Spirituality in substance abuse/dependence treatment

SPIRITUALITY IN SUBSTANCE ABUSE/DEPENDENCE TREATMENT

Abdullah Baniyameen
baniyameen@aol.com
August 12, 2009




OVERVIEW:

• Definitions of spirituality and religion.
• Why Spirituality is Important:

1. Relationship to Health.
2. Beliefs of Patients.
3. Beliefs of Medical Professionals.

• Spirituality’s Relationship to the Treatment of Substance Use Disorders.
• Research in AA and Spirituality.

DEFINITIONS:

• “Religio” – Humanity’s bond with a greater being.
• “Spiritus” – Breath or life.
• Religious thinking: “An intellectual endeavor out of the depths of reason.”

WHY SPIRITUALITY IS IMPORTANT?

• Involvement with spirituality / religion predicts improved quality of life and survival rates of patients with advanced malignancies.
• Association between religious commitment and lower blood pressure.
• Beliefs of our Clients.
• Beliefs of medical professionals.

BELIEVES OF OUR CLIENTS:

• 90% (or more) of Americans believe in God.
• 57% engage in daily prayer.
• 42% attended church in the last week.
• 80% believed that religious faith can aid in recovery from illness.
• 63% agreed that doctors should talk to them about spiritual issues.

- Mc Nichol, 1996

BELIEFS OF MEDICAL PROFESSIONALS:

• Most psychiatrists do not believe in God.
• Nurses and medical students in one survey ranked spirituality as a low consideration of patients treated on a dual diagnosis unit.
• However, the patients ranked spirituality and belief in God as most important to their recovery.

RELIGION & SPIRITUALITY IN SUBSTANCE ABUSE TREATMENT:

• “Religions have been far from silent on the use of psychoactive drugs.”
• Judeo – Christian sacraments involving wine.
• Native American, Polynesian and African religions have used hallucinogens and other substances to enhance spiritual transcendence.
• Judeo – Christian Bible denounces drunkenness.
• Islam strictly prohibits the use of alcohol and drugs.
• “… and spirituality has long been emphasized as an important factor in recovery from addiction.”
• Alcoholics Anonymous (AA) derived from a Christian Fellowship in 1935.
• 12 Steps.

FIRST III STEPS:

1. Admit powerlessness over alcohol.
2. Belief in a “power greater than ourselves”.
3. Turn will over to the care of God “as we understood Him”.

STEPS IV THROUGH VII:

1. Take a moral inventory.
2. Admit to God, to ourselves, and to another human being the exact nature of our wrongs.
3. Ready to have God remove all these defects of character.
4. Ask Him to remove our shortcomings.

STEPS VIII, IX & X:

1. Made a list of all persons harmed and became willing to make amends to them all.
2. Made direct amends wherever possible.
3. Ongoing personal inventory and promptly admitted when we were wrong.

FINAL II STEPS:

1. Through prayer and meditation improve our conscious contact with God, ‘as we understood Him’.
2. “Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs”.

RESEARCH INVOLVING SPIRITUALITY:

• Religious / Spiritual involvement predicts less use of and fewer problems with alcohol, tobacco and illicit drugs.
• Mechanisms are poorly understood:

1. Principles avoidance.
2. Social support for abstinence.
3. Involvement in activities those are incompatible with use.
4. Prosaically values.

RESEARCH INVOLVING ALCOHOLIC ANONYMOUS:

• Modest correlation found between improved drinking behavior and:

1. Having a sponsor.
2. Engaging in twelfth step work.
3. Leading a meeting.
4. Increasing participation compared to a prior involvement.

• Involvement with AA is associated with better outcomes after professional treatment.
• Project Match compared Twelve – Step Facilitation Therapy (TFT) with CBT and MET.
• TFT group did at least as well and did better on measures of complete abstinence.

FUTURE RESEARCH:

• Mechanisms unclear.
• Suggested:

1. Stress reduction.
2. Cognitive behavioral effect.
3. Affiliation.
4. Group therapy.

• Further research is necessary.

SUMMARY:

• Spirituality and religion have an important role in medicine, especially in the addiction field.
• Spirituality and religion play an important role in the lives and health of patients.
• Clinicians may have biases regarding spiritual issues.
• Current research findings.
• Further research is needed.

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