Recent Developments in Alcoholism: Research on Alcoholics Anonymous and Spirituality in Addiction Recovery PDF
Preview Recent Developments in Alcoholism: Research on Alcoholics Anonymous and Spirituality in Addiction Recovery
GALANTER KASKUTAS A R RECENT DEVELOPMENTS IN E C L E ALCOHOLISM C N T O D E H V E L O O P L M I E N S T M S I VOLUME 18 N RESEARCH ON ALCOHOLICS VOLUME ANONYMOUS AND 18 SPIRITUALITY IN ADDICTION RECOVERY ASAM RSA EDITED BY MARC GALANTER AND LEE ANN KASKUTAS An Official Publication of the American Society of Addiction Medicine isbn 978-0-387-77724-5 and the Research Society on Alcoholism. springer.com This series was founded by the National Council on Alcoholism. RECENTDEVELOPMENTSIN ALCOHOLISM VOLUME18 RESEARCHONALCOHOLICS ANONYMOUSANDSPIRITUALITY INADDICTIONRECOVERY RECENT DEVELOPMENTS IN Editedby MARC GALANTER NewYorkUniversitySchoolofMedicine NewYork,NewYork NatharKlineInstituteforPsychiatricResearch Orangeburg,NewYork and LEE ANN KASKUTAS AlcoholResearchGroup Emeryville,California Section Editors LEE ANN KASKUTAS THOMASINA BORKMAN SARAH E. ZEMORE J. SCOTT TONIGAN AssistantEditor DOLLYLAGRESSA AnOfficialPublicationoftheAmericanSocietyofAddictionMedicine andtheResearchSocietyonAlcoholism. ThisserieswasfoundedbytheNationalCouncilonAlcoholism. ALCOHOLISM VOLUME 18 RESEARCH ON ALCOHOLICS ANONYMOUS AND SPIRITUALITY IN ADDICTION RECOVERY The Twelve-Step Program Model Spiritually Oriented Recovery Twelve-Step Membership Effectiveness and Outcome Research 123 MarcGalanter LeeAnnKaskutas NewYorkUniversitySchoolofMedicine UniversityofManitoba NewYork,NewYork Emeryville,California NatharKlineInstitutefor PsychiatricResearch Orangeburg,NewYork ISBN:978-0-387-77724-5 e-ISBN:978-0-387-77725-2 DOI:10.1007/978-0-387-77725-2 LibraryofCongressControlNumber:2008930475 (cid:2)c 2008SpringerScience+BusinessMedia,LLC Allrightsreserved.Thisworkmaynotbetranslatedorcopiedinwholeorinpartwithoutthewrit- tenpermissionofthepublisher(HumanaPress,999RiverviewDrive,Suite208,Totowa,NJ07512 USA),exceptforbriefexcerptsinconnectionwithreviewsorscholarlyanalysis.Useinconnection withanyformofinformationstorageandretrieval,electronicadaptation,computersoftware,orby similarordissimilarmethodologynowknownorhereafterdevelopedisforbidden. Theuseinthispublicationoftradenames,trademarks,servicemarks,andsimilarterms,evenif theyarenotidentifiedassuch,isnottobetakenasanexpressionofopinionastowhetherornot theyaresubjecttoproprietaryrights. While the advice and information in this book are believed to be true and accurate at the date of going to press, neither the authors nor the editors nor the publisher can accept any legal responsibilityforanyerrorsoromissionsthatmaybemade.Thepublishermakesnowarranty, expressorimplied,withrespecttothematerialcontainedherein. Printedonacid-freepaper 9 8 7 6 5 4 3 2 1 springer.com ResearchSocietyonAlcoholism AmericanSocietyofAddictionMedicine President: President: RaymondAnton,M.D. MichaelM.Miller,M.D.,FASAM,FAPA VicePresident: President-elect: PeterMonti,Ph.D. LouisE.Baxter,Sr.,M.D.,FASAM Secretary: ExecutiveVicePresident: MaryLarimer,Ph.D. EileenMcGrath,JD Treasurer: Secretary: KennethLeonard,Ph.D. A.KenisonRoyIII,M.D.,FASAM,DFAPA ImmediatePastPresident: Treasurer: KathleenGrant,Ph.D. StuartGitlow,M.D.,M.P.H.,MBA,FAPA PublicationsCommitteeChair: ImmediatePastPresident: JanHoek,Ph.D. ElizabethF.Howell,M.D.,FASAM,DFAPA Preface I From the President of the American Society for Addiction Medicine RecentDevelopmentsinAlcoholismhasbeenanimportantcontributiontothelit- eratureinAddictionMedicineforalmosttwodecades.Itisabitironicthatthis year’santhologyaddressesnotoneoftherecent”new”thingsinrecovery,but one of the oldest: the ability of active participation in Alcoholics Anonymous and other related peer-assisted recovery activities to help initiate or sustain recovery. It is not ”new” that AA, NA, Al-anon and the like are available in communities around America and around the world or that thousands if not millionsofpersonsinrecoveryhaveattributedtoAAamajorroleintheirrecov- eries.Anditisnot”new”thatAAis,indeed,not”professionalhelp”andshould neverbeconsidered”treatment”byanypatient,familymember,publicpolicy maker, insurance company or managed care utilization reviewer.1 What is a recent development is that it is no longer appropriate to say ”there is no evidence about what AA is or how helpful it may be” or that ”evidence- basedmedicineincludespharmacotherapiesandspecificprofessionalcounsel- inginterventionsasreportedthroughrandomizedclinicaltrials,butitexcludes peer-assisted recovery activities.” The R. Brinkley Smithers Distinguished Sci- entistAwardgrantedattheASAMMedicalScientificConferencein2007hon- ored the work of one of the co-editors of this volume, Lee Ann Kaskutas, Dr.P.H.,oftheSchoolofPublicHealthoftheUniversityofCalifornia-Berkeley, examiningeffectivenessliteratureonAAandtheroleofspiritualityinaddiction andrecovery. Much of health care is showing increasing interest in not only the bio-psycho-social aspects of many health conditions, but the role of spiritu- ality in recovery from illness. The addiction field can lead the way for the rest of medicine in uncovering insights about this essential aspect of human 1 Relationship Between Treatment and Self Help: A Joint Statement of the American Society of Addiction Medicine, the American Academy of Addiction Psychiatry and the American PsychiatricAssociation.Adopted1997. vii viii Preface experience.ThisvolumeincludesimportantarticlesbyDr.Kaskutasandmany otheracademicianstoexpandourknowledgebaseandtoserveasanimportant compilationofcontemporarythoughtanddata.Relatedtopics,suchastherole of mindfulness meditation in recovery, are also addressed. As scientists such as Richard Davidson, Ph.D. of the University of Wisconsin HealthEmotions ResearchInstitute,learnmoreabouttheneurobiologyofemotionandtheneu- rophysiologicchangesthatoccurwithmeditation,wegetclosertounderstand- ingtheneurobiologyofrecoveryitself,whichwilllikelybeshownthroughneu- roimagingstudiestobeaffectedbypeer-assistedactivitiesandother”self-help” activitiessuchasparticipationin12-stepgroups. MichaelM.Miller,M.D.,FASAM,FAPA Preface II From the President of the Research Society on Alcoholism ThisvolumeoftheRecentDevelopmentsinAlcoholismseries“ResearchonAlco- holics Anonymous and Spirituality in Recovery” is an important and unique contribution to our scientific understanding of recovery from alcoholism. In essence, the body of work contained here frames an overall question of how thetwelve-stepprocessestablishedbyAlcoholicsAnonymous(AA)intersects withspiritualbeliefstoestablishabstinenceandguiderecoverywithlittlepro- fessional input. The scientific debate over AA and twelve-step programs has evolvedfromwhethertheyareeffectiveforindividualsthatutilizethemtowhy they are effective and how to improve participation. This includes a detailed look at special populations and the self-selection bias reflected in a voluntary organization.ThefirstfourchaptersaddresswhoparticipatesinAAandhow tomakeimprovementsintheparticipationoftwelve-stepprograms.Forindi- vidualsthat“work”twelve-stepprograms,thereappearstobeincreasesinthe spiritualgrowthandimprovementsinpsychosocialfunctioning.Severalchap- ters, beginning with Chapter 5, define spiritual experiences and the impact of spiritualityonrecoveryandrehabilitationfrommanypsychiatricdisorders,in- cludingalcoholism.Anexpandeddefinitionofspiritualityincludesmeditative practicesandthislendsitselftoexperimentaldesignsthataddresseffectiveness. The“corespiritualbeliefs”ofAAandtheexplicitstepsinenhancingspirituality are defined and examined. Chapters are devoted to understanding the role of spiritualgrowththroughbuildingacommunitybyhelpingotheralcoholicsand participatinginself-government.SeveralauthorsmakethedistinctionthatAA is more than a twelve-step approach to attaining sobriety. Nevertheless, it is alsoclearthatthetwelve-stepprogramofAAsetsaprototype“roadtorecov- ery” for many other addictions. Also included is how the research questions that address the effectiveness of AA and the role of spirituality are framed by historical perspectives, a lesson for how this volume will be received decades fromnow. ix x Preface Thescopeanddepthofthisvolumewillundoubtedlymakeitanimpor- tantreferenceforthepracticingphysicianandscientistsinterestedinimproving recoveryfromalcoholismorotheraddictions. KathleenGrant,Ph.D.
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