Holistic and Complementary Approaches

"Holistic" is a loose label, not a defined type of treatment. In addiction care it usually refers to practices outside mainstream medicine or counseling that aim to address body, mind and lifestyle together, such as acupuncture, yoga, meditation, exercise and diet. Some have been studied reasonably well, some barely at all, and some are sold with claims that go far beyond the research. This page uses the vocabulary of the U.S. National Center for Complementary and Integrative Health (NCCIH) to sort them.

What the terms mean

NCCIH says a non-mainstream approach used together with conventional medicine is "complementary", while one used in place of conventional medicine is "alternative". "Integrative" health brings conventional and complementary approaches together in a coordinated way. NCCIH groups approaches into nutritional (special diets, dietary supplements, herbs, probiotics), psychological (such as mindfulness) and physical (such as massage) categories.

NCCIH's digest on substance use disorders says psychological and physical approaches can be part of a comprehensive treatment plan that includes behavioral changes and may include medication, group therapy or counseling. NCCIH also advises against using any product or practice not proven safe and effective as a substitute for conventional treatment, or as a reason to postpone seeing a health care provider. In short, the people who study these approaches describe them as additions to treatment, not replacements. See medications used in treatment and cognitive behavioral therapy for the core options.

How they are meant to work

NCCIH explains that mindfulness-based approaches try, in part, to reduce the impact of negative emotion, which can trigger substance use, and to improve distress tolerance. Other approaches are proposed to ease craving, anxiety or stress. These are intended mechanisms, and the strength of proof differs for each one.

What sessions can look like

Formats vary widely. One NCCIH-summarized trial of a mindfulness program added to methadone treatment used eight weekly two-hour group sessions by video plus weekly home practice. Acupuncture sessions use needles, yoga sessions are led by an instructor, and exercise programs involve regular physical activity. The studies above used different schedules, so there is no single standard course.

What the research says

Summary of evidence, as reported by NCCIH and a recent exercise review
Approach	What reviews report
Acupuncture	A 2016 review of 41 studies (5,227 people) did not support acupuncture for substance use outcomes; some findings for craving, withdrawal and anxiety were limited by low-quality evidence. A 2023 review of 16 trials in alcohol use disorder found acupoint stimulation added to psychotherapy or medication eased craving and withdrawal severity, but studies were low quality and firm conclusions were not possible.
Yoga	A 2021 review of eight studies found positive results in seven, for anxiety, pain or substance use, but reviewers said larger, better trials are needed.
Mindfulness meditation	May reduce consumption of several substances versus control groups, but many studies were small with methodological problems. A trial of 286 people found mindfulness-based relapse prevention reduced substance use days at 6 and 12 months compared with usual care.
Hypnotherapy	Not definitive for smoking cessation; a 2019 Cochrane review found insufficient evidence.
Exercise	A 2025 meta-analysis of 17 trials in non-nicotine drug use found moderate improvements in use and craving, while the authors raised serious concerns about study quality.
Nutrition and supplements	The sources reviewed for this page did not evaluate diets or supplements as addiction treatment, so no claim is made.

Music-based approaches have a Cochrane review behind them, covered in music therapy, and the mindfulness evidence is expanded in mindfulness-based approaches. For horse-based and arts-based options, see equine-assisted therapy and art therapy.

Limits, safety and caution about claims

NCCIH reports that acupuncture complications are relatively rare given the millions of treatments, but inadequate needle sterilization or improper delivery can cause serious harm, including infections and punctured organs. Yoga is generally low-risk for healthy people with a trained instructor, with rare side effects including certain strokes and nerve pain, and people who are pregnant or have conditions such as high blood pressure, glaucoma or sciatica should modify some poses. Meditation is considered safe for healthy people, though rare reports suggest it could worsen symptoms in people with certain psychiatric problems, and that has not been fully researched. The exercise review's authors note that blinding is hard in such trials, so results may be biased.

NCCIH's guidance on choosing complementary approaches offers a checklist for claims. Evidence from research studies is stronger and more reliable than an advertisement or a personal story. Statements from people promoting a product may rest on a biased view of the science. Claims of a cure, or that something works for a variety of ailments, are a warning sign. NCCIH also suggests telling every provider about everything used, and checking the FDA and FTC for safety alerts and enforcement actions. Supplements deserve particular care, and anyone using medicines for alcohol or drug problems should tell their clinician before adding any product.

Enjoying an activity for its own sake is a separate matter from treating a substance use disorder; the page on fun activities for people in recovery takes that angle.

Questions to ask a clinician

Is there research for this approach in people with my substance and situation?
Could it interact with my medication or conflict with my treatment plan?
What training or licensing should the practitioner hold?
How will we tell whether it is helping, and when would we stop?