There is a pressing need to identify non-opioid, evidence-based treatments to address the high prevalence of chronic pain in licensed opioid treatment programs (OTP). Yoga is an effective pain coping strategy but is not widely used by OTP patients. Few studies have examined underlying factors related to poor yoga utilization in this population. Seventy-one participants with and without chronic pain enrolled in a hospital-based OTP completed an acceptability survey assessing pain, current pain coping strategies, prior yoga experience, willingness to try yoga, and beliefs about yoga. Participants with and without chronic pain were compared, as were participants with and without prior yoga experience. The relationships between primary study variables in the chronic pain group were also explored. Participants reported using over-the-counter medications, meditation, stretching, and exercise to manage chronic pain, but yoga was not commonly used. Participants with prior yoga experience reported higher willingness to try yoga and more favorable beliefs about yoga than participants without prior yoga experience. There were no significant differences in willingness to try yoga between participants with and without chronic pain. Among participants with chronic pain, there was a positive association between total number of pain coping strategies used and willingness to try yoga. This study adds to the existing literature on the implementation of yoga programs into OTPs by demonstrating the acceptability of yoga in patients with opioid use disorder, including those experiencing chronic pain, and encourages additional research exploring implementation.

Introduction

Mimicking movements of others makes both the imitating and imitated partners feel closer. Oxytocin may increase focus on others and has been shown to increase automatic imitation in healthy controls (HC). However, this has not been replicated, and oxytocin's effects on automatic imitation have not been demonstrated in clinical populations. This study attempts to replicate effects on HC and examine effects on people with comorbid posttraumatic stress disorder and alcohol use disorder (PTSD-AUD).

Methods

Fifty-four males with PTSD-AUD and 43 male HC received three intranasal treatment conditions (placebo, oxytocin 20 International Units (IU), and oxytocin 40 IU) in a randomized order, across three separate testing days, as part of a double-blind, crossover parent study. At 135 min post-administration, each performed the imitation-inhibition task, which quantifies automatic imitation as the congruency effect (CE). After exclusions, the final analyzed data set included 49 participants with PTSD-AUD and 38 HC.

Results

In HC, oxytocin 20 IU demonstrated a statistically significant increase in CE, and 40 IU showed a trend-level increase. In PTSD-AUD, oxytocin did not significantly increase CE. Post-hoc analysis showed the PTSD-AUD group had higher CE than HC on placebo visits.

Discussion

Our data suggest PTSD-AUD is associated with higher automatic imitation than HC in the absence of oxytocin administration. We successfully replicated findings that oxytocin increases automatic imitation in HC. This demonstrates an unconscious motor effect induced by oxytocin, likely relevant to more complex forms of imitative movements, which have the potential to improve social connection. We did not find a significant effect of oxytocin on automatic imitation in PTSD-AUD. Future research should examine imitation in both sexes, at peak oxytocin levels, and on increasingly complex forms of imitation.