David Eddie, Fiona N Conway, Nour Alayan, Jennifer Buckman, Marsha E Bates

Heart rate variability biofeedback (HRV BFB) shows promise as an adjunct intervention for individuals receiving treatment for substance use disorder (SUD), potentially due to its capacity to reduce craving and negative affect. The present study sought to examine the utility of integrating HRV biofeedback into a college recovery housing program and gauging its ability to reduce craving and negative affect in young adults in remission from SUD. Forty-six residents of an SUD recovery house at a public university in the northeastern United States took part in a non-randomized controlled trial. The active intervention was 12 weeks of HRV BFB performed over a college semester. The control intervention was a semester-long, waitlist condition. Changes in craving, perceived stress, anxiety, and depressive symptoms were measured across time during the active HRV BFB intervention and compared to changes that occurred during the waitlist period using piecewise regression analyses. Significant reductions in craving were noted during HRV BFB, but not during the waitlist control condition; however, the difference in slopes between conditions was not statistically significant. Levels of self-reported craving, stress, anxiety, and depression varied substantially between participants and across time. The results suggest that use of HRV BFB in the college recovery setting as a tool to help reduce craving warrants further examination, particularly among individuals with elevated craving. Added value of HRV BFB comes from the fact that it can be easily and affordably implemented in everyday life.