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IntroductionSexual minority (e.g., bisexual, gay, lesbian, queer) and gender minority (e.g., transgender, non-binary, gender expansive) individuals (SGMI) experience higher rates of alcohol and other substance use disorders than their heterosexual and cisgender (i.e., non-transgender) counterparts. 12-Step programs are currently the most common source of support for alcohol and other substance use-related problems in the United States. Little is known about rates and levels of participation and outcomes of SGMI in 12-Step programs. Examining SGMI with a lifetime alcohol or other substance use disorder, this study aims to: 1) describe lifetime attendance rates (any vs. none) and levels of participation (number of program activities) in 12-Step groups among SGMI overall and compare rates of attendance and levels of participation across sexual and gender minority identities and 2) determine how lifetime level of participation in 12-Step programs relates to past-year alcohol and other substance use outcomes.MethodsWe used data collected through The PRIDE Study, a national, large-scale, longitudinal health study of adult SGMI, administering supplemental questions to assess alcohol and other substance use disorders and 12-step participation. Zero-Inflated Negative Binomial models (N = 1353) run with sexual and gender identities as predictors of lifetime 12-step attendance (yes/no) and level of 12-Step participation determine if greater levels of 12-Step participation were associated with lower levels of past-year Alcohol and Substance Use Disorder (AUD & SUD) symptoms. The study ran models for those with lifetime AUD (n = 1074) and SUD (n = 659) separately.ResultsParticipants who engaged in greater levels of 12-Step participation had lower levels of past-year AUD and SUD symptoms. Gay and queer respondents with AUD were more likely and lesbian respondents with SUD were less likely than other participants to have ever participated in 12-Step programs. All other associations between sexual/gender identities and 12-Step participation disappeared when age was added to the model.ConclusionsThis study provides preliminary evidence that 12-Step participation may be an effective resource for reducing AUD and SUD symptoms among SGMI. Younger SGMI and SGMI holding sexual/gender identities other than gay and queer may require additional support to initiate participation in 12-Step programs.

This qualitative analysis looks at older women in recovery as members of Alcoholics Anonymous (AA). Eleven women's stories, taken together, encompass a white, middle-class, suburban American experience with adverse childhood events, alcohol use disorder (AUD), and membership in a women's group of AA. Analysis focuses on the uniqueness of gender and generation (age) recognizing that this sample of women came of age at the cusp of the second wave of the feminist movement, and while considered privileged by contemporary standards, their personal narratives reflect gender-based trauma and an appreciation for a gendered approach toward recovery. Individual stories recount childhood experiences that further deepen the analysis and bring forth more intimate issues of psychological trauma and victimization in addition to their alcohol use disorder (AUD). In response, the final focus on their recovery stories includes insightful references to personal healing as contextualized by working the 12-steps of AA and by developing meaningful relationships with other women in recovery. [ABSTRACT FROM AUTHOR]

This Consensual Qualitative Research study investigated how Christian Alcoholics Anonymous (A.A.) members in the Southeastern United States with sustained sobriety conceptualize spirituality, and their beliefs about how spirituality aided their recovery. Emergent themes of pre-recovery periods were futile attempts to nurture a connection with the sacred, lack of connectedness, and spiritual struggles leading to sanctifying substances. Emergent themes during sobriety were spiritual experiences and shifts away from traditional religious organizations. Results highlight the importance of addressing spiritual struggles and facilitating the exploration of meaningful conservation practices in addiction treatment. [ABSTRACT FROM AUTHOR]

Background: Substance use disorders represent a significant public health issue, with prevalence rates steadily increasing. Mutual help support groups like Alcoholics Anonymous (AA) have long played a crucial role in supporting individuals seeking recovery. However, AA has long been criticized for its religious/spiritual orientation, which may pose challenges for the growing number of nonreligious individuals. This study examines the experiences of nonreligious individuals in AA. Methods: Data were collected through semi-structured interviews with 51 nonreligious AA members. Results: There were five substantial barriers the nonreligius faced in AA: (1) The belief that being nonreligious was a liability and that AA was religious; (2) The religious undertone and "God talk" in meetings; (3) Prayers in meetings; (4) The Big Book; and (5) Discrimination. Conclusion: The nonreligious experience substantial barriers in AA; thus, there is a need for greater inclusivity and understanding within AA to better support nonreligious individuals seeking recovery. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to identify and elucidate the differences between highly affiliated and low/non-affiliated participants in Alcoholics Anonymous (AA) meetings. Methods: A qualitative study of 24 participants was conducted in Romania between March and June 2021. Data were collected by means of in-depth interviews. Thematic analysis was used to obtain a comprehensive synthesis of the data collected. Findings: Highly affiliated individuals are those who identify themselves as AA members, are sober, have worked the 12 Steps, are satisfied with their lives, experience a state of well-being, accept the Higher Power, have hit the bottom, have a strong desire for abstinence, attend AA meetings on a regular basis, and are committed to both AA and their sobriety. Conclusion: Although there are common themes among both highly and low/non-affiliated individuals, the results suggest that addiction specialists should pay more attention to organisational commitment, spirituality, well-being and addiction-related concepts as it seems some of them may determine successful AA affiliation, while others may reflect on recovery outcomes. These findings could prove useful to motivate individuals who struggle with alcohol addiction and are reluctant in joining AA, since high AA affiliation is associated with a wide range of recovery benefits. [ABSTRACT FROM AUTHOR]

Background: This study considers how the COVID-19 pandemic impacted individuals recovering from a substance use disorder (SUD). Method: Fifty individuals recovering from SUD in Vermont, a rural New England state (U.S.), were recruited for an interview from 12-step recovery meetings (Alcoholics Anonymous, Narcotics Anonymous) as well as via word-of-mouth. Interviews were transcribed and coded, and qualitative analyses were performed. Results: Many of the participants who were in recovery prior to the pandemic starting remained substance-free and in recovery throughout the pandemic period. Some individuals used substances during the pandemic period, although not typically in the context of a relapse caused by negative emotions (eg, distress over a loved one contracting COVID-19). The majority of those individuals indicated that the risk of catching COVID-19 did not alter their substance use. Conclusions: Many individuals already in SUD recovery before COVID-19 remained in recovery despite the challenges of pandemic era. The role of peer support in recovering individuals managing negative emotions caused by COVID-19 is considered. [ABSTRACT FROM AUTHOR]

While alcohol addiction is a significant social problem in Romania, there has been no research into mutual-help groups, such as Alcoholics Anonymous (AA) in the context of the COVID-19 pandemic. The purpose of this study was to investigate the influence of affiliation to AA, perceived stress, and length of sobriety on the recurrence of alcohol craving and obsession, and relapse during the COVID-19 pandemic, as well as to determine whether there are any differences between the level of AA affiliation and AA attendance before and after the pandemic began. A convenience sample of individuals suffering from alcohol addiction from Romania who attend AA meetings (n = 107, 69 men and 38 women) completed an online questionnaire in October 2020 to analyze the intricate relationship between affiliation to AA, perceived stress, and length of sobriety, and recurrence of alcohol craving and obsession and relapse, as well as to compare between the level of affiliation to AA and AA attendance before and after the COVID-19 pandemic began. Multiple logistic regression analysis was performed to investigate whether affiliation to AA, perceived stress, and length of sobriety had influenced the recurrence of craving and alcohol obsession and relapse during the COVID-19 pandemic. A paired samples t-test was performed to evaluate whether there were any differences between the level of AA affiliation and AA attendance before and after the COVID-19 pandemic began. Results indicated that affiliation to AA 12 months before the COVID-19 pandemic started (AAA), perceived stress in the last 9 months since the COVID-19 pandemic started (PSS) and length of sobriety are predictors of both relapse (together the three predictors accounted for 89.7% of the variance in relapse) and recurrence of alcohol craving and obsession during the COVID-19 pandemic (together the three predictors accounted for 81.3% of the variance in recurrence of alcohol craving and obsession). Surprisingly, the length of sobriety was found to be a significant predictor over and above AAA in the past 12 months before the COVID-19 pandemic started in both regression models. In addition, the level of AA affiliation and AA attendance after the COVID-19 pandemic started decreased compared to the level of AA affiliation and AA attendance before the COVID-19 pandemic began, with a very small effect size, respectively with a small effect size. The findings suggest that those working in the area of substance abuse should pay more attention to the influence of affiliation to AA and perceived stress in attaining and maintaining sobriety, as well as to the length of sobriety in maintaining abstinence, as these appear to play an important role in avoiding both recurrence of craving and alcohol obsession, and relapse during times of distress. [ABSTRACT FROM AUTHOR]

Alcoholics Anonymous (AA) is a mutual aid program where social processes help individuals maintain recovery. This study aimed to gain insight into attachment characteristics that support the social processes in AA. AA member participants (N = 113), from a publicly available data set, were examined to identify predictors of increased recovery capital (RC), utilizing the independent variables of attachment anxiety, attachment avoidance, and self-esteem. Results from a multiple linear regression revealed a positive, strong, significant relationship between RC and self-esteem; a negative, moderate, significant relationship between RC and attachment avoidance; and no significant relationship between RC and attachment anxiety. [ABSTRACT FROM AUTHOR]

Yalom's therapeutic factors (TFs) have been a focal point in therapeutic literature for over three decades. However, their specific application in group therapy for substance use disorders (SUD) remains underexplored. This review paper is divided into two primary sections. The first section offers a comprehensive review of the literature on TFs in general group therapy, highlighting empirical findings. The second section delves into the application of TFs in group therapy for SUD, with particular emphasis on 12-step programs and motivational interviewing groups. The paper concludes by discussing the implications for future development and enhancement of group therapy practices through the perspective of TFs. [ABSTRACT FROM AUTHOR]

Spiritual struggles are common for religion-affiliated and non-affiliated individuals, religious skeptics, agnostics, and atheists. They gain particular importance for people under significant stress, such as those who are alcohol dependent. This study examined the role of positive religious coping and God's support in the spiritual growth and recovery of alcohol-dependent individuals participating in Alcoholics Anonymous (AA). The study was cross-sectional. The participants were 115 alcohol-dependent individuals from Poland who were members of AA. A path analysis statistical method was used. The research emphasized the beneficial role of strong God's support in the relationship between positive religious coping and spiritual growth, abstinence, and happiness. The mechanism underlying the relationship between positive religious coping, God's support, spiritual growth, and recovery was confirmed. God's support was a moderator in the relationship between positive religious coping and spiritual growth. In a group with stronger God's support, positive religious coping was positively related to spiritual growth, which in turn was associated with a happy and alcohol-abstinent life for alcohol-dependent individuals participating in AA. Among individuals with weak God's support, positive religious coping was not directly related to spiritual growth, nor was it indirectly related to recovery through spiritual growth. Theoretical and practical implications of the results are discussed. [ABSTRACT FROM AUTHOR]

Alcoholics Anonymous (AA) is an established resource for people suffering from alcohol use disorder (AUD). However, Bill Wilson, the co‐founder of AA, in his second letter to Jung referred to its low success rate. One evidence‐based alternative, dating back to the 1950s, is the clinical use of lysergic acid diethylamide (LSD) for treating AUD. Bill Wilson was a strong advocate of using LSD as a preparation for alcoholics who had difficulty grasping the spiritual aspect of the 12‐step programme. Bill Wilson wrote a "secret" four‐page letter to Carl Jung detailing his own use of LSD and the success two psychiatrists in Canada had in treating alcoholics and asked for his advice on using LSD to help alcoholics. Aniela Jaffé, a Jungian analyst and co‐worker of Jung, replied to Wilson on May 29, 1961, "... as soon as Dr. Jung feels better and has enough strength to begin again his mail, I will show it to him." Jung died a week later. This article quotes Jung's previous hostile opinions on psychedelics and asks: Just as Jung overcame his negative views on groups when giving "complete instructions" on extending the 12‐step programme of AA to "general neurotics", might he similarly have changed his mind when he saw the documented success of using LSD with recalcitrant alcoholics? [ABSTRACT FROM AUTHOR]

Background: Individuals with a substance use disorder complete ecological momentary assessments (EMA) at lower rates than community samples. Previous research in tobacco users indicates that early log‐in counts to smoking cessation websites predicted subsequent smoking cessation website usage. We extended this line of research to examine individuals who are seeking to change their drinking behaviors through mutual support groups. We examined whether adherence in the first 7 days (1487 observations) of an intensive longitudinal study design could predict subsequent EMA protocol adherence (50% and 80% adherence separately) at 30 (5700 observations) and 60 days (10,750 observations). Methods: Participants (n = 132) attending mutual‐help groups for alcohol use completed two assessments per day for 6 months. We trained four classification models (logistic regression, recursive partitioning, support vector machines, and neural networks) using a training dataset (80% of the data) with each of the first 7 days' cumulative EMA assessment completion. We then tested these models to predict the remaining 20% of the data and evaluated model classification accuracy. We also used univariate receiver operating characteristic curves to examine the minimal combination of days and completion percentage to best predict subsequent adherence. Results: Different modeling techniques can be used with early assessment completion as predictors to accurately classify individuals that will meet minimal and optimal adherence rates later in the study. Models ranged in their performance from poor to outstanding classification, with no single model clearly outperforming other models. Conclusions: Traditional and machine learning approaches can be used concurrently to examine several methods of predicting EMA adherence based on early assessment completion. Future studies could investigate the use of several algorithms in real time to help improve participant adherence rates by monitoring early adherence and using early assessment completion as features in predictive modeling. [ABSTRACT FROM AUTHOR]

Background: Alcohol is the most commonly consumed psycho-active substance in India. People who use substances and are in recovery often face societal discrimination and rejection, such as difficulty in obtaining employment, poor support for treatment, and inter-personal rejection. Aim: To find out the factors affecting the integration of people recovering from alcohol dependence syndrome with their families. Materials and Methods: A cross-sectional observational study was conducted using a purposive sampling technique among 50 pairs of alcohol-dependent people and their family members. Data were collected using self-administered Family Adaptability and Cohesion Evaluation Scale (FACES IV package), Substance Abuse Self-Stigma Scale, Affiliate Stigma scale, and A Social Support Inventory for Successful Transition. Appropriate statistical tests were used to identify correlations. Results: A negative correlation (r = -0.313, P < 0.05) was found between affiliate stigma and integration, and a positive correlation (P < 0.05) was found between social support and integration. Alcohol-dependent people from Alcoholics Anonymous reported higher levels of perceived social support than those from a tertiary hospital (mean = 47.68 vs. 39.84, P < 0.05). Conclusion: Affiliate stigma negatively impacts people with alcohol dependence and contributes to increased opportunities for interventions to address stigma. Social support has a positive impact on family integration of alcohol-dependent people with Alcoholics Anonymous participants reporting higher levels of social support compared to tertiary hospital participants. Therefore, the findings of this study highlight the need to involve families more intensively to reduce affiliate stigma. [ABSTRACT FROM AUTHOR]

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: Alcohol use disorder (AUD) is a highly impairing condition with important public health impacts. Despite the availability of treatment options for AUD, research shows that few people receive treatment, and even fewer can maintain abstinence/low‐drinking levels. This study investigated the role of personality traits in past‐year alcohol use among individuals with severe AUD who ever attended Alcoholics Anonymous (AA), a widespread and easily accessible self‐help group for alcohol problems. Methods: Univariable and multivariable regressions were performed separately in females and males with alcohol consumption as an outcome. Socioeconomic factors, genetic liability, and psychopathology were included as covariates in the analyses. Results: Results from the multivariable model indicated that in females who attended AA, greater alcohol use was related to both positive and negative urgency and low sensation seeking, while in males, greater alcohol use was related to positive urgency. Results also showed that, in both sexes, younger age and lower educational levels were associated with greater alcohol use. Moreover, single males and individuals with lower AUD severity were at higher risk of using alcohol in the past year. Conclusions: These findings highlight sex‐specific correlates of drinking in individuals with AUD who engaged in self‐help groups. These findings may help to improve treatment options, as personality encompasses modifiable traits that can be targeted in psychological interventions. [ABSTRACT FROM AUTHOR]

Aim: This exploratory study analyses the interplay between the treatment philosophies of Alcoholics Anonymous (AA) and Relapse Prevention (RP) in personal stories of addiction. While the basic ideas of AA and RP are compatible in many ways, they also carry some fundamental differences. Methods: The data consisted of interviews with 12 individuals recovering from substance use problems, who had experience of both AA and RP. The analysis drew on a dialogical narrative perspective, and the concept polyphony was used to shed light on the interplay between different treatment philosophies in personal stories of relapse. Findings: Although sometimes resulting in incoherence, the treatment philosophies were combined idiosyncratically, in ways that appeared productive for the participants' self-images and recovery journeys. Conclusion: The combination of AA and RP philosophies in narratives of relapse and recovery may reflect a new treatment discourse where individualisation and responsibilisation stand in a complicated relationship with collectivism and surrendering to so-called addicting processes. [ABSTRACT FROM AUTHOR]

Background: Alcohol is the most commonly consumed psycho-active substance in India. People who use substances and are in recovery often face societal discrimination and rejection, such as difficulty in obtaining employment, poor support for treatment, and inter-personal rejection. Aim: To find out the factors affecting the integration of people recovering from alcohol dependence syndrome with their families. Materials and Methods: A cross-sectional observational study was conducted using a purposive sampling technique among 50 pairs of alcohol-dependent people and their family members. Data were collected using self-administered Family Adaptability and Cohesion Evaluation Scale (FACES IV package), Substance Abuse Self-Stigma Scale, Affiliate Stigma scale, and A Social Support Inventory for Successful Transition. Appropriate statistical tests were used to identify correlations. Results: A negative correlation (r = -0.313, P < 0.05) was found between affiliate stigma and integration, and a positive correlation (P < 0.05) was found between social support and integration. Alcohol-dependent people from Alcoholics Anonymous reported higher levels of perceived social support than those from a tertiary hospital (mean = 47.68 vs. 39.84, P < 0.05). Conclusion: Affiliate stigma negatively impacts people with alcohol dependence and contributes to increased opportunities for interventions to address stigma. Social support has a positive impact on family integration of alcohol-dependent people with Alcoholics Anonymous participants reporting higher levels of social support compared to tertiary hospital participants. Therefore, the findings of this study highlight the need to involve families more intensively to reduce affiliate stigma.

Addressing substance use disorder (SUD) requires intricate solutions, usually involving several organizations within a complex institutional environment. Alcoholics Anonymous (AA) shares the recovery ecosystem with other organizations, is ubiquitous across communities, and is notably inexpensive as an intervention; yet the exact nature of the connections between AA and other organizations in the recovery ecosystem is underexplored. Explore relationships AA has with other recovery ecosystem organizations and guide future research. Data were gathered via ethnographic participant observations, which were triangulated and contextualized via semi-structured interviews with key informants and archival documents. Though AA does not formally link itself with other organizations, findings point toward strong relationships at the individual level and of an informal nature. Individual members who also have affiliation with other organizations (e.g., legal institutions, treatment services) create bridges, enabling efficient solving of complex issues. Services wishing to leverage AA (or other mutual-aid) attendance will likely benefit from fostering informal relationships with individual AA members, including lowering barriers to disclosure of recovery status, and contacting local AA service elements capable of making these connections. Similarly, research to advance community-level SUD services and the knowledge-base would benefit from incorporating and partnering with people in recovery. [ABSTRACT FROM AUTHOR]

Background: Mutual‐help organizations (MHOs) are effective community‐based, recovery support options for individuals with alcohol and other drug use disorders (i.e., substance use disorder; SUD). Greater understanding of second‐wave MHOs, such as SMART Recovery, can help build on existing research that has focused primarily on 12‐step MHOs, such as Alcoholics Anonymous, to inform scientific, practice, and policy recommendations. Methods: We conducted a secondary analysis of the National Recovery Study, a representative sample of US adults who resolved a substance use problem (N = 1984). Using survey‐weighted estimates, we examined descriptive statistics for any lifetime, weekly lifetime, and past 90‐day MHO attendance; we compared rates of 12‐step and second‐wave MHO attendance over time by descriptively examining distributions for calendar year of the first meeting attended. We also used two logistic regression models to examine demographic, substance use, clinical, and recovery‐related correlates of weekly lifetime attendance separately for 12‐step (n = 692) and second‐wave MHOs (n = 32). Results: For any attendance, 41.4% attended a 12‐step MHO and 2.9% a second‐wave MHO; for weekly attendance, 31.9% attended a 12‐step MHO, and 1.7% a second‐wave MHO. Two‐thirds (64%) of initial second‐wave attendance occurred between 2006 and 2017 compared to 22% of initial 12‐step attendance during this time frame. Significant correlates of weekly 12‐step MHO attendance included histories of SUD treatment and arrest. Significant correlates of weekly second‐wave MHO attendance included Black identity (vs. White) and history of SUD medication. Conclusions: Attendance at second‐wave MHOs is far less common than 12‐step MHOs, but appears to be on the rise. Observed correlates of second‐wave MHO attendance should be replicated in larger second‐wave MHO samples before integrating these findings into best practices. Enhanced linkages from clinical and criminal justice settings to both second‐wave and 12‐step groups may help to "broaden the base" of MHOs. [ABSTRACT FROM AUTHOR]

This paper offers a systematic review of quantitative and qualitative studies on the main twelve-step mutual-help (TSMH) groups (excluding Alcoholics Anonymous) and four meta-analyses exploring the correlation between (i) duration or involvement in TSMH groups and; (ii) severity of symptoms or quality of life. Systematic review was conducted following PRISMA guidelines. Searches of databases (MEDLINE, PsychInfo), a register (ClinicalTrials) and citations were conducted, from inception through November 01 2022. Fifty five articles were included (24 quantitative, 27 qualitative, 4 mixed-methods), corresponding to 47 distinctive studies. 68% of these studies were conducted in North America, 17% in Middle East, 11% in the European Union and 4% in Australia. The most studied TSMH group were Gamblers Anonymous (28% of the 47 studies), Narcotics Anonymous (26%), Double Trouble in Recovery (15%), Overeaters Anonymous (19%) and TSMH groups for compulsive sexual behaviors (11%). The four meta-analyses pooled data from 9 studies. Pooled mean age ranged from 36.5 to 40.5. 80–81% of participants were male. TSMH attendance and involvement were negatively correlated with severity of symptoms (high and medium levels of evidence) and positively correlated with quality of life (low levels of evidence). Twenty-one qualitative papers reported factors influencing recovery: Social (n = 15), emotional (n = 9), spiritual (n = 8), self-identification or psychological (n = 6) factors. Review provides characteristics of TSMH groups others than Alcoholics Anonymous, with implications for both research and healthcare practice. The perspective to implement TSMH groups targeting ontological addiction, at the root of all addiction, is discussed. Protocol registration: Prospero registration number: CRD42022342605. [ABSTRACT FROM AUTHOR]

Aims The central aim of this study was to determine whether intentional, voluntary alcoholics anonymous (AA) participation showed any independent association with affect, over and above that which has been observed in association with other recovery-related behaviors, such as abstinence, among individuals with a history of alcohol use disorder. Additionally, we sought to determine the nature of the affective changes associated with specific dimensions of AA participation (i.e. meeting   attendance , fellowship   involvement , 12-step   work). Methods Thirty abstinent alcohol use disorder individuals were recruited and evaluated. Multivariate linear regressions were used to examine associations between dimensions of AA participation, measured using the Multidimensional Mutual-Help Assessment Scale and standardized measures of affective experiences, including the Profile of Mood States, Subjective Happiness Scale, and the Twelve Promises Scale. Results and Conclusions Increase in AA participation was associated with higher positive affective experiences. These associations were observed independently with AA meeting   attendance and fellowship   involvement , but not 12-step work. This study's findings suggest that greater AA meeting   attendance and fellowship   involvement are correlated with enhancements in the meta-emotional experience of personal meaningfulness. This study extends evidence on AA-related changes by considering affective improvements as a primary clinical outcome, thereby laying the foundation for subsequent, more comprehensive research into the relationship between dimensions of AA participation and recovery-related affective changes. [ABSTRACT FROM AUTHOR]

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In the area of addiction, Canada has been in a public health crisis since 2016. Addiction takes a toll on an individual's self-worth and identity. In this narrative literature review, the distinct nature of spirituality was addressed. Next, individualized conceptualizations of spirituality were outlined. Subsequently, the importance of fellowship in addiction recovery was detailed. Next, the significance of being of service was presented. Meaningful and authentic spirituality were discussed in the context of recovery identity. Lastly, spirituality as a personal journey is described. A narrative literature review of 70 manuscripts published between 1999 and 2021 was undertaken to determine multiple approaches to treating addiction recovery in the context of spiritual development. An understanding of spirituality can inform counsellors regarding spiritual development in addiction recovery. Implications for counselling include a roadmap to support clients developing an individualized spiritual connection and operating as a functional system. [ABSTRACT FROM AUTHOR]

The objective of this article is to give an account of the labor reintegration process in subjects in condition of drug addiction during their rehabilitation. Using a qualitative methodology, in-depth interviews were conducted with ten people in addiction in rehabilitation. Those who were interviewed have more than 15 years of sobriety and are part of a self-help group that implements the 12-step program of Alcoholics Anonymous in Guadalajara, Jalisco, Mexico. Among the results, it stands out that labor reintegration is a process that involves several phases, one of them is the period of service where the subject is prepared in the practice of punctuality, responsibility, commitment, and respect, as well as in emotional management for the performance of paid work. The decision of when, where and what activity to carry out falls, in principle, on the sponsor and the employer, since it depends on the subject's progress in their rehabilitation, the management of their emotions and the establishment of non-conflictive interpersonal relationships. To assign work activities, support networks made up of members of the self-help group are used, since the subjects must be monitored to avoid emotional and consumption relapses. [ABSTRACT FROM AUTHOR]

Copyright of Eurasian Journal of Ecology is the property of Al-Farabi Kazakh National University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study examines how Alcoholics Anonymous (AA) can be understood as a "lived religion" that seeks to legitimize and moralize certain experiences and beliefs through narratives that are affirmed by the substance abuse recovery community. Through a qualitative analysis of 20 in-depth interviews with both actively recovering and non-actively recovering participants of AA, we identify three distinct moral narratives described by participants related to the construction of spiritual beliefs, individual health, and social belonging that highlight how the structure of AA reifies stories of addiction recovery as morally charged. We contribute to sociology of religion and addiction studies by examining how social and spiritual systems (i.e. systems embodying our complex and multi-faceted social connections to other people and our beliefs and attitudes about powers greater than oneself) orient alcohol addiction recovery within the context of AA support groups. For sociological inquiry more broadly, we show how moral narratives have the power to shift individual understanding of social support, power and self-control, and belonging. [ABSTRACT FROM AUTHOR]

Recovery narratives are personal stories of health problems and recovery. A systematic review proposed a conceptual framework characterising alcohol misuse recovery narratives, consisting of eight principal dimensions, each with types and subtypes. The current study aims to apply and extend this preliminary conceptual framework. Semi-structured interviews were conducted to collect alcohol misuse recovery narratives from adult participants. A two-stage inductive and deductive thematic analysis approach was used to assess the relevance of the dimensions and types included in the preliminary conceptual framework and identify new components. The sample consisted of 11 participants from diverse socioeconomic backgrounds who had previously displayed varying degrees of alcohol misuse. All conceptual framework dimensions (genre, identity, recovery setting, drinking trajectories, drinking behaviours and traits, stages, spirituality and religion, and recovery experience) were present in the collected narratives. Three dimensions were extended by adding types and subtypes. Whilst the existing conceptual framework fitted the collected narratives, a new dimension describing the alcohol environment was required to fully characterise narratives. Types included in the alcohol environment dimension were policy and practice and social dynamics. The extended framework could guide the production of resources enabling clinicians to engage with narratives shared by their clients. [ABSTRACT FROM AUTHOR]

Background: Mutual‐help organizations (MHOs) play a crucial role for many individuals with alcohol use disorder (AUD) or other substance use disorders in achieving stable remission. While there is now substantial research characterizing who uses 12‐step MHOs, very little is known about who becomes affiliated with newer and rapidly growing MHOs, such as Self‐Management and Recovery Training ("SMART" Recovery). More research could inform knowledge regarding who may be best engaged by these differing pathways. Methods: We conducted a cross‐sectional analysis of participants (N = 361) with AUD recruited mostly from the community who were starting a new recovery attempt and self‐selected into one of four different recovery paths: (1) SMART Recovery ("SMART‐only"; n = 75); (2) Alcoholics Anonymous ("AA‐only"; n = 73); (3) Both SMART and AA ("Both"; n = 53); and (4) Neither SMART nor AA ("Neither"; n = 160). We compared the groups on demographics, clinical history, treatment and recovery support service use, and indices of functioning and well‐being. We computed descriptives and conducted inferential analyses according to the data structure. Results: Compared to study participants choosing AA‐only or Both, SMART‐only participants were more likely to be White, married, have higher income and more education, be full‐time employed, and evince a pattern of lower clinical severity characterized by less lifetime and recent treatment and recovery support services usage, lower alcohol use intensity and fewer consequences, and less legal involvement. AUD symptom levels, lifetime psychiatric diagnoses, psychiatric distress, and functioning were similar across MHO‐engaged groups. Conclusion: SMART Recovery appears to attract individuals with greater psychosocial stability and economic advantage and less severe histories of alcohol‐related impairment and legal involvement. Findings suggest that certain aspects specific to the SMART Recovery group approach, format, and/or contents may appeal to individuals exhibiting this type of profile. As such, SMART appears to provide an additional resource that expands the repertoire of options for individuals with AUD who seek recovery. [ABSTRACT FROM AUTHOR]

Sexual and gender minority individuals (e.g., gay, bisexual, non-binary, transgender; SGMI) are 2-6 times as likely as cisgender heterosexual individuals to experience alcohol or other substance use disorders. SGMI participate in 12-Step groups, such as Alcoholics Anonymous (AA), at high rates. Though social support is an established mechanism through which 12-Step programs support reductions in substance use, little is known about SGMI's experiences of the social support in 12-Step programs. This qualitative study aims to understand the experiences of social and community support among SGMI involved in 12-Step programs. This study employed thematic analysis to interpret open-ended responses from 302 SGMI who had participated in 12-Step programs. Data was from The PRIDE Study, a large, national, online, longitudinal, cohort study of SGMI. Two themes emerged about how SGMI experienced social and community support in 12-Step programs: beneficial connections and harmful environments. Beneficial connections included a sense of community, shared experiences, and skills provision. Harmful environments included marginalization, oppression, violence, and bullying. This study highlights the variability of experiences of SGMI participating in 12-Step programs. These findings suggest that many SGMI may benefit from 12-Step programs but may need support in coping with potential harms that can emerge through participation. [ABSTRACT FROM AUTHOR]

Copyright of Florence (1801-464X) is the property of Care Comm s.r.o. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Medication assisted treatment (MAT) for opioid use disorder (OUD) saves lives and enhances quality of life for people in recovery. However, only a small percentage of people eligible for MAT in the United States receive treatment, and among those who do seek treatment, retention is a challenge. This study aims to understand factors that help individuals enter and stay in MAT from the perspective of those in recovery. The patient perspective is vital in efforts to improve care delivery and best support individuals in treatment. Methods: Survey development was driven by a review of current peer-reviewed literature plus information gained through 3 semi-structured interviews and follow-up discussions with 5 individuals who have lived experience in MAT, termed Participant Advisors. Survey questions focused in part on MAT participants' opinions relating to program policies such as drug testing, relapse protocols, duration of treatment, participant use of anti-anxiety medications and marijuana, and requirements for attendance in peer recovery groups such as Narcotics Anonymous and Alcoholics Anonymous. Responses were collected from West Virginia-based MAT programs from February through August 2021, with 1700 surveys distributed to 21 MAT programs. Results: At the close of data collection, 225 survey responses, including over 500 free-text comments, were received (13.2% response rate). Most (n = 207, 95%) were currently in a MAT program and most (n = 187, 88.6%) reported using buprenorphine/naloxone for MAT, though participants reported having used other medications for treatment of OUD as well. Questions about how long a person should have MAT prescribed, how long they should be able to stay in treatment, whether they can use marijuana or anti-anxiety drugs while in treatment, and whether they should use a 12-step program generated mixed opinions. Findings strongly support consideration of individual situations and shared decision-making with providers. [ABSTRACT FROM AUTHOR]

Opioid addiction is a public health disease reaching epidemic proportions, destroying countless lives, and recently gaining increased media attention. In the past, spirituality has been utilized in the setting of alcoholism treatment with organizations such as Alcoholics Anonymous (AA). However, its role and significance in helping overcome opioid addiction remains a subject of ongoing investigation. In this paper, we explore various strategies of recovery and which strategies are the most helpful from the patients' perspective, in assisting them with their recovery. Patients in an outpatient, medication-assisted, opioid addiction recovery program were asked to participate in either a faith-based recovery program or a traditional recovery program. Two-thirds of patients chose the faith-based program; one-third chose the traditional, or secular one. Using a questionnaire designed for clinical use, participants in both groups reflected on over 20 strategies of recovery. We hypothesized that the faith-based group participants would tend to rely more heavily on non-traditional means of recovery, such as utilizing prayer and reading the Bible, to a significantly greater degree than their secular-based counterparts. We furthermore anticipated that desires for a recovery and well-being for family would be the most frequently-requested topics for prayer. Those in the faith-based group stated that the three most helpful recovery features included taking buprenorphine, not associating with others involved with drugs, and having support from family/friends. The three most helpful features in the secular-based group were identified by participants as taking buprenorphine, not associating with others involved with drugs, and talking with the doctor. To further elucidate one such faith-based strategy, prayer, we qualitatively evaluated in-office prayer content of participants. The most common topics for which participants requested prayer during visits with their doctor were family, friends and recovery. These results provide insight into what strategies participants feel are the most helpful in their recovery. Also, the findings suggest the significant role that bio-psycho-social-spiritual factors play in assisting participants with addiction recovery. [ABSTRACT FROM AUTHOR]

On new year's eve, Sunny worked at the fabric store, unloading bolts of duck and jacquard, tweed and gingham, a blue chenille that felt nice against her cheek. Later today, [...]

Objectives: Belief in an American Indian/Alaska Native (AIAN) specific biological vulnerability (BV) to alcohol problems is associated with worse alcohol outcomes among AIANs. Despite a notable lack of evidence that biogenetic factors play a greater role in the development of alcohol problems among AIANs than other groups, many people still believe this myth. Consistent with theory and evidence that greater experiences with discrimination leads to the internalization of stereotypes and oppression, we hypothesized that greater perceived racial discrimination (racism) would be associated with greater BV belief, but that having a stronger ethnic identity would weaken this association. We also examined whether previous substance use treatment as well as participation in Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) was associated with BV belief. Method: Participants were 198 reservation-dwelling AI adults with a substance use problem who completed a survey as part of a larger community-based participatory study. Results: A multiple regression analysis revealed that greater systemic racism was associated with greater belief in a BV; this association was not moderated by ethnic identity. Greater interpersonal racism was also associated with greater BV belief—but only among those low in ethnic identity. A regression analysis revealed that previous treatment, AA, and NA participation were not associated with BV belief. Conclusions: Greater systemic and interpersonal racism were associated with belief in a BV, and greater ethnic identity buffered the association between interpersonal racism and BV belief. This suggests that both combatting racism and fostering positive ethnic identity may help to lessen BV belief. Public Significance Statement: People who report experiencing more racial discrimination are more likely to accept stereotypes and negative societal beliefs about their own group (i.e., to internalize racism). In this study with American Indian/Alaska Natives (AIAN), systemic and interpersonal racism were associated with greater belief in the unfounded and harmful stereotype that AIAN people have a unique biological vulnerability (BV) to alcohol problems. However, a stronger ethnic identity was protective against the effects of interpersonal racism on belief in a BV. [ABSTRACT FROM AUTHOR]

Codependency is a serious mental, emotional, social, and physical problem. Little is known about the spiritual mechanism of recovery among codependent individuals participating in Al-Anon self-help groups. The aim of this study was to verify whether spiritual struggles are indirectly through spiritual growth and hope, related to life satisfaction of codependent individuals. The achieved results confirmed the indirect effect of spiritual struggles on life satisfaction through the spiritual growth and hope of codependent individuals participating in Al-Anon. The research confirmed the mechanism underlying the relationship between spiritual struggles and the life satisfaction of codependent individuals participating in Al-Anon. [ABSTRACT FROM AUTHOR]

The purpose of this study was to understand how older adults in recovery from substance use disorders experienced the transition from in-person to virtual 12-step meetings. We interviewed 11 older adults (age 50+) who self-identified as being members of 12-step programs. Participants completed an online survey including standardized measures assessing depression, anxiety, social isolation, and quality of life. Three themes emerged from interviews: Importance of the program; Promises and Limits of Technology; and Concern for Others. Participants' high level of commitment to their groups enabled them to adapt quickly to virtual meetings. Participants described their concerns about members of their groups who were unable to make this transition. Older adults in this study adapted quickly to virtual recovery groups. The social support participants received during groups, whether virtual or in person, may have acted as a buffer protecting them from the isolative effects of the pandemic. [ABSTRACT FROM AUTHOR]

Drawing from a prisoner-produced publication titled Realidad (Reality) as well as other sources, this article explores the history of Alcoholics Anonymous in Puerto Rico's premier carceral institution in the mid-twentieth century, the Insular/State Penitentiary at Río Piedras. An analysis of the AA penitentiary group La Última Copa (The Last Drink) under colonial populism--an era in which Puerto Rican carceral care revolved around rehabilitation--shows that incarcerated people deemed the group's activities and their magazine as viable, efficacious behavioral health care options. Socio-humanistic therapeutics like group therapy and testimonial writing were of particular consequence for inmates, who in turn produced multiscalar knowledge about alcoholism and served as frontline practitioners. [ABSTRACT FROM AUTHOR]

Copyright of Logos: A Journal, of Religion, Philosophy Comparative Cultural Studies & Art (08687692) is the property of Logos and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Addiction is a significant social problem in Romania. Despite the growing number of Alcoholics Anonymous (AA) mutual-help groups, there has been little research into support groups as an intervention in Romania. Although AA has been found to be effective in other countries, unfortunately in Romania it is little known, even among physicians. The purpose of this exploratory study, which is the first known study of 12-Step Programs in Romania, is to explore the motivation and motives of AA’s participants to become sober and maintain their sobriety. The study specifically explores both the intrinsic and extrinsic motivation of AA attendees, as well as other factors, such as social relationships, professional and economic status. This exploratory study uses qualitative methods. Data are analyzed using thematic analysis. Themes related to intrinsic motivations to become sober emerged as a much stronger theme among alcoholics who desired and maintained their sobriety than extrinsic factors. The most common intrinsic motivations are low self-esteem, dissatisfaction with alcohol consumption, and an internal desire to change. Extrinsic motivations, while not as preponderant as intrinsic motivations, included family pressure on the individual to change and the recommendations of physicians. The extrinsic motivation turned into intrinsic motivation as alcoholics sobriety grew. The commitment theory (Rudy & Greil, 1987) could explain this shift in participants` motivation since AA participants get involved in AA, invest time and energy in AA activities, and sacrifice their old identities in favor of new ones. As a result, they become committed to AA and to recovery. Their perspective on life and sobriety changes as they get involved in AA. The findings suggest that those working in the area of alcohol abuse should pay more attention to the intrinsic motivations to change for alcoholics, as these appear to play an important role in attaining and maintaining sobriety. In addition, while intrinsic motivation seems to be mandatory in maintaining sobriety, it is not imperative in attaining sobriety since it can turn into intrinsic motivation as a result of commitment to sobriety and AA. [ABSTRACT FROM AUTHOR]

BackgroundAlcohol craving, or the desire to drink alcohol, has been identified as a key experience preceding alcohol use. Alcoholics Anonymous has long claimed that individuals can allay alcohol cravings by eating sweets. Empirical tests of this strategy are limited to a few preclinical studies in rats, and there is no existing experiment testing the acute effect of eating sweets on alcohol cravings in humans.PurposeThe current study sought to experimentally test the acute effect of eating sweets on alcohol cravings in a sample with at-risk drinking.MethodsAfter being exposed to an alcohol cue, individuals with at-risk drinking (N = 150) were randomly assigned to eat sweets (n = 60), eat calorie-equivalent bland food (n = 60), or watch a video (n = 30). Caloric amounts were manipulated. Individuals with at-risk drinking were then exposed to a second alcohol cue. Changes in alcohol cravings from after the first to after the second alcohol cue were measured via visual analog scale and heart rate.ResultsThere were no significant between-group differences in changes in alcohol cravings. Caloric amounts did not modify effects.ConclusionsExperimental findings did not provide evidence to support the clinical lore that eating sweets can reduce alcohol cravings, albeit only acutely and for those with at-risk drinking. Other empirically supported strategies for managing alcohol cravings (e.g., pharmacotherapies, mindfulness) could instead be promoted.

This article aims to analyze the experiences related to motherhood and care among mothers who attend mutual support groups to address alcohol-related harm in Mexico City and the State of Mexico. Drawing on the conceptual framework of collective health from a gender perspective, we contend that socioeconomic and gender-related factors influence the social determination of alcoholism and the health-disease-attention-care process. A qualitative study was conducted between May 2020 and January 2021, which included interviews with ten women who were selected based on specific criteria, as well as non-participant observation in a women’s Alcoholics Anonymous group. The main findings show how trajectories of alcohol abuse and its management are interconnected with trajectories of care. From there, it was possible to identify a “break in care,” a category that sheds light on mistreatment and the precariousness of life and health of women and their children.

Participation in Alcoholics Anonymous (AA) appears to have numerous benefits beyond sobriety. Previous research has highlighted the role of gratitude and helping others in the AA philosophy, as well as their importance in creating social ties. Helping others, social relationships, and gratitude may contribute not only to sobriety but also physical health and psychological well-being; however, little is known about the relationship between these variables and how they contribute to well-being for people in recovery. In this study, we examined how gratitude (state and trait level), social contact, and helping predicted self-rated physical health and psychological distress in adult AA members maintaining sobriety. Participants (N = 113) completed baseline measures (trait gratitude, physical health) as well as daily reports of their participation in AA, helping behaviors, social contact, and psychological distress for 7 days. Analyses revealed different predictors for physical health and psychological distress. The implications for theory and practice are discussed. [ABSTRACT FROM AUTHOR]