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In the United States, one in 14 individuals experience a Substance Use Disorder (SUD). SAMHSA stated that in 2020, approximately 40 million individuals from ages 12 and above had a SUD (CDC, 2022 ; SAMHSA, 2021). There has been a 44% increase in overdose rates in Black communities between 1999 to 2023. One longitudinal study found that the opioid overdose fatality rate among “non-Hispanic Black men 55 years or older was 40.03 per 100,000 population, 4 times greater than the overall opioid overdose fatality rate of 10.70 per 100,000 for persons of the same age” (Mason, Soliman, Kim, & Post, 2022).
This poster describes CTN-0127, a pilot exploratory study that will pave the way for future initiatives focused on increasing SUD care in underserved Black communities through learning collaboratives (LC) between faith-based leaders (FBLs) and behavioral health providers (BHLs). An LC is a short-term (6- to 15-month) learning system that brings together teams (e.g., FBLs, community members, behavioral health/SUD, and social service providers) to seek improvement in a focused topic area.
Related protocols: CTN-0027
Engagement in 12-step meetings and activities has been shown to be a powerful aid to recovery from substance use disorders. However, only limited attention has been given to ethnic and racial differences in attitudes toward 12-step and involvement. This study utilized data from CTN-0031, “Stimulant Abuser Groups to Engage in 12-Step (STAGE-12),” a large multisite trial testing the effectiveness of a 12-step facilitation therapy (Twelve-Step Facilitation (TSF)) with stimulant-dependent treatment seekers. It compared baseline differences and treatment outcomes between African American and Caucasian participants. Results of the analysis found select few baseline differences (i.e., African Americans reported higher levels of spirituality than Caucasians; African American participants indicated more perceived benefits of 12-step involvement; Caucasians were more likely to endorse future involvement in 12-step). However, there were no outcome differences (e.g., substance use outcomes, 12-step meeting attendance).
Conclusions: The tested intervention, TSF, produced similar outcomes for both groups, indicating that it may be useful across racial categories. This finding is promising, given that much of the previous research on TSF treatments has focused on alcohol, and stimulant use may present unique problem profiles for African American and Caucasian individuals. That TSF performed equally well among the two study groups is important information for clinicians deciding which evidence-based practice might be best applied to a particular client.
Related protocols: CTN-0031
In addition to high rates of alcohol and drug use, Native Americans have high rates of suicide, homicide, and accidental death. These problems may be the result of “historical trauma,” according to many clinicians and researchers in the Native American community. In July of 2008, the California-Arizona Node of the National Drug Abuse Treatment Clinical Trials Network (CTN) hosted a day-long conference titled, “Historical Trauma: Healing Approaches in Native American Communities.” The conference was funded by a supplement from NIDA and featured presentations covering both theoretical discussions and research findings on historical trauma, as well as clinical approaches by frontline clinicians. Nearly 170 participants attended from across the western states, including California, Oregon, Washington, Arizona, and New Mexico.
- Introduction & Welcome (3:12)
Carmen L. Masson, PhD and James L. Sorensen, PhD, University of California, San Francisco (CA/AZ Node)
View online - Healing the Historical Trauma Response (61:00)
Maria Yellow Horse Brave Heart, PhD, Columbia University School of Social Work, Takini Network
View online - Holistic System of Care for Native Americans in an Urban Environment (30:01) Ethan Nebelkopf, PhD, San Francisco Family & Child Guidance Clinic, Native American Health Center, Oakland, CA
View online - Afflictions of Firewater and The Sword: Implications of Historical Trauma in Urban Native American Communities (24:24)
Michele Maas, MSW, San Francisco Family & Child Guidance Clinic, Native American Health Center, Oakland, CA
View online - Historical Trauma and Indigenist Stress-Coping Processes: Preliminary Research Findings from the HONOR Project (43:28)
Karina Walters, PhD, MSW, University of Washington School of Social Work, Indigenous Wellness Research Center.
View online - Cultural and Traditional Healing Approaches for Urban Native Americans (42:45)
Nelson Jim, MFT, San Francisco Department of Public Health
View online - The Four Generation Solution (26:15)
Theda New Breast, MPH, New Breast Consultants, Babb, Montana
View online - Re-Viewing Historical Trauma: Bridging Scientific Skepticism & Colloquial Claims (39:19)
Joseph P. Gone, PhD, University of Michigan, Department of Psychology
View online - Developing Evidence-Based Substance Abuse Treatments for Native American Communities: The Role of Historical Trauma (37:47)
Panel Discussion
View online
The aim of this study was to develop a comprehensive annotated public-domain bibliography of the literature on spirituality and addictions to facilitate future research and scholarship. This initiative built on a previous annotated bibliography on spirituality and substance use, developed at the University of New Mexico Center on Alcoholism, Substance Abuse and Addictions (CASAA). In 2003 and 2004, a subcommittee of the Spirituality Research Interest Group of the National Drug Abuse Treatment Clinical Trials Network (CTN) conducted a systematic and comprehensive search of the literature published in English on spirituality, religion, and addiction. A search was conducted of all citations listed in the MEDLINE, PsycINFO, and ALTA Religion databases from 1941-2004. Interest Group members then classified each citation according to empirically derived categories. A total of 1353 papers met the search parameters and were classified into 10 non-exclusive categories: 1) attitudes toward spirituality and substance use, 2) commentaries, 3) spiritual practices and development in recovery, 4) spiritual and religion variables in the epidemiology of substance abuse, 5) psychoactive substances and spiritual experiences, 6) religious and spiritual interventions, 7) literature reviews, 8) measurement of spirituality and addictions, 9) 12-Step spirituality, and 10) youth and development. The literature is voluminous but has focused primarily in a few areas. Common findings include an inverse relationship between religiosity and substance use/abuse, reduced use among those practicing medication, and protective effects of 12-Step group involvement during recovery. Although sound instruments are available for measuring spirituality, studies have tended to use simplistic, often single-item measures. The widespread belief that spirituality is important in recovery is consistent with findings to date, but the literature has only begun to explore ways in which spiritual processes or interventions may help to alleviate addiction and related suffering.
With the rapid growth of the literature on spirituality and addiction, it is important to take stock of research in this area and to begin to describe and understand research trends, gaps in knowledge, areas requiring future and further study, and methodological problems. As a contribution to this effort, a subcommittee of the Spirituality Research Interest Group of the NIDA Clinical Trials Network, along with the Center on Alcoholism, Substance Abuse, and Addictions (CASAA), compiled a library of publications on spirituality and addiction and classified the citations into ten categories that emerged. This poster describes the methods and results of this process and offer some preliminary thoughts on the current state of the knowledge base on addiction and spirituality as a resource for other researchers in the field.
An EndNote version of the bibliography can be requested from the CTN Dissemination Librarian (ctnlib@uw.edu).