Substance Use and Addiction Affect More Than the Brain: the Promise of Neurocardiac Interventions

David Eddie, Julianne L. Price, Marsha E. Bates, Jennifer F. Buckman

Research output: Contribution to journalReview articlepeer-review


Purpose of Review: Addiction and excessive substance use contribute to poor mental and physical health. Much research focuses tightly on neural underpinnings and centrally acting interventions. To broaden this perspective, this review focuses on bidirectional pathways between the brain and cardiovascular system that are well-documented and provide innovative, malleable targets to bolster recovery and alter substance use behaviors. Recent Findings: Cardiovascular signals are integrated via afferent pathways in networks of distributed brain regions that contribute to cognition, as well as emotion and behavior regulation, and are key antecedents and drivers of substance use behaviors. Heart rate variability (HRV), a biomarker of efficient neurocardiac regulatory control, is diminished by heavy substance use and substance use disorders. Promising evidence-based adjunctive interventions that enhance neurocardiac regulation include HRV biofeedback, resonance paced breathing, and some addiction medications. Summary: Cardiovascular communication with the brain through bidirectional pathways contributes to cognitive and emotional processing but is rarely discussed in addiction treatment. New evidence supports cardiovascular-focused adjunctive interventions for problematic substance use and addiction.

Original languageEnglish (US)
Pages (from-to)431-439
Number of pages9
JournalCurrent Addiction Reports
Issue number3
StatePublished - Sep 2021
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Clinical Psychology
  • Psychiatry and Mental health


  • Addiction
  • Evidence-based interventions
  • Heart rate variability
  • Holistic
  • Substance use


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