A new therapy to help substance abusers—moderating the heart rate by means of breathing techniques to quiet the mind—holds out the promise of reducing relapses.
A key to keeping former substance abusers from relapsing may lie in the interval between heartbeats—with some help from a smartphone app. That’s the hope propelling the research of Marsha Bates and Jennifer Buckman, faculty members at the Center of Alcohol Studies. They recently received a generous grant from the National Institute on Alcohol Abuse and Alcoholism to study the efficacy of a biofeedback technique called slow breathing (also known as resonance frequency breathing) in preventing relapses in people treated for substance abuse. If the approach works the way they suspect it will, it could offer new hope to recovering addicts, for whom relapse remains a constant threat.
Scientists have long known that having highly variable intervals between heartbeats is associated with better health. “The less like a metronome your heart is, the healthier you’re likely to be,” says Buckman, an associate research professor at the center. That may seem counterintuitive, but the health of the body relies on the ability of the brain to slow or accelerate the heart in response to the environment. (Lazing at the beach? Slow heartbeat. Wait—is that a shark in the shallows? Heartbeat quickens in anticipation of flight.) Alcohol and drug abuse, however, can damage the finely tuned communication loop between brain and heart, and flaws in that system can negatively affect both our overall health and, in former addicts, the ability to resist so-called relapse triggers: things like getting together with old drinking buddies, watching a film in which people are drinking alcohol or using drugs, or everyday stressors like having a fight with one’s spouse.
The good news, say Bates GSNB’78, ‘80 and Buckman DC’92, RBS’06, is that the system can be retuned, and one of the things that can retune it is slow breathing. As an example, they cite an earlier study that they conducted on male in-patients enrolled in a substance- abuse program. Half the subjects were trained in the biofeedback technique, and they had significantly fewer cravings than those who didn’t receive the training. In the new study, the researchers are partnering with the nonprofit Center for Great Expectations, whose patient population consists of women and female adolescents, either pregnant or with children. “It’s an understudied population,” notes Bates, a research professor and the associate director at the center. “And it’s a population where, if you can make changes, they not only affect the lives of the women themselves, but can also cascade through the family to the next generation.”
Traditionally, training in slow breathing consists of at least 10 weeks of daily one-hour sessions in a lab or doctor’s office, combined with two 20-minute daily practice sessions outside the lab or office throughout the regimen. But the technique is only helpful if patients use it, and “people in substance-abuse treatment aren’t always the most compliant group,” says Bates. Add to that the fact that mothers have particular constraints on their time, and you have a potential recipe for failure. So the new study will evaluate whether less time-intensive slow-breathing practice can have a significant effect. Half of the women in the study will receive the standard 10 weeks of training but will be asked to practice on their own for just five minutes whenever they encounter a potential trigger for substance abuse. The smartphone app will allow them to monitor their heart rate for maximum efficiency—anywhere, anytime.
The researchers believe that their work will be enhanced by the partnership with Great Expectations. “There are lots of scientists trying to create new ideas for intervening and treating,” says Buckman, “but those ideas don’t necessarily find their way into actual treatment facilities.” It’s a benefit that works both ways.
“We know that the outcomes for folks pursuing treatment for substance-abuse disorders aren’t great,” says Peg Wright, president and CEO of the Center for Great Expectations. “So we really need to be much more scientific in our approach.”
Buckman sums up the partnership: “It’s bidirectional communication—like the loop between the heart and the brain.”