{"id":996,"date":"2020-12-07T16:28:18","date_gmt":"2020-12-07T16:28:18","guid":{"rendered":"https:\/\/pressbooks.ulib.csuohio.edu\/substancemisusepart1\/?post_type=chapter&p=996"},"modified":"2020-12-07T16:41:53","modified_gmt":"2020-12-07T16:41:53","slug":"ch-6-1-spirituality-and-religion-in-substance-misuse-prevention-and-recovery","status":"publish","type":"chapter","link":"https:\/\/pressbooks.ulib.csuohio.edu\/substancemisusepart1\/chapter\/ch-6-1-spirituality-and-religion-in-substance-misuse-prevention-and-recovery\/","title":{"rendered":"Ch. 6.1: Spirituality and Religion in Substance Misuse Prevention and Recovery"},"content":{"raw":"Integrating spirituality and religion into substance use disorder assessment and treatment is complicated.\u00a0 While some find the integration affirming, others may feel indifferent or hurt by the historical judgement and discrimination connected to the moral model.\u00a0 Despite these limitations, most clients desire to have their spiritual or religious beliefs integrated into their counseling experiences.\u00a0 Counseling professional should be prepared to conduct spiritual assessment and integrate spiritually informed practices when indicated.\r\n

Moral Model<\/strong><\/h1>\r\nA moral model<\/em><\/strong> of substance misuse has been widely embraced at various times in American society.\u00a0 This explanatory model suggests that deceit and moral deficits are cardinal features of substance use disorders and a moral conversion is necessary to overcome addiction (Stoddard Dare and DeRigne, 2010). \u00a0Contrasting the strength of the simplicity of this model, one important disadvantage to this theory is that it seems to negate the role of biological, psychological, and social forces in the development of substance use disorders and the need to address those issues (Lassiter and Spivey, 2018).\r\n\r\nThe blending of morality and substance misuse dates back to the founding fathers of the United States.\u00a0 Katcher (1993) reviews the work of medical professor Dr. Benjamin Rush, a coauthor of the Declaration of Independence.\u00a0 In the late 1700\u2019s and early 1800\u2019s, Rush developed and widely circulated a \u201cmoral thermometer\u201d to rate an individuals\u2019 temperance or intemperance (cited in Katcher, 1993).\u00a0 The temperance section of the scale lists specific beverages such as water, milk, cider and wine and paired those drinks with qualities such as \u201ccheerfulness,\u201d \u201chealth.\u201d and \u201cstrength.\u201d\u00a0 The intemperance section included beverages such as \u201cstrong punch,\u201d \u201ctoddy,\u201d and \u201crum.\u201d Those drinks were mapped to \u201cvices,\u201d (lying, fraud and murder), \u201cdiseases\u201d (puking, tremors, melancholy), and \u201cpunishments\u201d such as debt, hunger, and jail (cited in Katcher,1993).\r\n\r\nRush\u2019s thermometer came at a time liquor was believed to help laborers by providing energy and relief from extreme heat or cold (Katcher, 1993) so part of his intent was to convey that alcohol use could be problematic.\u00a0 Rush\u2019s work highlights two important themes that have reoccurred over time.\u00a0 First, moral judgements are tied to substance use.\u00a0 Second, certain substances are considered acceptable, or more acceptable, while others are considered unacceptable.\r\n\r\nRush\u2019s work was extended by a broad temperance movement and later Prohibition.<\/strong>\u00a0 As described by Lassiter and Spivey (2018), intertwined with a Christian message of morality and deepening a personal connection with God, the temperance movement, which spanned 1826-1919, focused first on reducing alcohol use, and later on total abstinence in order to curb social ills such as violence against women and children.\u00a0 Also, in the mid 1800\u2019s opioid use increased substantially as it was viewed as a socially endorsed method to soothe children and reduce ailments.\u00a0 Societal acceptability of tobacco, alcohol, cocaine, and opioid use differed by race and class with racial minorities and individuals in lower socio-economic groups more likely to have their use classified as deviant or immoral.\u00a0 The passage of Prohibition in 1920 began a tremendous increase in the criminalization of alcohol and other drug use.\u00a0 Legislative activity (the Boggs Act 1951, the Narcotics Drug Act of 1956) continued through the 70\u2019s (establishment of the Drug Enforcement Administration) and 80\u2019s (Anti-Drug Abuse Act) which furthered a view that people who use illicit drugs are immoral and dangerous and should be incarcerated (Lassiter and Spivey, 2018). Racism was deeply ingrained in these policies as is evidence by the differential sentencing for crack and powder cocaine (https:\/\/www.aclu.org\/other\/cracks-system-20-years-unjust-federal-crack-cocaine-law<\/a>).\r\n\r\nDespite the complicated and sometimes damaging role of spirituality and religion, they also clearly can have a beneficial role to play in substance use, prevention, and treatment.\r\n

The Role of Spirituality and Religion in Prevention and Treatment of Substance Use Disorders<\/strong><\/h1>\r\nGrim and Grim (2019) provide an introduction to the role of spirituality and religion in substance use disorders.\u00a0 Edited excerpts from their open access publication follow as we,\r\n\r\n1) \u201cexamine the empirical evidence illustrating faith\u2019s contribution to preventing people from falling victim to substance abuse and helping them recover from it,\u201d and\r\n\r\n2) \u201cintroduce and flesh out a typology of faith-based substance abuse treatment facilities, recovery programs, and support groups (Grim and Grim, 2019, p 1751).\u201d\r\n\r\nThis passage from the\u00a0Journal of Religion & Health<\/a>\u00a0article \"Belief, Behavior, and Belonging: How Faith is Indispensable in Preventing and Recovering from Substance Abuse\" is by Brian J. Grim and Melissa E. Grim and licensed under a\u00a0CC-BY 4.0 license<\/a>.\r\n\r\nGrim and Grim, 2019 (p. 1713-1750) state:\r\n\r\nAlong with the body and the mind, the spirit is also a central part of the continuum of addiction health care. Based on [a] review of extensive evidence-based research on addiction that follows, it is clear that religion and spirituality\u2014which we refer to collectively as faith\u2014are exceptionally powerful, integral, and indispensable resources in substance abuse prevention and recovery. This body of research shows that the efficacy of faith includes not only the\u00a0behaviors<\/em>\u00a0people engage in (or don\u2019t engage in) because of their faith and the support people find in\u00a0belonging<\/em>\u00a0to faith communities, but also people\u2019s religious and spiritual\u00a0beliefs<\/em>\u00a0themselves.\r\n\r\nAt the start, it is useful to provide a working definition that differentiates religion from spirituality, both of which we categorize as aspects of\u00a0faith<\/em>\u00a0because the two frequently overlap\u2026\r\n\r\nSpirituality<\/em><\/strong> is defined as an openness to God, nature or the universe where one can experience harmony with truth, feelings of love, hope and compassion, inspiration or enlightenment with a sense of meaning and purpose in life, an individual\u2019s connection with God or the Transcendent. <\/em>\r\n\r\nOn the other hand, religion<\/strong> is viewed as the corporate expression of that connection, where one mediates their relationship to God and the community through an organized system of beliefs and practices (<\/em>Burnett\u00a02014<\/a>, pp. 28\u201329).<\/em>\r\n

Empirical Evidence of Faith\u2019s Contribution to Preventing Substance Abuse and Helping People Recover from It<\/strong><\/h2>\r\nAn emphasis on the biological aspect of healing has provided us with advanced diagnostics\u2026 and an extended lifespan; the benefits have been extraordinary. However, these achievements often \u2026disregard the important role of the inner, spiritual aspects of healing...However, this is changing. Writing in the American Medical Association Journal of Ethics, Robert Orr notes that \u201cthere is an increasing recognition in modern Western medicine of the importance of patient spirituality in treatment and healing\u201d (2015<\/a>, p. 414). The recognition of the significance of the spiritual aspects of healing has been growing, particularly since the 2001 mandate by the Joint Commission on Accreditation and Healthcare for the administration of a spiritual assessment by healthcare providers for patients and their families (Hodge\u00a02006<\/a>; The Joint Commission n.d.).\r\n\r\nHundreds of evidence-based studies demonstrate the positive impact of faith on health and well-being (e.g., Duke University n.d.; Koenig\u00a02005<\/a>,\u00a02008<\/a>,\u00a02011<\/a>,\u00a02018<\/a>; George et al.\u00a02002<\/a>; Johnson et al.\u00a02002<\/a>; Koenig et al.\u00a02012<\/a>; Rew and Wong\u00a02006<\/a>; Schoenthaler et al.\u00a02018<\/a>; VanderWeele\u00a02017<\/a>; Zemore\u00a02008<\/a>), and, as we will show in this section, nowhere is this positive impact more evident than in the recovery of people who are suffering from substance abuse. We should emphasize that the benefits of faith to health can be seen in a variety of religious contexts, including monotheistic and nontheistic faiths and beliefs.\r\n\r\nFor instance, Chan et al. (2002<\/a>) noted that the inner, spiritual aspects of healing are common in the Eastern philosophies of Buddhism, Taoism, and traditional Chinese medicine. Their research demonstrates significant improvements in patients when taking the body\u2013mind\u2013spirit integrated model of intervention.\r\n\r\nWe should also note that in more than any other area of modern health care, substance abuse treatment embraces the traditional paradigm of treating body, mind, and spirit (Borkman\u00a02008<\/a>; Polcin and Borkman\u00a02008<\/a>). This is not to say that all people with addictions benefit from faith content in recovery, but many do.\r\n