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CORK Bibliography: Spirituality

50 citations. 2008 to present

Prepared: March 2012

Alexander B. The Globalization of Addiction: A Study in Poverty of the Spirit. New York: Oxford University Press, 2011

To take the broadest possible view, it might be said that scientific modern medicine has failed when it comes to addiction. There are no reliable methods to cure it, prevent it, or take the pain out of it. There is no durable consensus on what addiction is, what causes it, or what should be done about it. Meanwhile, rates of addiction continue to increase around the world. This book argues that the cause of this failure to control addiction is that the conventional wisdom of the 19th and 20th centuries focused too single-mindedly on the afflicted individual. This was to overlook the obvious fact that prevalence differs markedly between societies. For example, it can be quite rare in a society for centuries, and then become common when a tribal culture is destroyed or a highly developed civilization collapses. Also of significance is that when addiction becomes common, people become addicted/dependent not only to alcohol and drugs, but other persuits be it money or power or sex or gambling or video games. Emphasis is made that a societal focus does not deny individual vulnerability and individual differences, but it simply removes them from the foreground of attention. The case is made that the nature of the emergent globalized free market society in conducive to the emergence of addiction. It subjects people to pressures towards individualism and competition, dividing rich and poor alike from the close social and spiritual ties that heretofore constitute human life. People adapt to their dislocation by finding the best substitutes for a sustaining social and spiritual life that they can, and addiction serves this function all too well. The case is made that the problems of addiction require not only the efforts of the helpfing professions but social and political initiatives that can reshape society with sufficent force to enable people to find social integration and meaning in everyday life, forces that would make it less imperative to fill their inner void with addictions.

Allen TM; Lo CC. Religiosity, spirituality, and substance abuse. Journal of Drug Issues 40(2): 433-459, 2010. (76 refs.)

With data from the 2004 General Social Survey, the study examined effects of religiosity and spirituality on substance abuse. Also explored was whether and how social bonding mediates religiosity's effects on substance abuse. The results show that religiosity was negatively associated with substance abuse and, further, that social bonding variables did somewhat mediate this negative relationship between the two. Additionally, and as expected, with religiosity controlled, the likelihood of substance abuse increased along with increasing spirituality, in the models. Policy implications and further research needs are discussed.

Bastos FI. Addiction and spirituality in a disenchanted world. (editorial). Substance Use & Misuse 45(14): 2378-2380, 2010. (4 refs.)

Belcher JR; Burry C. Charismatic/pentecostal Christians, spirituality, and treatment: The revival phenomenon. Journal of Social Work Practice in the Addictions 7(4): 93-111, 2007

This article examines the practice of revival as a means of treating people with addictions. Revival is practiced widely in Charismatic/Pentecostal circles and many people believe that that their recovery from addictions would not have been possible without it. The practice is reviewed and suggestions are made as to how to provide evidence-based practice while recognizing the contributions of revival practice.

Bliss DL. Beyond the disease model: Reframing the etiology of alcoholism from a spiritual perspective. Journal of Teaching in the Addictions 8(1/2): 10-26, 2009. (59 refs.)

The disease model of alcoholism, which has gained prominence since the mid-20th century as the major etiological model of alcoholism, suffers from several limitations including its overemphasis on biological factors at the expense of other psychosocial factors, in addition to its lack of consistency with a holistic, social work person-in-environment perspective. The increased interest in spirituality among social work and other helping professionals calls on educators and practitioners to be at the forefront of efforts to develop new holistic conceptualizations of alcoholism that can incorporate spirituality. Using transpersonal theory as a conceptual framework, a spiritual etiological model of alcoholism is presented that complements the strengths of the disease model by allowing for the inclusion of biological determinants of alcoholism, providing a complementary way to understand alcoholism that can be taught to students and utilized by practitioners.

Bliss DL. Empirical research on spirituality and alcoholism: A review of the literature. Journal of Social Work Practice in the Addictions 7(4): 5-25, 2007

The apparent success of Alcoholics Anonymous and its spiritually based program of recovery in 1935 led early researchers to explore how AA worked and ultimately led to more formalized research on alcoholism and spirituality in the latter part of the 20th century. Using Miller's suggested research framework, a review of empirical research was conducted on four roles of spiritual variables in alcohol abuse and recovery. Tentative conclusions about the relationship between alcoholism and spirituality are provided. Limitations of studies are examined and implications for social work research are discussed.

Borras L; Khazaal Y; Khan R; Mohr S; Kaufmann YA; Zullino D et al. The relationship between addiction and religion and its possible implication for care. Substance Use & Misuse 45(14): 2381+, 2010. (92 refs.)

Spirituality is a topic of increasing interest to clinicians and researchers interested in addiction because its perceived role in the promotion of meaningfulness in the recovery from addiction. Our review of the literature evaluates different domains relative to the relation between addiction, religion, and psychiatric treatment. Spirituality as a protective or precipitating factor for substance use and as a key component of recovery will be debated. Illustrations of its potential and limitations as a component of treatment will be presented. Types of investigation and integration of this dimension in an eventual therapeutic process strictly respecting the needs and specificities of each one will be discussed.

Bubnack T. Is there room for spirit in the field of chemical dependency treatment? Journal of Social Work Practice in the Addictions 7(4): 127-132, 2007

Burris JL; Sauer SE; Carlson CR. A test of religious commitment and spiritual transcendence as independent predictors of underage alcohol use and alcohol-related problems. Psychology of Religion and Spirituality 3(3): 231-240, 2011. (58 refs.)

Religiousness exerts a protective effect against underage alcohol use, but it is largely unknown whether its protective quality extends equally to alcohol-related problems. It is also unclear to what extent spirituality, which is related to religiousness, exerts a similar protective effect. The current study examined whether facets of religiousness and spirituality-religious commitment and spiritual transcendence-were differentially related to alcohol use and alcohol-related problems among an underage sample of young adults. Despite being underage, most participants (n = 344; 61% female) reported having an alcoholic drink at least once a month and having at least two to three drinks per occasion. Results of hierarchical linear regression analyses that controlled for demographics, positive alcohol expectancies, and impulsivity found unique associations between religious commitment and spiritual transcendence and alcohol use. Specifically, religious commitment operated as a protective factor, while spiritual transcendence operated as a risk factor for alcohol use. Neither religious commitment nor spiritual transcendence predicted alcohol-related problems. Results of this study inform future research by highlighting the importance of studying religiousness and spirituality as unique constructs with the potential for differential predictive utility.

Conner BT; Anglin MD; Annon J; Longshore D. Effect of religiosity and spirituality on drug treatment outcomes. Journal of Behavioral Health Services & Research 36(2): 189-198, 2009. (12 refs.)

This study empirically tested one component of a comprehensive model of the role of religiosity and spirituality (R/S) in drug treatment that is presented as a companion article in this special issue. Data collected from individuals dependent on heroin receiving narcotic replacement therapy were used to assess the effects of R/S on drug treatment outcomes. Based on their R and S scores, participants were assigned to one of four groups: those whose scores remained consistently high across the 12-month study period were compared to those whose scores were consistently low, increased, or decreased across the same period. Results indicated that at both study completion (12 months after admission) and 6 months after that participants in the consistently high and increasing spirituality groups self-reported significantly fewer days of heroin and cocaine/crack use than those in the consistently low group (p < 0.05). There were no significant differences among the religiosity groups on self-reported heroin or cocaine/crack use. Results from chi(2) analyses indicated that at 12 months the results of urinalysis for the presence of opiates, but not cocaine/crack, were dependent on spirituality group membership (p < 0.01) but not religiosity group membership. Results also indicated that at the 6-month follow-up, there were significantly more participants in the decreasing group who were not in maintenance treatment who had a positive urinalysis and fewer in the increasing group than would be expected if the two variables were independent (p < 0.05). Implications for addictions health services are discussed.

Delaney HD; Forcehimes AA; Campbell WP; Smith BW. Integrating spirituality into alcohol treatment. Journal of Clinical Psychology 65(2): 185-198, 2009. (32 refs.)

Spirituality is presumed by millions of Americans to be directly relevant to problems of alcohol abuse. We summarize findings regarding the role of religion and spirituality in the prevention and treatment of substance abuse and present a case illustration. We also consider mechanisms responsible for these effects. We offer advice about why, by whom, and how religion and spirituality should be discussed with clients with substance use disorders. In a recent clinical trial, therapists trained in a client-centered approach to facilitate exploration of spirituality fostered clients' use of spiritual practices. We suggest that the therapist's ability to skillfully engage clients in a discussion of spirituality is largely determined by how the therapist balances the dual roles of authoritative expert and evocative facilitator.

Dennis DL; Cox W; Black A; Muller S. The influence of religiosity and spirituality on drinking behaviors: Differences between students attending two southern universities. Journal of Drug Education 39(1): 95-112, 2009. (56 refs.)

The purpose of this study was to determine if-students (n = 431) from two southern universities -- one in the "buckle" of the Bible-belt, the other a southern "border" state -- have different drinking behaviors depending on their religiosity and spirituality. Approximately 95% of students indicated that they had at least one drink of alcohol during their lives, with almost 82% reporting that they used alcohol in the past 30 days. Binge drinking among underage students increased every year (approximately 43% to almost 70%). Students from the buckle university had higher degrees of religiosity and spirituality and reported fewer unhealthy drinking behaviors than those from the border university. By creating a learning environment where students are encouraged to increase the spiritual dimension of health, health educators may alleviate potentially deadly consequences of alcohol.

Dermatis H; James T; Galanter M; Bunt G. An exploratory study of spiritual orientation and adaptation to therapeutic community treatment. Journal of Addictive Diseases 29(3): 306-313, 2010. (27 refs.)

The purpose of this study was to determine the extent to which spiritual orientation was associated with adaptation to therapeutic community treatment. Spiritual orientation was assessed by the Spirituality Self-Rating Scale, a measure consistent with the conceptualization of spirituality typically reflected in Alcoholics Anonymous members' views. Spiritual orientation was positively correlated with acceptance of therapeutic community principles and clinical progress. Further assessment of spirituality related characteristics and their relation to treatment outcomes is important in informing the design of interventions aimed at improving progress in the therapeutic community, particularly those aspects involving the relative value of integrating the 12-Step group approach in therapeutic community programs.

Drerup ML; Johnson TJ; Bindl S. Mediators of the relationship between religiousness/spirituality and alcohol problems in an adult community sample. Addictive Behaviors 36(12): 1317-1320, 2011. (34 refs.)

Johnson et al. (2008b) reported that, in a college student sample, the effect of religiousness on alcohol use was mediated by negative beliefs about alcohol, social influences, and spiritual well-being, and that these variables in turn impacted alcohol use and problems both directly and indirectly via motives for drinking. This study attempted to replicate those findings in a sample of community dwelling adults (N = 211). The effect of Religious/Spiritual Involvement was mediated by Negative Beliefs about Alcohol, Social Modeling, and Spiritual-Well-Being. However, Social Modeling had stronger relationships with motives for drinking and alcohol consumption than the other two mediators. The effect of Religious Struggle on Alcohol Problems was mediated by Spiritual Well-Being and coping motives for drinking. Results provide further support for the motivational model of alcohol use and suggest plausible mechanisms by which religiousness could causally impact alcohol use and problems. Religious struggle may be a clinically significant correlate of alcohol problems.

Eliason MJ; Burke A; van Olphen J; Howell R. Complex interactions of sexual identity, sex/gender, and religious/spiritual identity on substance use among college students. Sexuality Research and Social Policy 8(2): 117- 125, 2011. (32 refs.)

Alcohol, tobacco, and other drug use pose serious health problems on college campuses. A significant body of research shows student religiosity to be a protective factor, but a very little research has examined influences of sexual identities on alcohol and other drug use among college students, and its associations with religious or spiritual identity. This study examined the relationships of sex/gender, sexual identity, and religious/spiritual identity on current alcohol use, drug use, and smoking via an online survey of 2,204 college students. We found a three-way interaction between sex/gender, sexual identity, and religious/spiritual identity, with religion showing protective value for nonheterosexual women, but not nonheterosexual men, related to alcohol use. Nonheterosexual students also showed different patterns of risk and protective factors. A subset of the sample that indicated that they did not use sexual identity labels showed very high rates of alcohol, tobacco, and drug use, often exceeding the lesbian, gay, and bisexual group on these measures. These findings provide new information on nonheterosexual student drug and alcohol use and indicate the need for additional research in this area of study.

Garrett MT; Torres-Rivera E; Brubaker M; Portman TAA; Brotherton D; West-Olatunji C et al. Crying for a vision: The Native American sweat lodge ceremony as therapeutic intervention. Journal of Counseling and Development 89(3): 318-325, 2011. (35 refs.)

The Native American sweat lodge ceremony or sweat therapy is being used increasingly in various medical, mental health, correctional, and substance abuse treatment centers serving both Native and non-Native clients. This article explores the sweat lodge ceremony's background, elements of Native American spirituality, origin story, cultural symbolism, prayer, and contemporary use. Current evidence of effectiveness and therapeutic benefits is presented, then implications for integrating the sweat lodge ceremony as a complementary counseling approach are discussed.

Hastings A. William James, conversion and rapid, radical transformation. Journal of Consciousness Studies 17(11-12): 116-120, 2010. (9 refs.)

This essay briefly considers the psychology of radical psychological transformations, sometimes termed 'quantum change', such as religious conversions. Such transformations are the focus of two of William James's chapters in The Varieties of Religious Experience. They can occur abruptly, resulting in a restructuring of the entire personality, sometimes in the direction of greater health, or recovery from drug addiction. The author summarizes seven reported aspects of quantum change such as positive shifts of values or attitudes, widening of perspectives, and increases in self discipline.

Heinz AJ; Disney ER; Epstein DH; Glezen LA; Clark PI; Preston KL. A focus-group study on spirituality and substance-user treatment. Substance Use & Misuse 45(1/2): 134-153, 2010. (52 refs.)

Focus groups were conducted in 2005-2006 with 25 urban methadone-maintained outpatients to examine beliefs about the role of spirituality in addiction and its appropriateness informal treatment. Thematic analyses suggested that spirituality and religious practices suffered in complex ways during active addiction, but went "hand in hand" with recovery. Participants agreed that integration of a voluntary spiritual discussion group into formal treatment would be preferable to currently available alternatives. One limitation was that all participants identified as strongly spiritual. Studies of more diverse samples will help guide the development and evaluation of spiritually based interventions in formal treatment.

Hodge DR. Alcohol treatment and cognitive behavioral therapy: Enhancing effectiveness by incorporating spirituality and religion. Social Work 56(1): 21-31, 2011. (104 refs.)

Cognitive behavioral therapy (CBT) is an effective modality for the treatment of alcoholism. Given widespread interest in incorporating spirituality into professional treatment, this article orients practitioners to spiritually modified CBT, an approach that may enhance outcomes with some spiritually motivated clients. More specifically, by integrating clients' spiritual beliefs and practices into treatment, this modality may speed recovery, enhance treatment compliance, prevent relapse, and reduce treatment disparities by providing more culturally congruent services. The process of constructing spiritually modified CBT self-statements is described and illustrated, and suggestions are provided for working with client spirituality in an ethical manner. The article concludes by emphasizing the importance of this approach in light of the growing spiritual diversity that characterizes contemporary society.

Hook JN; Worthington EL; Davis DE; Jennings DJ; Gartner AL; Hook JP. Empirically supported religious and spiritual therapies. Journal of Clinical Psychology 66(1): 46-72, 2010. (74 refs.)

This article evaluated the efficacy status of religious and spiritual (R/S) therapies for mental health problems, including treatments for depression, anxiety, unforgiveness, eating disorders, schizophrenia, alcoholism, anger, and marital issues. Religions represented included Christianity, Islam, Taoism, and Buddhism. Some studies incorporated a generic spirituality. Several R/S therapies were found to be helpful for clients, supporting the further use and research on these therapies. There was limited evidence that R/S therapies outperformed established secular therapies, thus the decision to use an R/S therapy may be an issue of client preference and therapist comfort.

Huguelet P; Borras L; Gillieron C; Brandt PY; Mohr S. Influence of spirituality and religiousness on substance misuse in patients with schizophrenia or schizo-affective disorder. Substance Use & Misuse 44(4): 502-513, 2009. (27 refs.)

Substance misuse represents a major issue in the treatment of schizophrenia patients. Spirituality and religiousness have been shown to reduce substance misuse and to foster recovery among substance misusers in the general population. One hundred and fifteen stabilized outpatients with schizophrenia (mean age 39; 70% male) were selected in 2004 for an interview about religious coping. Religious involvement was significantly inversely correlated to substance use and abuse. A content analysis showed that religion may play a protective role toward substance misuse in 14% of the total sample, especially for patients who had stopped substance misuse (42%). It played a negative role in 3% of cases. Religion may play a role in the recovery of schizophrenia patients with substance misuse comorbidity.

Humphreys K; Gifford E. Religion, spirituality, and the troublesome use of substances. (Chapter 16). IN: Miller WR; Carroll KM, eds. Rethinking Substance Abuse: What the Science Shows, and What We Should Do about It. New York: Guilford Press, 2010

This is one of five chapters in Section V devoted to factors related to intervention with substance use and misuse. It considers the role of spirituality, which is a component of twelve step programs, as well as activity in formal religion. This is examined as a protective factor as well as a factor in recovery.

Kaskutas LA. Alcoholics Anonymous effectiveness: Faith meets science. Journal of Addictive Diseases 28(2): 145-157, 2009. (42 refs.)

Research on the effectiveness of Alcoholics Anonymous (AA) is controversial and subject to widely divergent interpretations. The goal of this article is to provide a focused review of the literature on AA effectiveness that will allow readers to judge the evidence effectiveness of AA for themselves. The review organizes the research on AA effectiveness according to six criterion required for establishing causation: (1) magnitude of effect; (2) dose response effect; (3) consistent effect; (4) temporally accurate effects; (5) specific effects; (6) plausibility. The evidence for criteria 1- 4 and 6 is strong: rates of abstinence are about twice as high among those who attend AA (criteria 1, magnitude); higher levels of attendance are related to higher rates of abstinence (criteria 2, dose-response); these relationships are found for different samples and follow-up periods (criteria 3, consistency); prior AA attendance is predictive of subsequent abstinence (criteria 4, temporal); and mechanisms of action predicted by theories of behavior change are present in AA (criteria 6, plausibility). However, rigorous experimental evidence establishing the specificity of an effect for AA or Twelve Step Facilitation/TSF (criteria 5) is mixed, with 2 trials finding a positive effect for AA, 1 trial finding a negative effect for AA, and 1 trial finding a null effect. Studies addressing specificity using statistical approaches have had two contradictory findings, and two that reported significant effects for AA after adjusting for potential confounders such as motivation to change.

Kelly JF; Stout RL; Magill M; Tonigan JS; Pagano ME. Spirituality in recovery: A lagged mediational analysis of Alcoholics Anonymous' principal theoretical mechanism of behavior change. Alcoholism: Clinical and Experimental Research 35(3): 454-463, 2011. (77 refs.)

Background: Evidence indicates Alcoholics Anonymous (AA) can play a valuable role in recovery from alcohol use disorder. While AA itself purports it aids recovery through "spiritual" practices and beliefs, this claim remains contentious and has been only rarely formally investigated. Using a lagged, mediational analysis, with a large, clinical sample of adults with alcohol use disorder, this study examined the relationships among AA, spirituality/religiousness, and alcohol use, and tested whether the observed relation between AA and better alcohol outcomes can be explained by spiritual changes. Method: Adults (N = 1,726) participating in a randomized controlled trial of psychosocial treatments for alcohol use disorder (Project MATCH) were assessed at treatment intake, and 3, 6, 9, 12, and 15 months on their AA attendance, spiritual/religious practices, and alcohol use outcomes using validated measures. General linear modeling (GLM) and controlled lagged mediational analyses were utilized to test for mediational effects. Results: Controlling for a variety of confounding variables, attending AA was associated with increases in spiritual practices, especially for those initially low on this measure at treatment intake. Results revealed AA was also consistently associated with better subsequent alcohol outcomes, which was partially mediated by increases in spirituality. This mediational effect was demonstrated across both outpatient and aftercare samples and both alcohol outcomes (proportion of abstinent days; drinks per drinking day). Conclusions: Findings suggest that AA leads to better alcohol use outcomes, in part, by enhancing individuals' spiritual practices and provides support for AA's own emphasis on increasing spiritual practices to facilitate recovery from alcohol use disorder.

Koenig HG. Research on religion, spirituality, and mental health: A review. Canadian Journal of Psychiatry 54(5): 283-291, 2009. (82 refs.)

Religious and spiritual factors are increasingly being examined in psychiatric research. Religious beliefs and practices have long been linked to hysteria, neurosis, and psychotic delusions. However, recent studies have identified another side of religion that may serve as a psychological and social resource for coping with stress. After defining the terms religion and spirituality, this paper reviews research on the relation between religion and (or) spirituality, and mental health, focusing on depression, suicide, anxiety, psychosis, and substance abuse. The results of an earlier systematic review are discussed, and more recent studies in the United States, Canada, Europe, and other countries are described. While religious beliefs and practices can represent powerful sources of comfort, hope, and meaning, they are often intricately entangled with neurotic and psychotic disorders, sometimes making it difficult to determine whether they are a resource or a liability.

Labate B; MacRae E, eds. Ayahuasca, Ritual and Religion in Brazil. London: Equinox Publishing, 2010. (Chapter refs.)

This book examines the emergence of religious groups in the Brazilian Amazon who organize their systems of ritual, myth and beliefs around the use of a psychoactive brew known by diverse names, one of which is the Quechua term �ayahuasca�. Although the study of these religious groups has seen much development in recent decades there are still few publications in English, especially in the area of anthropology. This book with 8 articles, presents material previously published only in Portuguese. The collection includes samples of the main types of research conducted, thus providing an overview of the current research activities. The ethnographic pieces included provide an introduction of the mapping of this phenomenon, and the nature of its historical and cultural origins. The book speaks to the history, theology, cosmology, rituals, liturgical practices, and social organization of these three religious groups, located in the forests of Brazil. Among the dilemmas facing those in policy positions in Brazil is how to distinguish between .ayahuasca and common street drugs, and how to discuss these distinctions with the general population. A central complication stems from the fact that indigenous conceptions of ayahuasca are based on different premises from the usual notions about drugs. it is suggested that the general views of drugs rely on a version of Christian cosmology that posits a transcendent spiritual realm radically divorced from the everyday. In contrast the indigenous cultures have combined indigenous cosmology with Christian morality. Within this cosmology spirit and matter retain a contrastive relationship, but the difference between them is perspectival rather than ontological. The worlds of humans, animals, and spirits interpenetrate, and are mediated by social and moral relationships. Indigenous hunters, for example, take care to maintain a respectful relationship with the spirit �owners� of the forest and its animals in order to insure fruitful hunting. Likewise, plant drugs such as ayahuasca are materializations of spirit beings, and their ingestion can initiate the perspectival changes that define the boundaries between worlds by crossing them.

Lambert NM; Fincham FD; Marks LD; Stillman TF. Invocations and intoxication: Does prayer decrease alcohol consumption? Psychology of Addictive Behaviors 24(2): 209-219, 2010. (59 refs.)

Four methodologically diverse studies (N = 1,758) show that prayer frequency and alcohol consumption are negatively related. In Study 1 (n = 824), we used a cross-sectional design and found that higher prayer frequency was related to lower alcohol consumption and problematic drinking behavior. Study 2 (n = 702) used a longitudinal design and found that more frequent prayer at Time 1 predicted less alcohol consumption and problematic drinking behavior at Time 2, and this relationship held when controlling for baseline levels of drinking and prayer. In Study 3 (n = 117), we used an experimental design to test for a causal relationship between prayer frequency and alcohol consumption. Participants assigned to pray every day (either an undirected prayer or a prayer for a relationship partner) for 4 weeks drank about half as much alcohol at the conclusion of the study as control participants. Study 4 (n = 115) replicated the findings of Study 3, as prayer again reduced drinking by about half. These findings are discussed in terms of prayer as reducing drinking motives.

Longshore D; Anglin MD; Conner BT. Are religiosity and spirituality useful constructs in drug treatment research? Journal of Behavioral Health Services & Research 36(2): 177-188, 2009. (81 refs.)

Religiosity and spirituality (R/S) have been shown to be related to better outcomes in many health service areas, including drug abuse treatment. The latter area, however, lacks a fully emergent empirical framework to guide further study. Moreover, although scientists have tested isolated hypotheses, no comprehensive process model has been designed and validated, limiting conceptual development as well. This paper reviews the relevant R/S and health research literature with a primary focus on drug treatment processes. Then a conceptual model is suggested to guide future incremental study of R/S assessment and intervention development. Implications for addiction health services include increased efforts to empirically validate R/S interventions, to increase practitioner competencies in this area, and to disseminate relevant research findings.

Lorencova R. Religiosity and spirituality of alcohol and marijuana users. Journal of Psychoactive Drugs 43(3): 180-187, 2011. (34 refs.)

This study focuses on measuring the spirituality of alcohol and marijuana users, using the new and exclusively Czech measuring tool, the Prague Spiritual Questionnaire (PSQ). The data from 155 respondents shows that users of both marijuana and alcohol scored significantly higher in the mysticism dimension of spirituality than those who only drank alcohol. People who mentioned that the specified spiritual feelings resulted from drug use are significantly more spiritual than those who do not associate their experiences with any drugs. The gender, age, education and professions of respondents show no significant effect on spirituality, while there is a significant difference between religious and nonreligious drug users in the specific dimensions of spirituality. Various implications of these findings, as well as the limitations of the PSQ, are further discussed.

Lyons GCB; Deane FP; Caputi P; Kelly PJ. Spirituality and the treatment of substance use disorders: An exploration of forgiveness, resentment and purpose in life. Addiction Research & Theory 19(5): 459-469, 2011. (51 refs.)

Faith-based treatment programs are a viable treatment option for many individuals with substance use disorders; however, the psychological mechanisms that explain the relationship between spirituality and a recovery from substance use disorders have not been established. The Spirituality, Forgiveness, and Purpose (SFP) model of recovery proposes that forgiveness and purpose in life may mediate the spirituality-recovery relationship. As a preliminary step in exploring this theory, a cross-sectional investigation of 277 clients of the Australian Salvation Army Rehabilitation Service Centres was performed. A multiple regression found that forgiveness of others, forgiveness of self, receiving forgiveness from others, and receiving forgiveness from God predicted resentment. Furthermore, multiple mediation analyses found that forgiveness of self and receiving forgiveness from others and God mediated the relationship between daily spiritual experiences and purpose and engagement in life.

Lyons GCB; Deane FP; Kelly PJ. Forgiveness and purpose in life as spiritual mechanisms of recovery from substance use disorders. Addiction Research & Theory 18(5): 528-543, 2010. (56 refs.)

Spirituality has often been associated with recovery from substance use disorders through its emphasis in faith-based rehabilitation programs. The purpose of this article is to describe some psychological dynamics that may explain how spirituality aids in the treatment of substance abuse and dependence. Forgiveness and purpose in life are proposed as "spiritual mechanisms" that partially mediate a spiritually directed recovery. Recent empirical studies on spirituality and recovery from substance use disorders are discussed in relation to 12-steps of Alcoholics Anonymous and Christian principles in order to describe how forgiveness and purpose in life interact with spiritual development in substance use disorder treatment programs. A theoretical model detailing the relationship between spirituality, forgiveness, purpose, and recovery is presented based on anecdotal and empirical literature.

Mason SJ; Deane FP; Kelly PJ; Crowe TP. Do spirituality and religiosity help in the management of cravings in substance abuse treatment? Substance Use & Misuse 44(13): 1926-1940, 2009. (39 refs.)

The purpose of this study was to examine the relationship of spirituality, religiosity and self-efficacy with drug and/or alcohol cravings. A cross-sectional survey was completed by 77 male participants at an Australian Salvation Army residential rehabilitation service in 2007. The survey included questions relating to the participants' drug and/or alcohol use and also measures for spirituality, religiosity, cravings, and self-efficacy The sample included participants aged between 19 and 74 years, with more than 57% reporting a diagnosis for a mental disorder and 78% reporting polysubstance misuse with alcohol most frequently endorsed as the primary drug of concern (71%). Seventy-five percent of the clients reported that spirituality and religious faith were useful components of the treatment program. A multivariate multiple regression analysis identified that spirituality and self-efficacy have significant relationships with cravings. Self-efficacy mediated the relationship between spirituality and drug and/or alcohol cravings. The limitations of this study included its cross-sectional design and a sample that was drawn from a faith-based program. Future research would benefit from the longitudinal examination of the relationship between spirituality, self-efficacy, and cravings: the exploration of a broader range of client-specific and interpersonal variables; and the inclusion of a control group from a secular treatment facility.

McFadden D; Croghan IT; Piderman KM; Lundstrom C; Schroeder DR; Hays JT. Spirituality in tobacco dependence: A Mayo Clinic survey. Explore: The Journal of Science and Healing 7(3): 162- 167, 2011. (23 refs.)

Context: With widespread interest in natural remedies and "wholistic" treatments, there has been a renewed focus on the impact of spirituality related alternative therapy for many current chronic diseases. Objective: To assess the potential impact of spiritual beliefs on lifestyle choices such as tobacco use, we conducted a patient survey. Design:/Setting: This cross-section study was conducted using a 27-question survey of patients seen at the Mayo Clinic over a 14-week period. Patients: We invited all patients (smokers and nonsmokers) seen in several Mayo Clinic divisions to participate in this voluntary survey. Interventions: The survey included demographic information, history of tobacco use or nonuse, and assessment of spirituality. Main Outcome Measure: Among the 501 patients who participated, 370 were nonsmokers and 131 were smokers. Compared with smokers, nonsmokers more often participated in religious activities such as regular weekly church attendance (48% vs. 24%), daily prayer, and Bible study (49% vs. 24%; P < .001). Current smoking was negatively correlated with religious activities. However, after adjustment for demographic facdtors, there was no significant difference in intrinsic spirituality (importance of religion) between the two groups (P < .130). Result: Nonsmokers are more likely to engage in religious activities such as prayer, Bible study, and regular church attendance. Further studies may be helpful to clearly define the potential impact of spirituality on smoking cessation.

Miller ML; Saunders SM. A naturalistic study of the associations between changes in alcohol problems, spiritual functioning, and psychiatric symptoms. Psychology of Addictive Behaviors 25(3): 455-461, 2011. (31 refs.)

The study evaluated how spiritual and religious functioning (SRF), alcohol-related problems, and psychiatric symptoms change over the course of treatment and follow-up. Problem drinkers (n = 55, including 39 males and 16 females) in outpatient treatment were administered questionnaires at pretreatment, posttreatment, and follow up, which assessed two aspects of SRF (religious well-being and existential well-being), two aspects of alcohol misuse (severity and consequences), and two aspects of psychiatric symptoms (depression and anxiety). Significant improvements in SRF, psychiatric symptoms and alcohol misuse were observed from pretreatment to follow-up. Although SRF scores were significantly correlated with psychiatric symptoms at all three time points, improvement in the former did not predict improvement in the latter. When measured at the same time points, SRF scores were not correlated with the measures of alcohol misuse. However, improvement in SRF (specifically in existential well-being) over the course of treatment was predictive of improvement in the alcohol misuse measures at follow-up. These results suggest that the association between SRF, emotional problems, and alcohol misuse is complex. They further suggest that patients who improve spiritual functioning over the course of treatment are more likely to experience improvement in drinking behavior and alcohol-related problems after treatment has ended.

Montagne M. The science of spirituality and addiction: What is being measured? What does it mean? (editorial). Substance Use & Misuse 45(14): 2402-2406, 2010. (8 refs.)

Moos R. Spirituality and religiosity in context. (editorial). Substance Use & Misuse 45(14): 2386-2388, 2010. (5 refs.)

Piderman KM; Schneekloth TD; Pankratz VS; Stevens SR; Altchuler SI. Spirituality during alcoholism treatment and continuous abstinence for one year (vol 18, pg 502, 2009) (correction). American Journal on Addictions 18(6): 502-502, 2009. (1 refs.)

Pillon SC; dos Santos MA; Goncalves AMD; de Araujo KM. Alcohol use and spirituality among nursing students. Revista da Escola de Enfermagem de USP 45(1): 98-105, 2011. (23 refs.)

The purpose of this cross-sectional study was to investigate alcohol use and the levels of spirituality among nursing students. The tests used were the Alcohol Use Disorders Identification Test and the Spirituality Scale. Participants were 191 (80.2%) nursing undergraduates from a city in the state of Minas Gerais, 75.4% of which were female, average age 25 years, and 149 (78%) were Catholic. As for alcohol use per gender, 117 (75%) women used alcoholic beverages and 33 (56.9%) had a drinking problem (p 0.05), against 25 men (43.1%). Low scores for spirituality levels were found in the sample: in average, women had lower scores compared to men (12.7 against 13.5). Comparing the level of spirituality with having a drinking problem, it was observed that students with low risk alcohol use had lower levels of spirituality. In conclusion, spirituality may not function as a protecting factor for alcohol use, hence this behavior may be under the control of other variables.

Riley S; Thompson J; Griffin C. Turn on, tune in, but don't drop out: The impact of neo-liberalism on magic mushroom users' (in)ability to imagine collectivist social worlds. International Journal of Drug Policy 21(6): 445-451, 2010. (28 refs.)

Background: Between 2002 and 2005 fresh or unprepared psilocin-based 'magic' mushrooms were legal to possess and traffic in the UK, and commercial sales demonstrated a significant market for this hallucinogenic drug. During and after this time there has been relatively little analysis concerning how magic mushroom users accounted for their drug use, nor on the wider political and cultural discourses that might have shaped this sense making. Method: In this paper we present a critical analysis of contemporary discourses around magic mushroom use in the UK through a multi-level discourse analysis of focus group data from 20 magic mushroom users (13 male and 7 female, mean age 25 years), taken at a time when magic mushrooms were being legally sold in the UK. Results: Locating participants' use of magic mushrooms within the context of a culture of intoxication, neo-liberalism and the legacy of 1960s psychedelic philosophy, we identify six interpretative repertoires in their talk, which were subsumed within two overarching discourses. The first discourse drew on neo-liberal rhetoric, constructing participants as rational risk managing subjects engaged in a form of calculated hedonism that was legitimated as an act of personal freedom and consumer choice. The second discourse, identified as 'post-psychedelic', both celebrated and problematised a collective, connected 'hippy' form of spirituality. Conclusion: The paper analyses the relationships between identity, consumption and citizenship by arguing that people's ability to imagine collectivist, spiritual or interconnected social worlds has been contained within neo-liberalism rhetoric.

Robinson EAR; Krentzman AR; Webb JR; Brower KJ. Six-month changes in spirituality and religiousness in alcoholics predict drinking outcomes at nine months. Journal of Studies on Alcohol and Drugs 72(4): 660-668, 2011. (48 refs.)

Objective: Although spiritual change is hypothesized to contribute to recovery from alcohol dependence, few studies have used prospective data to investigate this hypothesis. Prior studies have also been limited to treatment-seeking and Alcoholics Anonymous (AA) samples. This study included alcohol-dependent individuals, both in treatment and not, to investigate the effect of spiritual and religious (SR) change on subsequent drinking outcomes, independent of AA involvement. Method: Alcoholics (N = 364) were recruited for a panel study from two abstinence-based treatment centers, a moderation drinking program, and untreated individuals from the local community. Quantitative measures of SR change between baseline and 6 months were used to predict 9-month drinking outcomes, controlling for baseline drinking and AA involvement. Results: Significant 6-month changes in 8 of 12 SR measures were found, which included private SR practices, beliefs, daily spiritual experiences, three measures of forgiveness, negative religious coping, and purpose in life. Increases in private SR practices and forgiveness of self were the strongest predictors of improvements in drinking outcomes. Changes in daily spiritual experiences, purpose in life, a general measure of forgiveness, and negative religious coping also predicted favorable drinking outcomes. Conclusions: SR change predicted good drinking outcomes in alcoholics, even when controlling for AA involvement. SR variables, broadly defined, deserve attention in fostering change even among those who do not affiliate with AA or religious institutions. Last, future research should include SR variables, particularly various types of forgiveness, given the strong effects found for forgiveness of self.

Russell C; Davies JB; Hunter SC. Predictors of addiction treatment providers' beliefs in the disease and choice models of addiction. Journal of Substance Abuse Treatment 40(2): 150-164, 2011. (58 refs.)

Addiction treatment providers working in the United States (n = 219) and the United Kingdom (n = 372) were surveyed about their beliefs in the disease and choice models of addiction, as assessed by the 18-item Addiction Belief Scale of J. Schaler (1992). Factor analysis of item scores revealed a three-factor structure, labeled "addiction is a disease," "addiction is a choice," and "addiction is a way of coping with life," and factor scores were analyzed in separate hierarchical multiple regression analyses. Controlling for demographic and addiction history variables, treatment providers working in the United States more strongly believe addiction is a disease, whereas U.K.-based providers more strongly believe that addiction is a choice and a way of coping with life. Beliefs that addiction is a disease were stronger among those who provide for-profit treatment, have stronger spiritual beliefs, have had a past addiction problem, are older, are members of a group of addiction professionals, and have been treating addiction longer. Conversely, those who viewed addiction as a choice were more likely to provide public/not-for-profit treatment, be younger, not belong to a group of addiction professionals, and have weaker spiritual beliefs. Additionally, treatment providers who have had a personal addiction problem in the past were significantly more likely to believe addiction is a disease the longer they attend a 12-step based group and if they are presently abstinent.

Sered S; Norton-Hawk M. Whose higher power? Criminalized women confront the "Twelve Steps". Feminist Criminology 6(4): 308-332, 2011. (58 refs.)

Drawing on 3 years of fieldwork with a community of criminalized women in eastern Massachusetts, this article explores their ambivalent, often negative, relationship with and feelings about Alcoholics Anonymous/Narcotics Anonymous (AA/NA). We suggest that coerced participation in AA/NA undermines any potential value that these programs may have for other types of participants and that the Twelve Step ideology of personal responsibility and turning oneself over to a Higher Power fails to resonate for women who are homeless, poor, incarcerated, abused, and have had their children taken from them.

Solhkhah R; Galanter M; Dermatis H; Daly J; Bunt G. Spiritual orientation among adolescents in a drug-free residential therapeutic community. Journal of Child & Adolescent Substance Abuse 18(1): 57-71, 2009. (27 refs.)

Clinically, the treatment of substance abuse has relied on the Twelve Steps model, which is heavily focused on issues of spirituality. Adolescents may have cognitive and developmental issues that preclude them from taking advantage of the Alcoholics Anonymous (AA) model. To this end, we examined the spiritual orientation and spiritual behaviors among adolescent substance abusers in a drug-free residential therapeutic community (TC). One hundred and eighty-six adolescent clients of a drug-free residential therapeutic community were given a self-report questionnaire about their substance abuse and attitudes toward spirituality. The adolescents had a mean Spiritual Orientation Score of 21.48, reflecting a significantly lower level of spiritual orientation than adults in a similar setting. Also, adolescents who were heavy marijuana users were less spiritual than those adolescents who used marijuana less. Spirituality and affiliation with religious institutions may be considered a protective factor because they represent more conventional beliefs and attitudes and indicate a stronger social bond to conventional society.

Steiker LKH; Pape PA. Spirituality and substance abuse treatment. Journal of Social Work Practice in the Addictions 7(4): 117-126, 2007

Sussman S. Addiction, religion, spirituality, treatment. (editorial). Substance Use & Misuse 45(14): 2383-2386, 2010. (15 refs.)

Sussman S; Reynaud M; Aubin HJ; Leventhal AM. Drug addiction, love, and the higher power. Evaluation & the Health Professions 34(3), 2011. (25 refs.)

This discussion piece suggests that reliance on a Higher Power in drug abuse recovery programs is entertained among some addicts for its psychobiological effects. Prayer, meditation, early romantic love, and drug abuse may have in common activation of mesolimbic dopaminergic pathways of the brain and the generation of intense emotional states. In this sense, reliance on a Higher Power may operate as a substitute addiction, which replaces the psychobiological functions formerly served by drug use. Implications of this perspective are discussed.

Travis T. The Language of the Heart: A Cultural History of the Recovery Movement from Alcoholics Anonymous to Oprah Winfrey.. Chapel Hill, NC: The University of North Carolina Press, 2010

This book, authored by a cultural historian, traces the history of recovery movements in the United States, from the earliest days of Alcoholics Anonymous to the present day, and examines their connections to broader historical and cultural currents. It is based on the extensive examination of archival documents. The author discusses the relationship of the recovery movement to the broad American tradition of self-help, highlighting the roles that gender, mysticism, and print culture have played in that development. Organized into three parts, Part I examines the orignins of the recovery movement in the experiences of Alcoholics Anonymous, its philosophy, its postulating alcoholism as a disease, but different than the usual definitions of disease, as it is not limited to the physical body. The debt to earlier Protestant Evangelical fellowships is recognized, but the differences are are signiticant. Shorn from specific religious content, it embraces spirituality. The goal was not only embrace sobriety, but also to renounce toxic self-centeredness in favor of humility and service. Part II focus upon the importance of print media in the history of the recovery movement. This too represents a legacy from the evangelical Protestanism and from "new thought Christiany" which William James discussed. While formed in 1935, by 1951, AA had begun publishing conference approved literature. For a group with little formal organization, this was in effect its "glue". In 1971, Hazelden a leading treatment progam also established a publishing arm. The expansion of the recovery movement beyond AA is also discussed. There were other twelve-step programs modeled after AA, but also growing attention to behaviorial addiction. Of note was the attention to co-dependency, a word that has become part of the culture. Part III considers the nature of the recovery movement in the past decade. A component is seen as attention to empowerment, and efforts to escape/confront the psychological consequences of social conditions and social hierarchies. The thread which ties these to earlier efforts is the appeal to spiritual solutions to problems of gender and power.

Trichter S; Klimo J; Krippner S. Changes in spirituality among ayahuasca ceremony novice participants. Journal of Psychoactive Drugs 41(2): 121-134, 2009. (45 refs.)

Ayahuasca, a hallucinogenic plant brew from the Amazon basin used as part of healing ceremonies by the local indigenous people of the region for centuries, is now being consumed by growing numbers of people throughout the world. Anecdotal evidence and previous research suggest that there are spiritual effects experienced among participants who take part in ayahuasca ceremonies. The current study examined whether novice participants' spirituality was affected through participation in an ayahuasca ceremony, and if so, how. A mixed-design method was used, comparing those participating in an ayahuasca ceremony to those who did not participate. This investigation used the Peak Experience Profile, the Spiritual Well-being Scale, and the Mysticism Scale as quantitative measures. Participant interviews and written accounts of ceremony experiences were analyzed. Results showed that neither the SWB score nor the M-Scale score increased significantly after participating in an ayahuasca ceremony. However, it was found that the higher the PEP score, the greater the positive change in SWB and M-Scale scores. Qualitative data revealed common spiritual themes in many of the participants' interviews, and written accounts. Experiential differences were displayed within the ayahuasca ceremony group, warranting continued investigation into, and identification of, various confounding variables that prompt reported changes in spirituality within some participants while not in others.

Webb JR; Brewer K. Forgiveness, health, and problematic drinking among college students in southern Appalachia. Journal of Health Psychology 15(8): 1257-1266, 2010. (48 refs.)

Evidence is growing regarding the salutary relationships between spirituality and health, including alcohol problems, yet little is known about spirituality and health in the context thereof. Cross-sectional associations between forgiveness and health were examined among college student problematic drinkers (n = 126; female = 60%; M-age = 22) in Southern Appalachia. Controlling for demographic variables (including religiosity), dimensions of forgiveness accounted for 7-33 percent of the variance in the health-related variables in a salutary fashion. Forgiveness of Self appears to be the most important dimension of forgiveness measured, yet the most difficult to develop.

Webb JR; Robinson EAR; Brower KJ. Mental health, not social support, mediates the forgiveness-alcohol outcome relationship. Psychology of Addictive Behaviors 25(3): 462-473, 2011. (77 refs.)

Religiousness and spirituality are important to most Americans, and evidence suggests that they may contribute to both addiction and recovery. Forgiveness is a specific dimension of religiousness and spirituality that may enhance recovery, but the mechanism(s) through which it operates is unknown. We hypothesized that higher levels of forgiveness would be associated with higher levels of mental health and social support, which, in turn, would be associated with improved alcohol-related outcomes. Baseline and 6-month longitudinal data from a sample of 149 individuals with alcohol use disorders seeking outpatient substance abuse treatment were analyzed through multiple-mediation statistical techniques. While previous research has shown direct associations among forgiveness, alcohol-related outcomes, mental health, and social support, this study found that the direct associations between forgiveness and alcohol-related outcomes were no longer significant when mental health and social support were analyzed as mediator variables. At baseline, for each alcohol-related outcome measured (alcohol-related problems, percent heavy drinking days, percent days abstinent, and drinks per drinking day), mental health individually played a role in the relationship with both forgiveness of self and forgiveness of others, fully mediating or operating through an indirect-only pathway. For alcohol-related problems only, mental health fully mediated the relationship with forgiveness of self at follow-up and operated through an indirect-only pathway with forgiveness of others longitudinally. Social support and feeling forgiven by God were nonsignificant variables at baseline, follow-up, and longitudinally.