Development, validation, and feasibility testing of a yoga module for substance use disorder

Abstract

Introduction: Research evidence and theoretical models point to the need to implement yoga and mindfulness interventions as they impact different physiological and psychological functioning associated with addiction and relapse. To ensure the safe application of yoga, a standardized yoga module that can be practiced across any drug type of substance addiction is required. This study focuses on developing, validating, and testing a yoga module's feasibility for the management of substance use disorder (SUD). Materials and Methods: The yoga module was developed for SUD by including specific yogic practices derived from research evidence from Google Scholar, PubMed, and traditional literature targeting symptoms related to SUD. Yoga experts validated the module using a 3-point Likert scale. Practices which scored a content validity ratio (CVR) score ≥0.33 were retained in the yoga module for SUD. A pilot assessment was done online to test the module's feasibility. Participants in a 9-week residential rehabilitation center participated in the study. The module was taught as an add-on to their existing treatment. The motivation for seeking treatment was assessed at baseline, and quality of life was assessed at pre- and post-intervention using the questionnaire de motivation au traitement des toxicomanies and the World Health Organization Quality of Life BREF (WHOQOL BREF), respectively. Results: Thirty experts validated the developed module. Based on the CVR scoring, 37 yoga practices were retained. The final list of practices included breathing exercises, sukshmāvyāyāma (loosening exercise), āsana (postures), prāṇāyāma (breathing exercise), and dhyāna (meditation). In the feasibility study, all participants (n = 12) reported satisfaction and mentioned no adverse effects of the yoga intervention. The participants' mean ± standard deviation (SD) of identified motivation was 26.6 ± 1.9, introjected amotivation 22.7 ± 5.1, external motivation 16.4 ± 6.2, and a motivation 15.1 ± 5.7. The Global score or Internalization coefficient mean ± SD was 29.1 ± 18.1. The participant's total score on the WHOQOL-BREF was significant post intervention (P = 0.004). With the practice of the module, there was a significant change in the participant's psychological (P = 0.008), social (P = 0.002), and environmental domains (P < 0.001) but not in physical health (P = 0.17). At 1 month follow-up, 11 participants (n = 12) maintained abstinence. Conclusion: The designed yoga module for SUD was validated by yoga experts and was considered safe and feasible by patients with SUD. In addition, patients reported an increase in their quality of life. This can be further studied in randomized controlled trials.