1
|
Galanter M, White WL, Khalsa J, Hansen H. A scoping review of spirituality in relation to substance use disorders: Psychological, biological, and cultural issues. J Addict Dis 2024; 42:210-218. [PMID: 36772834 DOI: 10.1080/10550887.2023.2174785] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
BACKGROUND Spirituality is a construct encompassing a diversity of strongly held beliefs and pursuits related to life's meaning and purpose. Empirical studies in key domains of spirituality related to substance use disorder (SUD) can be valuable in guiding research, and potentially clinical care. OBJECTIVES To conduct a scoping review of research on the psychological, biological, and cultural dimensions of spirituality and their role in relation to SUD. To identify limitations in empirical findings within these domains and identify promising areas for related research. DATA SOURCES, STUDY APPRAISAL, AND SYNTHESIS METHODS Illustrative studies available in the empirical literature are reviewed in order to characterize these three key domains. RESULTS Certain areas of importance stand out: On Psychology, attribution of SUD to a spiritual outlook; spiritual awakening; the relation of spirituality to drug craving; and spirituality in the context of psychedelic-assisted psychotherapy. On Biology, heritability of traits related to shared spiritual experience; neurophysiologic correlates of spiritually related experiences; and correlates in brain imaging; On Culture, spiritual aspects of SUD in different cultural settings; distinctions between spiritual and religious phenomena; roles that international organizations play; and context of acquiring recovery capital. The need for further research in each area is defined. CONCLUSIONS There is utility in examining the diversity of findings in the roles of psychology, biology, and culture in the SUD field. Further research, particularly applying randomization and clinical controls, would be useful in improving the effective application of the construct of spirituality in clinical care.
Collapse
Affiliation(s)
- Marc Galanter
- Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
| | | | - Jag Khalsa
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - Helena Hansen
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| |
Collapse
|
2
|
Galanter M, White WL, Hunter B, Khalsa J. Internet-based, continuously available Narcotics Anonymous meetings: a new resource for access to Twelve Step support for abstinence. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2024; 50:321-327. [PMID: 38557160 DOI: 10.1080/00952990.2024.2309648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 01/17/2024] [Accepted: 01/21/2024] [Indexed: 04/04/2024]
Abstract
Background: A Zoom-based website was developed in 2020 that offers continuous access to online Narcotics Anonymous (NA) meetings for the first time. This website provides immediate access for persons with substance use disorder to support abstinence from substance-related addictive disorders.Objectives: This study is designed to characterize attendees employing this online format; to evaluate their experiences for gaining support to maintain abstinence; and to compare the 24/7 experience to face-to-face (FF) meetings they attend.Methods: An anonymous 33-item survey was made available on the 24/7 NA website that links to the 24/7 meetings. Persons accessing the site could choose to fill out the survey.Results: 530 respondents completed the survey (64.9% female/35.1% male). Most had stable prior involvement in NA. They had attended more 24/7 meetings (14.9, SD 19.7) than FF meetings (4.6, SD 7.8) in the previous month. 86% had previously attended FF meetings, 48% had served as sponsors, and 92% reported that the 24/7 meetings were more comfortable for them than the FF meetings (p < .001, Cohen's d = 0.65) and more supportive of abstinence (p < .001, Cohen's d = 0.91). Of the respondents, 8% were still using drugs, of whom 52% had previously completed some of the Twelve Steps.Conclusions: The 24/7 format provides a new and easily accessible way for NA members to gain support for abstinence and is positively rated by attendees seeking support for recovery from substance use disorders. It may serve as a valuable adjunct to the traditional FF format.
Collapse
Affiliation(s)
- Marc Galanter
- Department of Psychiatry, New York University School of Medicine, New York, NY, USA
| | - William L White
- Lighthouse Department, Chestnut Health Systems, Punta Gorda, FL, USA
| | - Brooke Hunter
- Lighthouse Department, Chestnut Health Systems, Normal, IL, USA
| | - Jag Khalsa
- National Institute on Drug Abuse, National Institute of Health, Bethesda, MD, USA
- Department of Psychiatry, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| |
Collapse
|
3
|
Galanter M, White WL, Hunter B. Internal and External Resources Relied on by Established Twelve Step Fellowship Members for Their Recoveries. Subst Use Misuse 2023; 58:139-145. [PMID: 36512831 DOI: 10.1080/10826084.2022.2151311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background: The Twelve Steps described by Narcotics Anonymous (NA) and Alcoholics Anonymous denote key aspects of how members can achieve abstinence from alcohol and other drugs. However, there are limited empirical findings on what long-term members rely on to support their ongoing recovery.Method: In order to clarify the members' reliance on those latter resources, we surveyed 2,293 long-term NA members through the internet on items they rely on for their recovery. They scored nine NA-related resources (e.g., their sponsor) and three non-NA institutional ones (e.g., a professional therapist).Results: Three factors accounted for 53.6% of the variance in the respondents' scores of the 12 items. We labeled them, with the percent of variance accorded, as NA-based social (24.9%) support, spiritual (17.8%) support, and outside professional (10.9%) help. While NA-based resources ranked highest, outside resources (a house of worship, a therapist, or medications for psychological distress) were scored by 75.4% of the respondents. Analysis by subgroups of respondents reflected the diversity of resources members draw on. The use of internet-based meetings during the COVID-19 period reflected the resilience of the NA format.Conclusion: Members of Twelve Step programs can be studied to shed light on options that they rely on for support for their ongoing recovery, both within the fellowships and outside them. Long-term members can apparently rely on resources inside the fellowship and simultaneously on professional ones, as well. These findings can be helpful for researchers in considering mechanisms that underlie long-term Twelve Step-related recovery and for clinicians in employing both these fellowships and outside resources as adjuncts to their professional care.
Collapse
Affiliation(s)
- Marc Galanter
- Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
| | - William L White
- Research Division, Chestnut Health Systems, Punta Gorda, Florida, USA
| | - Brooke Hunter
- Research Division, Chestnut Health Systems, Normal, Illinois, USA
| |
Collapse
|
4
|
Rosmarin DH, Kaufman CC, Ford SF, Keshava P, Drury M, Minns S, Marmarosh C, Chowdhury A, Sacchet MD. The neuroscience of spirituality, religion, and mental health: A systematic review and synthesis. J Psychiatr Res 2022; 156:100-113. [PMID: 36244198 DOI: 10.1016/j.jpsychires.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 08/22/2022] [Accepted: 10/03/2022] [Indexed: 12/12/2022]
Abstract
Prior research highlights the importance of spirituality/religion (S/R) as it relates to several aspects of mental health and clinical interventions. This research has been expanded to include the concurrent examination of neurobiological correlates of S/R to elucidate potential biological mechanisms. However, the majority of neurobiological research on S/R has neglected mental health, and the relationship across all three of these domains (S/R, mental health, and neurobiology) remains unclear. This study systematically reviewed research concurrently examining S/R, mental health, and neurobiology, and rated the methodological quality of included studies. Eighteen identified studies were then included in an integrated literature review and discussion, regarding the neurobiological correlates of S/R as it pertains to depression, anxiety, alcohol/substance misuse, and psychosis. The majority of studies demonstrated moderate to high methodological quality. Findings highlight the need for additional studies in this area as well as research that includes validated assessment of S/R.
Collapse
Affiliation(s)
- David H Rosmarin
- Spirituality & Mental Health Program, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| | - Caroline C Kaufman
- Spirituality & Mental Health Program, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Stephanie Friree Ford
- Spirituality & Mental Health Program, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Poorvi Keshava
- Spirituality & Mental Health Program, McLean Hospital, Belmont, MA, USA; Meditation Research Program, Massachusetts General Hospital, Boston, MA, USA
| | - Mia Drury
- Spirituality & Mental Health Program, McLean Hospital, Belmont, MA, USA
| | - Sean Minns
- Spirituality & Mental Health Program, McLean Hospital, Belmont, MA, USA
| | - Cheri Marmarosh
- Spirituality & Mental Health Program, McLean Hospital, Belmont, MA, USA; Department of Psychology, Divine Mercy University, USA
| | - Avijit Chowdhury
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Meditation Research Program, Massachusetts General Hospital, Boston, MA, USA
| | - Matthew D Sacchet
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Meditation Research Program, Massachusetts General Hospital, Boston, MA, USA
| |
Collapse
|
5
|
Galanter M, Hansen H, Potenza MN. The role of spirituality in addiction medicine: a position statement from the spirituality interest group of the international society of addiction medicine. Subst Abus 2021; 42:269-271. [PMID: 34214398 DOI: 10.1080/08897077.2021.1941514] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Spirituality is a construct that is reflected in a diversity of strongly felt personal commitments in different cultural and national groups. For persons with substance use disorders (SUDs), it can serve as a component of the recovery capital available to them. This position statement reviews empirical research that can shed light on psychological, social, and biological aspects of this construct. On this basis, the Spirituality Interest Group of the International Society of Addiction Medicine (ISAM) makes recommendations for how this construct can be incorporated into research and clinical care.
Collapse
Affiliation(s)
- Marc Galanter
- Department of Psychiatry, New York University School of Medicine, New York, New York, USA
| | - Helena Hansen
- Department of Anthropology and Psychiatry, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USA
| | - Marc N Potenza
- Department of Psychiatry and the Child Study Center, Yale School of Medicine, New Haven, Connecticut, USA.,Connecticut Council on Problem Gambling, Wethersfield, Connecticut, USA.,Connecticut Mental Health Center, New Haven, Connecticut, USA.,Department of Neuroscience, Yale University, New Haven, Connecticut, USA
| |
Collapse
|
6
|
Chin F, Chou R, Waqas M, Vakharia K, Rai H, Levy E, Holmes D. Efficacy of prayer in inducing immediate physiological changes: a systematic analysis of objective experiments. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2021; 18:679-684. [PMID: 33544510 DOI: 10.1515/jcim-2020-0075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 12/29/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To assess the immediate impact of prayer on physiological state by systematically reviewing objective, controlled experimental studies in the literature. CONTENT Experimental studies measuring objective physiological changes induced by prayer. Studies containing the keyword, "Prayer" anywhere in the title or abstract were curated from the following databases: Public/Publisher Medline (PubMed), Excerpta Medica Database (EMBASE) and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) in May 2019. Titles and abstracts were screened with the remaining 30 articles analyzed for inclusion. Only experimental studies were included. SUMMARY Eight experimental studies were identified of which five investigated neurocognitive changes and three investigated systemic physiological changes during prayer. The five studies focusing on neuroactivity used functional MRI (fMRI), electroencephalography or SPECT imaging to obtain measurements. The remaining three studies analyzed an array of systemic physiological metrics, including blood pressure, heart rate, respiratory rate, peripheral resistance, baroreceptor sensitivity and/or cardiovascular rhythm variability during prayer. All studies aside from one saw objective changes during prayer. Neurocognitive changes were mainly associated with improved mental functioning, control and pain tolerance. Prayer was found to slow down physiological functions in two of the three vital-based studies, with the third reporting no change in physiological status. None of the studies measured blood marker changes. OUTLOOK Experimental studies show prayer to induce healthy neurocognitive and physiological changes. Additional studies exploring objective measures from prayer are encouraged to provide practitioners with a more nuanced, scientific perspective when it comes to prescribing prayer as a complementary and alternative medicine (CAM) therapy.
Collapse
Affiliation(s)
- Felix Chin
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.,Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, NY, USA
| | - Ryan Chou
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Muhammad Waqas
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.,Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, NY, USA
| | - Kunal Vakharia
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.,Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, NY, USA
| | - Hamid Rai
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.,Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, NY, USA
| | - Elad Levy
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.,Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, NY, USA
| | - David Holmes
- Department of Family Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| |
Collapse
|
7
|
Kakanakova A, Popov S, Maes M. Immunological Disturbances and Neuroimaging Findings in Major Depressive Disorder (MDD) and Alcohol Use Disorder (AUD) Comorbid Patients. Curr Top Med Chem 2021; 20:759-769. [PMID: 32108009 DOI: 10.2174/1568026620666200228093935] [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: 10/29/2019] [Revised: 11/17/2019] [Accepted: 12/02/2019] [Indexed: 01/02/2023]
Abstract
Mood disorders and Major Depressive Disorder, in particular, appear to be some of the most common psychiatric disorders with a high rate of comorbidity most frequently of anxiety or substance abuse disorders (alcohol use disorder). In both cases - MDD and AUD, a number of immunological disturbances are observed, such as chronic mild inflammation response, increased level of cytokines, hypercortisolaemia, which lead to specific changes in brain neurotransmitter functions. Some of the contemporary brain imaging techniques are functional magnetic resonance imaging (fMRI) and magnetic spectroscopy which are most commonly used to assess the brain metabolism and functional connectivity changes such as altered responses to emotional stimuli in MDD or overactivation of ventromedial prefrontal areas during delayed and underactivation of dorsolateral prefrontal regions during impulsive reward decisions in AUD and dysfunction of gamma-aminobutyric acid (GABA) and/or glutamate neurotransmitter systems, low NAA and myo-Inositol in both MDD and AUD.
Collapse
Affiliation(s)
- Andriana Kakanakova
- Department of Psychiatry and Medical Psychology, Medical University Plovdiv, Faculty of Medicine, Plovdiv, Bulgaria
| | - Stefan Popov
- Department of Psychiatry and Medical Psychology, Medical University Plovdiv, Faculty of Medicine, Plovdiv, Bulgaria
| | | |
Collapse
|
8
|
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.
Collapse
Affiliation(s)
- Marc Galanter
- Department of Psychiatry, New York University School of Medicine , New York, NY, USA
| | | | | | | |
Collapse
|
9
|
The Value of Experimental Support for the Acceptance of Alcoholics Anonymous by Clinicians. J Addict Med 2020; 14:360-361. [DOI: 10.1097/adm.0000000000000600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
10
|
The Effects of Acupuncture Stimulation for Brain Activation and Alcohol Abstinence Self-Efficacy: Functional MRI Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 2017:2850124. [PMID: 28280514 PMCID: PMC5322448 DOI: 10.1155/2017/2850124] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 01/04/2017] [Indexed: 01/10/2023]
Abstract
We attempted to investigate whether acupuncture stimulation at HT7 can have an effect on brain activation patterns and alcohol abstinence self-efficacy. Thirty-four right-handed healthy subjects were recruited for this study. They were randomly assigned into two groups: the HT7 (Shenmen) group and the LI5 (Yangxi) group. Acupuncture stimulation was performed using a block paradigm during fMRI scanning. Additionally, the Korean version of Alcohol Abstinence Self-Efficacy Scale (AASES) was used to determine the effect of acupuncture stimulation on self-efficacy to abstain from alcohol use. According to the result of fMRI group analysis, the activation induced by HT7 stimulation was found on the bilateral postcentral gyrus, inferior parietal lobule, inferior frontal gyrus, claustrum, insula, and anterior lobe of the cerebellum, as well as on the left posterior lobe of the cerebellum (p < 0.001, uncorrected). According to the AASES analysis, the interaction effect for gender and treatment was marginally significant (F(1, 30) = 4.152, p = 0.050). For female group, the simple main effect of treatment was significant (F(1, 11) = 8.040, p = 0.016), indicating that the mean change score was higher in the HT7 stimulation than in the LI5 stimulation. Therefore, our study has provided evidence to support that HT7 stimulation has a positive therapeutic effect on the alcohol-related diseases.
Collapse
|
11
|
Ghahremani DG. Craving, prayer, and the brain. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2016; 43:1-3. [PMID: 27712120 DOI: 10.1080/00952990.2016.1200061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Dara G Ghahremani
- a Laboratory of Molecular Neuroimaging , UCLA Semel Institute for Neuroscience , Los Angeles , CA , USA
| |
Collapse
|