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Jaramillo Y, DeVito EE, Frankforter T, Silva MA, Añez LM, Kiluk BD, Carroll KM, Paris M. Religiosity and Spirituality in Latinx Individuals with Substance Use Disorders: Association with Treatment Outcomes in a Randomized Clinical Trial. JOURNAL OF RELIGION AND HEALTH 2022; 61:4139-4154. [PMID: 35305222 PMCID: PMC9482997 DOI: 10.1007/s10943-022-01544-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/03/2022] [Indexed: 06/14/2023]
Abstract
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.
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Affiliation(s)
- Yudilyn Jaramillo
- Department of Psychiatry, Yale School of Medicine, Yale University, 34 Park Street, New Haven, CT, 06519, USA.
| | - Elise E DeVito
- Department of Psychiatry, Yale School of Medicine, Yale University, 34 Park Street, New Haven, CT, 06519, USA
| | - Tami Frankforter
- Department of Psychiatry, Yale School of Medicine, Yale University, 34 Park Street, New Haven, CT, 06519, USA
| | - Michelle A Silva
- Department of Psychiatry, Yale School of Medicine, Yale University, 34 Park Street, New Haven, CT, 06519, USA
| | - Luis M Añez
- Department of Psychiatry, Yale School of Medicine, Yale University, 34 Park Street, New Haven, CT, 06519, USA
| | - Brian D Kiluk
- Department of Psychiatry, Yale School of Medicine, Yale University, 34 Park Street, New Haven, CT, 06519, USA
| | - Kathleen M Carroll
- Department of Psychiatry, Yale School of Medicine, Yale University, 34 Park Street, New Haven, CT, 06519, USA
| | - Manuel Paris
- Department of Psychiatry, Yale School of Medicine, Yale University, 34 Park Street, New Haven, CT, 06519, USA
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Positive and negative religiousness and search for meaning: Impact on treatment of substance abuse after 6 months. Drug Alcohol Depend 2022; 230:109182. [PMID: 34864358 DOI: 10.1016/j.drugalcdep.2021.109182] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 10/23/2021] [Accepted: 10/25/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND Religiousness and meaning in life are protective factors against addiction. Understanding this relationship may help to improve treatment. The aim of the current study was to assess the associations of positive and negative religiousness and search for meaning with treatment outcome, for patients with substance disorder (SUD). METHOD The sample consisted of 115 participants attending a Christian drug addiction treatment center in the Netherlands. The study had a longitudinal design in which associations of positive/negative religiousness and search for meaning at baseline (T0) with treatment outcome after six months (T1) were assessed by means of regression analyses. Treatment outcome was measured by clinical dysfunction and the degree of addiction. Instruments used were the ROM (Routine Outcome Monitoring) Meaning and Religious Faith, the Outcome Questionnaire (OQ-45) and the Measurements in the Addictions for Triage and Evaluations (MATE-1). RESULTS A high degree of positive religiousness at T0 was associated with less addiction at T1 (p < .01). A high degree of negative religiousness at T0 was related to more clinical dysfunction at T1 (p = <0.05). A higher search for meaning at T0 predicted a higher level of addiction at T1 (p = <0.05). CONCLUSIONS Positive religiousness is associated with less, whereas search for meaning is associated with more addiction after six months. Negative religiousness is not associated with addiction, but with clinical dysfunction. Health professionals are recommended to assess these factors at the start of treatment and to consider possibilities to integrate them into treatment.
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McGeough BL, Karriker-Jaffe KJ, Zemore SE. Rates and predictors of Alcoholics Anonymous attendance across sexual orientations. J Subst Abuse Treat 2021; 129:108400. [PMID: 34080558 PMCID: PMC8380678 DOI: 10.1016/j.jsat.2021.108400] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 04/04/2021] [Accepted: 04/05/2021] [Indexed: 10/21/2022]
Abstract
Sexual minority (e.g., gay, lesbian, bisexual) individuals experience alcohol dependence at 2-6 times the rates of heterosexual individuals. Among the general population, Alcoholics Anonymous (AA) serves as the most common source of support for alcohol-related problems in the United States. Yet, relatively little is known about sexual minority involvement in AA, including rates and predictors of AA attendance among sexual minorities. This paper aims to: 1) Compare rates of AA attendance across sexual orientations; 2) Compare relationships between AA attendance and common predictors of AA attendance across sexual orientations. Using five waves of the National Alcohol Survey (N = 7862 respondents with at least one lifetime AUD symptom), this study found lesbian and bisexual women, but not gay and bisexual men, had greater odds of attending AA, even while controlling for lifetime AUD severity, gender, race/ethnicity, age, religiosity, and current income. Interaction models for women showed there was a stronger association between older age and AA attendance, a stronger association between greater religiosity and AA attendance, and a weaker association between lifetime AUD severity and AA attendance for sexual minority women relative to heterosexual women. This study did not find significant interactions between sexual orientation and these covariates for men. These results suggest AA may serve as a promising resource for sexual minority individuals experiencing alcohol-related problems, particularly for sexual minority women who are older, more religious, and have less severe AUD.
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Affiliation(s)
- Briana L McGeough
- School of Social Welfare, University of Kansas, Lawrence, KS, United States of America.
| | | | - Sarah E Zemore
- Alcohol Research Group, Emeryville, CA, United States of America
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Do Involvement in Alcoholics Anonymous and Religiousness Both Directly and Indirectly through Meaning in Life Lead to Spiritual Experiences? RELIGIONS 2021. [DOI: 10.3390/rel12100794] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Spirituality is a key element of Alcoholics Anonymous (AA) recovery. However, little is known about the potential religious and secular sources of spiritual experiences in AA fellowship. The aim of the study was to verify if in a sample of AA participants, meaning in life mediates the relationship between their religiousness and spiritual experiences, as well as between their involvement in AA and spiritual experiences. The study sample consisted of 70 Polish AA participants, and the following tools were used: the Alcoholics Anonymous Involvement Scale (AAIS); Santa Clara Strength of Religious Faith Questionnaire (SCSORFQ); Purpose in Life Test (PIL); two one-item measures regarding frequency of prayer and Mass attendance; and the Daily Spiritual Experiences Scale (DSES) duration of AA participation, which was positively related to involvement in addiction self-help groups and religiousness. Involvement in AA and religiousness were positively related to meaning in life, which in turn positively correlated with spiritual experiences. This research indicated that in a sample of AA participants, finding meaning in life partially mediates the relationship between religiousness and spiritual experiences, as well as fully mediating the relationship between involvement in AA and spiritual experiences. The theoretical and practical implications are discussed.
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Corneille JS, Luke D. Spontaneous Spiritual Awakenings: Phenomenology, Altered States, Individual Differences, and Well-Being. Front Psychol 2021; 12:720579. [PMID: 34489825 PMCID: PMC8417526 DOI: 10.3389/fpsyg.2021.720579] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 07/09/2021] [Indexed: 11/13/2022] Open
Abstract
Spontaneous Spiritual Awakenings (SSAs) are subjective experiences characterised by a sudden sense of direct contact, union, or complete nondual merging (experience of oneness) with a perceived ultimate reality, the universe, "God," or the divine. These profound transformative experiences have scarcely been researched, despite extensive anecdotal evidence suggesting their potential to catalyse drastic, long-term, and often positive shifts in perception, world-view, and well-being. The aims of this study were to investigate the phenomenological variances of these experiences, including the potential differences between SSAs and Spontaneous Kundalini Awakenings (SKAs), a subset of awakening experiences that the authors postulate may produce a higher likelihood of both physical and negative effects; to explore how these experiences compare to other altered states of consciousness (ASCs), including those mediated by certain psychedelic substances; and understand their impact on well-being. Personality trait absorption and temporal lobe lability (TLL) were assessed as predictors of Spontaneous Spiritual and Kundalini Awakenings (SSA/SKAs). A mixed within and between-participants self-report survey design was adopted. A total of 152 participants reporting their most powerful SSA/SKAs completed questionnaires measuring nondual, kundalini, and mystical experience, as well as depth of ASC, and trait absorption and TLL. Spontaneous Kundalini Awakenings were found to be significantly more physical, but not significantly more negative than SSAs, and overall, both sets of experiences were perceived to be overwhelmingly more positive than negative, even in cases where the experience was initially challenging. The phenomenological distribution of SSA/SKAs was similar to other measured ASCs although greater in magnitude, and appeared most similar in distribution and in magnitude to drug-induced ASCs, particularly classic psychedelics DMT and psilocybin. Temporal lobe lability and trait absorption were found to predict the SSA/SKA experience. The limitations and implications of these findings are discussed.
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Affiliation(s)
- Jessica Sophie Corneille
- Centre for Mental Health, School of Human Sciences, University of Greenwich, London, United Kingdom
| | - David Luke
- Centre for Mental Health, School of Human Sciences, University of Greenwich, London, United Kingdom.,Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
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McInerney K, Cross A. A Phenomenological Study: Exploring the Meaning of Spirituality in Long-term Recovery in Alcoholics Anonymous. ALCOHOLISM TREATMENT QUARTERLY 2021. [DOI: 10.1080/07347324.2021.1895016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
| | - Ainslea Cross
- School of Psychology, University of Derby, Derby, UK
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Rothberg RL, Azhari N, Haug NA, Dakwar E. Mystical-type experiences occasioned by ketamine mediate its impact on at-risk drinking: Results from a randomized, controlled trial. J Psychopharmacol 2021; 35:150-158. [PMID: 33307947 DOI: 10.1177/0269881120970879] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Sub-anesthetic ketamine administration may be helpful for substance use disorders. Converging evidence suggests that the efficacy of ketamine for certain conditions may implicate a subset of its psychoactive effects. AIMS The aim of this analysis is to evaluate whether the mystical-type effects of ketamine are critical for clinical efficacy in alcohol-dependent individuals. In this secondary analysis, we determine if a subset of the psychoactive effects of ketamine, the so-called mystical-type experience, mediates the effect of ketamine, when combined with motivational enhancement therapy, on at-risk drinking behavior in alcohol-dependent individuals interested in treatment. METHODS Forty alcohol dependent adults were randomized to either a 52-minute infusion of ketamine or midazolam, which they received on a designated quit-day during the second week of a five-week motivational enhancement therapy regimen. Psychoactive effects were assessed following the infusion, and alcohol use was monitored for the subsequent 3 weeks at each twice-weekly visit. RESULTS We found that ketamine leads to significantly greater mystical-type effects (by Hood Mysticism Scale) and dissociation (by Clinician Administered Dissociative States Scale) compared to the active control. Ketamine also led to significant reduction in at-risk drinking. The Hood Mysticism Scale, but not Clinician Administered Dissociative States Scale score, was found to mediate the effect of ketamine on drinking behavior. CONCLUSIONS This trial adds evidence to the literature on the importance of mystical-type experiences in addiction treatment. Future research should continue to investigate the relationship between the psychoactive effects of psychedelic therapeutics and clinical outcomes for other substance use and mental health disorders.
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Affiliation(s)
| | - Nour Azhari
- New York State Psychiatric Institute, Columbia University Medical Center, New York, USA
| | - Nancy A Haug
- Department of Psychology, Palo Alto University, Palo Alto, USA
| | - Elias Dakwar
- New York State Psychiatric Institute, Columbia University Medical Center, New York, USA
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Vogelsang EM, Lariscy JT. Let's Drink to Being Socially Active: Family Characteristics, Social Participation, and Alcohol Abuse across Mid- and Later-life. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2020; 61:453-469. [PMID: 33047985 DOI: 10.1177/0022146520962456] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Researchers and practitioners often extol the health benefits of social relationships and social participation for older adults. Yet they often ignore how these same bonds and activities may contribute to negative health behaviors. Using data from the Wisconsin Longitudinal Study (16,065 observations from 7,007 respondents), we examined how family characteristics, family history, and social participation predicted three measures of alcohol abuse between ages 53 and 71. Results indicate that, generally, greater social participation is associated with increased drinking days per month. We also found that religious participation and having ever lived with an alcoholic are each associated with reporting possible alcohol dependence but not with alcohol consumption itself. Lastly, we identified gendered associations between marital dissolution and drinking behavior. These findings contextualize the increasing rates of alcohol abuse among older adults by emphasizing the possible negative consequences of "linked lives" on health via relationship stress and group norms.
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Affiliation(s)
- Eric M Vogelsang
- California State University-San Bernardino, San Bernardino, CA, USA
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Galanter M, White WL, Ziegler PP, Hunter B. An empirical study on the construct of "God" in the Twelve Step process. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2020; 46:731-738. [PMID: 32870030 DOI: 10.1080/00952990.2020.1789870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Background: The term God, included in 5 of the 12 Steps of Narcotics Anonymous (NA) and Alcoholics Anonymous (AA), self-designated spiritual fellowships, has not been studied empirically relative to members' experiences. A greater understanding of this can be clinically useful and can shed light on the 12 Step process of recovery. Objectives: To determine how NA members understand the 12-step concept "God as we understood Him" and the relationship between their understanding of God and the intensity of their craving and depressive symptoms." Methods: 450 (59% male) NA members completed a survey related to their experiences relative to their relationship with "God." The relationship among these variables and comparisons to the general population was analyzed. Craving and depressive symptoms were assessed by self-report. Results: 98% of the NA participants believe in God explicitly or some other higher power (vs 89% of a probability sample of the US population), 67% believe that God determines what happens to them some or all of the time (vs 48%), 78% (vs 28%) report hearing God talking to them "in their mind"; and 37% report that God talks to them "out loud." Acceptance of 12 Step God-related variables inversely predicted a significant portion of the variance of scores on craving (7.5%) and depression (13.5%). Conclusions: Respondents' understanding of God in NA varied considerably and was predictive of their depressive symptoms and craving intensity. These findings can serve as a basis for research into mechanisms underlying NA/AA recovery experiences and can also aid clinicians in how to employ these programs.
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Affiliation(s)
- Marc Galanter
- Department of Psychiatry, New York University School of Medicine , New York, NY, USA
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Mericle AA, Karriker-Jaffe K, Patterson D, Mahoney E, Cooperman L, Polcin DL. Recovery in context: Sober living houses and the ecology of recovery. JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 48:2589-2607. [PMID: 32939779 PMCID: PMC7809921 DOI: 10.1002/jcop.22447] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 08/04/2020] [Accepted: 08/11/2020] [Indexed: 06/11/2023]
Abstract
Sober living houses (SLHs) are an increasingly common element of the recovery support services landscape, yet little is known about their neighborhood context. This study describes neighborhoods in which SLHs are located and examines differences by house characteristics. SLHs in Los Angeles County (N = 297) were geocoded and linked with U.S. Census, alcohol outlet, recovery resources, and accessibility data. Regression analyses tested differences by house characteristics. Co-ed houses were in neighborhoods that were less ethnically diverse and farther away from recovery resources. Larger house capacity was associated with increased density of off-premise alcohol outlets but also increased proximity to treatment. Higher fees were associated with lower neighborhood disadvantage and off-premise alcohol outlet density but the greater distance from treatment programs and other recovery resources. House characteristics are associated with neighborhood factors that both support recovery and place residents at risk.
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Affiliation(s)
- Amy A Mericle
- Alcohol Research Group at the Public Health Institute, Emeryville, California, USA
| | | | - Deidre Patterson
- Alcohol Research Group at the Public Health Institute, Emeryville, California, USA
| | - Elizabeth Mahoney
- Behavioral Health and Recovery Studies at the Public Health Institute, California, USA
| | - Laya Cooperman
- Alcohol Research Group at the Public Health Institute, Emeryville, California, USA
| | - Douglas L Polcin
- Behavioral Health and Recovery Studies at the Public Health Institute, California, USA
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Milani RM, Nahar K, Ware D, Butler A, Roush S, Smith D, Perrino L, O’Donnell J. A qualitative longitudinal study of the first UK Dual Diagnosis Anonymous (DDA), an integrated peer-support programme for concurrent disorders. ADVANCES IN DUAL DIAGNOSIS 2020. [DOI: 10.1108/add-01-2020-0001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeDual Diagnosis Anonymous (DDA) is a peer-led programme developed in the USA, which aims to address mental and addictive disorders in an integrated manner. This study is part of a mixed-methods evaluation of the first DDA pilot in the UK, and the purpose of this study is to explore the impact and mechanism of change of the programme through the perspective of DDA attendees, facilitators and the funding commissioners.Design/methodology/approachSix DDA members were interviewed three times over a period of 12 months, the facilitators were interviewed twice and the commissioner was interviewed once. The qualitative longitudinal data were analysed using a trajectory thematic analysis.FindingsDDA attendance was perceived to have had a positive impact on five main areas: acceptance of self, of others and from others; social functioning; self-development; recovery progression; and feeling of hope. The possibility of addressing both mental health and addiction at the same time was a key factor in the recovery process. The facilitators observed that DDA had contributed to integrate members into employment and education, while the commissioner stressed the importance of joint commissioning and sustainability.Originality/valueThe longitudinal approach provided a unique insight into the recovery process of DDA members. Being able to address the mental health as well as the substance use problems was considered to be a fundamental strength of DDA in comparison to the single purpose peer-support fellowships.
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Karriker-Jaffe KJ, Witbrodt J, Mericle AA, Polcin DL, Kaskutas LA. Testing a Socioecological Model of Relapse and Recovery from Alcohol Problems. Subst Abuse 2020; 14:1178221820933631. [PMID: 33192069 PMCID: PMC7594231 DOI: 10.1177/1178221820933631] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 05/20/2020] [Indexed: 11/21/2022]
Abstract
This study tests a socioecological model of relapse and recovery using latent class growth mixture modeling to identify neighborhood, social network and individual-level predictors of alcohol dependence trajectories among a large, longitudinal sample of problem drinkers recruited from substance use treatment settings. We identified four distinct alcohol dependence trajectories: Stable Recovery/Low (Class 1); Relapsing/Rising (Class 2); Late Recovery/Declining (Class 3); and Chronic/High (Class 4). Neighborhood context (poverty and density of bars), social network characteristics (less involvement with Alcoholics Anonymous [AA], continued affiliation with heavy drinkers), and individual predisposing (psychiatric severity) and need (returning to treatment) characteristics each distinguished individuals in the Relapsing/Rising class from individuals in the Stable Recovery/Low class. Social network characteristics (AA involvement and continued affiliation with heavy drinkers) were the primary distinguishing factors for individuals in the Chronic/High class compared to the Late Recovery/Declining class. Study findings can be used to promote recovery and help prevent relapse by: guiding development of community-level interventions to improve social and physical environments; identifying potentially modifiable factors (social network support for sobriety, participation in self-help) to reduce negative consequences among problem drinkers who remain in high-risk neighborhoods; and contributing to ongoing discussions about new and continued licensing of alcohol outlets and regulation of alcohol sales to prevent alcohol problems in high-risk areas and among high-risk people.
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Affiliation(s)
| | - Jane Witbrodt
- Alcohol Research Group, Public Health Institute,
Emeryville, CA, USA
| | - Amy A Mericle
- Alcohol Research Group, Public Health Institute,
Emeryville, CA, USA
| | - Douglas L Polcin
- Alcohol Research Group, Public Health Institute,
Emeryville, CA, USA
| | - Lee Ann Kaskutas
- Alcohol Research Group, Public Health Institute,
Emeryville, CA, USA
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Garcia V, Lambert E, Fox K, Heckert D, Pinchi NH. Grassroots interventions for alcohol use disorders in the Mexican immigrant community: A narrative literature review. J Ethn Subst Abuse 2020; 21:773-792. [PMID: 32757884 DOI: 10.1080/15332640.2020.1803781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This narrative literature review addresses grassroots interventions for alcohol use disorders as practiced in Mexican immigrant communities. These organic efforts are 24-hour AA groups, or anexos, fourth and fifth step AA groups, juramentos, and curanderismo. Literature was identified using PubMed and CINAHL and limited to works published from 2000 to 2018. In all, three publications on 24-hour groups were found, two on fourth and fifth step groups, four on juramentos, and one on curanderismo use. The review offers insight on their practices and concludes that the interventions' cultural resonance provides advantages over cultural competency AUDs programs developed in public health.
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Affiliation(s)
- Victor Garcia
- Indiana University of Pennsylvania, Indiana, Pennsylvania
| | - Emily Lambert
- Indiana University of Pennsylvania, Indiana, Pennsylvania
| | | | - Daniel Heckert
- Indiana University of Pennsylvania, Indiana, Pennsylvania
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Segal G. ALCOHOLICS ANONYMOUS "SPIRITUALITY" AND LONG-TERM SOBRIETY MAINTENANCE AS A TOPIC FOR INTERDISCIPLINARY STUDY. Behav Brain Res 2020; 389:112645. [PMID: 32353394 DOI: 10.1016/j.bbr.2020.112645] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/16/2020] [Accepted: 04/06/2020] [Indexed: 11/26/2022]
Abstract
The foundational literature of Alcoholics Anonymous provides a good example of how ideas from different intellectual paradigms can be woven together to enhance understanding of addiction and recovery. A detailed hypothesis about how the 12 steps of Alcoholics Anonymous work as a program of emotion management is presented. The hypothesis assigns a central role to a secular interpretation of spirituality, consistent with naturalism. Clinical research which appears to indicate that spirituality is not the chief mechanism of recovery in Alcoholics Anonymous is critiqued. Interdisciplinary research is required, if the extent and nature of the efficacy of AA's 12 steps are to be understood.
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Dale E, Kelly PJ, Lee KSK, Conigrave JH, Ivers R, Clapham K. Systematic review of addiction recovery mutual support groups and Indigenous people of Australia, New Zealand, Canada, the United States of America and Hawaii. Addict Behav 2019; 98:106038. [PMID: 31302311 DOI: 10.1016/j.addbeh.2019.106038] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 05/10/2019] [Accepted: 06/25/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Addictions contribute significantly to the overall disease burden for Indigenous peoples of colonised countries. Mutual support groups are one of the most common addiction recovery resources, however their effectiveness for Indigenous peoples is unclear. METHODS A PRISMA-informed search was performed to retrieve empirical studies on addiction recovery mutual support groups for Indigenous peoples of Australia, New Zealand, Canada, United States of America and Hawaii. Databases searched were: MEDLINE, CINAHL Plus, PsychINFO, PsychARTICLES, SocINDEX, Cochrane Database of Systematic Reviews, PubMed, Scopus and UlrichsWeb, Informit Collections, Australian Indigenous HealthInfonet and Lowitja Institute electronic databases. Exclusion criteria were: 1) not an Indigenous focus; 2) not an addiction focus (i.e. including alcohol, other drug, gambling); 3) not a mutual support group focus; 4) not an original study; 5) not a complete study; 6) not published in English language. RESULTS Four studies published between 2001 and 2006 met review criteria. All studies were conducted in the United States of America with Native American Indian peoples (n = 1600) and featured Alcoholics Anonymous only. Study designs were: a retrospective analysis of survey data, a cross-sectional survey report, a clinical case study and an ethnographic study. Methodological differences precluded meaningful translation of results. CONCLUSION There is a lack of empirical knowledge on the acceptability and outcomes of addiction recovery mutual support groups for Indigenous peoples of Australia, New Zealand, Canada, United States of America and Hawaii. This review suggests recommendations for future research.
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Affiliation(s)
- Elizabeth Dale
- Ngarruwan Ngadju First Peoples Health and Wellbeing Research Center, Australian Health Services Research Institute and Illawarra Health and Medical Research Institute, School of Psychology, University of Wollongong, New South Wales, Australia.
| | - Peter J Kelly
- Ngarruwan Ngadju First Peoples Health and Wellbeing Research Center, Australian Health Services Research Institute and Illawarra Health and Medical Research Institute, School of Psychology, University of Wollongong, New South Wales, Australia
| | - K S Kylie Lee
- The University of Sydney, Faculty of Medicine and Health, Discipline of Addiction Medicine, Indigenous Health and Substance Use, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, New South Wales, Australia; La Trobe University, Centre for Alcohol Policy Research, Victoria, Australia
| | - James H Conigrave
- The University of Sydney, Faculty of Medicine and Health, Discipline of Addiction Medicine, Indigenous Health and Substance Use, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, New South Wales, Australia
| | - Rowena Ivers
- School of Medicine, The University of Wollongong, Wollongong, New South Wales, Australia; Illawarra Aboriginal Medical Service, New South Wales, Australia
| | - Kathleen Clapham
- Ngarruwan Ngadju First Peoples Health and Wellbeing Research Center, Australian Health Services Research Institute, Faculty of Business, University of Wollongong, New South Wales, Australia
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Gonzales-Castaneda R, McKay JR, Steinberg J, Winters KC, Yu CH(A, Valdovinos IC, Casillas JM, McCarthy KC. Testing mediational processes of substance use relapse among youth who participated in a mobile texting aftercare project. Subst Abus 2019; 43:1-12. [PMID: 31638878 PMCID: PMC7174140 DOI: 10.1080/08897077.2019.1671941] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND The goal of this paper is to advance the understanding of mechanisms of action involved in behavioral-driven aftercare interventions for substance use disorders (SUDs) among youth populations. This paper reports data from a study that measured the impact of an aftercare intervention on primary substance use relapse among youth who completed treatment in Los Angeles County for SUDs. The aftercare intervention, Project ESQYIR-Educating and Supporting inQuisitive Youth In Recovery, utilized text messaging to monitor relapse and recovery processes, provide feedback, reminders, support, and education among youth from SUD specialty settings during the initial 3-month period following treatment completion. Method: Mediational modeling informed by Baron and Kenny was used to examine the extent to which select recovery processes including participation in extracurricular activities and self-help, were impacted by the texting intervention, and if such processes helped sustain recovery and prevent primary substance use relapse. The data come from a two-group randomized controlled pilot study testing the initial efficacy of a mobile health texting aftercare intervention among 80 youth (Mage= 20.7, SD = 3.5, range: 14-26 years) who volunteered to participate after completing SUD treatment between 2012 and 2013. Results: Among the two recovery processes examined in the mediational modeling, only involvement in extracurricular activities mediated the effects of the texting aftercare intervention on reductions in primary substance use relapse; not self-help participation. Conclusion: Findings from this pilot study offer greater understanding about potential recovery-related mechanisms of action of mobile aftercare interventions. Mobile texting was found to promote increased engagement in recovery-related behaviors such as participation in extracurricular activities, which mediated the effects of the mobile aftercare intervention on decreasing primary substance use relapse. Findings suggest mobile approaches may be effective for increasing adherence to a wide-array of recovery behavioral regiments among youth populations challenged by complex behavioral issues.
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Affiliation(s)
- Rachel Gonzales-Castaneda
- University of California at Los Angeles, Integrated Substance Abuse Programs, Los Angeles, CA
- Azusa Pacific University, Psychology Department, Azusa, CA
| | - James R. McKay
- University of Pennsylvania, Center on the Continuum of Care in the Addictions, Philadelphia, PA
| | - Jane Steinberg
- Azusa Pacific University, Psychology Department, Azusa, CA
- Keck School of Medicine, University of Southern California, Los Angeles, CA
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Grim BJ, Grim ME. Belief, Behavior, and Belonging: How Faith is Indispensable in Preventing and Recovering from Substance Abuse. JOURNAL OF RELIGION AND HEALTH 2019; 58:1713-1750. [PMID: 31359242 PMCID: PMC6759672 DOI: 10.1007/s10943-019-00876-w] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
This study reviews the voluminous empirical evidence on faith's contribution to preventing people from falling victim to substance abuse and helping them recover from it. We find that 73% of addiction treatment programs in the USA include a spirituality-based element, as embodied in the 12-step programs and fellowships initially popularized by Alcoholics Anonymous, the vast majority of which emphasize reliance on God or a Higher Power to stay sober. We introduce and flesh out a typology of faith-based substance abuse treatment facilities, recovery programs, and support groups. This typology provides important background as we then move on to make an economic valuation of nearly 130,000 congregation-based substance abuse recovery support programs in the USA. We find that these faith-based volunteer support groups contribute up to $316.6 billion in savings to the US economy every year at no cost to tax payers. While negative experiences with religion (e.g., clergy sex abuse and other horrendous examples) have been a contributory factor to substance abuse among some victims, given that more than 84% of scientific studies show that faith is a positive factor in addiction prevention or recovery and a risk in less than 2% of the studies reviewed, we conclude that the value of faith-oriented approaches to substance abuse prevention and recovery is indisputable. And, by extension, we also conclude that the decline in religious affiliation in the USA is not only a concern for religious organizations but constitutes a national health concern.
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Affiliation(s)
- Brian J. Grim
- Institute for Studies of Religion, Baylor University, One Bear Place #97236, Waco, TX 76798 USA
| | - Melissa E. Grim
- Religious Freedom & Business Foundation, 1A Perry Circle, Annapolis, MD 21402 USA
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The efficacy of spiritual/religious interventions for substance use problems: A systematic review and meta-analysis of randomized controlled trials. Drug Alcohol Depend 2019; 202:134-148. [PMID: 31349206 DOI: 10.1016/j.drugalcdep.2019.04.045] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 04/25/2019] [Accepted: 04/26/2019] [Indexed: 02/07/2023]
Abstract
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.
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Richardson GB, Hanson-Cook BS, Figueredo AJ. Bioecological Counseling. EVOLUTIONARY PSYCHOLOGICAL SCIENCE 2019. [DOI: 10.1007/s40806-019-00201-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Richardson GB, Blount TN, Hanson-Cook BS. Life History Theory and Recovery From Substance Use Disorder. REVIEW OF GENERAL PSYCHOLOGY 2018. [DOI: 10.1037/gpr0000173] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Recovery has emerged as an important paradigm in addictions treatment but the field has yet to achieve consensus on how it should be defined and measured. The recovery construct has been extended beyond sustained reductions in use or abstinence to enhancements in global health/well-being and also prosocial community reintegration. However, few studies have included these broader domains in their measurement of recovery and few scientific theories have been advanced to explain why reductions in substance use occasion these broader life changes. This article applies life history theory to recovery for the first time to help define recovery, advance recovery measurement, and explain why broad change across multiple life domains should facilitate sustained recovery progress. We conclude with a discussion of future directions and challenges for future research informed by our life history framework for recovery.
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Affiliation(s)
- George B. Richardson
- School of Human Services, College of Education, Criminal Justice, and Human Services, University of Cincinnati
| | - Taheera N. Blount
- School of Human Services, College of Education, Criminal Justice, and Human Services, University of Cincinnati
| | - Blair S. Hanson-Cook
- School of Human Services, College of Education, Criminal Justice, and Human Services, University of Cincinnati
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Kuerbis A, Tonigan JS. More than Taking a Chair: The Perceived Group Social Dynamics of Alcoholics Anonymous Related to Changes in Spiritual Practices. ALCOHOLISM TREATMENT QUARTERLY 2018; 36:314-329. [PMID: 30397366 DOI: 10.1080/07347324.2017.1420437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Alcoholics Anonymous (AA) meeting attendance and spiritual practices are established predictors of abstinence. This study utilized longitudinal data from two studies of AA to investigate 1) how perceived within meeting social dynamics in AA meetings affect later AA attendance, and thus exposure to the emphasis of spiritual practices and 2) influence the extent that spiritual gains are mobilized, beyond AA attendance. Findings revealed that greater group cohesion was associated with lower AA attrition, and that expressiveness, or openness, of the group predicted reported practice of spiritual behaviors. Findings reveal distinct group dynamics may foster distinct mechanism of change of AA attendees.
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Affiliation(s)
- Alexis Kuerbis
- Silberman School of Social Work, Hunter College at the City University of New York
| | - J Scott Tonigan
- University of New Mexico and the Center for Alcoholism, Substance Abuse and Addiction
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Bluma L. The role of spirituality in alcohol abstinence self-efficacy amongst alcoholics anonymous members. DRUGS AND ALCOHOL TODAY 2018. [DOI: 10.1108/dat-09-2017-0049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Previous research indicates that Alcoholics Anonymous (AA) can play an effective role in alcohol use disorder recovery (Kelly, Stout, Magill, Tonigan and Pagano, 2011). Acceptance of a “Higher Power” and experiencing a “spiritual awakening” are essential components of AA recovery programme (Alcoholics Anonymous World Service, 2014). The purpose of this paper is to identify if there are high associations in levels of spirituality and alcohol abstinence self-efficacy (AASE) measures amongst AA members.
Design/methodology/approach
Self-reported measures were collected from members of AA of their spiritual and religious beliefs and their everyday experiences of alcohol abstinence. Demographic information of participant’s ethnical background, age and length of AA membership was also obtained.
Findings
The analysis revealed high levels of spirituality amongst participants with a mean of 70.14 (2dp). There was no difference in participant high or low spiritual beliefs and their attitude towards alcohol abstinence. The frequency measures of spiritual activities showed that 73.7 per cent of participants engage in private spiritual or religious activities more than once a week.
Originality/value
Overall the study supports previously conduced researches in the field of spirituality and AASE amongst AA members when considering other variables associated with sustained sobriety. The implications of the results of this study are discussed and suggestions have been made for further investigation.
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Zemore SE, Lui C, Mericle A, Hemberg J, Kaskutas LA. A longitudinal study of the comparative efficacy of Women for Sobriety, LifeRing, SMART Recovery, and 12-step groups for those with AUD. J Subst Abuse Treat 2018; 88:18-26. [PMID: 29606223 PMCID: PMC5884451 DOI: 10.1016/j.jsat.2018.02.004] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 02/13/2018] [Accepted: 02/14/2018] [Indexed: 10/18/2022]
Abstract
BACKGROUND Despite the effectiveness of 12-step groups, most people reporting a prior alcohol use disorder (AUD) do not sustain involvement in such groups at beneficial levels. This highlights the need for research on other mutual help groups that address alcohol problems and may attract those who avoid 12-step groups. The current study addresses this need, offering outcome data from the first longitudinal, comparative study of 12-step groups and their alternatives: The Peer ALlternatives for Addiction (PAL) Study. METHODS Adults with a lifetime AUD were surveyed at baseline (N=647), 6months (81% response rate) and 12months (83% response rate). Members of the largest known secular mutual help alternatives, namely Women for Sobriety (WFS), LifeRing, and SMART, were recruited in collaboration with group directors; current 12-step attendees were recruited from an online meeting hub. Online surveys assessed demographic and clinical variables; mutual help involvement; and alcohol and drug use and severity. Analyses involved multivariate logistic GEEs separately modelling alcohol abstinence, alcohol problems, and total abstinence across 6 and 12months. Key predictors were baseline primary group affiliation (PGA); primary group involvement (PGI) at both baseline and 6months; and the interaction between baseline PGA and 6-month PGI. The critical effects of interest were the interactions, expressing whether associations between changes in PGI from baseline to 6months and substance use outcomes differed by primary group. RESULTS None of the interactions between baseline PGA and 6-month PGI were significant, suggesting no differences in the efficacy of WFS, LifeRing, or SMART, vs. 12-step groups. Nevertheless, some PGA main effects emerged. Compared to 12-step members, those identifying SMART as their primary group at baseline fared worse across outcomes, and those affiliating with LifeRing showed lower odds of total abstinence. Still, these effects became nonsignificant when controlling for baseline alcohol recovery goal, suggesting that any group differences may be explained by selection of those with weaker abstinence motivation into LifeRing and (especially) SMART. CONCLUSIONS This study makes a valuable contribution in view of the extremely limited evidence on mutual help alternatives. Results tentatively suggest that WFS, LifeRing, and SMART are as effective as 12-step groups for those with AUDs, and that this population has the best odds of success when committing to lifetime total abstinence. An optimal care plan may thus involve facilitating involvement in a broad array of mutual help groups and supporting abstinence motivation.
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Affiliation(s)
| | - Camillia Lui
- Alcohol Research Group, Emeryville, CA, United States
| | - Amy Mericle
- Alcohol Research Group, Emeryville, CA, United States
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Ronel N, Ben Yair Y. Spiritual Criminology: The Case of Jewish Criminology. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2018; 62:2081-2102. [PMID: 29237306 DOI: 10.1177/0306624x17693865] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Throughout the ages and in most cultures, spiritual and religious thinking have dealt extensively with offending (person against person and person against the Divine), the response to offending, and rehabilitation of offenders. Although modern criminology has generally overlooked that body of knowledge and experience, the study of spirituality and its relation to criminology is currently growing. Frequently, though, it is conducted from the secular scientific perspective, thus reducing spiritual knowledge into what is already known. Our aim here is to present a complementary perspective; that is, spiritual criminology that emerges from the spiritual perspective. Following a description of the state-of-the-art in criminological research concerning spirituality and its impact upon individuals, we focus on Jewish criminology as an illustrative case study, and present a spiritual Jewish view on good and evil, including factors that lead to criminality, the issue of free choice, the aim of punishment and societal response, crime desistance, rehabilitation, and prevention. The proposed establishment of spiritual criminology can be further developed by including parallel schools of spirituality, to create an integrated field in criminology.
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Affiliation(s)
| | - Y Ben Yair
- 1 Bar-Ilan University, Ramat Gan, Israel
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26
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Lyytikäinen L. Mutual support and recovery in the Russian Alcoholics Anonymous online community. NORDIC STUDIES ON ALCOHOL AND DRUGS 2017. [DOI: 10.1515/nsad-2016-0013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Aims In Russia the paradigm of alcoholism as a disease is still in contrast to the general perception of alcoholics as weak-willed. This article studies alcoholism and recovery in Russia through the case study of the Russian Alcoholics Anonymous online group. It studies how people who are seeking help for their drinking problems in this online community come to incorporate a new self-understanding of being ill with alcoholism. Design The data were collected from a Russian online support group for people struggling with alcoholism. The source material consists of 617 posts by more than 35 individuals. The data was analysed with qualitative content analysis using the RQDA software. Results The online group acts as a virtual space where people can anonymously talk about alcoholism and engage with AA's 12-Step program. Typically, a new forum member goes through a process of admitting one's problem with alcohol and coming to a new understanding of oneself as a person suffering from a chronic disease. This process includes creating a new relation to alcohol, a new understanding of one's reasons for drinking and a commitment to stay sober and to help others to recover. Conclusions The online community creates a space for engagement with AA's 12-Step program and service work of supporting other alcoholics in recovery in the context of Russia, where face-to-face AA groups and other recovery programmes are scarce. When the state cannot deliver the services for problem drinkers or recovering alcoholics, people may turn to the Internet to find alternative information and social support.
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27
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Ranes B, Johnson R, Nelson L, Slaymaker V. The Role of Spirituality in Treatment Outcomes Following a Residential 12-Step Program. ALCOHOLISM TREATMENT QUARTERLY 2016. [DOI: 10.1080/07347324.2016.1257275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Bethany Ranes
- Butler Center for Research, Hazelden Betty Ford Foundation, Center City, Minnesota, USA
| | - Ryan Johnson
- Butler Center for Research, Hazelden Betty Ford Foundation, Center City, Minnesota, USA
| | - Lindsay Nelson
- Butler Center for Research, Hazelden Betty Ford Foundation, Center City, Minnesota, USA
| | - Valerie Slaymaker
- Butler Center for Research, Hazelden Betty Ford Foundation, Center City, Minnesota, USA
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Dermatis H, Galanter M. The Role of Twelve-Step-Related Spirituality in Addiction Recovery. JOURNAL OF RELIGION AND HEALTH 2016; 55:510-521. [PMID: 25701085 DOI: 10.1007/s10943-015-0019-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This paper reviews empirical studies conducted on the role of spirituality and religiosity (S/R) characteristics in 12-step recovery among program members followed up after substance abuse treatment and those assessed independent of formal treatment. Aspects of spiritual functioning that change in relation to program participation and those S/R characteristics that were found to mediate the association between program involvement and drinking-related outcomes are discussed. In addition, a review is provided of 12-step program studies investigating S/R-related predictors of clinical outcomes relevant to risk of relapse among members in long-term recovery. To further examine the role of S/R characteristics in recovery, a study was conducted on long-term AA members to assess the relationship of S/R characteristics and AA program involvement to craving for alcohol and emotional distress after controlling for relevant demographic variables. Feeling God's presence daily, believing in a higher power as a universal spirit, and serving as an AA sponsor were all predictive of positive outcomes.
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Affiliation(s)
- Helen Dermatis
- Division of Alcoholism and Drug Abuse, Department of Psychiatry, The Center for Spirituality and Healthcare, NYU School of Medicine, 550 First Avenue, New York, NY, 10016, USA.
| | - Marc Galanter
- Division of Alcoholism and Drug Abuse, Department of Psychiatry, The Center for Spirituality and Healthcare, NYU School of Medicine, 550 First Avenue, New York, NY, 10016, USA
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Galanter M, Josipovic Z, Dermatis H, Weber J, Millard MA. An initial fMRI study on neural correlates of prayer in members of Alcoholics Anonymous. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2016; 43:44-54. [DOI: 10.3109/00952990.2016.1141912] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Marc Galanter
- Department of Psychiatry, Division of Alcoholism and Drug Abuse, New York University School of Medicine, New York, NY, USA
| | - Zoran Josipovic
- Department of Psychology, New York University, New York, NY, USA
| | - Helen Dermatis
- Department of Psychiatry, Division of Alcoholism and Drug Abuse, New York University School of Medicine, New York, NY, USA
| | - Jochen Weber
- Department of Psychology, Social Cognitive Neuroscience Lab, Columbia University, New York, NY, USA
| | - Mary Alice Millard
- Department of Psychiatry, Division of Alcoholism and Drug Abuse, New York University School of Medicine, New York, NY, USA
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30
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Bliss DL. Spirituality-Enhanced Addiction Treatment Protocol: Conceptual and Operational Development. ALCOHOLISM TREATMENT QUARTERLY 2015. [DOI: 10.1080/07347324.2015.1077640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Galanter M, Dermatis H, Sampson C. Narcotics Anonymous: A Comparison of Military Veterans and Non-Veterans. J Addict Dis 2014; 33:187-95. [DOI: 10.1080/10550887.2014.950031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Bakken NW, DeCamp W, Visher CA. Spirituality and desistance from substance use among reentering offenders. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2014; 58:1321-1339. [PMID: 23824084 DOI: 10.1177/0306624x13494076] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Prior research has indicated an inverse relationship between religion and criminal behavior; however, few studies have specifically examined the effect of spirituality on the desistance process among a contemporary and diverse sample of reentering drug-involved offenders. A comprehensive understanding of how spirituality is related to desistance from substance use can lead to more effective and evidence-based preventive and rehabilitative interventions. Using data from a longitudinal study of 920 diverse offenders returning to the community after a period of incarceration, the current study examines three distinct forms of substance use (alcohol, marijuana, and cocaine) to gauge the effect that spirituality plays in the desistance process. The findings suggest a relatively high importance of spirituality in terms of preventing substance use during reentry, particularly concerning the use of both alcohol and cocaine.
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Yeterian JD, Bursik K, Kelly JF. Religiosity as a Predictor of Adolescents' Substance Use Disorder Treatment Outcomes. Subst Abus 2014; 36:453-61. [PMID: 25222569 DOI: 10.1080/08897077.2014.960550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND A growing body of research on adults with substance use disorders (SUDs) suggests that higher levels of religiosity and/or spirituality are associated with better treatment outcomes. However, investigation into the role of religiosity and spirituality in adolescent SUD treatment response remains scarce. The present study examines religiosity as a predictor of treatment outcomes in an adolescent sample, with alcohol/other drug problem recognition as a hypothesized moderator of this relationship. Problem recognition was selected as a moderator in an attempt to identify a subset of adolescents who would be more likely to use religious resources when attempting to change their substance use. METHODS One hundred twenty-seven outpatient adolescents aged 14 to 19 (Mage=16.7, SD=1.2, 24% female) were followed for 1 year after treatment intake. Growth curve analyses were used to assess the impact of baseline religiosity and problem recognition on subsequent abstinence rates, drug-related consequences, and psychological distress. RESULTS On average, abstinence did not change significantly during the follow-up period, whereas drug-related consequences and psychological distress decreased significantly. Religiosity did not predict changes in abstinence or psychological distress over time. Religiosity did predict reductions in drug-related consequences over time (b=-0.20, t=-2.18, P=.03). However, when problem recognition was added to the model, the impact of religiosity on consequences became nonsignificant, and there was no interaction between religiosity and problem recognition on consequences. CONCLUSIONS The main hypothesis was largely unsupported. Possible explanations include that the sample was low in religiosity and few participants were actively seeking sobriety at treatment intake. Findings suggest adolescent outpatients with SUD may differ from their adult counterparts in the role that religiosity plays in recovery.
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Affiliation(s)
- Julie D Yeterian
- a Department of Psychology, Suffolk University , Boston , Massachusetts , USA.,b Department of Psychiatry, Center for Addiction Medicine Massachusetts General Hospital , Boston , Massachusetts , USA
| | - Krisanne Bursik
- b Department of Psychiatry, Center for Addiction Medicine Massachusetts General Hospital , Boston , Massachusetts , USA
| | - John F Kelly
- b Department of Psychiatry, Center for Addiction Medicine Massachusetts General Hospital , Boston , Massachusetts , USA.,c Department of Psychiatry, Harvard Medical School , Boston , Massachusetts , USA
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Reingle Gonzalez JM, Caetano R, Mills BA, Vaeth PAC. An assessment of individual-level factors associated with alcohol treatment utilization among Mexican Americans. J Subst Abuse Treat 2014; 47:347-52. [PMID: 25113028 DOI: 10.1016/j.jsat.2014.06.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Revised: 05/16/2014] [Accepted: 06/30/2014] [Indexed: 11/30/2022]
Abstract
The purpose of this study is to identify enabling factors for treatment utilization for alcohol-related problems, and to evaluate how enabling factors vary by need for treatment, among two samples of Mexican American adults. These two distinct samples included 2,595 current and former drinkers (one sample included 787 U.S./Mexico border residents; the other sample included 740 Mexican Americans living in U.S. cities not proximal to the border). Need for treatment (alcohol disorder severity) and (male) gender were the primary correlates of treatment utilization; and there was no moderation in the enabling factors by need for treatment as "enablers" of utilization. Further theoretical and empirical research is necessary to determine which mechanisms are driving disparities in treatment utilization across racial/ethnic groups generally, and Hispanic national groups specifically.
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Affiliation(s)
| | - Raul Caetano
- University of Texas School of Public Health, 5323 Harry Hines Blvd., V8.112, Dallas, TX 75390
| | - Britain A Mills
- University of Texas School of Public Health, 5323 Harry Hines Blvd., V8.112, Dallas, TX 75390
| | - Patrice A C Vaeth
- Prevention Research Center, 180 Grand Avenue, Suite 1200, Oakland, CA 94612-3749
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Relationship of spirituality or religion to recovery from substance abuse: a systematic review. J Addict Nurs 2014; 24:217-26; quiz 227-8. [PMID: 24335768 DOI: 10.1097/jan.0000000000000001] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Spirituality and religion are frequently acknowledged as significant contributors to individuals' recovery from substance use disorders. This review focuses on the role that spirituality or religion plays in substance abuse treatment outcomes. Our search of three databases-PubMed, CINAHL, and Psych Info-turned up 29 eligible studies for review. We group our findings according to whether the study's focus was on alcohol only or alcohol and other drug use. The most common treatment outcome was abstinence followed by treatment retention, alcohol or drug use severity, and discharge status. For most studies, we found evidence suggesting at least some support for a beneficial relationship between spirituality or religion and recovery from substance use disorders. Our review addresses the strengths and limitations of these studies.
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Fromson JA, Shah RM. The Role of Spirituality in Physician Recovery from Alcoholism. ALCOHOLISM TREATMENT QUARTERLY 2014. [DOI: 10.1080/07347324.2014.907053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Kelly JF, Greene MC. Toward an Enhanced Understanding of the Psychological Mechanisms by which Spirituality Aids Recovery in Alcoholics Anonymous. ALCOHOLISM TREATMENT QUARTERLY 2014. [DOI: 10.1080/07347324.2014.907015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Galanter M, Dermatis H, Sampson C. Spiritual Awakening in Alcoholics Anonymous: Empirical Findings. ALCOHOLISM TREATMENT QUARTERLY 2014. [DOI: 10.1080/07347324.2014.907058] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Galanter M. Understanding Alcoholics Anonymous as a Spiritual Fellowship: From Individual to Social Structure. ALCOHOLISM TREATMENT QUARTERLY 2014. [DOI: 10.1080/07347324.2014.907057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Tonigan JS, Rynes K, Toscova R, Hagler K. Do changes in selfishness explain 12-step benefit? A prospective lagged analysis. Subst Abus 2014; 34:13-9. [PMID: 23327500 DOI: 10.1080/08897077.2012.691453] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
12-Step attendance is associated with increased abstinence. A strong claim made in 12-step literature is that alcoholics are pathologically selfish and that working the 12 steps reduces this selfishness, which, in turn, leads to sustained alcohol abstinence. This study tested this assumption by investigating the linkages between 12-step attendance, pathological narcissism, and drinking. One hundred thirty early Alcohol Anonymous (AA) affiliates with limited AA and treatment histories were recruited from treatment and community-based AA. A majority of the sample was alcohol dependent and reported illicit drug use before recruitment. Participants were interviewed at intake and at 3, 6, and 9 months. A majority of participants attended AA meetings throughout follow-up and such attendance predicted increased abstinence and reduced drinking intensity. 12-Step affiliates were significantly higher on pathological narcissism (PN) relative to general population samples and their PN remained elevated. Contrary to predictions, PN was unrelated to 12-step meeting attendance and did not predict later abstinence or drinking intensity. The findings did not support the hypothesis that reductions in PN explain 12-step benefit. An alternative function for the emphasis placed on pathological selfishness in 12-step programs is discussed and a recommendation is made to use unobtrusive measures of selfishness in future research.
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Affiliation(s)
- J Scott Tonigan
- Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, Albuquerque, NM87106, USA.
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Krentzman AR, Cranford JA, Robinson EAR. Multiple dimensions of spirituality in recovery: a lagged mediational analysis of Alcoholics Anonymous' principal theoretical mechanism of behavior change. Subst Abus 2014; 34:20-32. [PMID: 23327501 DOI: 10.1080/08897077.2012.691449] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Alcoholics Anonymous (AA) states that recovery is possible through spiritual experiences and spiritual awakenings. Research examining spirituality as a mediator of AA's effect on drinking has been mixed. It is unknown whether such findings are due to variations in the operationalization of key constructs, such as AA and spirituality. To answer these questions, the authors used a longitudinal model to test 2 dimensions of AA as focal predictors and 6 dimensions of spirituality as possible mediators of AA's association with drinking. Data from the first 18 months of a 3-year longitudinal study of 364 alcohol-dependent individuals were analyzed. Structural equation modeling was used to replicate the analyses of Kelly et al. (Alcohol Clin Exp Res. 2011;35:454-463) and to compare AA attendance and AA involvement as focal predictors. Multiple regression analyses were used to determine which spirituality dimensions changed as the result of AA participation. A trimmed, data-driven model was employed to test multiple mediation paths simultaneously. The findings of the Kelly et al. study were replicated. AA involvement was a stronger predictor of drinking outcomes than AA attendance. AA involvement predicted increases in private religious practices, daily spiritual experiences, and forgiveness of others. However, only private religious practices mediated the relationship between AA and drinking.
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Affiliation(s)
- Amy R Krentzman
- University of Michigan Addiction Research Center, 4250 Plymouth Road, Ann Arbor, MI 48109, USA.
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Weisner C. Conversation with Connie Weisner. Addiction 2014; 109:12-9. [PMID: 23566038 DOI: 10.1111/add.12091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kelly JF, Greene MC. The Twelve Promises of Alcoholics Anonymous: psychometric measure validation and mediational testing as a 12-step specific mechanism of behavior change. Drug Alcohol Depend 2013; 133:633-40. [PMID: 24004905 PMCID: PMC3818412 DOI: 10.1016/j.drugalcdep.2013.08.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Revised: 07/25/2013] [Accepted: 08/09/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Empirical support for the recovery utility of 12-step mutual-help organizations (MHOs) has led to increased investigation of how such organizations confer benefit. The Twelve Promises of Alcoholics Anonymous (AA) feature prominently in 12-step philosophy and culture and are one of the few documented explications of the cognitive, affective, and behavioral benefits that members might accrue. This study investigated the psychometric properties of a measure of AA's Twelve Promises and examined whether it mediated the effect of 12-step participation on abstinence. METHOD Young adults (N=302, M age 20.4 [1.6], range 18-25; 27% female; 95% White) enrolled in an addiction treatment effectiveness study completed assessments at intake and 3-, 6-, and 12-months post treatment including a 26-item, Twelve Promises Scale (TPS). Factor analyses examined the TPS' psychometrics and lagged mediational analyses tested the TPS as a mechanism of behavior change. RESULTS Robust principal axis factoring extraction with Varimax rotation revealed a 2-factor solution explaining 45-58% of the variance across three administrations ("Psychological Wellbeing"=26-39%; "Freedom from Craving=17-21%); internal consistency was high (alpha=.83-.93). Both factors were found to increase in relation to greater 12-step participation, but significant mediation was found only for the Freedom from Craving factor explaining 21-34% of the effect of 12-step participation in increasing abstinence. CONCLUSIONS The TPS shows potential as a conceptually relevant, and psychometrically sound measure and may be useful in helping elucidate the extent to which the Twelve Promises emerge as an independent benefit of 12-step participation and/or explain SUD remission and recovery.
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Strobbe S, Cranford JA, Wojnar M, Brower KJ. Spiritual awakening predicts improved drinking outcomes in a Polish treatment sample. J Addict Nurs 2013; 24:209-16. [PMID: 24335767 PMCID: PMC4198522 DOI: 10.1097/jan.0000000000000002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE This study examined concurrent and longitudinal associations between two dimensions of affiliation in Alcoholics Anonymous (AA)-attendance and spiritual awakening-and drinking outcomes among adult patients who were in treatment for alcohol dependence in Warsaw, Poland. In a study conducted at four addiction treatment centers, male and female patients (n = 118) with a DSM-IV diagnosis of alcohol dependence were assessed at baseline (Time 1 or T1), 1 month (T2), and 6-12 months postbaseline (T3) for AA meeting attendance, various aspects of AA affiliation, and alcohol use. Alcoholics Anonymous meeting attendance and alcohol consumption were measured using the Timeline Followback interview. Self-report of having had a spiritual awakening was measured using a modified version of the Alcoholics Anonymous Involvement Scale. RESULTS There were no cross-sectional or longitudinal associations between AA meeting attendance and improved drinking outcomes. In contrast, self-report of a spiritual awakening between T2 and T3 was significantly associated with abstinence (OR = 2.4, p < .05) and the absence of any heavy drinking (OR = 3.0, p < .05) at T3, even when demographic and clinical characteristics were statistically controlled. CONCLUSIONS Self-reports of spiritual awakening predicted improved drinking outcomes in a Polish treatment sample.
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Affiliation(s)
| | | | | | - Kirk J. Brower
- University of Michigan Addiction Research Center (UMARC)
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Tonigan JS, Rynes KN, McCrady BS. Spirituality as a change mechanism in 12-step programs: a replication, extension, and refinement. Subst Use Misuse 2013; 48:1161-73. [PMID: 24041178 PMCID: PMC4768745 DOI: 10.3109/10826084.2013.808540] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This National Institutes of Health funded study investigated spiritual growth as a change mechanism in 12-step programs. A total of 130 people, early 12-step affiliates with limited Alcoholics Anonymous (AA) histories, were recruited from 2007 to 2008 from AA, treatment, and community centers in a Southwestern city in the United States. A majority of the sample was alcohol dependent. Participants were interviewed at baseline and at 3, 6, and 9 months. Lagged General Linear Modeling analyses indicated that spiritual change as measured by the Religious Background and Behavior (RBB) self-report questionnaire were predictive of increased abstinence and decreased drinking intensity, and that the magnitude of this effect varied across different RBB scoring algorithms. Future research should address study limitations by recruiting participants with more extensive AA histories and by including assessments of commitment to, and practice of, AA prescribed activities. The study's limitations are noted.
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Affiliation(s)
- J Scott Tonigan
- Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico , Albuquerque, New Mexico , USA
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Galanter M, Dermatis H, Stanievich J, Santucci C. Physicians in Long-Term Recovery Who Are Members of Alcoholics Anonymous. Am J Addict 2013; 22:323-8. [DOI: 10.1111/j.1521-0391.2013.12051.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Revised: 09/01/2011] [Accepted: 09/06/2011] [Indexed: 10/26/2022] Open
Affiliation(s)
- Marc Galanter
- Division of Alcoholism and Drug Abuse, NYU School of Medicine; New York, New York
| | - Helen Dermatis
- Division of Alcoholism and Drug Abuse, NYU School of Medicine; New York, New York
| | | | - Courtney Santucci
- Division of Alcoholism and Drug Abuse, NYU School of Medicine; New York, New York
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Bogenschutz MP, Pommy JM. Therapeutic mechanisms of classic hallucinogens in the treatment of addictions: from indirect evidence to testable hypotheses. Drug Test Anal 2012; 4:543-55. [PMID: 22761106 DOI: 10.1002/dta.1376] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2012] [Revised: 04/30/2012] [Accepted: 04/30/2012] [Indexed: 12/12/2022]
Abstract
Alcohol and drug addiction are major public health problems, and existing treatments are only moderately effective. Although there has been interest for over half a century in the therapeutic use of classic hallucinogens to treat addictions, clinical research with these drugs was halted at an early stage in the early 1970s, leaving many fundamental questions unanswered. In the past two decades, clinical research on classic hallucinogens has resumed, although addiction treatment trials are only now beginning. The purpose of this paper is to provide a targeted review of the research most relevant to the therapeutic potential of hallucinogens, and to integrate this information with current thinking about addiction and recovery. On the basis of this information, we present a heuristic model which organizes a number of hypotheses that may be tested in future research. We conclude that existing evidence provides a convincing rationale for further research on the effects of classic hallucinogens in the treatment of addiction.
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Affiliation(s)
- Michael P Bogenschutz
- University of New Mexico Health Sciences Center, Department of Psychiatry Center for Psychiatric Research, University of New Mexico, Albuquerque, NM 87131-0001, USA.
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Recovery Characteristics and Practices of Alcoholics Anonymous Sponsors. ADDICTIVE DISORDERS & THEIR TREATMENT 2012. [DOI: 10.1097/adt.0b013e318234e98d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Galanter M, Dermatis H, Santucci C. Young People in Alcoholics Anonymous: The Role of Spiritual Orientation and AA Member Affiliation. J Addict Dis 2012; 31:173-82. [DOI: 10.1080/10550887.2012.665693] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Marc Galanter
- a Division of Alcoholism and Drug Abuse, NYU School of Medicine , New York , New York , USA
| | - Helen Dermatis
- a Division of Alcoholism and Drug Abuse, NYU School of Medicine , New York , New York , USA
| | - Courtney Santucci
- a Division of Alcoholism and Drug Abuse, NYU School of Medicine , New York , New York , USA
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Avalos LA, Mulia N. Formal and informal substance use treatment utilization and alcohol abstinence over seven years: is the relationship different for blacks and whites? Drug Alcohol Depend 2012; 121:73-80. [PMID: 21940115 PMCID: PMC3671756 DOI: 10.1016/j.drugalcdep.2011.08.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2011] [Revised: 08/05/2011] [Accepted: 08/09/2011] [Indexed: 11/23/2022]
Abstract
BACKGROUND This study examines whether the effects of formal substance use treatment utilization and Alcoholics Anonymous (AA) on 30-day abstinence vary for black versus white Americans. METHODS The current analysis utilizes data from a longitudinal sample of 1013 black and white, dependent and problem drinkers across a 7-year period. Participants were identified through a probability survey in the general population and consecutive intakes in chemical dependency treatment programs in a California County. Generalized Estimating Equations assessing interactions between race and treatment utilization incorporated variables from four post-baseline interviews, controlling for baseline variables. RESULTS Formal treatment utilization was associated with 30-day abstinence (OR:1.6, 95%CI: 1.3, 2.1), yet this relationship did not differ for blacks and whites. In contrast, there was a significant interaction between AA utilization, race and 30-day abstinence. While both whites and blacks who attended AA were more likely to report 30-day abstinence compared to their non-AA attending counterparts (white OR:4.0, 95%CI: 3.2-5.1 and black OR:2.2, 95%CI: 1.5-3.2), the relationship was stronger for whites. Among those who did not attend AA, blacks were more likely than whites to be abstinent. Post hoc analyses suggest that these latter findings may be related to greater religiosity and "drier" social networks among black Americans. CONCLUSIONS While utilization of formal treatment may yield similar benefits for blacks and whites, AA utilization may be more important for maintaining abstinence among whites than blacks. Future research should investigate racial differences in social network drinking patterns and religious reinforcement of sobriety, and the role these may play in AA outcomes.
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Affiliation(s)
- Lyndsay Ammon Avalos
- Alcohol Research Group, 6475 Christie Ave, Ste 400, Emeryville, CA 94608, United States.
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