ABSTRACT
In the height of the COVID-19 pandemic, statistics related to the ongoing crisis of addiction in the United States hit record levels. Those statistics include drug overdose deaths, rates of substance use and misuse, and alcohol-related fatalities. Some Christian denominations and individual congregations, including a handful of Roman Catholic parishes, have sought to respond to the suffering experienced by those in active addiction through intentional ministries of care, support, and community. Yet preaching on the topic of addiction-and the hope found in recovery-remains rare in churches on Sunday morning. This thesis explores the complex and confounding realities of addiction, its causes, and multiple pathways to recovery, while articulating an urgent and salient call for Roman Catholic priests and deacons to address the crisis of addiction in their midst. The primary ministerial intervention for the thesis consisted of a one-day workshop for Roman Catholic priests and permanent deacons in Minnesota. Pre-workshop interviews were conducted with two cohorts: ten priests and permanent deacons in active ministry (Cohort One), and ten practicing Catholics in recovery from addiction (Cohort Two). The interviews considered whether preaching on the topic of addiction and recovery was taking place in Roman Catholic parishes around the country and what might be most helpful or harmful for people in recovery or in active addiction to hear from preaching in their parishes. Chapter 1 introduces the thesis project overall.Chapter 2 considers addiction theologically, focusing on three areas of study: sacramentality;sin, grace, and the unconditional love of God;and trauma-informed or trauma-sensitive theology. Chapter 3 explores the importance of story, specifically in the salvific and life-giving tradition of twelve-step storytelling and in the inductive practice of narrative preaching in the style of the New Homiletic. Chapter 4 provides a detailed exploration of addiction, considering clinical diagnostic criteria, neurological and sociological research, and current trends regarding the prevalence of stigma and challenges to achieving recovery for many. The chapter also considers multiple pathways to recovery, including twelve-step programs focused on abstinence, harm reduction strategies, and natural recovery methods. Chapter 5 reports on the ministerial intervention and provides key findings from the research conducted. Chapter 6 considers next steps and offers final conclusions. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
ABSTRACT
BACKGROUND: In recent years, reductions in drinking in the UK and the rise of online 'positive' sobriety communities have been observed, yet peer led support groups such as Alcoholics Anonymous (AA) and neo-liberal discourses of control and responsibility dominate public understandings of (problematic) alcohol use. This paper presents research exploring how women active in the 'positive sobriety' community on Instagram position and construct their non-drinking identities and relationships with alcohol within these overlapping discourses. METHODS: Semi-structured interviews (n=15) and online content produced by women active in the positive sobriety community on Instagram were analysed using thematic analysis. FINDINGS: Women challenged, reproduced and amalgamated AA discourses of addiction, and the broader discourses of neo-liberalism, in ways that positioned (alcohol) consumption, agency, control and individual responsibility as defining features of feminine identity making. Drawing on these discourses, binary understandings of problematic drinking, the identity of the 'alcoholic', and the need to reach 'rock bottom' in the recovery process were rejected and challenged, but at times reproduced. Whilst a broader framing of problematic drinking that situated drinking problems on a spectrum was constructed, abstinence was engaged with and promoted as the most effective way of gaining control and responsibility over drinking in gendered ways, and in establishing an authentic sense of self. CONCLUSION: This paper contributes to emerging research on online 'positive' sobriety communities, their gendered nature, and the intertwined presence of traditional recovery and neo-liberal discourses in women's accounts. Online sober communities offered alternative spaces of support and allowed for sobriety and sober femininities to be framed more positively than within traditional AA conceptualisations. However, those involved may experience tensions around (a) the need to 'tell' their personal stories of complete abstinence whilst still appealing to those who seek to 'moderate' and (b) the pressure to create and craft an 'authentic' sober self on an online platform that demands a carefully curated self-image and personal 'brand'. Further research should aim to gain more understanding of the role social media plays in "doing" sobriety and non-drinking, how this is done by people of different genders, the intersectional experiences of those participating, and how these communities can be made more equally available and accessible to those who do not consider full abstinence as necessary, whilst still appealing to those that do.
Subject(s)
Alcoholism , Humans , Female , Male , Alcoholics Anonymous , Self-Help Groups , Femininity , United KingdomABSTRACT
Background: The Twelve Steps described by Narcotics Anonymous (NA) and Alcoholics Anonymous denote key aspects of how members can achieve abstinence from alcohol and other drugs. However, there are limited empirical findings on what long-term members rely on to support their ongoing recovery.Method: In order to clarify the members' reliance on those latter resources, we surveyed 2,293 long-term NA members through the internet on items they rely on for their recovery. They scored nine NA-related resources (e.g., their sponsor) and three non-NA institutional ones (e.g., a professional therapist).Results: Three factors accounted for 53.6% of the variance in the respondents' scores of the 12 items. We labeled them, with the percent of variance accorded, as NA-based social (24.9%) support, spiritual (17.8%) support, and outside professional (10.9%) help. While NA-based resources ranked highest, outside resources (a house of worship, a therapist, or medications for psychological distress) were scored by 75.4% of the respondents. Analysis by subgroups of respondents reflected the diversity of resources members draw on. The use of internet-based meetings during the COVID-19 period reflected the resilience of the NA format.Conclusion: Members of Twelve Step programs can be studied to shed light on options that they rely on for support for their ongoing recovery, both within the fellowships and outside them. Long-term members can apparently rely on resources inside the fellowship and simultaneously on professional ones, as well. These findings can be helpful for researchers in considering mechanisms that underlie long-term Twelve Step-related recovery and for clinicians in employing both these fellowships and outside resources as adjuncts to their professional care.
Subject(s)
Alcoholism , COVID-19 , Humans , Fellowships and Scholarships , Alcoholics Anonymous , Surveys and Questionnaires , Alcoholism/psychologyABSTRACT
In the height of the COVID-19 pandemic, statistics related to the ongoing crisis of addiction in the United States hit record levels. Those statistics include drug overdose deaths, rates of substance use and misuse, and alcohol-related fatalities. Some Christian denominations and individual congregations, including a handful of Roman Catholic parishes, have sought to respond to the suffering experienced by those in active addiction through intentional ministries of care, support, and community. Yet preaching on the topic of addiction-and the hope found in recovery-remains rare in churches on Sunday morning. This thesis explores the complex and confounding realities of addiction, its causes, and multiple pathways to recovery, while articulating an urgent and salient call for Roman Catholic priests and deacons to address the crisis of addiction in their midst. The primary ministerial intervention for the thesis consisted of a one-day workshop for Roman Catholic priests and permanent deacons in Minnesota. Pre-workshop interviews were conducted with two cohorts: ten priests and permanent deacons in active ministry (Cohort One), and ten practicing Catholics in recovery from addiction (Cohort Two). The interviews considered whether preaching on the topic of addiction and recovery was taking place in Roman Catholic parishes around the country and what might be most helpful or harmful for people in recovery or in active addiction to hear from preaching in their parishes. Chapter 1 introduces the thesis project overall.Chapter 2 considers addiction theologically, focusing on three areas of study: sacramentality;sin, grace, and the unconditional love of God;and trauma-informed or trauma-sensitive theology. Chapter 3 explores the importance of story, specifically in the salvific and life-giving tradition of twelve-step storytelling and in the inductive practice of narrative preaching in the style of the New Homiletic. Chapter 4 provides a detailed exploration of addiction, considering clinical diagnostic criteria, neurological and sociological research, and current trends regarding the prevalence of stigma and challenges to achieving recovery for many. The chapter also considers multiple pathways to recovery, including twelve-step programs focused on abstinence, harm reduction strategies, and natural recovery methods. Chapter 5 reports on the ministerial intervention and provides key findings from the research conducted. Chapter 6 considers next steps and offers final conclusions. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
ABSTRACT
Background/Significance: Alcohol-associated liver disease (ALD) is now the leading indication for liver transplantation (LT). Disease burden, as well as hospitalizations, have risen during the SARS-CoV2 pandemic. Alcohol use disorder (AUD) treatments are underutilized in patients with ALD, which is an important focus for quality improvement at LT centers. Our aim was to describe current communication practices surrounding AUD care for hospitalized adults with ALD at a large-volume single LT center without integrated specialty addiction services. Methods: We performed semi-structured interviews with healthcare professionals providing care to hospitalized patients on an inpatient LT service from April to June 2021 using a videoconferencing platform. Interview guides focused on current processes for discussing and connecting hospitalized patients to AUD treatment;these were pilot-tested prior to use. Audio-files were professionally transcribed and imported to NVivo 12 (QSR International). Two qualitative researchers developed a codebook corresponding to 4 major domains of AUD care (discussing AUD, pharmacotherapy, behavioral therapy, and referrals to specialty addiction services) and assigned codes to all transcripts, with regular meetings to resolve discrepancies. A combination of inductive and deductive approaches was used to generate non-overlapping themes. Results: We interviewed 17 providers. Six main themes were generated (Table 1). When discussing AUD, most providers, other than social workers, rarely assessed patients' insight and motivations for drinking. Most providers were uncomfortable with the topic and encouraged behavior change by promoting guilt and fear of the consequences of continued alcohol use. Discussions about pharmacotherapy were rare and limited to few providers offering baclofen. Alcoholics Anonymous (AA) was offered as standard form of non-pharmacologic therapy, but alternative options were rarely presented. Discussions about referrals to specialty addiction services were emphasized most consistently to post-LT patients only;in general, providers expressed it was the patient's responsibility to set up appointments. Conclusions: Communication about AUD from the LT team was rare and focused on narrow topics, including negative consequences of drinking, AA participation, and importance to self-navigate specialty addiction referrals. Opportunities for improving communication include framing and exploring addiction in less stigmatizing ways, discussing the full range of evidence-based pharmacologic and non-pharmacologic treatments for AUD, and providing more direction for setting up specialty addiction referrals. These factors, including advocating for reduced insurance-related barriers for specialty addiction services, should be considered by LT centers when performing needs assessments for improving AUD care. (Table Presented) Table 1: Themes and Quotes from Providers Regarding Current Practices Surrounding AUD
ABSTRACT
Purpose: Social support is critically important to recovery from alcohol use disorder (AUD). During the COVID-19 pandemic, community and government social restrictions and mandates reduced inperson contact and increased social isolation, heightening the risk of relapse for many persons in recovery. A key question concerns what forms and sources of social connection and support were important for maintaining recovery during the pandemic. Methods: This study used a large, pre-existing, national cohort, Knowledge Panel, to recruit participants with resolved AUD for an online survey. The sample consisted of 1,492 adults, 71% of whom had been in recovery more than 5 years. In addition to close-ended questions on COVID-19 stressors and coping responses, an open-ended question asked participants what was most helpful in sustaining their recovery during the pandemic. A qualitative codebook was created, and iterative coding was conducted by multiple analysts using Dedoose, followed by preliminary analysis of themes from codes on COVID-19 restrictions and sources of social connection and support. Results: Participants commonly referenced talking to, staying in touch with, and/or spending time with family members, including children (latter mentioned more commonly by women) as helpful in maintaining recovery. Participants also highlighted support and encouragement from family. Communication and interaction with friends were also integral to recovery maintenance. Support, care, and contact from and towards others in their networks, including those in recovery, were also cited. Many participants continued to attend Alcoholics Anonymous (AA) meetings and other mutual support groups throughout the pandemic. When in-person gatherings were not possible, participants sustained social connections through various forms of telecommunication. Unexpectedly, some participants characterized the lack of social interactions during COVID-19 as beneficial to their continued recovery, as it removed opportunities and temptations to drink with others. Conclusions: Despite profound disruption to social routines during the pandemic, many individuals in recovery experienced helpful social connections and support that were important to maintaining recovery. For some, social restrictions were perceived as beneficial and limiting opportunities for relapse. These findings underscore the importance of social support and networks in long-term recovery, warranting further investigation into the dynamics of support systems conducive to recovery maintenance.
ABSTRACT
The purpose of this study was to understand how older adults in recovery from substance use disorders experienced the transition from in-person to virtual 12-step meetings. We interviewed 11 older adults (age 50+) who self-identified as being members of 12-step programs. Participants completed an online survey including standardized measures assessing depression, anxiety, social isolation, and quality of life. Three themes emerged from interviews: Importance of the program;Promises and Limits of Technology;and Concern for Others. Participants’ high level of commitment to their groups enabled them to adapt quickly to virtual meetings. Participants described their concerns about members of their groups who were unable to make this transition.Older adults in this study adapted quickly to virtual recovery groups. The social support participants received during groups, whether virtual or in person, may have acted as a buffer protecting them from the isolative effects of the pandemic. [ FROM AUTHOR] Copyright of Journal of Social Work Practice in the Addictions is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
ABSTRACT
Face-to-face mutual-aid meetings such as Alcoholics Anonymous shuttered with the onset of COVID-19. Research could not be conducted quickly enough to provide guidance for how to respond. However, two powerful tools could be leveraged: the research on mutual aid conducted before the pandemic and the vast number of virtual resources that proliferated with the onset of the pandemic. This article reviews the existing mutual aid research and its relevance to COVID-19, describes the diverse array of virtual resources, and provides recommendations for successful engagement with virtual mutual aid during COVID-19 and beyond.