Religion and spirituality have long been suspected of providing a recovery edge for substance abusers in treatment programs. While several studies have produced findings that suggest this may be true, the complexity of religious beliefs and the variety of treatment modalities prevent drawing generalizable conclusions. This essay examines a few of these empirical studies to reveal the state of this research area.
RELIGION'S ROLE in RECOVERY
Religion in Recovery
Religion's Role in Recovery
Religion's Role in Recovery
Spirituality has been defined in many ways, including experiencing an inner life, developing a deeper understanding of connections within the community, and achieving a transcendent state (reviewed by Borras et al., 2010). By comparison, religion is an organizational structure that seeks to foster spiritual pursuits through rituals. While spirituality is largely seen as a force of good, the same cannot be assumed about religion. Despite this cautionary note, religion is increasingly recognized as having the potential to be protective against substance abuse, increase treatment efficacy, and provide support for maintaining an abstinence lifestyle (Magida, 1993). This essay examines the empirical evidence for this claim.
The Efficacy of Religion in Substance Abuse Recovery
A large study examined the 5-year success rate of patients enrolled in methadone treatment programs in eight U.S. cities by treatment modality (Flynn, Joe, Broome, Simpson, and Brown, 2003). During the follow-up phase of the study, 28% were judged to be in recovery, while the other 78% had used opiates or cocaine in the past year (67%), engaged in criminal activity, or abused alcohol. Successful recovery was positively associated with time spent in a rehabilitation facility and the effect increased between 90 and 270 days [Odds Ratio (or) 3.21 at 90 days to 1.66 at 270 days, with a peak at 120 with or 3.25]. Participation in Alcoholics (or 1.08) and Narcotics (or 0.76) Anonymous, two self-help programs that incorporate religious and spiritual elements, did not have a significant effect on recovery status.
When recovering and non-recovering patients were interviewed at the 5-year follow-up, a much larger proportion of patients in recovery claimed that religion/spirituality was an important source of recovery support (Flynn, Joe, Broome, Simpson, and Brown, 2003). Nearly 40% of the patients in recovery felt this way compared to only 11% of the non-recovering patients (or 1.82, p < 0.01). This finding suggests that religion and spiritual practices can help some patients achieve and maintain sobriety.
Shields and colleagues (2007) directly examined the efficacy of religion by program and patient religiosity. No correlation could be found between patient religiosity and program retention across all patients. However, the authors noted that programs with patient populations scoring higher on religiosity also did significantly better in retaining patients (p = 0.02), which was interpreted as religious individuals following through on treatment better when grouped together. In terms of commitment to becoming drug-free, individual religiosity was a strong positive predictor of treatment efficacy in methadone programs only (p = 0.01); however, the authors noted that methadone programs typically had the greatest diversity in terms of patient commitment, which would facilitate finding a statistically significant outcome.
To test whether a treatment program's emphasis on religion affected efficacy, programs were categorized as minimally, moderately, or highly religious (Shields, Broome, Delany, Fletcher, and Flynn, 2007). No interaction with patient retention was found (p = 0.74). Patient commitment to becoming drug-free was higher among the more religious programs, but was borderline significant (p = 0.53). Grouping the programs based on patient religiosity ratings revealed higher religiosity was associated with more commitment (p = 0.02).
Overall, the findings of Shields and colleagues (2007) suggest that religious patients entering a substance abuse treatment program will tend to seek out treatment programs that are more religious. This grouping effect will then have a positive effect on retention rates and commitment to establishing a drug-free lifestyle.
The diversity of individual religious practices is one of the main impediments to researchers attempting to define it efficacy in treatment programs (reviewed by Puffer, Skalski, and Meade, 2012). For example, the Religious Coping Scale (RCOPE) instrument is intended to bring some measure of standardization to the research being conducted in this area by discriminating between positive and negative religious beliefs. A positive religious coping practice would be the belief in a benevolent Higher Power and finding meaning in personal suffering. Negative religious coping, on the other hand, would be to believe personal suffering is God's punishment for past wrongs.
When Puffer and colleagues (2012) examined religious coping scores using the RCOPE instrument for patients undergoing a 3-4 day opioid detoxification program, they found that most had improved religious coping scores at the two-week follow-up interview; however, patients with either a positive or negative religious belief system will tend to maintain that belief system during recovery. Accordingly, a positive RCOPE score was not correlated with remaining drug free during the two-week period following detoxification, but a negative score accurately predicted relapse (p = 0.003).
You’re 81% through this paper. Sign up to read the full paper.
Sign Up Now — Instant Access Already a member? Log inAlways verify citation format against your institution’s current style guide requirements.