Addiction & Recovery

Methods

Comprehensive narrative review of HRV in SUD

Key Findings

• Significantly decreased resting HRV in substance users
• Lower HRV associated with greater craving intensity
• HRV correlates with SUD symptom severity
• Acute and chronic substance use diminishes HRV
• HRV may indicate early relapse risk

Limitations

Heterogeneous substances and study designs

Methods

Phase 2 clinical trial, 115 adults with severe SUD, 8 weeks

Key Findings

• HRV biofeedback device reduced cravings vs control
• AI-prompted biofeedback when stress/cravings detected
• 10 minutes scheduled + 5 minutes prompted practice daily
• Targets autonomic systems disrupted by chronic substance use
• Cost-effective adjunct to standard recovery programs

Limitations

8-week study, longer-term effects not assessed

Methods

Longitudinal study of smoking and SUD recovery outcomes

Key Findings

• Smoking cessation associated with 30% increased recovery odds
• Smoking interventions during treatment enhance long-term sobriety
• Cigarette smoking diminishes HRV acutely and chronically
• E-cigarettes and passive smoke also reduce HRV
• HRV improves after smoking cessation

Limitations

Self-selection effects possible

Methods

HRV monitoring during naloxone-induced opioid withdrawal

Key Findings

• HF-HRV and RMSSD significantly lower during withdrawal
• Heart rate and blood pressure increase substantially
• Sympathetic hyperactivity drives withdrawal symptoms
• HRV changes predict treatment outcomes
• Medications targeting ANS may help withdrawal

Limitations

Acute withdrawal setting, various opioid types

Methods

Controlled THC administration with HRV monitoring

Key Findings

• THC dose-dependently increases heart rate
• HF-HRV decreases with THC administration
• Greater intoxication = greater HRV reduction
• Effects persist during sleep (22-23% RMSSD reduction)
• Women may be particularly affected

Limitations

Acute effects; chronic users may differ

Methods

Comparison of HRV in OUD vs non-OUD opioid patients

Key Findings

• OUD patients have significantly lower HF-HRV (d = 0.36)
• Lower HRV correlates with higher craving intensity
• HRV correlates with OUD severity
• May help identify patients at addiction risk
• Potential target for treatment interventions

Limitations

Cross-sectional design, chronic pain confounds