Spiritual guidance doesn’t help substance abusers

Spiritual guidance doesn’t help substance abusers February 4, 2009

Spirituality is traditionally a part of recovery programmes for substance abusers. Alcoholics Anonymous, for example, includes invocation of a higher power as part of its program. Surprisingly, however, nobody has looked too closely at whether such spiritual guidance is any help. Until now, that is.

A team from New Mexico, lead by Professor William Miller, has tested the effects of spiritual intervention in two meticulously designed studies. In addition to their usual treatment, patients were also also offered a series of one-on-one sessions with counsellors delivering a manual-guided form of spiritual direction designed by Miller specifically for this population. The guidance comprised the patients selection from:

… acceptance, celebration, fasting, gratitude, guidance, meditation, prayer, reconciliation, reflection, service to others, solitude, and worship. The chosen disciplines have historic roots of practice for hundreds or thousands of years, and are familiar within the Judeo-Christian tradition that is the most common religious background in the US population.

And what happened? Well, in both studies, normal treatment was highly effective, significantly and rapidly increasing the percentage of days that patients were able to stay off the drugs . The addition of spiritual guidance, however, had no effect.

Well, not quite no effect…

In turns out that, in Study 1, the patients who were given spiritual guidance suffered significantly more anxiety and depression in the first 6 months of the study. In fact, what happened was that patients just given usual treatment saw their anxiety and depression reduce. Spiritual guidance prevented that happening.

Now, this effect was not seen in Study 2. And the difference between the two studies was? Well, in the first study, the guidance was given by “three highly experienced, certified professional spiritual directors”. In the second study, the guidance was provided by secular counsellors (with qualifications in psychology or social work).

In other words, spiritual guidance from religious enthusiasts can successfully put the fear of god into these people, but it doesn’t get them off drugs. Drug rehabilitation is an expensive, time consuming, and vitally important business. Spending money on unvalidated spiritual intervention is a distraction.

It’s time we got drug abuse counsellors off their addiction to religion.


W MILLER, A FORCEHIMES, M OLEARY, M LANOUE (2008). Spiritual direction in addiction treatment: Two clinical trials Journal of Substance Abuse Treatment, 35 (4), 434-442 DOI: 10.1016/j.jsat.2008.02.004

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