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Current Drug Research Reviews


ISSN (Print): 2589-9775
ISSN (Online): 2589-9783

Review Article

Spirituality, Religiosity and Addiction Recovery: Current Perspectives

Author(s): Livia Beraldo, Felipe Gil, Antonio Ventriglio, Arthur G. de Andrade, Antonio Geraldo da Silva, Julio Torales, Priscila D. Gonçalves, Dinesh Bhugra and João M. Castaldelli-Maia*

Volume 11, Issue 1, 2019

Page: [26 - 32] Pages: 7

DOI: 10.2174/1874473711666180612075954

Price: $65


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.

Keywords: Spirituality, religiosity, alcohol, cocaine, opioid, alcoholics anonymous.

Graphical Abstract
Degenhardt L, Whiteford HA, Ferrari AJ, et al. Global burden of disease attributable to illicit drug use and dependence: Findings from the Global Burden of Disease Study 2010. Lancet 2013; 382(9904): 1564-74.
GBD 2015 Risk Factors Collaborators Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015 Lancet 388(10053): 1659-724.s
Booth J, Martin JE. Spiritual and religious factors in substance use, dependence, and recovery Handbook of religion and mental health. Orlando: Elsevier Science 1998.
Hirsh J. Historical perspectives of the problem of alcoholism. Bull N Y Acad Med 1953; 29(12): 961-71.
The story of how many thousand of men and women have recovered from alcoholism. 3rd ed. New York: Alcoholism Anonymous World Services 1976.
Kurtz E. Why A.A. works; the intellectual significance of Alcoholics Anonymous. J Stud Alcohol 1982; 43(1): 38-80.
Carroll S. Spirituality and purpose in life in alcoholism recovery. J Stud Alcohol 1993; 54(3): 297-301.
James W. Varieties of religious experience. New York: Touchstone 1997.
White W, Whiters D. Faith-based recovery: Its historical roots. Counselor (Deerfield Beach) 2005; 6: 58-62.
Sussuman S, Ames SL. Drug Abuse: Concepts, prevention and cessation. New York, NY: Cambrigde University Press 2008.
Miller WR, Bogenschutz MP. Spirituality and addiction. South Med J 2007; 100(4): 433-6.
Bonelli RM, Koenig HG. Mental disorders, religion and spirituality 1990 to 2010: a systematic evidence-based review. J Relig Health 2013; 52(2): 657-73.
Krentzman AR, Farkas KJ, Townsend AL. Spirituality, religiousness, and alcoholism treatment outcomes: A comparison between black and white participants. Alcohol Treat Q 2010; 28(2): 128-50.
Norrish ME, Jooste K. Nursing care of the patient undergoing alcohol detoxification. Curationis 2001; 24(3): 36-48.
Robinson EA, Cranford JA, Webb JR, Brower KJ. Six-month changes in spirituality, religiousness, and heavy drinking in a treatment-seeking sample. J Stud Alcohol Drugs 2007; 68(2): 282-90.
Robinson EA, Krentzman AR, Webb JR, Brower KJ. Six-month changes in spirituality and religiousness in alcoholics predict drinking outcomes at nine months. J Stud Alcohol Drugs 2011; 72(4): 660-8.
Puchalski CM. The spiritual dimension: The healing force for body and mindCaregiving book series Americus. Rosalyn Carter Institute for Human Development, Georgia Southwestern State University 2003.
Galanter M, Dermatis H, Talbot N, McMahon C, Alexander MJ. Introducing spirituality into psychiatric care. J Relig Health 2011; 50(1): 81-91.
Hill PC, Pargament KI, Wood RW, et al. Conceptualizing religion and spirituality: Points of commonality, points of departure. J Theory Soc Behav 2000; 30(1): 51-77.
Crocq MA. Historical and cultural aspects of man’s relationship with addictive drugs. Dialogues Clin Neurosci 2007; 9(4): 355-61.
Prayag G, Mura P, Hall CM, Fontaine J. Spirituality, drugs, and tourism: tourists’ and shamans’ experiences of ayahuasca in Iquitos, Peru. Tour Recreat Res 2016; 41(3): 314-25.
Kelly JF, Magill M, Stout RL. How do people recover from alcohol dependence? A systematic review of the research on mechanisms of behavior change in Alcoholics Anonymous. Addict Res Theory 2009; 17(3): 236-59.
Kelly JF. Is Alcoholics Anonymous religious, spiritual, neither? Findings from 25 years of mechanisms of behavior change research. Addiction 2016.
Castaldelli-Maia JM, Oliveira HP, Andrade AG, Lotufo-Neto F, Bhugra D. Using selected scenes from Brazilian films to teach about substance use disorders, within medical education. Sao Paulo Med J 2012; 130(6): 380-91.
Castaldelli-Maia JM, Bhugra D, de Andrade AG, Lotufo-Neto F. Substance use and misuse in Brazilian movies (2000-2008). Subst Use Misuse 2013; 48(3): 248-57.
Adamson SJ, Sellman JD, Frampton CM. Patient predictors of alcohol treatment outcome: A systematic review. J Subst Abuse Treat 2009; 36(1): 75-86.
Gomes FC, de Andrade AG, Izbicki R, Moreira Almeida A, Oliveira LG. Religion as a protective factor against drug use among Brazilian university students: a national survey. Br J Psychiatry 2013; 35(1): 29-37.
DiClemente CC. Addiction and change: How addictions develop and addicted people recover. New York: Guilford Press 2003.
Fletcher AM. Sober for good: New solutions for drinking problems - Advice from those who have succeeded. New York: Houghton Mifflin 2001.
Humphreys K, Gifford E. Religion, spirituality and the troublesome use of substanceRethinking substance abuse: What the science shows and what we should do about it. New York: Guilford Press 2006.
Hoaken PN, Stewart SH. Drugs of abuse and the elicitation of human aggressive behavior. Addict Behav 2003; 28(9): 1533-54.
Shorey RC, Elmquist J, Anderson S, Stuart GL. The relationship between spirituality and aggression in a sample of men in residential substance use treatment. Int J Ment Health Addict 2016; 14(1): 23-30.
Giancola PR, Josephs RA, Parrott DJ, Duke AA. Alcohol myopia revisited clarifying aggression and other acts of disinhibition through a distorted lens. Perspect Psychol Sci 2010; 5(3): 265-78.
Steele CM, Josephs RA. Alcohol myopia. Its prized and dangerous effects. Am Psychol 1990; 45(8): 921-33.
DeWall CN, Pond RS Jr, Carter EC, et al. Explaining the relationship between religiousness and substance use: Self-control matters. J Pers Soc Psychol 2014; 107(2): 339-51.
Finkel EJ. Impelling and inhibiting forces in the perpetration of intimate partner violence. Rev Gen Psychol 2007; 11(2): 193-207.
Lim SS, Vos T, Flaxman AD, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380(9859): 2224-60.
Grant BF, Goldstein RB, Saha TD, et al. Epidemiology of DSM-5 Alcohol Use Disorder: Results From the National Epidemiologic Survey on Alcohol and Related Conditions III. JAMA Psychiatry 2015; 72(8): 757-66.
Shield KD, Rylett M, Gmel G, Gmel G, Kehoe-Chan TA, Rehm J. Global alcohol exposure estimates by country, territory and region for 2005--a contribution to the Comparative Risk Assessment for the 2010 Global Burden of Disease Study. Addiction 2013; 108(5): 912-22.
Gibson MA. Immigrant adaptation and patterns of acculturation. Hum Development 2001; 44: 19-23.
Karriker-Jaffe KJ, Zemore SE. Associations between acculturation and alcohol consumption of Latino men in the United States. J Stud Alcohol Drugs 2009; 70(1): 27-31.
Berry JW. Acculturation and identity Textbook of Cultural Psychiatry. Cambridge: Cambridge University Press 1997.
Castaldelli-Maia JM, Bhugra D. Investigating the interlinkages of alcohol use and misuse, spirituality and culture - Insights from a systematic review. Int Rev Psychiatry 2014; 26(3): 352-67.
Powell LH, Shahabi L, Thoresen CE. Religion and spirituality. Linkages to physical health. Am Psychol 2003; 58(1): 36-52.
Flynn PM, Joe GW, Broome KM, Simpson DD, Brown BS. Looking back on cocaine dependence: reasons for recovery. Am J Addict 2003; 12(5): 398-411.
Koski-Jannes A, Turner N. Factors influencing recovery from different addictions. Addict Res 1997; 7(6): 469-92.
Hopson RE. The 12-step programReligion and the Clinical Practice of Psychology. Washington, DC: American Psychological Association 1996.
Humphreys K, Wing S, McCarty D, et al. Self-help organizations for alcohol and drug problems: toward evidence-based practice and policy. J Subst Abuse Treat 2004; 26(3): 151-8.
Heinz A, Epstein DH, Preston KL. Spiritual/Religious experiences and in-treatment outcome in an inner-city program for heroin and cocaine dependence. J Psychoactive Drugs 2007; 39(1): 41-9.
Williamson WP, Hood RW Jr. Psychology and spiritual transformation in a substance abuse program: The Lazarus project. Rowman & Littlefield 2016.
Schoenthaler SJ, Blum K, Braverman ER, et al. NIDA-Drug Addiction Treatment Outcome Study (DATOS) Relapse as a Function of Spirituality/Religiosity. J Reward Defic Syndr 2015; 1(1): 36-45.
Yeterian JD, Bursik K, Kelly JF. God put weed here for us to smoke: A mixed-methods study of religion and spirituality among adolescents with cannabis use disorders. Subst Abus 2018. [Epub ahead of print].
Noormohammadi MR, Nikfarjam M, Deris F, Parvin N. Spiritual Well-Being and Associated Factors with Relapse in Opioid Addicts. J Clin Diagn Res 2017; 11(3): VC07-10.
Puchalski C, Ferrell B. Making health care whole: Integrating spirituality into patient care. West Conshohocken: Templeton Press 2010.
Dermatis H, Galanter M. The role of twelve-step-related spirituality in addiction recovery. J Relig Health 2016; 55(2): 510-21.
Green LL, Fullilove MT, Fullilove RE. Stories of spiritual awakening. The nature of spirituality in recovery. J Subst Abuse Treat 1998; 15(4): 325-31.
Baker CR. Defining and measuring affiliation motivation. Eur J Soc Psychol 1979; 9: 97-9.
Kelly JF, Urbanoski KA, Hoeppner BB, Slaymaker V. Facilitating comprehensive assessment of 12-step experiences: A Multidimensional Measure of Mutual-Help Activity. Alcohol Treat Q 2011; 29(3): 181-203.
Buckingham SA, Frings D, Albery IP. Group membership and social identity in addiction recovery. Psychol Addict Behav 2013; 27(4): 1132-40.
Koob GF, Volkow ND. Neurobiology of addiction: a neurocircuitry analysis. Lancet Psychiatry 2016; 3(8): 760-73.
Lewis SJ, Zuccolo L, Davey Smith G, et al. Fetal alcohol exposure and IQ at age 8: evidence from a population-based birth-cohort study. PLoS One 2012; 7(11): e49407.
Emrick CD, Tonigan JS. The American Psychiatric Publishing textbook of substance abuse treatment 2004 Alcoholics anonymous and other 12-step groups Washington: American Psychiatric Press.
McCrady BS, Tonigan JS. Recent research into twelve step programsPrinciples of addiction medicine. 4th ed. Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins 2009.
McKellar J, Stewart E, Humphreys K. Alcoholics anonymous involvement and positive alcohol-related outcomes: cause, consequence, or just a correlate? A prospective 2-year study of 2,319 alcohol-dependent men. J Consult Clin Psychol 2003; 71(2): 302-8.
Gorsuch RL, Miller WR. Assessing spiritualityIntegrating spirituality into treatment: Resources for practitioners. Washington: American Psychological Association 1999.
Walker R, Godlaski TM, Staton-Tindall M. Spirituality, drugs, and alcohol: a philosophical analysis. Subst Use Misuse 2013; 48(12): 1233-45.
Nichter M. Idioms of distress revisited. Cult Med Psychiatry 2010; 34(2): 401-16.
Garcia A, Anderson B, Martinez M. Fourth and fifth step groups: a new and growing self-help organization for underserved latinos with alcohol and other drug use disorders. Alcohol Treat Q 2015; 33(2): 235-43.
Benish SG, Quintana S, Wampold BE. Culturally adapted psychotherapy and the legitimacy of myth: a direct-comparison meta-analysis. J Couns Psychol 2011; 58(3): 279-89.
Mattis JS, Jagers RJ. A relational framework for the study of religiosity and spirituality in the lives of African Americans. J Community Psychol 2001; 29(5): 519-39.
Taylor RJ, Chatters LM, Levin J. Extended family households among Black Americans. Afr Am Res Perspect 2003; 9(1): 133-51.
Duvall JL, Staton-Tindall M, Oser CB, Leukeld CG. Persistence in turning to faith as a predictor of drug use and criminality among drug court clients. J Drug Issues 2008; 38(3): 911-28.
Fallot RD, Heckman JP. Religious/spiritual coping among women trauma survivors with mental health and substance use disorders. J Behav Health Serv Res 2005; 32(2): 215-26.
Tonigan JS. Spirituality and alcoholics anonymous. South Med J 2007; 100(4): 437-40.
Stone RAT, Whitbeck LB, Chen X, Johnson K, Olson DM. Traditional practices, traditional spirituality, and alcohol cessation among American Indians. J Stud Alcohol 2006; 67(2): 236-44.
Ahmadi J, Pridmore S, Alimi A, et al. Epidemiology of opium use in the general population. Am J Drug Alcohol Abuse 2007; 33(3): 483-91.
Raghibi M. Examining High-Risky Behavior among Students of Zahedan Universities. Int J High Risk Behav Addict 2012; 1(1): 37-41.
Hafizi S, Memari AH, Pakrah M, Mohebi F, Saghazadeh A, Koenig HG. The Duke University Religion Index (DUREL): validation and reliability of the Farsi version. Psychol Rep 2013; 112(1): 151-9.
Shamsalina A, Norouzi K, Fallahi Khoshknab M, Farhoudiyan A. Recovery based on spirituality in substance abusers in Iran. Glob J Health Sci 2014; 6(6): 154-62.
Heinz AJ, Disney ER, Epstein DH, Glezen LA, Pamela IC, Preston KL. A focus-group study on spirituality and substance-abuse treatment. Subst Use Misuse 2010; 45(1-2): 1-16.
Draus PJ, Carlson RG. Change in the scenery: an ethnographic exploration of crack cocaine use in rural Ohio. J Ethn Subst Abuse 2007; 6(1): 81-107.
Draus PJ, Siegal HA, Carlson RG, Falck RS, Wang J. Cracking the cornfields: Recruiting illicit stimulant drug users in rural Ohio. Sociol Q 2005; 46: 165-89.
Booth BM, Leukefeld C, Falck R, Wang J, Carlson R. Correlates of rural methamphetamine and cocaine users: results from a multistate community study. J Stud Alcohol 2006; 67(4): 493-501.
Sexton RL, Carlson RG, Siegal H, Leukefeld CG, Booth B. The role of African-American clergy in providing informal services to drug users in the rural South: preliminary ethnographic findings. J Ethn Subst Abuse 2006; 5(1): 1-21.

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