Relationship of spirituality or religion to recovery from substance abuse: a systematic review

The impact of spiritual well-being and social support on substance use treatment outcomes within a sample of predominantly Black/African American adults

INTRO

Substance use and associated problems often return following treatment for substance use disorder (SUD), which disproportionally impact Black/African American (AA) individuals. Social support and spiritual well-being are sources of recovery capital identified as particularly important among Black/AA adults. Social support and spiritual well-being are also posited mechanisms in 12-step; thus, this study tested the effects of social support and spiritual well-being on substance use outcomes over time, distinct from 12-step involvement, among Black/AA adults post-SUD treatment. The study hypothesized that social support and spiritual well-being would demonstrate significant interactions with time, respectively, on substance use frequency and substance use consequences, above the effect of 12-step involvement.

METHOD

The study drew data from a study of 262 adults (95.4 % Black/AA) entering residential SUD treatment (NCT#01189552). Assessments were completed at pretreatment and at 3-, 6-, and 12-months posttreatment. Two generalized linear mixed models (GLMM) tested the effects of social support and spiritual well-being, above the effect of 12-step involvement, on substance use frequency and substance use consequences over the course of 12-months posttreatment.

RESULTS

Higher spiritual well-being predicted significantly less frequent substance use during recovery (β = 0.00, p = .03). Greater 12-step involvement predicted significantly fewer substance use consequences during recovery (β = 0.00, p = .02). In post hoc analyses the effect of spiritual well-being and 12-step involvement dissipated by 3.5- and 6.6-months posttreatment, respectively. The study found no significant effects of social support over time.

DISCUSSION

Spiritual well-being and 12-step involvement are associated with lower substance use and substance use consequences, respectively, in the early months of posttreatment recovery among Black/AA adults. These findings contribute to the growing recovery capital literature informing paths to recovery and sources of support outside of 12-step affiliation. However, these effects diminish over time.

Psychometric Evaluation of an Adapted Short-Form Spirituality Scale in a Sample of Predominantly White Adults in an Inpatient Substance Use Disorder Treatment Program

Spirituality is an important aspect of treatment and recovery for substance use disorders (SUDs), but ambiguities in measurement can make it difficult to incorporate as part of routine care. We evaluated the psychometric properties of an adapted short-form version of the Spirituality Scale (the Spirituality Scale-Short-Form; SS-SF) for use in SUD treatment settings. Participants were adult patients (N = 1,388; Mage = 41.23 years, SDage = 11.55; 68% male; 86% White) who entered a large, clinically mixed inpatient SUD treatment program. Factor analysis supported the two-dimensional structure, with factors representing Self-Discovery and Transcendent Connection. Tests of measurement invariance demonstrated that the scale was invariant across age and gender subgroups. The SS-SF exhibited convergent and concurrent validity via associations with participation in spiritual activities, hopefulness, life satisfaction, 12-step participation, and depressive symptoms. Finally, scores on the SS-SF were significantly higher at discharge compared to admission, demonstrating short-term sensitivity to change. These findings support use of the SS-SF as a concise, psychometrically sound measure of spirituality in the context of substance use treatment.

Using the Recovery Capital Model to Explore Barriers to and Facilitators of Recovery in Individuals with Substance Use Disorder, Psychiatric Comorbidity and Mild-to-Borderline Intellectual Disability: A Case Series

Recovery capital (RC) encompasses the wide range of resources individuals can employ to recover from Substance Use Disorder (SUD). It consists of five subdomains: human, social, cultural, financial, and community RC. Negative recovery capital (NRC) represents the obstacles to recovery. Research on (N)RC in complex multimorbid populations is scarce. This study offers an initial exploration of the viability of (N)RC in three individuals with SUD, psychiatric comorbidities, and an intellectual disability (a triple diagnosis) in inpatient addiction treatment. We collected case file data, ranked recovery goals, and conducted follow-up interviews. The data were subjected to template analysis, using (N)RC domains as codes. All domains were prevalent and relevant, showing dynamic and reciprocal effects, influenced by critical life events acting as catalysts. Notably, during treatment, patients prioritized individual skill development despite challenges in other domains. RC emerges as a valuable concept for mapping recovery barriers and facilitators in individuals with a triple diagnosis, serving as an alternative to the medical model and complementing the biopsychosocial model. It provides a systematic framework to assess critical factors for recovery in complex cases and accordingly align interventions. Future studies should explore the intersections of NRC domains and the dynamic nature of (N)RC to enhance the understanding of the challenges faced by individuals with a triple diagnosis.

Further Validation of the Religious Surrender and Attendance Scale-3 (RSAS-3)

Background: The Religious Surrender and Attendance Scale -3 (RSAS-3) is a very brief measure used to quantify religious commitment as a protective health factor.Methods: To provide evidence of criterion-related validity of the RSAS-3, 440 community members and undergraduate students completed a survey containing three religiosity measures: the RSAS-3, the Intrinsic/Extrinsic Orientation scale, and the Belief into Action scale (BIAC), and a measure of problematic substance use, Texas Christian University Drug Screen-5. It was hypothesized all religiosity measures would be positively interrelated, the measure of problematic use would be negatively related to all religiosity measures, and that the RSAS-3 would be strongly predictive of absence of problematic substance use. After data filtering and imputation, bivariate correlations were calculated to establish convergent validity.Results: All relationships were in the predicted directions. Specifically, BIAC had the strongest relationship with the RSAS-3, r (440) = .906, p < .001, followed by intrinsic religiosity, r (440) =.814, p < .001, and extrinsic religiosity, r (440) = .694, p < .001. The RSAS-3 was the strongest predictor of problematic use among the religiosity measures, r (440) = -0.230, p <.001. Criterion-related validity of the RSAS-3 was supported using logistic regression to explore intrinsic religiosity, extrinsic religiosity, BIAC, and RSAS-3 as predictors of the presence/absence of problematic substance use. The RSAS-3 was the only significant predictor (OR = .858 [95% CI .757 - .973], p = .017).Conclusion: All results provide further evidence for the validity of the RSAS-3 as a very brief measure of religious commitment useful in health settings.

Affected family members social support experiences when assisting an individual with substance use disorder

INTRODUCTION

Social support is a factor in the health and well-being of all populations (WHO, 2018). Having a loved one with substance use disorder (SUD) negatively affects family members. Affected Family Members (AFM) providing support for individual with substance use disorder (ISUD) are at risk of losing their social support network. Losing social support negatively influences AFMs health and well-being.

DESIGN

As part of a larger mixed methods study, the researchers used qualitative inquiry to explore the experiences and perceptions of social support of the AFM of an ISUD.

METHODS

The thematic framework of social support was applied to this qualitative study to identify the conceptual determinants of the perceptions and experiences of the AFM and the development of emergent themes. Participants completed an anonymous electronic survey that included Open-ended questions. A total of 101 participants completed the open-ended questions with 1088 narrative responses received. The utilization of an audit trail, reflexive journal, and in-depth thematic analysis conducted by the researchers has ensured the rigor of the study.

RESULTS

Three themes emerged from the AFMs perspective: (1) We are all alone, and we have to fend for ourselves, (2) No one understands what we are going through and (3) People cannot relate and recoil from us.

CONCLUSION

Identification of the specific needs of the AFM was crucial, and the first step in designing programs in future research to provide social support for ensuring the health and well-being of the AFM.

CLINICAL RELEVANCE

Nurses need to provide family-centred care to ISUD, including their AFMs, in order for the ISUD to continue to receive support to facilitate their recovery. This research highlights ways in which the nurse caring for the ISUD can provide supportive interventions for the AFMs.

A Systematic Review on Alcohol Consumption among Non-Religious and Religious Adults

Background: Research has suggested that religiosity is a protective factor in alcohol use, but this is an area that could be further explored. Objective: To undertake a systematic review of the literature on drinking patterns and their relationship with religiosity and non-religiosity in adult populations. Methods: We searched for relevant studies using the PubMed, LILACS, Web of Science, Scopus, and Psych-INFO databases. This review included only studies of people aged 18 and over which had a non-religious group as a comparison measure. Results: Fifty-one studies met the inclusion criteria. The present review showed that religious people tend to have lower alcohol consumption compared to those with no religion. However, this difference appears only when religions are analyzed together without differentiating between religious affiliations (Catholicism, Buddhism, Evangelicalism, etc.). Some religious affiliations, such as Buddhism, Catholicism and Lutheranism, appear to be risk factors for alcohol consumption. Definitions of risk consumption showed high heterogeneity, ranging from eight to 21 or more doses per week, a difference of 13 doses of alcohol between studies. Conclusions: The present review showed that religious people tend to have lower alcohol consumption compared to non-religious people. However, the results are contradictory when religious affiliations are analyzed separately and compared with non-religious participants. Adequately understanding which dimensions of religiosity and non-religiosity (e.g., group processes, engagement, meaning, rules of behavior) are protective in adulthood is fundamental to the construction of more effective interventions in this age group.

"Can we get a Black rehabilitation center"? Factors impacting the treatment experiences of Black people who use opioids

INTRODUCTION

With opioid overdose rates doubling in the state of Kentucky over the last year, the opioid crisis is having a deadly impact on the state. Among Black individuals in particular, overdose rates have increased by nearly a third. As such, we must examine ways to effectively intervene to reduce deaths among this underrepresented population.

METHOD

The current study utilized a thematic analysis to examine factors influencing treatment perceptions and experiences among a sample of 39 Black adults with a recent history of opioid use.

RESULTS

The primary themes highlighted in the study included "autonomous accessibility," "provider characteristics," and "relational support," which are aligned with Self-Determination Theory.

CONCLUSIONS

We discuss how these themes relate to treatment initiation, engagement, and completion and discuss implications of this research in treatment for Black adults. Specifically, we discuss treatment considerations among Black adults who use prescription opioids such as ensuring autonomy and a collaborative approach to treatment, especially in mandated treatment, with strategies such as motivational interviewing. Further, we discuss the importance of nonjudgmental providers, gauging client preferences for racially, ethnically, and gender matched providers; and we assess support networks among clients and how these networks can be integrated or utilized in treatment planning.

Recovery Identity and Psychosocial-Spiritual Health: A Survey of Individuals in Remission From Substance Use Disorders

Recovery identity – the degree to which someone identifies as “in recovery” from a substance use disorder – has been shown to be associated with a host of positive health outcomes. The purpose of the present study was to test the association between recovery identity, quality of life, spiritual well-being, and relational health in a sample of individuals in remission from moderate or severe SUDs recruited from Amazon’s Mechanical Turk crowdsourcing platform ( n = 494). Results indicated that the presence of a recovery identity was significantly associated with greater spiritual health, but not significantly associated with psychological, social, or environmental quality of life, nor with family functioning. Results have important implications for understanding paths to recovery and important correlates of health outcomes.

Religiosity and Spirituality in Latinx Individuals with Substance Use Disorders: Association with Treatment Outcomes in a Randomized Clinical Trial

Although many studies have examined religiosity as a protective factor for substance use, few have considered its relationship to treatment outcomes among Latinx adults. Using data from 89 individuals participating in a randomized clinical trial evaluating a culturally adapted Spanish-language version of web-based cognitive behavioral therapy (CBT4CBT-Spanish) for substance use, we evaluated the relationship between religiosity, as measured by the Religious Background and Behavior questionnaire, and treatment outcomes. Overall, there were few significant correlations between religiosity scores and treatment outcomes. Past-year religiosity was positively correlated with one measure of abstinence for those randomized to CBT4CBT-Spanish, but this did not persist during a six-month follow-up period. Findings suggest that religiosity may be associated with short-term abstinence outcomes among Latinx adults receiving a culturally adapted cognitive behavioral therapy treatment. However, additional research is needed with larger and more heterogenous Latinx populations.

Faith Communities' Improvements in Readiness to Engage in Addictions Resilience and Recovery Support Programming

Spirituality and religion are well-documented components of prevention, treatment and recovery of substance use disorders. Faith communities are in a distinct position to support recovery and resilience regarding substance use disorders-not only in times of crisis, but every day. We conducted an exploratory study of congregational (i.e., organizational) "levers" that can drive change readiness in implementing recovery and resilience programming for substance use disorders within faith communities. Findings point to enhanced effectiveness post-intervention and the importance of developing awareness of resources to help with someone who has an alcohol or other drug problem.

Religion and Recovery Among Individuals Experiencing Homelessness

Faith-based organizations provide essential recovery services to individuals experiencing homelessness. Research suggests that religion and spirituality aid recovery from alcohol and drug addiction, although less is known about these factors in homeless populations. This study used qualitative interviews to explore the role of religion in recovery from addiction in a sample of 14 adults with a history of homelessness. Analysis of emergent themes revealed that religion provided participants with a range of personal and social benefits, many which addressed personal, social, and tangible losses and crises associated with substance use and homelessness. Understanding the specific benefits religion may provide during recovery can guide research and help providers improve programs for this vulnerable population.

Spirituality, religiousness, and mental health: A review of the current scientific evidence

Research in the field of “Spirituality and Health” has been growing, with spirituality/religiousness (S/R) being consistently related to both physical and mental health. The objective of this article is to provide an updated review of the current scientific evidence on the relationship between S/R and mental health, highlighting the most important studies. As a secondary objective, the mechanisms that explain this relationship and the interventions that utilize this information in treating mental disorders will be discussed. The findings reveal a large body of evidence across numerous psychiatric disorders. Although solid evidence is now available for depression, suicidality, and substance use, other diagnosis, such as post-traumatic stress disorder, psychosis, and anxiety, have also shown promising results. The effects of S/R on mental health are likely bidirectional, and the manner in which religious beliefs are used to cope with distress (i.e. negative and positive), may affect mental health outcomes. Despite these findings, the mechanisms that explain these associations and the role of S/R interventions need further study. Concerning clinical practice, mental health providers should ask patients about S/R that are important in their lives to provide holistic and patient-centered care.

Religiosity and substance use in U.S. adults: Findings from a large-scale national survey

BACKGROUND

In recent decades, the US religious landscape has undergone considerable change such as a decline in religious service attendance. These changes may indicate that religious social support structures have deteriorated, possibly leading to a decrease in strengths of associations with substance use. Considering this, and given limitations of past studies (e.g., limited control for potential confounders), large-scale general population studies are needed to reexamine associations between religiosity domains and substance use.

METHODS

This cross-sectional study used data from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (N = 36,309). In unadjusted and adjusted models, controlling for religiosity domains and other covariates, we examined associations between three religiosity domains (importance of religiosity/spirituality, service attendance, and religious affiliation) and DSM-5 SUD. Focusing on service attendance, we also examined associations with other substance use-related outcomes.

RESULTS

Among religiosity domains, only frequency of service attendance was associated with SUD across most substances. Frequent service attendees had lower odds of alcohol use disorder (adjusted OR [aOR] = 0.4, 95 % CI 0.33,0.51), tobacco use disorder (aOR = 0.3, 95 % CI 0.22,0.33) and cannabis use disorder (aOR = 0.4, 95 % CI 0.24,0.68), compared to non-service attendees. For alcohol and tobacco, the protective effect of frequent service attendance was more robust for SUD than for respective substance use.

CONCLUSIONS

Despite decreasing rates of religious belief and practice in the US, service attendance independently lowered the odds of substance use and SUD across multiple substances. Results may inform religious leaders and clinicians about the value of utilizing religious social support structures in the prevention and treatment of substance use and SUD.

Mental Health, Physical Health, and Cultural Characteristics Among American Indians/Alaska Natives Seeking Substance Use Treatment in an Urban Setting: A Descriptive Study

Although approximately 70% of American Indians/Alaska Natives (AI/ANs) reside in urban areas, our knowledge of risk and protective factors among AI/ANs seeking substance use treatment within urban areas is limited. We analyze substance and commercialized cigarette use, AI/AN cultural identity and involvement, physical health and cognitive functioning, and mental health symptoms among 63 AI/AN adults seeking substance use treatment within an urban area in California. Alcohol (37%), marijuana (27%), and methamphetamine (22%) were the most commonly reported substances. Sixty-two percent used commercialized tobacco use. The majority of AI/AN adults (78%) engaged in at least one traditional practice during the past month and endorsed high levels of spiritual connectedness. Those who engaged in traditional practices demonstrated significantly less depression (p = 0.007) and anxiety (p = 0.04). Medical and mental health issues were not prominent, although participants revealed high levels of cognitive impairment. Results highlight the importance of utilizing AI/AN traditional practices for AI/AN adults seeking substance use treatment within urban areas. Clinical Trials Registry Number NCT01356667.

A feasibility study providing substance use treatment in the Black church

BACKGROUND

Black adults with substance use disorders (SUDs) experience health care disparities, including access to and retention in treatment. The Black church is a trusted institution in the Black community and could be a novel setting for providing SUD treatment.

METHOD

We conducted a nonrandomized feasibility study evaluating (1) whether it was possible to conduct a clinical trial of SUD treatment in this setting, (2) whether an adequate number of individuals with SUDs would participate in technology-based treatment in this setting, and (3) whether an adequate number of individuals would be retained in this setting. We evaluated computer-based training for cognitive behavioral therapy (CBT4CBT), with modifications that the church-based health advisors (CHAs), who delivered the intervention within the church, made.

RESULTS

Participants were 40 Black adults, all of whom met DSM-5 criteria for a current SUD, (55% severe). The mean number of sessions completed was 6.8 and 31 completed all 7 sessions of CBT4CBT. Both self-reports and weekly urine toxicology screens indicated reduction in substance use over time.

CONCLUSION

We demonstrated feasibility, as we were able to (1) collect weekly data and protect participant confidentiality, (2) recruit an adequate number of individuals with SUD, with (3) high uptake and retention of an adapted CBT4CBT in the Black church. If demonstrated to be effective in a future randomized clinical trial, delivery of technology-based treatments in the Black church may prove a promising, easily disseminable strategy to provide evidence-based interventions to an underserved and undertreated population.

Spirituality in Recovery From Substance Use Disorders

Substance use disorders (SUDs) are chronic health disorders with exacerbation rates of approximately 50%. Spirituality has been identified as a factor that can improve recovery rates. Various definitions of spirituality exist that include concepts of finding meaning and connection in life and contact with the divine or something larger than ourselves. Patients generally want to include spirituality as part of their health care but barriers often exist for health care providers to address it, including lack of confidence, knowledge, and organizational support, and time constraints. Nursing programs lack content related to spirituality and should increase course content on this subject to improve comfort levels and competencies of nurses. Keeping in mind professional boundaries and respecting patients' individual differences, nurses have the potential to help patients in their recovery journey by facilitating discussion and growth in spirituality. Nurses can also advocate for their patients by including spiritual leaders in integrated health care teams. [Journal of Psychosocial Nursing and Mental Health Services, 58(9), 14-17.].

The efficacy of spiritual/religious interventions for substance use problems: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Spiritual/religious (S/R) interventions are commonly used to treat substance use problems, but this is the first systematic review and meta-analysis to examine their efficacy for these problems.

METHODS

Ten electronic databases were searched to identify eligible studies (i.e., randomized controlled trials) published between January 1990 and February 2018 that examined S/R interventions' efficacy for substance use or psycho-social-spiritual outcomes. Two reviewers independently screened studies, extracted data, and assessed risks of bias. Robust variance estimation in meta-regression was used to estimate effect sizes and conduct moderator analysis.

RESULTS

Twenty studies comprising 3700 participants met inclusion criteria. Four studies used inactive controls, 14 used active controls, and two used both inactive and active controls and were therefore included in estimating both absolute and relative effect sizes. The absolute effect of S/R interventions (compared with inactive controls such as no treatment) was moderate but non-significant (six studies, d = .537, 95% confidence interval [CI] = -.316, 1.390), possibly due to low power. The relative effect of S/R interventions (compared with other interventions) was statistically significant (16 studies, d = .176, 95% CI = .001, .358). Because only 12-step-oriented interventions were compared with other interventions, this finding does not apply to the relative effect of non-12-step-oriented S/R interventions. Moderator analysis showed that relative effect sizes differ significantly by country.

CONCLUSION

We found evidence of S/R interventions' efficacy in helping people with substance use problems. More high-quality efficacy studies of non-12-step-oriented S/R interventions for substance use problems are needed.

The Opioid Crisis in Black Communities

While much of the social and political attention surrounding the nationwide opioid epidemic has focused on the dramatic increase in overdose deaths among white, middle-class, suburban and rural users, the impact of the epidemic in Black communities has largely been unrecognized. Though rates of opioid use at the national scale are higher for whites than they are for Blacks, rates of increase in opioid deaths have been rising more steeply among Blacks (43%) than whites (22%) over the last five years. Moreover, the rate of opioid overdose deaths among Blacks already exceeds that of whites in several states. The lack of discussion of Black overdose deaths in the national opioid discourse further marginalizes Black people, and is highly consistent with a history of framing the addictions of people of color as deserving of criminal punishment, rather than worthy of medical treatment. This article argues that, because racial inequalities are embedded in American popular and political cultures as well as in medicine, the federal and state governments should develop more culturally targeted programs to benefit Black communities in the opioid crisis. Such programs include the use of faith-based organizations to deliver substance use prevention and treatment services, the inclusion of racial impact assessments in the implementation of drug policy proposals, and the formal consideration of Black people's interaction with the criminal justice system in designing treatment options.

Spirituality and mental health status among Northern Plain tribes

Spirituality measures often show positive associations with preferred mental health outcomes in the general population; however, research among American Indians (AIs) is limited. We examined the relationships of mental health status and two measures of spirituality - the Midlife Development Inventory (MIDI) and a tribal cultural spirituality measure - in Northern Plains AIs, aged 15-54 (n = 1636). While the MIDI was unassociated with mental health status, the tribal cultural spirituality measure showed a significant relationship with better mental health status. Mental health conditions disproportionately affect AIs. Understanding protective factors such as cultural spirituality that can mitigate mental health disorders is critical to reducing these health disparities.

What works in inclusion health: overview of effective interventions for marginalised and excluded populations

Inclusion health is a service, research, and policy agenda that aims to prevent and redress health and social inequities among the most vulnerable and excluded populations. We did an evidence synthesis of health and social interventions for inclusion health target populations, including people with experiences of homelessness, drug use, imprisonment, and sex work. These populations often have multiple overlapping risk factors and extreme levels of morbidity and mortality. We identified numerous interventions to improve physical and mental health, and substance use; however, evidence is scarce for structural interventions, including housing, employment, and legal support that can prevent exclusion and promote recovery. Dedicated resources and better collaboration with the affected populations are needed to realise the benefits of existing interventions. Research must inform the benefits of early intervention and implementation of policies to address the upstream causes of exclusion, such as adverse childhood experiences and poverty.

Relationship of Religiosity and Spirituality to Hazardous Drinking, Drug Use, and Depression Among Sexual Minority Women

Using data from Wave 3 of the Chicago Health and Life Experiences of Women (CHLEW) study (N = 699), we explored whether religiosity and spirituality were associated with risk of hazardous drinking, drug use, and depression among sexual minority women (SMW; i.e., lesbian, bisexual) and possible differences by race/ethnicity. Participants were more likely to endorse spirituality than religiosity, and endorsement of each was highest among African American SMW. We found no protective effect of religiosity or spirituality for hazardous drinking or drug use. An association initially found between identifying as very spiritual and past-year depression disappeared when controlling for help-seeking. Among SMW with high religiosity, African American SMW were more likely than White SMW to report hazardous drinking. Latina SMW with higher spirituality were more likely than White SMW to report drug use. Results suggest that religiosity and spirituality affect subgroups differently, which should be considered in future research on resiliency among SMW.

Advancing our understanding of religion and spirituality in the context of behavioral medicine

Recognizing and understanding the potentially powerful roles that religiousness and spirituality (RS) may serve in the prevention and amelioration of disease, as well as symptom management and health related quality of life, significantly enhances research and clinical efforts across many areas of behavioral medicine. This article examines the knowledge established to date and suggests advances that remain to be made. We begin with a brief summary of the current knowledge regarding RS as related to three exemplary health conditions: (a) cardiovascular disease; (b) cancer; and, (c) substance abuse. We then focus on particular concerns for future investigations, emphasizing conceptual issues, possible mediators and moderators of relationships or effects, and methodology. Our discussion is framed by a conceptual model that may serve to guide and organize future investigations. This model highlights a number of important issues regarding the study of links between RS and health: (a) RS comprise many diverse constructs, (b) the mechanisms through which RS may influence health outcomes are quite diverse, and (c) a range of different types of health and health relevant outcomes may be influenced by RS. The multidimensional nature of RS and the complexity of related associations with different types of health relevant outcomes present formidable challenges to empirical study in behavioral medicine. These issues are referred to throughout our review and we suggest several solutions to the presented challenges in our summary. We end with a presentation of barriers to be overcome, along with strategies for doing so, and concluding thoughts.

Recovery in Substance Use Disorders: What to Know to Inform Practice

Use of illicit substances and nonmedical use of prescription medication worldwide has increased dramatically in the past several years. Approximately 10% of people who use illicit substances will develop a substance use disorder (SUD). Similar to other chronic health disorders, periods of remission and exacerbation commonly occur in SUDs. Due to stigma and difficulty with definition, terminology related to SUDs has changed and evolved. Terms referring to nonuse of substances such as sobriety and abstinence are likely best replaced with the term remission. Similarly, the use of the term relapse, in reference to a return to use after remission should be replaced with the term exacerbation. Research and professional organization consensus indicate that after a period of five years of remission or recovery, the risk of exacerbation is low in SUDs. Recovery is a term used to describe overall improvements in quality of life during remission. Recovery has been defined by organizations and studied in research. Factors that have been shown to improve the success of recovery are increased quality of life, improved self-efficacy, employment, and spirituality. It is important for nurses to improve their understanding of the terminology related to SUDs and to communicate with others using the terms that are the least stigmatizing. Nurses are in a prime position to assess recovery and to help patients and their families implement changes in order to improve the success of their recovery.

General and religious coping predict drinking outcomes for alcohol dependent adults in treatment

BACKGROUND

Religiosity is associated with improved treatment outcomes among adults with alcohol dependence; however, it is unknown whether religious coping predicts drinking outcomes above and beyond the effects of coping in general, and whether gender differences exist.

METHODS

We assessed 116 alcohol-dependent adults (53% women; mean age = 37, SD = 8.6) for use of religious coping, general coping, and alcohol use within 2 weeks of entering outpatient treatment, and again 6 months after treatment.

RESULTS

Religious coping at 6 months predicted fewer heavy alcohol use days and fewer drinks per day. This relationship was no longer significant after controlling for general coping at 6 months.

CONCLUSIONS

The relationship between the use of religious coping strategies and drinking outcomes is not independent of general coping. Coping skills training that includes religious coping skills, as one of several coping methods, may be useful for a subset of adults early in recovery.

SCIENTIFIC SIGNIFICANCE

This novel, prospective study assessed the relationship between religious coping strategies, general coping, and treatment outcomes for alcohol-dependent adults in treatment with results suggesting that the use of religious coping as one of several coping methods may be useful for a subset of adults early in recovery.