Spirituality in Substance AbuseDependence Treatment by kmo20868

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									Spirituality in Substance
Abuse/Dependence Treatment

   Marianne T. Guschwan, M.D.




               Copyright Alcohol Medical Scholars Program   1
Overview
 Definitions of spirituality and religion
 Why Spirituality is Important
    – Relationship to Health
    – Beliefs of Patients
    – Beliefs of Medical Professionals
 Spirituality‟s Relationship to the
  Treatment of Substance Use Disorders
 Research in AA and Spirituality

                          Copyright Alcohol Medical Scholars Program   2
Definitions
 “Religio” – humanity‟s bond with a
  greater being
 “Spiritus” – breath or life
 Religious thinking: “An intellectual
  endeavor out of the depths of
  reason….”



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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


                         Copyright Alcohol Medical Scholars Program   4
Why Spirituality Is Important

   Beliefs of our patients

   Beliefs of medical professionals




                         Copyright Alcohol Medical Scholars Program   5
Beliefs of Our Patients
 Over 90% of Americans believe in God
 57% engage in daily prayer
 42% attended church in the last week




                    Copyright Alcohol Medical Scholars Program   6
Beliefs of Our Patients
 80% believed that religious faith can
  aid in recovery from illness
 63% agreed that doctors should talk to
  them about spiritual issues (McNichol,
  1996)




                     Copyright Alcohol Medical Scholars Program   7
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

                      Copyright Alcohol Medical Scholars Program   8
    Religion and 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 drunkeness
   Islam strictly prohibits the use of alcohol and
    drugs


                              Copyright Alcohol Medical Scholars Program   9
Religion and Spirituality in
Substance Abuse/Dependence
Treatment
 “…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



                     Copyright Alcohol Medical Scholars Program   10
First Three Steps
   Admit powerlessness over alcohol

   Belief in a “power greater than
    ourselves”

   Turn will over to the care of God “as
    we understood Him”


                        Copyright Alcohol Medical Scholars Program   11
Steps 4 through 7
 Take a moral inventory
 Admit to God, to ourselves, and to
  another human being the exact nature
  of our wrongs
 Ready to have God remove all these
  defects of character
 Ask Him to remove our shortcomings



                     Copyright Alcohol Medical Scholars Program   12
Steps 8, 9 and 10
   Made a list of all persons harmed and
    became willing to make amends to
    them all

   Made direct amends wherever possible

   Ongoing personal inventory and
    promptly admitted when we were
    wrong

                       Copyright Alcohol Medical Scholars Program   13
Final Two Steps
   Through prayer and meditation
    improve our conscious contact with
    God, „as we understood Him‟

   “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”

                         Copyright Alcohol Medical Scholars Program   14
Research involving Spirituality
 Religious/spiritual involvement predicts
  less use of and fewer problems with
  alcohol, tobacco and illicit drugs
 Mechanisms are poorly understood
    – Principles avoidance
    – Social support for abstinence
    – Involvement in activities that are
      incompatible with use
    – Prosocial values

                           Copyright Alcohol Medical Scholars Program   15
Research Involving AA
   Modest correlation found between
    improved drinking behavior and:
    – having a sponsor
    – engaging in twelfth step work
    – leading a meeting
    – increasing participation compared to a
      prior involvement


                          Copyright Alcohol Medical Scholars Program   16
Research Involving AA
 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

                     Copyright Alcohol Medical Scholars Program   17
Future Research
 Mechanisms unclear
 Suggested:
    – Stress reduction
    – Cognitive behavioral effect
    – Affiliation
    – Group therapy
   Futher research is necessary

                          Copyright Alcohol Medical Scholars Program   18
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

                            Copyright Alcohol Medical Scholars Program   19
Copyright Alcohol Medical Scholars Program   20

								
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