Spirituality in Chemical Dependency Treatment Research Paper

Introduction

Chemical addiction or abuse is a growing menace to individuals by themselves and society at large worldwide. Figures from the United Nations shows that 5% of the world population has indulged in chemical abuse at least once in their lifetime” (Doweiko 2009, p.3). Moving closer to home, the United States of America (U.S.A.) is responsible for 60% of the consumption of illicit drugs, though making up only 5% of the world’s population, which leads to the possibility of 35% of the men and 18% of the women in the U.S.A. likely to suffer from some kind of chemical addiction or abuse disorder during some period of their lives. This demonstrates the scope of the chemical addiction problem in the U.S.A (Doweiko 2009, p.3).

Mechanisms of the Problem

The scope of the problem of chemical addiction is compounded by the minimal current understanding of the disease of addiction that raises the probability of misunderstanding of the disease of chemical addiction. Available evidence and general opinion among psychiatry healthcare professionals point to the disease having a strong bearing on the weaknesses in the will and moral character of the individual, as chemical addiction develops from a malfunctioning cascade of neurotransmitters that is worsened through chemical abuse (Marley, 2001).

The limited understanding of the disease of chemical addiction has led to different models of chemical addiction, and hence different frameworks for the treatment of the disease. Irrespective of these differences, more successful outcomes, are seen in the treatment of chemical addiction, when the focus of the treatment is on the whole person of the individual, using elements of behavioral, pharmacological, and social treatment that correspond to the specific needs of the concerned individual (Gidden-Tracy 2005, p.78).

Religiosity and Spirituality

According to Moritz et al 2006, p.26, findings from epidemiological studies show that religion and spirituality have a positive impact on the mental health of individuals. Moritz et al, 2006 conducted their study to evaluate how effective a home-based spirituality program was as an intervention strategy on mood disturbance in patients who were emotionally distressed. Participants in the study were randomly assigned to a spirituality group, a mindfulness meditation-based stress reduction group, and a wait-list control group, wherein there was no intervention during the study. Subsequent to the twelve weeks of the study period, significant positive effects were observed in the spirituality group.

However, actual research into the effects of religion and spirituality has been hampered by the complexity involved and the overlapping of definitions (Moritz et al, 2006, p.26). Nevertheless, there is increasing use of religion and spiritual therapy in the treatment of chemical addiction. This increased use of religion and spirituality in the treatment of chemical addiction brings with it the responsibility of conducting adequate studies into it so that religion and spirituality therapy is rightly used based on evidence (Hook, et al, 2010).

In the clinical environment, there is a need for a distinction between religion and spirituality. This is because spirituality is more concerned with the personal search for the understanding of what it is to be a human being and the possibility of connection to some supreme force, whereas religion is related to the beliefs that are demonstrated through the rituals of a religious institution. In some individuals, spirituality and religion may remain intertwined, but in many other individuals, spirituality and religion remain as distinct elements (Burke, 2006).

Given this distinction between religion and spirituality, this study lays its focus on spirituality in the treatment of chemical addiction. The enormity of the scope of chemical addiction, the limited understanding of the disease of chemical addiction, combined with the limited evidence available to guide non-pharmacological treatment methods, makes it important for further studies to establish evidence for the right use of individualized supportive treatment measures in chemical addiction.

This becomes even more relevant when the current trend in the treatment of substance abuse is to establish the outcome approaches from the different clinical approaches and modalities in the treatment of substance abuse, so as to arrive at the appropriate treatment modalities and approaches in the treatment of substance abuse (Walker, Cole & Logan, 2008, p. 1786). Thus the main goal of my research is to investigate the effectiveness of incorporating spiritual counseling into a substance abuse treatment program (Justine, 2010).

Though spirituality has been accepted by both clinicians and patients as a useful treatment adjuvant for chemical addiction, its use is still restricted, owing to the stand taken by many professionals that it is not a significant supportive treatment and is not suitable for application to all chemical addiction patients (Priester et al, 2009, p.316)

The problem of alcohol abuse is widespread, and individuals requiring support for their problem of alcohol abuse need accessible and affordable support. Alcoholics Anonymous (AA) provides such accessible and affordable support. More than 2,000,000 individuals from around the world use the support provided by the AA for the treatment of alcohol abuse Support for the use of spirituality as an adjuvant treatment modality in chemical addiction comes from AA and their experiences with it. AA follows the 12-step program in the treatment of chemical addiction (Straussner & Byrne 2009, p.349).

The 12-steps program of AA has a strong focus on the spirituality of the individual. In this aspect, the emphasis is on the self-relationship of the individual and the relationship to the Supreme power. Thus, within the 12 steps program, the supreme power remains the central theme, there are also strong elements through which transformation of the individual is targeted from self-absorption to self-reflection and accountability (Neff 2008, p.296).

The AA 12- steps program has demonstrated its ability to positively affect the outcomes of alcohol and drug treatments (Polcin et al, 2010, p.356-357). Sober living houses (SLH) constitute living environments that are free from alcohol and drug abuse, employing involvement with 12-step groups and social support in the recovery process. Polcin et al, 2010 evaluated SLH from the viewpoint of their capacity to provide the much-needed stable environment for the recovery of patients with chemical addiction. Their study showed that the environment of SLH and the 12-step program helped the residents to improve in various aspects towards recovery from their chemical addiction (Polcin et al, 2010).

A large number of women are incarcerated in prisons in the U.S.A., many of whom have chemical addiction problems (Zlotnick, Johnson & Najavits, 2009, p.325).. Zlotnick, Johnson, and Najavits, 2009 compared the outcomes of the treatment modalities of treatment-as-usual and cognitive-behavioral support to treatment-as-usual in incarcerated women and found no significant difference in the outcomes.

Addiction problems are sometimes the cause of the acts that lead to their incarceration. Interventions that are efficient in helping these women to overcome their addiction problems are needed, as they will go a long way in assisting these women to integrate better into the community and live as drug-free, law-abiding citizens. This makes the search for such interventions important to society.

Evidence from Studies

This study was conducted at the Greenhope Services for Women in New York City, with the target group of women on parole and women from the community. OASAS Client Data Management was used to capture information including clients demographics, retention, completion, vocational, chemical dependency, mental health, family, incarceration, and criminal justice status, and the outcome measures consisted of the addiction severity index, religious practices and belief, and Texas Christian University motivation scales, and drug abstinence efficiency scale, and the University of Rhode Island Change assessment scale. The interventions consisted of three groups, consisting of a history of the religious group, spirituality group, and treatment as usual group.

Given the hope that spirituality holds out as an efficient intervention in chemical addiction, a rigorous examination of the spirituality group intervention is warranted. This study will attempt a report on the longitudinal outcomes for 92 resident clients at baseline, 6 months, and 12 months. Should the study show that there was no significant improvement observed over time, or there was an increase in the drug abuse problem it would suggest that more studies on the use of spirituality in the treatment of chemical addiction are not required.

On the other hand, should the study show that there was a significant improvement with the use of spirituality as an intervention in chemical addiction, then it would point to the need for additional studies to fully evaluate the beneficial effects of the spirituality group in the treatment of chemical abuse.

The primary focus of this study will be to evaluate outcomes using the complete sample base over the differentiated time period and the intervention groups, and assess how the variety of covariates influenced the outcomes. The primary outcomes that will be included are the severity of the drug problem, self-efficacy, and treatment motivation, while the secondary outcomes will comprise religious beliefs and values.

The hypothesis of this study is that clients who attend the spirituality group will demonstrate better improvement than those who did not attend the spirituality group and that the improvements demonstrated would be maintained over the 6 months and 12 months periods. The study also expects to find that the three test groups will not differ on the addiction severity index, the motivational treatment scales, and the drug abstinence self-efficacy scale. However, the study expects to find a difference in religious beliefs and values between the participants who were exposed to spirituality or history of religion, and the participants who were in the treatment as usual group and did not have any exposure to spirituality or history of religion.

References

Burke, P. A. (2006). ‘Enhancing Hope and Resilience Through a Spiritually Sensitive Focus in the Treatment of Trauma and Addiction’. In Bruce Carruth (Ed.), Psychological Trauma and Addiction Treatment. New York: The Haworth Press Inc., pp. 187-206.

Doweiko, H. E. (2009). Concepts of Chemical Dependency. Belmont, CA: Brookes/Cole Cengage Learning.

Gidden-Tracy, C. E. (2005). Counseling and Therapy with Clients who Abuse Alcohol or Other Drugs: Integrated Approach. Mahwah, New Jersey: Lawrence Erlbaum Associates, Inc.

Hook, N. J., Worthington, E. L., Davis, D. E., Jennings II, D. J. & Gartner, A. L. (2010). Empirically Supported Religious and Spiritual Therapies. Journal of Clinical Psychology, 66(1), 46-72.

Justine, N. (2010). The Efficiency of Spirituality Group in Chemical Dependency Treatment Program. Temple University.

Marley, D. (2001). ‘Chemical Addiction, Drug Use, and Treatment’. Web.

Moritz, S., Quan, H., Rickhi, B., Liu, M., Angen, M., Vintila, R., Sawa, R., Soriana, & Toews, J. ‘A Home-Study Based Spirituality Education Program Decreases Emotional Distress and Increases Quality of Life – A Randomized, Controlled Study’. Alternative Therapies, 12 (6), 26-35.

Neff, J. A. (2008). ‘A Multidimensional Measure of Spirituality-Religiosity in Diverse Substance Abuse Populations’. Journal for the Scientific Study of Religion, 47(3), 393-409.

Polcin, D. L., Korcha, R. A., Bond, J & Galloway, G. (2010). ‘Sober Living Houses for Alcohol and Drug Dependence: 18 Month Outcomes’. Journal of Substance Abuse Treatment. 38, 356-365.

Priester, P. E., Scherer, J., Steinfeldt, J. A., Jana-Masri, A., Jashinsky, T., Lones, J. E. & Vang, G. (2009). ‘The Frequency of Prayer, Meditation and Holistic Intervention in Addictions Treatment: A National Survey’. Pastoral Psychology, 58, 315-322.

Straussner, S. L. A. & Byrne, H. (2009). ‘Alcoholics Anonymous: Key Research Findings from 2002 – 2007’. Alcoholism Treatment Quarterly, 27, 349-367.

Walker, R., Cole, J. & Logan, T. K. (2008). ‘Identifying Client-Level Indicators of Recovery Among DUI, Criminal Justice, and Non-Criminal Justice Referral’. Substance Use & Misuse, 43, 1785-1801.

Zlotnick, C. Johnson, J & Najavits, L. M. (2009). ‘Randomised Controlled Pilot Study of Cognitive-Behavioral Therapy in a Sample of Incarcerated Women with Substance Use Disorder and PTSD’. Behavior Therapy, 40, 325-366.