Abstract
BACKGROUND: Methamphetamine (MA) addiction is a chronic relapsing disorder that impairs physical health, induces mental distress (e.g., anxiety), and triggers abnormal inflammatory and neurotransmitter responses, all contributing to high relapse rates. Mindfulness and yoga interventions may alleviate psychological distress and improve physical well-being in substance users; however, few studies have systematically investigated their comprehensive effects on physical function, inflammatory markers, neurotransmitter balance, and relapse intention in MA addicts, leaving a gap in non-pharmacological interventions for this population. OBJECTIVE: This randomized controlled trial aimed to investigate the effects of a 24-week yoga intervention integrated with mindfulness components on multiple health outcomes among individuals with methamphetamine use disorder, ncluding physical function (assessed by Functional Movement Screening [FMS], reaction time, sleep quality, subjective fatigue, and creatine kinase [CK]), anxiety, inflammatory response (tumor necrosis factor-α [TNF-α], interleukin-6 [IL-6], and interleukin-10 [IL-10]), heart rate variability (HRV), relapse-related neurotransmitters (dopamine [DA], serotonin [5-HT], and norepinephrine [NE]), and relapse intention. METHODS: Eighty MA addicts meeting DSM-5 criteria were randomly assigned to an experimental group (n = 41; 40-min mindfulness yoga sessions, three times weekly for 24 weeks) or a control group (n = 39; no additional intervention). Assessments were conducted at baseline and post-intervention for all outcomes, with additional measurements at 4 and 12 weeks for fatigue, CK, and inflammatory markers. RESULTS: Following the 24-week intervention, the experimental group demonstrated significant improvements in sleep quality (PSQI score reduced from 14.32 to 8.41), anxiety levels (BAI score decreased), FMS total score (increased from 9.24 to 12.12), and reaction time (improved from 0.59 s to 0.48 s) compared to baseline and controls (p < 0.01). Relapse intention (OCDS score reduced from 29.12 to 18.45) and NE levels significantly decreased, while DA and 5-HT levels significantly increased (p < 0.01). The experimental group also showed enhanced parasympathetic activity (higher HF index, lower LF/HF ratio; both p < 0.01), reduced CK, TNF-α, IL-6, and subjective fatigue, and elevated IL-10 levels (p < 0.05). CONCLUSION: Compared with a traditional relaxation and stretching control condition, mindfulness yoga intervention demonstrated superior efficacy in improving physical function, sleep quality, and reaction ability of MA addicts. These findings support mindfulness yoga as a promising non-pharmacological intervention for MA addiction rehabilitation. CLINICAL TRIAL REGISTRATION: https://www.chictr.org.cn/showproj.html?proj=40393, Unique Identifier is ChiCTR1900024439.