A focus-group study on spirituality and substance-user treatment

Positive Clinical Outcomes for Severe Reported Pain Using Robust Non-Addictive Home Electrotherapy-A Case-Series

The North American opioid epidemic has resulted in over 800,000 related premature overdose fatalities since 2000, with the United States leading the world in highest opioid deaths per capita. Despite increased federal funding in recent years, intended to address this crisis, opioid overdose mortality has continued to increase. Legally prescribed opioids also chronically induce a problematic reduction in affect. While an ideal analgesic has yet to be developed, some effective multimodal non-opioid pharmacological regimens for acute pain management are being more widely utilized. Some investigators have suggested that a safer and more scientifically sound approach might be to induce "dopamine homeostasis" through non-pharmacological approaches, since opioid use even for acute pain of short duration is now being strongly questioned. There is also increasing evidence suggesting that some more robust forms of electrotherapy could be applied as an effective adjunct to avoid the problems associated with opioids. This 4-patient case-series presents such an approach to treatment of severe pain. All 4 of these chiropractic treatment cases involved a component of knee osteoarthritis, in addition to other reported areas of pain. Each patient engaged in a home recovery strategy using H-Wave^® device stimulation (HWDS) to address residual extremity issues following treatment of spinal subluxation and other standard treatments. A simple statistical analysis was conducted to determine the change in pain scores (Visual Analogue Scale) of pre and post electrotherapy treatments, resulting in significant reductions in self-reported pain (p-value = 0.0002). Three of the four patients continued using the home therapy device long-term as determined by a post-analysis questionnaire. This small case-series demonstrated notably positive outcomes, suggesting consideration of home use of HWDS for safe, non-pharmacological and non-addictive treatment of severe pain.

Religious and spiritual beliefs and attitudes towards addiction and addiction treatment: A scoping review

INTRODUCTION

Throughout history, ideas about addiction have been informed and influenced by religious belief and practice. Even continuing into the present, religion and spirituality are often thought to impact attitudes towards addiction and its treatment, particularly given the use of religion and spirituality in various well-known treatments such as Alcoholics Anonymous. Although research has flourished with regards to the role that addiction and spirituality might play in vulnerability to addiction or the treatment of addiction, there has been comparatively less research examining how religion might impact attitudes toward addiction more broadly.

METHOD

The present work sought to examine the current state of empirical literature evaluating the relationships between religion and attitudes toward addiction and addiction treatment. In service of the above aim, a scoping review was conducted.

RESULTS

This summary of peer-reviewed, quantitative studies (n = 36) found that higher religiosity is related to more belief in the disease model of addiction in providers, negative attitudes towards addiction, and a stronger support for spiritually-based treatments. However, results varied based on the measures used and many relationships tested were not significant. There also appeared to be differences in the interaction between religion and spirituality and other variables, such as the respondent's sex or whether the individual was a student or provider, in terms of attitudes.

CONCLUSIONS

Further research is needed to fully understand the nuances in the relationship between these variables, including more clear operationalization and standardized measurement. Until such research is conducted, no cohesive conclusions can be drawn, and clinical implications remain unclear.

Correlation of self-compassion and spiritual well-being with drug craving in people with substance use disorders

Background

Globally, drug abuse is a serious and exacerbating phenomenon, not only in terms of its prevalence and its impact on individuals, families, professional and social aspects but also because of its economic and medical repercussions. Cravings, the main feature of addiction, are the drivers of continued drug abuse and a return to addiction after recovery. This research aimed to explore the relationship between self-compassion and spiritual well-being with drug cravings. This research used a descriptive correlational study design. The study sample consisted of all accessible addiction patients who had visited the outpatient clinics or were admitted to the Addiction Unit of the Psychiatry Department at Mansoura University Hospital during a 3-month period from October to December 2020. Patients were asked to respond to questionnaires assessing self-compassion, spiritual well-being, and drug craving.

Results

The results showed that the majority of the participants had a moderate level of self-compassion and spiritual well-being. However, drug cravings were negatively related to both self-compassion and spiritual well-being.

Conclusions

People with drug addiction consistently need programs to increase their self-compassion and spiritual well-being to overcome the intensity of cravings. Improving feelings of self-compassion and spiritual well-being has a positive effect in reducing craving for substance abuse among drug-addict patients.

Racial dynamics among clients in a residential substance use disorder treatment program in South Los Angeles and its impact on clients' treatment experiences

This study seeks to investigate racial dynamics among clients in a female-only residential substance use disorder treatment facility in South Los Angeles and its effects on treatment experiences. Clients were interviewed about their interracial interactions, perceptions of clients of races and ethnicities different from their own and how racial dynamics might affect their experiences in treatment. Nine interviews were conducted and analyzed using thematic analysis. Participants recounted that racial differences do not play a significant role in their treatment experiences, although racial identities shape social group formation. Motivation to recover from addiction and other shared lived experiences facilitate interracial harmony.

Grassroots interventions for alcohol use disorders in the Mexican immigrant community: A narrative literature review

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.

Spirituality, Religiosity and Addiction Recovery: Current Perspectives

Substance use disorders are an important public health problem with a multifactorial etiology and limited effective treatment options. Within this context, spirituality-based approaches may provide interesting and useful options in managing substance use disorders. This kind of intervention can have positive effects in alleviating some core symptoms associated with substance use, such as aggressiveness. Improvement in cessation rates for alcohol, cocaine and opioid use disorders have also been described in some clinical studies. However, spirituality may not play a beneficial role in some subgroups, such as among individuals with crack cocaine and cannabis use disorders. A widely available intervention for alcohol use disorders is Alcoholics Anonymous (AA), which can be seen as a spirituality-based intervention. Spirituality also seems to be especially beneficial for minorities such as Latinos, African-Americans and Native-Americans. Moreover, spiritual-based interventions are also helpful alternatives in many rural environments where conventional healthcare for substance use disorders may not be easily available. However, spiritual-based interventions may be considered as a possible adjunctive therapeutic option to conventional treatments. There is a need for prospective studies outside U.S., especially where spiritual-based approaches are available. It may be difficult to carry out randomized controlled trials because of the nature of the spiritual/ religious dimensions. However, prospective studies that evaluate mediation effect of spirituality and religiosity on recovery would be helpful. Qualitative studies combined with quantitative design offer excellent options to evaluate the recovery process, especially among special populations.

Raja yoga meditation and medication-assisted treatment for relapse prevention: A pilot study

The continued need for advancement in evidence-based SUD treatment, as well as increases in treatment expense and decline in support from insurance providers, suggest that brief, innovative, and affordable treatments are needed. Meditation, spirituality, and adherence to medication-assisted treatments have all been shown to support abstinence. The current trial assessed effects of spiritually-based meditation, versus relaxation or standard treatment, on substance abstinence and psychological distress and dysfunction in a partially buprenorphine-supported (41.5%) treatment sample. Participants (N = 40) were recruited from an intensive outpatient treatment program, in which three treatment locations acted as separate experimental conditions. Abstinence was measured through urinalyses at baseline and weekly thereafter for the duration of the intervention. Psychological distress and dysfunction were assessed with a Likert-scaled questionnaire measuring symptoms typically associated with SUD. Co-varying for buprenorphine use, participants in the Meditation condition had better odds of remaining abstinent than participants in the Treatment-as-Usual (TAU) and Relaxation conditions. There were no significant differences in substance abstinence between the Relaxation and TAU conditions. Further, co-varying out baseline there were no significant differences at post-course in psychological distress and dysfunction between the three conditions. Results from this pilot trial suggest that this spiritually-informed approach may offer additive support to individuals in SUD treatment, as an aid to the meditative aspect of the 12 steps, or a non-12-step alternative spiritual supplement to standard SUD treatment.

Focus Group Study to Examine Content of Family Meetings in Short-term Substance Use Disorder Treatment

This study explores the content family members find helpful in family meetings that occur while patients are in short-term treatment for substance use disorders. Three focus groups were conducted; two with 23 family members and one with 10 patients who were asked to identify those topics that are helpful or unhelpful for families with and without prior treatment experiences. Families identified education about substance use disorders and an overview of treatment options as useful for family members new to treatment, and an emphasis on response to relapse and family supports as important for those with prior treatment experiences.

The role of spirituality in alcohol abstinence self-efficacy amongst alcoholics anonymous members

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.

Exploring Experiences and Perceptions of Older African American Males Aging With HIV in the Rural Southern United States

The HIV (human immunodeficiency virus) epidemic in the United States remains a serious public health concern. Despite treatment and prevention efforts, approximately 50,000 new HIV cases are transmitted each year. Estimates indicate that 44% of all people diagnosed with HIV are living in the southern region of the United States. African Americans represent 13.2% of the United States population; however, 44% (19,540) of reported new HIV cases in 2014 were diagnosed within this ethnic group. The majority of cases were diagnosed in men (73%, 14,305). In the United States, it is estimated that 21% of adults living with HIV are 50 years or older. There exists limited data regarding how well African American men are aging with HIV disease. The purpose of this study was to explore the perceptions and experiences of older African American men living with HIV in rural Georgia. Data were collected from 35 older African American men living with HIV using focus groups and face-to-face personal interviews. Qualitative content analysis revealed six overlapping themes: (1) Stigma; (2) Doing Fine, Most of the Time; (3) Coping With Age-Related Diseases and HIV; (4) Self-Care; (5) Family Support; and (6) Access to Resources. The findings from this study provide new insights into the lives of rural HIV-infected African American men, expands our understanding of how they manage the disease, and why many return to or remain in rural communities.

Religious participation and substance use behaviors in a Canadian sample of homeless people

This study examined religious behaviors in 380 homeless individuals. We hypothesized that higher frequency of religious attendance is associated with lower rates of use of all substances, lower rates of drug and alcohol dependence, and lower psychological distress. Individuals attending religious ceremonies at least weekly ("frequent attendees") were compared to infrequent attendees. Participants also provided qualitative information about their faith. In univariate analyses, frequent attendees had significantly lower rates of alcohol, cocaine, and opioid use than infrequent attendees. They also had lower rates of alcohol and drug dependence, lifetime suicide attempts, and psychological distress, but these differences were not significant. In multivariate analyses, religious attendance remained significantly associated with alcohol use and opioid use. Researchers need to examine how spiritual and religious practices can be effectively incorporated as a part of substance abuse treatment.

Recovery based on spirituality in substance abusers in Iran

Background and Purpose:

Spirituality is an important factor influencing the decrease of substance abuse severity and maintenance of the recovery phase. This research, investigates the effect of spiritual experiences in the recovery of substance abusers.

Material and Methods:

Qualitative data was collected from 16 men and 6 women, selected through purposeful sampling to ensure an equilibrated gender representation and data from different recovery periods. Data were collected via semi-structured interviews.

Results:

Data showed two main categories: “Mutual relationship between spirituality and recovery,” divided into four subcategories: religious background, religious teachings, experience exchange, and support of family and society; and “A new perspective toward life” subdivided into access to calmness and spiritual development. A factor “spirituality meaning religion” arose repeatedly throughout the study.

Conclusion:

The results of this study can be useful for policy makers, care providers, families, and drug addicts. The promotion of spirituality in substance abusers can help in their struggle with temptation. Effective strategies to ensure drug abstinence and maintenance of the recovery phase are encouraging substance abusers and their families to participate in spirituality-based psychotherapy sessions held in addiction treatment centers, multi-disciplinary cooperation among the organizations involved in the addiction phenomenon, and training the families regarding the importance of spirituality in the mental health of their children through mass media.

Spirituality, Religiosity, Depression, Anxiety, and Drug-Use Consequences During Methadone Maintenance Therapy

Substance addiction is damaging to the health of persons, families, and society. Often the person with addiction has decreased spirituality and religiosity and suffers from anxiety, depression, or both, increasing the risk for continued substance use and its concomitant negative consequences. The study purpose was to describe spirituality and religiosity, among persons enrolled in methadone maintenance therapy and to examine associations between spirituality, religiosity, anxiety, depression, and drug-use consequences. Using a descriptive and cross-sectional correlational design, 108 participants completed questionnaires assessing the study variables. Spiritual well-being was similar to other addiction samples and lower than healthy person samples. Most participants described themselves as spiritual or religious though religious participation was lower than in their past. The analysis indicated that spirituality, religiosity, depression, anxiety, and negative drug-use consequences are interrelated in the person with addiction. Higher anxiety was predictive of negative drug-use consequences.