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Spirituality is a construct encompassing a diversity of strongly held beliefs and pursuits related to life's meaning and purpose. Empirical studies in key domains of spirituality related to substance use disorder (SUD) can be valuable in guiding research, and potentially clinical care. To conduct a scoping review of research on the psychological, biological, and cultural dimensions of spirituality and their role in relation to SUD. To identify limitations in empirical findings within these domains and identify promising areas for related research. Illustrative studies available in the empirical literature are reviewed in order to characterize these three key domains. Certain areas of importance stand out: On Psychology, attribution of SUD to a spiritual outlook; spiritual awakening; the relation of spirituality to drug craving; and spirituality in the context of psychedelic-assisted psychotherapy. On Biology, heritability of traits related to shared spiritual experience; neurophysiologic correlates of spiritually related experiences; and correlates in brain imaging; On Culture, spiritual aspects of SUD in different cultural settings; distinctions between spiritual and religious phenomena; roles that international organizations play; and context of acquiring recovery capital. The need for further research in each area is defined. There is utility in examining the diversity of findings in the roles of psychology, biology, and culture in the SUD field. Further research, particularly applying randomization and clinical controls, would be useful in improving the effective application of the construct of spirituality in clinical care. [ABSTRACT FROM AUTHOR]

Background: A Zoom-based website was developed in 2020 that offers continuous access to online Narcotics Anonymous (NA) meetings for the first time. This website provides immediate access for persons with substance use disorder to support abstinence from substance-related addictive disorders. Objectives: This study is designed to characterize attendees employing this online format; to evaluate their experiences for gaining support to maintain abstinence; and to compare the 24/7 experience to face-to-face (FF) meetings they attend. Methods: An anonymous 33-item survey was made available on the 24/7 NA website that links to the 24/7 meetings. Persons accessing the site could choose to fill out the survey. Results: 530 respondents completed the survey (64.9% female/35.1% male). Most had stable prior involvement in NA. They had attended more 24/7 meetings (14.9, SD 19.7) than FF meetings (4.6, SD 7.8) in the previous month. 86% had previously attended FF meetings, 48% had served as sponsors, and 92% reported that the 24/7 meetings were more comfortable for them than the FF meetings (p <.001, Cohen's d = 0.65) and more supportive of abstinence (p <.001, Cohen's d = 0.91). Of the respondents, 8% were still using drugs, of whom 52% had previously completed some of the Twelve Steps. Conclusions: The 24/7 format provides a new and easily accessible way for NA members to gain support for abstinence and is positively rated by attendees seeking support for recovery from substance use disorders. It may serve as a valuable adjunct to the traditional FF format. [ABSTRACT FROM AUTHOR]

Clinically, the treatment of substance abuse has relied on the Twelve Steps model, which is heavily focused on issues of spirituality. Adolescents may have cognitive and developmental issues that preclude them from taking advantage of the Alcoholics Anonymous (AA) model. To this end, we examined the spiritual orientation and spiritual behaviors among adolescent substance abusers in a drug-free residential therapeutic community (TC). One hundred and eighty-six adolescent clients of a drug-free residential therapeutic community were given a self-report questionnaire about their substance abuse and attitudes toward spirituality. The adolescents had a mean Spiritual Orientation Score of 21.48, reflecting a significantly lower level of spiritual orientation than adults in a similar setting. Also, adolescents who were heavy marijuana users were less spiritual than those adolescents who used marijuana less. Spirituality and affiliation with religious institutions may be considered a protective factor because they represent more conventional beliefs and attitudes and indicate a stronger social bond to conventional society. (Contains 1 table.)

The purpose of the present study was to assess the relationship of history of gang involvement to engagement in Therapeutic Community (TC) treatment. Residents (N = 222) at two Daytop facilities completed a survey assessing sociodemographic characteristics, prior gang involvement and multiple aspects of TC functioning. Residents with prior gang involvement (21%) were younger and less educated than those without prior gang involvement. Although gang involved residents were more likely to achieve a high work role status in the program they scored lower on multiple indicators of engagement in treatment including acceptance of Daytop philosophy and TC clinical progress. (Contains 1 table.)

Objective: Childhood and adolescence represent a critical period for the potential initiation of substance use, and thus it is important that child and adolescent psychiatry (CAP) residents learn to screen, assess, refer, and/or treat children and adolescents who have substance abuse diagnoses. Method: The authors conducted a survey by mail of directors from all accredited U.S. CAP residency programs in order to describe addiction training in their respective programs. Results: Seventy percent of program directors responded and indicated diverse addiction training experiences for their residents. Findings indicate that the majority of CAP residents are treating patients with substance use disorders in both years of training and in multiple treatment settings. Conclusion: The survey provides preliminary data for system-level constraints that merit additional consideration in order to potentially advance addiction training in CAP residencies.

Background: The Twelve Steps described by Narcotics Anonymous (NA) and Alcoholics Anonymous denote key aspects of how members can achieve abstinence from alcohol and other drugs. However, there are limited empirical findings on what long-term members rely on to support their ongoing recovery. Method: In order to clarify the members' reliance on those latter resources, we surveyed 2,293 long-term NA members through the internet on items they rely on for their recovery. They scored nine NA-related resources (e.g., their sponsor) and three non-NA institutional ones (e.g., a professional therapist). Results: Three factors accounted for 53.6% of the variance in the respondents' scores of the 12 items. We labeled them, with the percent of variance accorded, as NA-based social (24.9%) support, spiritual (17.8%) support, and outside professional (10.9%) help. While NA-based resources ranked highest, outside resources (a house of worship, a therapist, or medications for psychological distress) were scored by 75.4% of the respondents. Analysis by subgroups of respondents reflected the diversity of resources members draw on. The use of internet-based meetings during the COVID-19 period reflected the resilience of the NA format. Conclusion: Members of Twelve Step programs can be studied to shed light on options that they rely on for support for their ongoing recovery, both within the fellowships and outside them. Long-term members can apparently rely on resources inside the fellowship and simultaneously on professional ones, as well. These findings can be helpful for researchers in considering mechanisms that underlie long-term Twelve Step-related recovery and for clinicians in employing both these fellowships and outside resources as adjuncts to their professional care. [ABSTRACT FROM AUTHOR]

Background and Objectives: Methamphetamine use disorder (MUD) is a major public health problem, but there are no evidence‐based, best‐practice, pharmacologic, or behavioral treatments for it. Narcotics Anonymous (NA) may provide an option for referral for such patients. Methods: Two waves of surveys were sent to a sample of NA members to evaluate demographic, drug use, and NA‐related issues. Of 4445 responses received from US residents, 647 listed themselves as abstinent from their worst drug problem, methamphetamine. Twelve possible sources of support were scored by these latter respondents for how important each was for their own recovery. Results: Methamphetamine respondents were longstanding NA members, with their first NA meeting 30.2 years ago, 84.3% having served as sponsors for other members, and with little current craving (0.65 out of 10). Although now abstinent for an average of 13.4 years, at some point over the course of the membership, 47.4% had experienced a relapse, for an average of 16.7 months. In a factor analysis of resources scored, 29.6% of the variance fell under NA social and 29.2% spiritual; and 11.8% under outside professional support. Discussion and Conclusions: NA served as a resource for supporting abstinence for some members with MUD. They scored social resources of NA support higher than both spiritual and outside institutional ones. Scientific Significance: NA can serve as a community‐based resource for MUD. Determining the nature of recovery that members with MUD have in NA can be useful for further research of socially grounded support for recovery in substance use disorders. [ABSTRACT FROM AUTHOR]

This paper reviews a body of findings in order to define the nature of spirituality from a biopsychosocial perspective and to illustrate its relevance to the field of psychiatry. The emergence of spirituality within the common culture is described, after which a number of sociobiologically related studies are presented to illustrate how its component dimensions can be defined. These are evolutionary adaptation, affectional ties, subjective experiences, and positive psychology. The relevance of spiritually related issues in psychiatric diagnosis are illustrated, along with examples of their role in symptom relief. The paper concludes with a description of a program implemented to integrate the issue of spirituality into resident training and into group support for hospital-based patients.

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