Shifting the Autonomic Nervous System balance and Addiction Recovery

Mudie [1] showed that the different methods that people have used to promote recovery from Substance Use Disorders (SUD) all seem to produce a change in the Autonomic Nervous System (ANS). He observed that a person suffering from a SUD has a dominating Sympathetic Nervous System (SNS). The SNS is characterized by feelings of anger, fear and tendencies to fight or flee [2,3] The recovering person has a more active Parasympathetic Nervous System (PSNS) which is characterized by feelings of serenity humility, calm lack of fear, connection acceptance, and a tendency to care for others. He reported that the underlying feature of all methods of recovery from SUD’s are ways to increase the activity of the PSNS. 

In this paper we propose that just the act of shifting the balance of the ANS from an active SNS to a more active PSNS is a necessary and sufficient condition to promote recovery from a SUD.

• Meditation 

Wu and Lo [4] showed that inward-mediation increased PSNS activity and Chiesa A, Serretti A [5] stated “Our review suggests that Mindfulness-based interventions” can result in reduced consumption of several substances including alcohol, a range of types of drugs, smoke, and opiates to a significantly higher extent than waitlist controls, non-specific educational support group, and some specific control group. 

Garland et al., [6] showed that a meditation practice (MORE) improved the recovery of chronic opioid users. As meditation has been shown to activate the PSNS [4] this can be interpreted as showing that deliberate shifting of the ANS by meditation can improve the recovery from a SUD, in this case opiod use disorder. 

Nijjar et al., [7] suggested that Mindfulness Based Stress Reduction (MBSR) training improved sympatho-vagal balance, the use of MBSR [8] has been shown to reduce craving.

• Aromatherapy 

Chang and Shen [9] stated “After two ten-minute aromatherapy sprays with Bergamot essential oil on elementary school teachers, the parasympathetic nervous system was enhanced”. 

Watanabe et al., [10] stated when inhaling Bergamot dissolved in water vapor “the HF component of the heart rate variability, which is an indicator for the function of the parasympathetic nervous system, significantly increased”. 

Chien et al., [11] stated that “The study demonstrated that lavender inhalation may have a persistent short-term effect on HRV with an increase in parasympathetic modulation”. 

• Chiropractic 

Welch and Boone [12] reported that “In this study, the findings after a cervical adjustment were linked to an increase in parasympathetic dominance”. 

• Massage 

Field [13] reported that a study when foot and hand massages were given to children who were hospitalized on a pediatric intensive care unit that during the massage, parasympathetic activity (as measured by vagal activity) increased by 75%. 

• Slow Deep Breathing 

Jerath et al., [14] showed that slow breathing enhances parasympathetic activity Slow breathing pranayama exercises showed a strong tendency of improving or balancing the autonomic nervous system through enhanced activation of parasympathetic nervous system. Specifically, with slow breathing pranayama there is a noted increase in parasympathetic activity and a decrease in sympathetic dominance. 

Brook et al., [15] reported that device guided slow breathing was more successful than meditation in reducing blood pressure. 

Pal GK., et al., [16] also found that “… increased parasympathetic activity and decreased sympathetic activity were observed in slow breathing group”.

Brook et al., [15] showed that device-guided breathing greatly reduced blood pressure perhaps by activating the PSNS. If this is true, then presumably device guided breathing would also support recovery from addictions. As the device used in the Brook et al., [15] report was manufactured by RESPeRATE (cost about $370) the cost for ongoing treatment is minimal compared with treatment provided by residential treatment centers for SUD recovery.

We have proposed and shown that shifting the balance of the autonomic system from a more active SNS to a more active PSNS supports recovery from SUD’s. We have described novel methods of shifting the balance and proposed a low-cost treatment that might enhance recovery from SUD’s.

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2. Dana D (2021) Anchored: How to befriend your nervous system using polyvagal theory. Sounds True: 1-208.
3. Porges SW (2009) The polyvagal theory: new insights into adaptive reactions of the autonomic nervous system. Cleveland Clinic journal of medicine 76: 86-90.
4. Wu SD, Lo PC (2008) Inward-attention meditation increases parasympathetic activity: a study based on heart rate variability. Biomedical Research 29: 245-250.
5. Chiesa A, Serretti A (2014) Are mindfulness-based interventions effective for substance use disorders? A systematic review of the evidence. Substance use & misuse 49: 492-512.
6. Garland EL, Hanley AW, Nakamura Y, Barrett JW, Baker AK, et al. (2022) Mindfulness-oriented recovery enhancement vs supportive group therapy for co-occurring opioid misuse and chronic pain in primary care: A randomized clinical trial. JAMA internal medicine 182: 407-417.
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8. Witkiewitz K, Lustyk MKB, Bowen S (2013) Retraining the addicted brain: a review of hypothesized neurobiological mechanisms of mindfulness-based relapse prevention. Psychology of Addictive Behaviors 27: 351-365.
9. Chang KM, Shen CW (2011) Aromatherapy benefits autonomic nervous system regulation for elementary school faculty in Taiwan. Evidence-Based Complementary and Alternative Medicine: 946537.
10. Watanabe E, Kuchta K, Kimura M, Rauwald HW, Kamei T, et al. (2015) Effects of bergamot (Citrus bergamia (Risso) Wright & Arn.) essential oil aromatherapy on mood states, parasympathetic nervous system activity, and salivary cortisol levels in 41 healthy females. Complementary Medicine Research 22: 43-49.
11. Chien LW, Cheng SL, Liu CF (2012) The effect of lavender aromatherapy on autonomic nervous system in midlife women with insomnia. Evidence-based complementary and alternative medicine: 740813.
12. Welch A, Boone R (2008) Sympathetic and parasympathetic responses to specific diversified adjustments to chiropractic vertebral subluxations of the cervical and thoracic spine. Journal of chiropractic medicine 7: 86-93.
13. Field T (2019) Pediatric massage therapy research: a narrative review. Children 6: 78.
14. Jerath R, Edry JW, Barnes VA, Jerath V (2006) Physiology of long pranayamic breathing: neural respiratory elements may provide a mechanism that explains how slow deep breathing shifts the autonomic nervous system. Medical hypotheses 67: 566-571.
15. Brook RD, Appel LJ, Rubenfire M, Ogedegbe G, Bisognano JD, et al. (2013) Beyond medications and diet: alternative approaches to lowering blood pressure: a scientific statement from the American Heart Association. Hypertension 61: 1360-1383.
16. Pal GK, Velkumary S, Madanmohan (2004) Effect of short-term practice of breathing exercises on autonomic functions in normal human volunteers. Indian Journal of Medical Research 120: 115-121.