A new review gives one of the simplest entries on that list a clearer position. Researchers at Monash University pooled 20 studies covering 1,249 participants.
They found that controlled breathing was associated with lower cravings among people with substance use disorders. The review appears in Addiction, the peer-reviewed journal of the Society for the Study of Addiction.
What the Review Looked At
The team searched eight databases through November 14, 2025, and included randomized trials, nonrandomized controlled trials, and crossover studies.
Five uncontrolled studies were set aside from the pooled analysis. Participants had substance use disorders involving alcohol, nicotine, or other psychoactive substances.
Craving was measured across 12 studies with 696 participants. Withdrawal symptoms were measured in four studies with 289 participants, and dependence in two studies with 144.
What the Evidence Showed
On craving, breathing-based interventions came out ahead of control conditions. The effect was small, but it was statistically significant and consistent from study to study.
The picture on withdrawal symptoms was murkier. Results varied substantially between studies, and the review treats that finding as uncertain rather than positive. The dependence evidence rests on two studies, too thin to draw much from.
One nuance matters for anyone evaluating a program. Breathing paired with a heart rate sensor did not outperform breathing without one, though the sensor-based evidence came mostly from multi-session programs rather than one-off sessions.
How the Techniques Differ
The review covered six approaches rather than a single method. Heart rate variability biofeedback uses a sensor to help a person pace their breathing against their own heart rhythm. Resonant breathing does the same without the sensor, at roughly six breaths per minute.
Yogic breathing follows set patterns of inhalation and exhalation, sometimes with holds. Rhemercise pairs slow breathing with deliberate smiling and positive self-talk. A
nother approach borrows the rhythm of smoking with timed deep breaths, and three-part breathing works through expanding different areas of the body in sequence.
Where Breathing Fits in Addiction Treatment
Lead author Ariel Dart Roxburgh described breathing work as a low-cost addition to addiction treatment rather than a substitute for it, and pointed to smartphone-assisted delivery as a way to reach more people. The researchers called for larger pre-registered trials with standardized measures and longer follow-up.
That framing is the important part. For opioid and alcohol use disorder, medications including buprenorphine, methadone, and naltrexone remain the treatments with the strongest evidence behind them. A breathing protocol sits alongside that care, not in place of it.
What This Means for Treatment Seekers
Craving is one of the harder parts of early recovery to manage, and it is where relapse risk concentrates. A technique that requires no prescription, no equipment, and no added cost is worth asking about directly when you compare programs.
A reasonable question at intake is whether a facility teaches structured craving-management skills, what those skills are, and whether they continue after discharge.
It is also worth asking who delivers them. A breathing protocol taught once during orientation and never revisited is a different thing from one practiced in session with a clinician and carried into aftercare, and the review found the sensor-based evidence concentrated in programs that ran multiple sessions rather than a single one.
Exploring Treatment Options
If you are weighing programs, a few things are worth verifying before you commit. Ask which evidence-based therapies a facility actually delivers rather than lists.
Confirm whether medication-assisted treatment is available if opioids or alcohol are involved. Check what your insurance covers, and ask what aftercare looks like once the formal program ends.
Rehab.com’s directory lets you compare verified treatment centers by location, level of care, and insurance accepted. You can call
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