Spirituality,Drugs, and Alcohol: A Philosophical Analysis

Spirituality has long been associated with recovery from the socially constructed “addictive disease.” Alcoholics Anonymous (AA) and its analogs have enjoyed widespread acceptance as a spiritual approach for achieving recovery. AA or its derivatives are the predominant approaches in treatment programs even though a wide array of evidence-based approaches are now promoted by governmental sources in the United States. This philosophical analysis contrasts the state of science about addictive disorders with the reliance on a spiritual approach that is heavily grounded in Christian theology. We present four problems that need consideration before accepting the applicability of 12-step spiritual practices as the backbone of addiction treatment or recovery.     

Perception of the Role of Spirituality and Religiosity in the Addiction Treatment Program Among the Italian Health Professionals: A Pilot Study

In this pilot study, 69 health professionals working in public and private programs treating drug users and alcohol misusers in Italy were interviewed during 2012 using the Vederhus and Laudet questionnaire as a framework to explore the importance of the concepts of spirituality and religiosity and their possible roles in the treatment through patient's referral to mutual-help groups. The study's limitations are noted.     

Exercise Addiction: Symptoms,Diagnosis, Epidemiology,and Etiology

Regular physical activity plays a crucial role in health maintenance and disease prevention. However, excessive exercise has the potential to have adverse effects on both physical and mental health. The scholastic and empirical discussion of excessive physical activity focuses on obsessive and compulsive exercising, and uses several labels. However, in this review, we argue that the most appropriate term for this phenomenon is exercise addiction, emphasizing that excessive physical exercise fits the typical and most common characteristics of behavioral addictions. The aim of this review is to synthesize the current knowledge on symptomology, diagnosis, epidemiology, and etiology of exercise addiction.     

Spirituality and the Health Professional

The inclusion of spirituality in addictions recovery began with the 12-steps program of Alcoholics Anonymous. Cofounded by Bill Wilson, the 12-steps’ spiritual orientation is based on Wilson's own recovery from alcoholism that was associated with a spiritual experience. His correspondence with Carl Jung, who verified the importance of Wilson's experience, empowered Wilson to make spirituality central to the 12 steps. Spirituality remains a source of misunderstanding between the scientific, empirically informed mental health community, and the 12-step recovery movement. This article offers an outline of spiritual development, based on neuroscience, which the professional can utilize in the spiritual aspect of a patient's recovery.     

On Addiction,Complexity, and Freedom: Toward a Liberation-Focused Addiction Treatment

This article outlines a liberation-focused model of addiction treatment. Drawing on the Latin root word "addictus", addiction is seen as slavery and freedom, rather than the cessation of drug and alcohol use, is proposed as a viable, alternative treatment goal. Freedom is defined as: (1) the capacity to create a life of social and internal complexity and multiplicity; (2) the ability to make choices from an array of options; and (3) the possibility of engaging in long-term, goal-directed behavior. This vision of personal liberation is then embedded within a biopsychosocial model of care and treatment. Examples of how biomedical, psychological, and social interventions can each serve to promote the goal and experience of freedom and liberation are provided. Engaging in identity projects and using harm reduction interventions and philosophies are also seen as key to this transformative journey.     

河豚毒素中毒机理与临床救治探讨

探讨河豚毒素(TTX)的中毒机理及临床TTX中毒的有效救治措施。     

Spirituality and the Treatment of the Dually Diagnosed:

Spirituality is a neglected area of study and research in the treatment of addictions. The role of spirituality in the treatment of the dually diagnosed has received particularly scant attention. One hundred and one patients on an in-patient dual-diagnosis unit, as well as the 31 members of the nursing staff who treat them were surveyed. Patients and staff were questioned about their spiritual beliefs and what was the role of spirituality in the patients' recovery from addiction. Staff were questioned about their own spirituality and what they think the patients' level of spirituality is. In addition the staff were asked what they think the patients' view of spiritually is. Results indicate that the patients and staff are equally spiritually oriented. The patients view spirituality as essential to their recovery and value spiritual programming in their treatment more than some concrete items. The nursing staff underestimated both the patients' level of spirituality and this importance placed on spiritual issues. The authors suggest that more attention should be given by staff to spirituality in the treatment of this population.     

Internet Game Addiction,Parental Attachment,and Parenting of Adolescents in South Korea

The adolescent-parent relationship is a major factor influencing juvenile delinquency, and Internet gaming addiction may exacerbate any conflict in that relationship. The aim of this study was to determine the relationships among Internet game addiction, parental attachment, and parental attitude toward the rearing of adolescents in South Korea. The initial selected convenience sample comprised 624 middle school and high school students. Self-reported measures of an Internet Game Addiction Scale, Inventory of Parent and Peer Attachment–Revised version, and the modified Parental Acceptance-Rejection Questionnaire were analyzed. A significant relationship was found between Internet game addiction and both parental attachment and the adolescents’ perception of parenting of adolescents. Those helping adolescents with an Internet game addiction should consider not only the adolescents’ Internet game usage pattern but also their relationship with their parents.     

Religiosity and Spirituality of Alcohol and Marijuana Users

Abstract

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.     

Young People in Alcoholics Anonymous: The Role of Spiritual Orientation and AA Member Affiliation

Empirical findings characterizing long-term, committed Alcoholics Anonymous (AA) members are limited, particularly among younger members. The authors studied a sample of 266 highly committed attendees (mean age, 27 years) at an annual conference of Young People in Alcoholics Anonymous (YPAA), whose first encounter with AA was 6 years previously. Most (72%) had abused drugs and alcohol, and 36% had never received substance abuse treatment. They now reported a mean duration of abstinence of 44 months and had attended an average of 233 AA meetings in the previous year; 66% had served as AA sponsors, and 92% reported experiencing an AA “spiritual awakening,” itself associated with a decreased likelihood of alcohol craving. Scores on AA beliefs, affiliation to other members, and the experience of spiritual awakening were associated with lower depression scores. These findings are discussed to clarify the nature of long-term AA membership.     

Voice of the Psychonauts: Coping,Life Purpose,and Spirituality in Psychedelic Drug Users

Abstract

Psychoactive drug use shows great diversity, but due to a disproportionate focus on problematic drug use, predominant nonproblematic drug use remains an understudied phenomenon. Historic and anecdotal evidence shows that natural sources of “psychedelic” drugs (e.g., mescaline and psilocybin) have been used in religious and spiritual settings for centuries, as well as for psychological self-enhancement purposes. Our study assessed a total of 667 psychedelic drug users, other drug users, and drug nonusers by online questionnaires. Coping, life purpose, and spirituality were measured with the Psychological Immune Competence Inventory, the Purpose in Life test, and the Intrinsic Spirituality Scale, respectively. Results indicate that the use of psychedelic drugs with a purpose to enhance self-knowledge is less associated with problems, and correlates positively with coping and spirituality. Albeit the meaning of “spirituality” may be ambiguous, it seems that a spiritually-inclined attitude in drug use may act as a protective factor against drug-related problems. The autognostic use of psychedelic drugs may be thus hypothesized as a “training situation” that promotes self-enhancement by rehearsing personal coping strategies and by gaining self-knowledge. However, to assess the actual efficiency and the speculated long-term benefits of these deliberately provoked exceptional experiences, further qualitative investigations are needed.     

Spirituality as a Change Mechanism in 12-Step Programs: A Replication,Extension, and Refinement

This National Institutes of Health funded study investigated spiritual growth as a change mechanism in 12-step programs. A total of 130 people, early 12-step affiliates with limited Alcoholics Anonymous (AA) histories, were recruited from 2007 to 2008 from AA, treatment, and community centers in a Southwestern city in the United States. A majority of the sample was alcohol dependent. Participants were interviewed at baseline and at 3, 6, and 9 months. Lagged General Linear Modeling analyses indicated that spiritual change as measured by the Religious Background and Behavior (RBB) self-report questionnaire were predictive of increased abstinence and decreased drinking intensity, and that the magnitude of this effect varied across different RBB scoring algorithms. Future research should address study limitations by recruiting participants with more extensive AA histories and by including assessments of commitment to, and practice of, AA prescribed activities. The study's limitations are noted.     

Buprenorphine and Cocaine Addiction:

No abstract available for this article.     

The Relationship Between Substance User Treatment and 12-Step Fellowships: Current Knowledge and Research Questions

This article reviews and synthesizes information about the relationship between two distinct approaches to helping substance users, formal “addiction treatment” and 12-step mutual aid. The following issues are addressed: Extent of formal treatment and 12-step fellowship participation for persons with substance use-related problems; overlap between treatment and 12-step participation; early attempts to “integrate” treatment and 12-step mutual aid; differences and similarities between the 12-step program and treatment; issues of spirituality in the 12-step program; effectiveness of 12-step participation as treatment aftercare; and whether help-seekers can be “matched” to 12-step. The article poses pertinent questions that could answered by additional research, including life cycle patterns of usage of treatment and 12-step, outcomes of such episodes, reasons for using different interventions at different times, feasibility of 12-step participation as a primary intervention, the relative contributions of striving for spiritual values vs. social support factors to the effectiveness of 12-step, and the comparative effectiveness of secular vs. 12-step mutual aid. The article concludes with a proposed reconceptualization of the relationship between formal treatment and 12-step mutual aid that may help in structuring future research.

In the rarer sort … inexorable sorrow takes the form of fellowship and makes the imagination tender. George Eliot (1876)     

Addiction and the adaptive cycle: A new focus

This paper explores addiction through the lens of complex adaptive systems theory, as an emergent, non-linear phenomenon that undergoes cyclical patterns of stability and change. Particularly, an addiction is a behavioural pattern that emerges through the dynamic interactions of numerous variables operating both within the individual and in the environment. Furthermore, we argue that an addiction moves through the four phases of the adaptive cycle and exists at a given scale nested within a panarchy of other complex systems. Each of these complex adaptive systems is moving through its own adaptive cycle at faster and slower rates, affecting the course of addiction in various ways. We conclude this work by suggesting that forthcoming addiction interventions and research may benefit from the consideration that addiction is a function of three separate, but related, adaptive cycles; the addiction cycle itself; a transitory cycle, and a final cycle in which the individual is actively responsible for the maintenance of his or her own recovery.     

The Role of Stress and Spirituality in Adolescent Substance Use

Background: Substance use can occur as a result of coping with stress. Within the school context, youth are exposed to stressors related to school achievement and peer-relationships. Protective factors, such as spirituality, may moderate adolescents' engagement in substance use. Objective: The current study investigated the role of spirituality in the association between stress and substance use, in an effort to test the hypothesis that spirituality moderates the association between stress and substance use. Methods: This study used data from youth in grades 6–8 attending 40 parochial private schools. A total of 5,217 students participated in the web-based survey administered in Spring 2013. Multilevel structural equation models were used to examine the association between stress, spirituality, and substance use, while accounting for the nested nature of the data (i.e., students within schools). Results: Higher stress was significantly associated with increased alcohol, tobacco, and other drug use among youth (b =.306, p <.001). In addition, lower spiritual beliefs were associated with greater substance use (b =.349, p <.001). Spiritual beliefs did not moderate the relationship between stress and substance use. Conclusions/Importance: Implications for increasing students' adaptive coping when confronted with school-related stressors and the role of school climate are discussed.     

Development of a bibliography on religion, spirituality and addictions

INTRODUCTION AND AIMS: The aim of this study was to develop a comprehensive annotated public-domain bibliography of the literature on spirituality and addictions to facilitate future research and scholarship. DESIGN AND METHODS: A search was conducted of all citations listed in the MEDLINE, PsychINFO and ALTA Religion databases covering a period from 1941 to 2004 using the following search terms: substance abuse, substance dependence, addiction, religion, spirituality. A group of experts in the field then classified each citation according to empirically derived categories. RESULTS: A total of 1353 papers met the search parameters and were classified into 10 non-exclusive categories: (1) attitudes toward spirituality and substance use, (2) commentaries, (3) spiritual practices and development in recovery, (4) spiritual and religion variables in the epidemiology of substance abuse, (5) psychoactive substances and spiritual experiences, (6) religious and spiritual interventions, (7) literature reviews, (8) measurement of spirituality and addictions, (9) 12-Step spirituality and (10) youth and development. DISCUSSION AND CONCLUSIONS: The literature is voluminous, but has focused primarily in a few areas. Common findings included an inverse relationship between religiosity and substance use/abuse, reduced use among those practising meditation and protective effects of 12-Step group involvement during recovery. Although sound instruments are available for measuring spirituality, studies have tended to use simplistic, often single-item measures.     

Addiction,Abuse, and Family Relationships

Abstract

Young, poor African American women are at high risk for victimization and stigmatization through multiple avenues, including childhood sexual abuse, drug use, and incarceration. This study describes the childhood experiences of five imprisoned African American women who have extensive histories of drug addiction and criminal behavior. Through the use of personal interviews and qualitative analysis, the women's childhood experiences are explored with attention to the themes of alcohol and drug use, sexual abuse, and mother-daughter relationships. Relational theory provides a conceptual framework for the analysis. Practice and policy considerations are discussed, with an emphasis on benefiting women with histories of abuse and addiction.     

Alcohol Expectancies Mediate the Relationship Between Age of First Intoxication and Drinking Outcomes in College Binge Drinkers

Background: While prior research has shown that age of first intoxication (AI) is associated with negative alcohol outcomes, limited research has examined factors accounting for this relationship. Alcohol expectancies, or beliefs about the effects of alcohol, may explain such associations as both positive and negative expectancies have been shown to be key predictors of drinking outcomes. Objective: The present study examined expectancies as mediators between early AI and alcohol-related outcomes. Method: Data collection occurred in 2012 and 2013. Participants were college students (N = 562, 65.8% women) who completed an online survey including measures of alcohol use history, alcohol expectancies, typical alcohol consumption, and alcohol-related problems. Structural equation modeling was used to test the hypothesized model. Results: Our findings support a model whereby AI is associated with drinking through its influence on both positive and negative expectancies. Specifically, an earlier AI was associated with stronger alcohol expectancies, which in turn, was associated with heavier alcohol use and alcohol-related problems. Conclusions/Importance: These findings are consistent with expectancy theory and previous research suggesting that more experienced drinkers hold stronger drinking-related beliefs, be it positive or negative, and these expectancies ultimately explain variability in alcohol use and problems. Our findings further support that expectancies play an important role in the initiation of drinking behavior.