The difference between spirituality and religion is often blurred and difficult to distinguish. Even research studies that attempt to assess the contribution of spirituality to recovery from substance use disorders often find that the terms are not well defined.
The major difference between the notion of spirituality and a religion is that religion concentrates on faith in a supreme being, whereas spirituality is more the belief that there is a higher part of the self and divine experiences emanate from everyone. Spirituality does not assume that there is a supreme being that dictates how individuals should behave, but recognizes that there is more to existence than the physical world, but individuals are free to interpret what drives them without being hindered by the doctrines of one specific religion.
Thus, the notion of spirituality allows people the autonomy to interpret the spirit or soul for themselves, whereas religion is the participation in a communal practice of divine worship and the specific interpretation of what a higher power is. Religion incorporates aspects of spirituality, whereas those who practice a form of spirituality tend to dissociate their beliefs from the major tenets associated with religions.
People who incorporate their religion into recovery or adopt a spiritual approach to recovery may be implementing protective factors that mediate the stresses in their life and reduce the potential for relapse. Individuals who have committed spiritual or religious beliefs appear to have lower rates of substance abuse than those who do not. There does appear to be evidence that individuals in recovery who have spiritual and religious convictions may have better overall outcomes than those who don’t.
Nonetheless, programs that embrace spirituality and religion such as 12-Step programs are often criticized for their adherence to these components of recovery. Moreover, most of the research that is available regarding 12-Step programs like Alcoholics Anonymous does not suggest that these programs are any more successful than recovery programs that have no religious or spiritual component to them.The medical profession has recognized how religious beliefs can affect treatment approaches for numerous conditions. Medical professionals are often encouraged to be cognizant of the different religious and spiritual belief systems in their clients in order to better serve them.
Despite the evidence that religion and spiritual approaches may enhance outcomes in recovery from substance use disorders, it should be noted that the overall body of research regarding the effective principles of substance use disorder treatment does not specify the contribution of spiritual-based or religious-based interventions as important factors in evidence-based treatments. In fact, one of the most comprehensive overall summaries of the principles of effective substance use disorder treatment by the National Institute on Drug Abuse (NIDA) does not specifically include any notion of spirituality or religion as one of the 13 major principles of treatment for recovery. The principles include the following:
There must be recognition that addiction is a treatable disease that alters the functioning of the brain.
There is no one approach to treatment that will work for everybody.
Effective treatment for substance abuse addresses the multiple needs of the person and not just their use of drugs or alcohol.
A crucial component to a successful treatment outcome is to remain in treatment for a sufficient length of time.
Behavioral interventions, such as individual therapy, group therapy, or family therapy, are the most common forms of treatment for substance use disorders.
Treatment should begin with an assessment of the person’s needs, a formal treatment plan, and then the assessment and readjusting of the plan as needed to suit the situation.
Medically assisted detoxification (medical detox) is only the first step in recovery. If individuals only receive medical detox services, there is little change in their substance abuse behavior. Individuals require long-term treatment programs after medical detox.
Substance use disorder treatment does not have to be voluntary in order for it to be effective. Individuals who are coerced into treatment have similar outcomes to individuals who volunteered to enter treatment.
Those in substance use disorder treatment programs should be continuously monitored for drug and alcohol use. Lapses and relapses are common.
Individuals in substance use disorder treatment programs should also be tested for infectious diseases like HIV, hepatitis, or tuberculosis. If they are positive for any of these conditions, they should be treated accordingly.
The above principles of effective treatment for substance use disorders are based on numerous research studies. Notice that no single principle mentions the necessity of the religious or spiritual approach in recovery. Thus, while incorporating religion or spirituality into the recovery program may enhance the benefits of substance use disorder treatment, these components are neither necessary nor sufficient for successful recovery from any substance use disorder.
Virtually all treatments for substance abuse, such as medication management, behavioral therapy, or alternative therapies, are based on the need to adopt a spiritual or religious approach. The use of medications will be just as effective whether or not a person has a commitment to a divine supreme being or spiritual beliefs. The use of behavioral therapies, such as Cognitive Behavioral Therapy, is not affected by any specific commitment to spirituality.
Typically, physicians and therapists will discuss a person’s belief system with them prior to the implementation of treatment. The treatment can be adjusted for those who have a strong religious commitment or wish to incorporate notions of spirituality in their recovery, or these notions can be completely discarded for those who are atheists, agnostics, or just have no specific religious type commitment. Thus, treatment that is implemented according to the NIDA principles of effective substance use disorder interventions do not require any type of spiritual or religious belief or commitment.
The types of programs that regularly attempt to incorporate religion or spirituality into recovery are typically peer support groups like 12-Step groups or other similar groups. These groups will often refer to notions of spirituality or religion and surrendering to God or a higher power as a component of their program. However, many of these groups demonstrate acceptance for individuals who do not have any type of spiritual or religious belief.
Individuals who do not wish to be involved in programs that focus on spirituality or a religious doctrine, but still wish to become involved in peer support groups that allow them to freely interact with others in recovery, can readily find groups to suit their needs. Some of the major organizations that offer nonreligious environments that are appropriate for atheist or agnostic individuals include the following:
It should be noted that individuals in recovery, regardless of whether they incorporate spiritual or religious practices into their substance abuse treatment, should get involved in programs that follow the effective principles of treatment listed above.
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