire� covered the previous 6 months� rating on various aspects of the patient�s life, and each item could be scored from 1 to 5 (1 being �no impact at all� and 5 being �definitely improved.�): Physical health (5/5), Psychological health (4), Overall well-being (5), Anxiety levels (4), Ability to cope with stress (5), Relaxation levels (5), Concentration levels (4), addiction (5), depression (4), sleep (4). It is evident, form Lucy�s subjective ratings that she perceives yoga to have had significant positive impact on several aspects of her life.

In our drug and alcohol service in Solihull, I offer yoga to patients on a once weekly basis. I am experienced in working with this group, and this particular class has been running since May 2013. We practice Hatha yoga incorporating four key elements: Asanas (physical movements), Pranayama (breathing practices), relaxation (Shavasana) and Dhyana (meditation). This class is attended by patients in various stages of addiction including some who are actively using substances, some in recovery, and also some carers of addicts.

So how does yoga help? Simply put, yoga practice brings balance into the body- at both physical and mental levels. It restores a sense of well-being and gives a patient more energy. By bringing focus on breath, yoga helps reduce anxiety and stress levels. Breathing exercises or pranayama help clear the mind, thus helping a patient make better, more confident and competent decisions. And with this, comes the ability to deal with stressful situations, knowing that they now have to hand positive ways of dealing with it. This makes them feel happier and more content. On a physical level, yoga poses or Asanas are known to help with problems caused by substance misuse. For example, some postures relieve constipation and help bowel movement.

Yoga is also known to reduce the stress hormone cortisol, increases oxygen consumption and reduces muscle stiffness and tension. Many studies from India have shown that yoga and meditation can alter the very biochemistry of the brain more directly and efficiently than regular exercise [4].

Conclusion

I acknowledge that as this is a case report it has inherent limitations regarding its potential generalizability. However, from my experience of working with this patient group, yoga has a vital role as an adjunct in relapse prevention packages of care for addicts. Some of the greatest benefits of yoga are its affordability, feasibility and patient acceptability. I call for more addiction services to incorporate yoga as a therapeutic intervention to those who are recovering from addictions. I acknowledge that more research needs to be done before robust conclusions are to be drawn about yoga�s place in the therapeutic armamentarium of addiction services.

Acknowledgement

My sincere thanks to Lucy (anonymised) for her consent to her story being published, and for her contribution to this case report.

References

1. Alcohol treatment in England 2013 � 13. Public Health England. PHE publications gateway number: 2013259. October 2013, Crown copyright 2013.
2. Ghodse H. Drugs and addictive behaviour: A guide to treatment. 3^rd edn. Cambridge University Press, 2002.
3. Kumar A, Kumar S. Karma yoga: A path towards work in positive psychology. Indian J Psychiatry. 2013; 55: S150-152.
4. Dharma Singh Khalsa. Meditation as Medicine: Activate the power of your natural healing force. New York: Pocket Books. 2001.