A meta-analysis of studies examining the association between spirituality and harmful use of alcohol, tobacco, marijuana, and other drugs found that higher spirituality was associated with a 13% reduced risk of harmful use across the drugs studied. Individuals who participate in a spiritual or religious community (defined as those who attend religious or spiritual services at least once a week) had an 18% reduced risk. The paper is JAMA Psychiatry.
Harmful or dangerous alcohol and other drug (AOD) use refers to a pattern of drinking or drug use that increases the risk of physical, psychological, social, or legal problems. Dangerous use means that a person’s level or pattern of use creates a significant risk of future harm, even if no serious consequences have yet occurred. Harmful use means that alcohol or drug use has already caused harm, such as health problems, accidents, relationship problems, or reduced ability to work or study.
AODs may include alcohol, tobacco, cannabis, stimulants, opioids, sedatives, and other psychoactive substances. The level of risk depends on factors such as amount, frequency, method of use, combination of substances, and the person’s age and health. Binge drinking is an example of dangerous alcohol use because it increases the risk of injury, alcohol poisoning, and risky behavior.
Using drugs in situations such as driving, operating machinery, or caring for children is also considered dangerous. Harmful or dangerous use does not necessarily mean that a person has a substance use disorder or addiction. However, if it continues, it can develop into a more serious pattern.
Study author Howard K. Coe and colleagues note that harmful or harmful alcohol and other drug use is a health threat that affects 16.7% of Americans and imposes a significant societal burden associated with hospitalizations, deaths, and economic costs. However, researchers note that spirituality may be a means to lower the risk of AOD use and increase the likelihood of recovery. They adopt the definition that spirituality is “a dynamic and essential aspect of human nature in which a person seeks ultimate meaning, purpose, and transcendence and experiences relationships with self, family, others, community, society, nature, and the significant or sacred.”
Aiming to synthesize findings on the association between spirituality and AOD risk, these authors conducted a meta-analysis of longitudinal studies based on studies identified in previously published reviews. The studies listed in that review were identified using “spirituality,” “religion,” or “faith” (and variations thereof) as search terms, along with long strings aimed at capturing potential health outcomes.
Studies published in English from 2000 to 2022 used validated measures of spirituality and examined longitudinal associations between spirituality and AOD use or related health outcomes. The study was either a prospective study involving 1,000 or more participants, or a randomized controlled trial or public health intervention involving at least 100 participants.
This meta-analysis was conducted based on 55 articles that met the criteria for inclusion in the analysis. Of the effects investigated, 87% were classified as preventive effects and 13% were related to recovery. Fifty-four of the studies were longitudinal studies of specific groups (cohorts), and one was a randomized controlled trial. Sample sizes for individual studies ranged from 1,045 to 68,376 participants. The total number of participants across all studies was 540,712.
Results showed that higher spirituality had a protective effect against AOD misuse. Higher spirituality was associated with a 13% lower risk of AOD misuse in all four drug categories investigated. For individuals who attended religious or spiritual services at least once a week, the reduction in AOD risk increased to 18%.
The study authors report that 60% of the reported effects suggest that the risk of AOD is at least 10% lower in people with high spirituality, and 17% of studies report that the risk is at least 20% lower.
“This meta-analysis highlights the holistic potential of engaging with spirituality as part of prevention and recovery for those wishing to engage with it. Further exploration is needed into how spirituality can represent a large part of both community-based and clinic-based resources,” the study authors concluded.
This study contributes to the scientific understanding of the association between spirituality and the risk of harmful or harmful substance use behaviors. However, it should be noted that the association between spirituality and AOD was relatively weak and barely detectable due to the huge sample size of the investigated studies. Additionally, only one of the studies was a randomized controlled trial, and the design of the remaining 54 studies included in this meta-analysis means that definitive causal inferences cannot be drawn from the results.
The paper, “A Meta-Analysis of Longitudinal Studies of Spirituality and Harmful or Harmful Alcohol and Other Drug Use,” was written by Howard K. Coe, Donald E. Frederick, Tracy A. Balboni, Samantha M. O’Reilly, John F. Kelly, Keith Humphreys, Michael Botticelli, Maya B. Mercer, Constantine S. Psimopoulos, Caitlin NG Long, and Tyler J. Vanderweele.
