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Spirituality is a construct encompassing a diversity of strongly held beliefs and pursuits related to life's meaning and purpose. Empirical studies in key domains of spirituality related to substance use disorder (SUD) can be valuable in guiding research, and potentially clinical care. To conduct a scoping review of research on the psychological, biological, and cultural dimensions of spirituality and their role in relation to SUD. To identify limitations in empirical findings within these domains and identify promising areas for related research. Illustrative studies available in the empirical literature are reviewed in order to characterize these three key domains. Certain areas of importance stand out: On Psychology, attribution of SUD to a spiritual outlook; spiritual awakening; the relation of spirituality to drug craving; and spirituality in the context of psychedelic-assisted psychotherapy. On Biology, heritability of traits related to shared spiritual experience; neurophysiologic correlates of spiritually related experiences; and correlates in brain imaging; On Culture, spiritual aspects of SUD in different cultural settings; distinctions between spiritual and religious phenomena; roles that international organizations play; and context of acquiring recovery capital. The need for further research in each area is defined. There is utility in examining the diversity of findings in the roles of psychology, biology, and culture in the SUD field. Further research, particularly applying randomization and clinical controls, would be useful in improving the effective application of the construct of spirituality in clinical care. [ABSTRACT FROM AUTHOR]

Background: A Zoom-based website was developed in 2020 that offers continuous access to online Narcotics Anonymous (NA) meetings for the first time. This website provides immediate access for persons with substance use disorder to support abstinence from substance-related addictive disorders. Objectives: This study is designed to characterize attendees employing this online format; to evaluate their experiences for gaining support to maintain abstinence; and to compare the 24/7 experience to face-to-face (FF) meetings they attend. Methods: An anonymous 33-item survey was made available on the 24/7 NA website that links to the 24/7 meetings. Persons accessing the site could choose to fill out the survey. Results: 530 respondents completed the survey (64.9% female/35.1% male). Most had stable prior involvement in NA. They had attended more 24/7 meetings (14.9, SD 19.7) than FF meetings (4.6, SD 7.8) in the previous month. 86% had previously attended FF meetings, 48% had served as sponsors, and 92% reported that the 24/7 meetings were more comfortable for them than the FF meetings (p <.001, Cohen's d = 0.65) and more supportive of abstinence (p <.001, Cohen's d = 0.91). Of the respondents, 8% were still using drugs, of whom 52% had previously completed some of the Twelve Steps. Conclusions: The 24/7 format provides a new and easily accessible way for NA members to gain support for abstinence and is positively rated by attendees seeking support for recovery from substance use disorders. It may serve as a valuable adjunct to the traditional FF format. [ABSTRACT FROM AUTHOR]

Abstract Objective The high rate of treatment failure is a common problem in the treatment of methamphetamine use. Therefore, the aim of this research is to identify the most common causes of relapse in methamphetamine users. Method This is a qualitative study and of content analysis type. Information was collected using purposeful sampling and through semi-structured interviews and focus group discussions. The statistical population consisted of all people with the methamphetamine-use disorder in 2022 who were in the abstinence phase and participated in the meetings of the Narcotics Anonymous (NA) Center of Bojnord. Theoretical sampling continued until data saturation. A total of 10 one-on-one interviews were conducted, each lasting between 45 to 80 min. Additionally, two focus group interviews were conducted with six members in each group, lasting between 95 to 110 min and data saturation was achieved through these interviews. Data analysis was done using the content analysis method (Sterling). Recoding and Holsti's method were used to measure reliability; validity was then calculated through content validity assessment. Findings The results of the thematic analysis showed that laps and relapse factors were identified and categorized into 5 organizing themes, including negative emotional states, positive emotional states, negative physical states, interpersonal factors, and environmental factors, consisting of 39 basic themes. Result Identifying the risk factors leading to laps and relapse in methamphetamine users and increasing the knowledge in this field can lay the groundwork for preventive therapeutic interventions in this community.

Abstract Background Addiction is a chronic and relapsing disorder characterized by compulsive drug seeking and lasting changes in the brain. Low quality of life may influence the substance craving, which leads to relapsing. Therefore, the present study aimed to investigate the relationship between beliefs in substance craving and quality of life among narcotics anonymous. Methods This cross-sectional study was performed on 202 narcotics anonymous in Kerman, southeastern Iran. Convenience sampling was used to select anonymous patients in the Narcotics Anonymous (NA) association in Kerman city. Narcotics anonymous completed the demographic questionnaire, the Craving Beliefs Questionnaire (CBQ), and the World Health Organization Quality of Life-BREF (WHOQOL-BREF). Multiple linear regression model was used to determine the predictors of craving beliefs. The data were then analyzed using SPSS 22. Results The mean age of the participants was 38.48 ± 11.32 years. The majority of the samples were male (86.1%), married (65.4%), educated (93.6%) and urban (86.1%). The mean scores of craving beliefs and overall Quality of Life (QOL) were 77.58 ± 20.70 and 64.42 ± 23.13, respectively. Forty-two-point 1% had high level of craving beliefs. We found a significant negative and weak correlation between beliefs in substance craving, physical health domain (r = -0.16, p = 0.02), and overall quality of life (r = -0.15, p = 0.03). History of crack use, job, and physical health domain of QOL were predictors of beliefs in substance craving among the NAs. Conclusion Based on the study results, the participants had a high level of substance craving, and some aspects of the quality of life had an impact on the beliefs of addiction. However, it is necessary to conduct more studies in this field; psychological interventions and programs to increase the quality of life may reduce the substance craving.

Objective: The high rate of treatment failure is a common problem in the treatment of methamphetamine use. Therefore, the aim of this research is to identify the most common causes of relapse in methamphetamine users. Method: This is a qualitative study and of content analysis type. Information was collected using purposeful sampling and through semi-structured interviews and focus group discussions. The statistical population consisted of all people with the methamphetamine-use disorder in 2022 who were in the abstinence phase and participated in the meetings of the Narcotics Anonymous (NA) Center of Bojnord. Theoretical sampling continued until data saturation. A total of 10 one-on-one interviews were conducted, each lasting between 45 to 80 min. Additionally, two focus group interviews were conducted with six members in each group, lasting between 95 to 110 min and data saturation was achieved through these interviews. Data analysis was done using the content analysis method (Sterling). Recoding and Holsti's method were used to measure reliability; validity was then calculated through content validity assessment. Findings: The results of the thematic analysis showed that laps and relapse factors were identified and categorized into 5 organizing themes, including negative emotional states, positive emotional states, negative physical states, interpersonal factors, and environmental factors, consisting of 39 basic themes. Result: Identifying the risk factors leading to laps and relapse in methamphetamine users and increasing the knowledge in this field can lay the groundwork for preventive therapeutic interventions in this community. [ABSTRACT FROM AUTHOR]

Background: Much remains unknown about the dynamics of substitute behaviors during addiction recovery among persons attending recovery support groups. Insight into the nature, motives for, and course of substitute behaviors could help to shape recovery support and harm reduction services. Methods: Twenty-three semi-structured in-depth interviews (n = 14 males and n = 9 females) were conducted with a convenience sample of Narcotics Anonymous attendees from a number of groups in the Western Cape, South Africa. Participants ranged in age from 22—55 years (M = 39.3, SD = 9.35). Results: Thematic analysis yielded four themes: (i) substance-to-substance substitution; (ii) substance-to-behavior substitution; (iii) substitute behaviors and harm (reduction) and (iv) support needs to manage and resolve substitute behaviors. According to the study, participants' substitute behaviors developed across recovery stages; were temporary or long-term replacements for substance use disorders and were engaged for distraction, isolation from others, calming, assuaging boredom, keeping occupied, filling a perceived experiential void, modifying mood and to self-medicate. While substitutes were utilized for harm reduction or relapse prevention, the potential for ostensibly healthy behaviors to threaten recovery and lead to relapse was also recognized. Conclusions: Self-monitoring, ongoing vigilance, and awareness of when substitutes become genuine addictions are critical for timely, suitable interventions. [ABSTRACT FROM AUTHOR]

Objectives: Belief in an American Indian/Alaska Native (AIAN) specific biological vulnerability (BV) to alcohol problems is associated with worse alcohol outcomes among AIANs. Despite a notable lack of evidence that biogenetic factors play a greater role in the development of alcohol problems among AIANs than other groups, many people still believe this myth. Consistent with theory and evidence that greater experiences with discrimination leads to the internalization of stereotypes and oppression, we hypothesized that greater perceived racial discrimination (racism) would be associated with greater BV belief, but that having a stronger ethnic identity would weaken this association. We also examined whether previous substance use treatment as well as participation in Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) was associated with BV belief. Method: Participants were 198 reservation-dwelling AI adults with a substance use problem who completed a survey as part of a larger community-based participatory study. Results: A multiple regression analysis revealed that greater systemic racism was associated with greater belief in a BV; this association was not moderated by ethnic identity. Greater interpersonal racism was also associated with greater BV belief—but only among those low in ethnic identity. A regression analysis revealed that previous treatment, AA, and NA participation were not associated with BV belief. Conclusions: Greater systemic and interpersonal racism were associated with belief in a BV, and greater ethnic identity buffered the association between interpersonal racism and BV belief. This suggests that both combatting racism and fostering positive ethnic identity may help to lessen BV belief. Public Significance Statement: People who report experiencing more racial discrimination are more likely to accept stereotypes and negative societal beliefs about their own group (i.e., to internalize racism). In this study with American Indian/Alaska Natives (AIAN), systemic and interpersonal racism were associated with greater belief in the unfounded and harmful stereotype that AIAN people have a unique biological vulnerability (BV) to alcohol problems. However, a stronger ethnic identity was protective against the effects of interpersonal racism on belief in a BV. [ABSTRACT FROM AUTHOR]

Background: Addiction is a chronic and relapsing disorder characterized by compulsive drug seeking and lasting changes in the brain. Low quality of life may influence the substance craving, which leads to relapsing. Therefore, the present study aimed to investigate the relationship between beliefs in substance craving and quality of life among narcotics anonymous. Methods: This cross-sectional study was performed on 202 narcotics anonymous in Kerman, southeastern Iran. Convenience sampling was used to select anonymous patients in the Narcotics Anonymous (NA) association in Kerman city. Narcotics anonymous completed the demographic questionnaire, the Craving Beliefs Questionnaire (CBQ), and the World Health Organization Quality of Life-BREF (WHOQOL-BREF). Multiple linear regression model was used to determine the predictors of craving beliefs. The data were then analyzed using SPSS 22. Results: The mean age of the participants was 38.48 ± 11.32 years. The majority of the samples were male (86.1%), married (65.4%), educated (93.6%) and urban (86.1%). The mean scores of craving beliefs and overall Quality of Life (QOL) were 77.58 ± 20.70 and 64.42 ± 23.13, respectively. Forty-two-point 1% had high level of craving beliefs. We found a significant negative and weak correlation between beliefs in substance craving, physical health domain (r = -0.16, p = 0.02), and overall quality of life (r = -0.15, p = 0.03). History of crack use, job, and physical health domain of QOL were predictors of beliefs in substance craving among the NAs. Conclusion: Based on the study results, the participants had a high level of substance craving, and some aspects of the quality of life had an impact on the beliefs of addiction. However, it is necessary to conduct more studies in this field; psychological interventions and programs to increase the quality of life may reduce the substance craving. [ABSTRACT FROM AUTHOR]

Background Substance use (SU) contributes to poor health outcomes, yet limited data exist to inform strategies to optimize SU treatment among persons with human immunodeficiency virus (HIV). We describe SU and SU treatment utilization among women with and without HIV in the Women's Interagency HIV Study (WIHS). Methods We included data from women enrolled in WIHS from 2013 to 2020. Current SU was self-reported, nonmedical use of drugs in the past year, excluding use of only marijuana. SU treatment utilization was self-reported use of a drug treatment program in the past year. Multivariable regression models were used to investigate associations between participant characteristics and SU treatment. Results Among 2559 women (1802 women living with HIV [WWH], 757 women without HIV), 14% reported current SU. Among those with current SU (n = 367), 71% reported crack/cocaine followed by 40% reporting opioids, and 42% reported any treatment in the past year. The most common treatments were methadone (64%), Narcotics Anonymous (29%), inpatient programs (28%), and outpatient programs (16%). Among women using opioids (n = 147), 67% reported methadone use in the past year compared to 5% using buprenorphine/naloxone. Multivariable analysis showed lower odds of treatment utilization among WWH with concurrent alcohol or marijuana use. Visiting a psychiatrist/counselor was associated with higher odds of treatment. Among WWH, SU treatment was not associated with HIV-related clinical outcomes. Conclusions Treatment utilization was high, especially for methadone use. Our results highlight opportunities for accessing SU treatment for WWH, such as the need to prioritize buprenorphine and comprehensive, wraparound services in HIV care settings. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background and Objectives: Methamphetamine use disorder (MUD) is a major public health problem, but there are no evidence‐based, best‐practice, pharmacologic, or behavioral treatments for it. Narcotics Anonymous (NA) may provide an option for referral for such patients. Methods: Two waves of surveys were sent to a sample of NA members to evaluate demographic, drug use, and NA‐related issues. Of 4445 responses received from US residents, 647 listed themselves as abstinent from their worst drug problem, methamphetamine. Twelve possible sources of support were scored by these latter respondents for how important each was for their own recovery. Results: Methamphetamine respondents were longstanding NA members, with their first NA meeting 30.2 years ago, 84.3% having served as sponsors for other members, and with little current craving (0.65 out of 10). Although now abstinent for an average of 13.4 years, at some point over the course of the membership, 47.4% had experienced a relapse, for an average of 16.7 months. In a factor analysis of resources scored, 29.6% of the variance fell under NA social and 29.2% spiritual; and 11.8% under outside professional support. Discussion and Conclusions: NA served as a resource for supporting abstinence for some members with MUD. They scored social resources of NA support higher than both spiritual and outside institutional ones. Scientific Significance: NA can serve as a community‐based resource for MUD. Determining the nature of recovery that members with MUD have in NA can be useful for further research of socially grounded support for recovery in substance use disorders. [ABSTRACT FROM AUTHOR]

When the COVID-19 pandemic began, many 12-step meetings rapidly transitioned from an in-person to an online format. In this qualitative focus group study, 17 attendees of 12-step programs from six U.S. states participated in one of two focus groups on Zoom platform in August 2021 in which their experiences of attending online versus in-person meetings were explored. Respondents praised the accessibility and convenience of online meetings, and the ability to interact with members from different geographic locations. However, they noted the loss of intensive social support found at in-person meetings and technological/procedural challenges that remain unsolved online. [ABSTRACT FROM AUTHOR]

STUDY QUESTION Do children whose mothers have polycystic ovary syndrome (PCOS) have an increased risk of morbidity? SUMMARY ANSWER Maternal PCOS is associated with an increased risk of infection, allergy and other childhood morbidity. WHAT IS KNOWN ALREADY PCOS is associated with higher rates of gestational diabetes, pre-eclampsia and preterm delivery, but the long-term impact on child health is poorly understood. STUDY DESIGN, SIZE, DURATION We conducted a retrospective longitudinal cohort study of 1 038 375 children in Quebec between 2006 and 2020. PARTICIPANTS/MATERIALS, SETTING, METHODS We included 7160 children whose mothers had PCOS and 1 031 215 unexposed children. Outcomes included child hospitalization for infectious, allergic, malignant and other diseases before 13 years of age. We estimated hazard ratios (HRs) and 95% CI for the association of PCOS with childhood morbidity in adjusted Cox proportional hazards regression models. MAIN RESULTS AND THE ROLE OF CHANCE Children exposed to PCOS were hospitalized at a rate of 68.9 (95% CI 66.2–71.8) per 1000 person-years, whereas unexposed children were hospitalized at a rate of 45.3 (95% CI 45.1–45.5) per 1000 person-years. Compared with no exposure, maternal PCOS was associated with 1.32 times the risk of any childhood hospitalization (95% CI 1.26–1.40), 1.31 times the risk of infectious disease hospitalization (95% CI 1.25–1.38) and 1.47 times the risk of allergy-related hospitalization (95% CI 1.31–1.66). Risk of hospitalization was also elevated for childhood metabolic (HR 1.59, 95% CI 1.16–2.18), gastrointestinal (HR 1.72, 95% CI 1.53–1.92), central nervous system (HR 1.74, 95% CI 1.46–2.07) and otologic disorders (HR 1.34, 95% CI 1.26–1.43). Subgroup analyses suggested that there was little difference in the association of PCOS with hospitalization among boys (HR 1.31, 95% CI 1.24–1.39) and girls (HR 1.34, 95% CI 1.26–1.43). LIMITATIONS, REASONS FOR CAUTION We analyzed severe childhood morbidity requiring hospitalization, not mild diseases treated in ambulatory clinics. We lacked data on ethnicity, education and physical activity, and cannot rule out residual confounding. WIDER IMPLICATIONS OF THE FINDINGS Our findings suggest that maternal PCOS is associated with an increased risk of childhood morbidity. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by grant PJT-162300 from the Canadian Institutes of Health Research. N.A. acknowledges a career award from the Fonds de recherche du Québec-Santé (296785). The authors declare no competing interests. TRIAL REGISTRATION NUMBER N/A. [ABSTRACT FROM AUTHOR]

Objectives: Face-to-face meetings are key components of Twelve Step (TS) fellowships' support of members' abstinence. Home confinement during COVID-19 made this less feasible. Our objective was to ascertain whether a transition to virtual online meetings among TS members took place, and whether it was potentially effective. Methods: Two thousand one hundred fifty-two long-standing USA members of Narcotics Anonymous (NA) were surveyed to ascertain their recovery-related experiences and their relation to the transition to virtual meetings. Results: During the previous week (ie, 'during COVID-19') respondents attended more virtual meetings (= 4.13[SD4.64]) than they had attended both face-to-face meetings before COVID-19 (Conclusions: In a survey of well-established NA members, most had made a successful transition from face-to-face to virtual meetings, relative to their antecedent characteristics. This successful transition suggests the possibility of an enhanced opportunity for stabilizing TS membership. [ABSTRACT FROM AUTHOR]

Abstract Background Mutual aid organizations, such as Narcotics Anonymous (NA), can provide support in substance use disorder (SUD) recovery processes. However, research on NA and its recovery-supportive elements is scarce and perspectives of NA-members remain understudied, in particular outside the US. Therefore, this study aims to gain insight into recovery-supportive elements of NA, as experienced by its members. Methods To explore the perspectives on and experiences with recovery-supportive elements in NA, 11 in-depth interviews with NA-members were conducted in Flanders (Belgium). Interviews were audio-taped, transcribed verbatim and analyzed by using CHIME-D, a personal recovery framework (Connectedness, Hope, Identity, Meaning in life, Empowerment, Difficulties) developed by Leamy and colleagues in 2011. Results Various recovery-supportive elements of NA were highlighted, with Connectedness as a key component including opportunities for building up a social network and for providing a safety net or sounding board. Elements that enabled Connectedness were 1) a non-judgemental approach, and 2) mutual understanding through sharing in NA. Other elements of the CHIME-D framework were less frequently mentioned, although these were inextricably linked to Connectedness. Conclusions Connectedness appeared to be the crucial recovery-supportive element in NA, emphasizing the relational character of SUD recovery. Although other elements of the CHIME-D framework were identified, these were closely related to and intertwined with the concept of connectedness.

Abstract Background For persons with substance use disorders (SUDs), 12-step groups (TSGs) are the most available and used peer-based recovery resource, worldwide. However, disengagement is common, and attrition may partly be due to practices and procedures within these groups that are unacceptable to a portion of the population with SUDs. Our overall aim was to identify problematic issues related to Narcotics Anonymous (NA) participation in Norway, to inform addiction professionals’ strategies when referring persons to addiction-related self-help groups (SHGs). Methods In this qualitative study, we interviewed ten individuals who had previously participated regularly in NA for at least 6 months, to examine their reasons for disengagement. We interpreted the interviews using thematic analysis. Results We identified three themes: (1) ‘The model did not fit’, either the strategies utilized in NA (e.g., meeting format and step working) or NA’s explanatory model of addiction, (2) ‘Negative experiences spurred frustration’, and (3) ‘The safe place can become a cage’. The respondents believed that a main aim of recovery was reintegration into society, such that SHG participation should not be an end goal, but rather a platform for normalization back into society. Despite their negative experiences and strong critique, respondents still regarded NA as a valuable recovery resource, but pointed out that one size does not fit all. Conclusion Addiction professionals should recognize possible problems related to TSG participation, to help prevent negative experiences and possible harms to individuals. Professionals should also inform individuals about alternative support groups, to help them find the recovery resource best suited to them.

The article discusses the potential obstacles that Narcotics Anonymous (NA) may pose to methadone maintenance treatment for opioid use disorder (OUD). Methadone is a commonly used drug for treating heroin addiction, but some patients may not accept methadone treatment due to various reasons, including the influence of NA. NA is an association that follows a 12-step program similar to Alcoholics Anonymous and believes that drugs like methadone can hinder spiritual transformation. The article suggests educating NA about the benefits of methadone, making the latest NA guidelines available to local groups, and forming a group called Methadone Anonymous (MA) to address these issues. [Extracted from the article]

This article focuses on the ways in which members of Alcoholics Anonymous and Narcotics Anonymous construct themselves as being in recovery from addiction. In this original study, data were taken from 19 participants. They were analysed using Willig's six-stage Foucauldian discourse analytic method. This method is suited to enabling the analyst to locate discourse resources used by participants within broader, dominant, discourses, and for exploration of the implications of these constructions for subjectivity and practice. This article presents a discussion of analytic findings. Mainstream academia has often constructed 12-Step recovery as a largely totalising discourse. This is likely to have negatively prejudiced health professionals and may help explain relatively low referral rates into 12-Step resources for addicted clients. However, our analysis suggested that participants constructed themselves not as subjected by Alcoholics Anonymous and Narcotics Anonymous discourse, but as drawing on it in ways aligned with agency, in order to practice care of the self in pursuit of various ethical goals. This implies 12-Step recovery to be less antithetical to, and indeed more aligned with, humanistic practitioner values than is perhaps often assumed to be the case. This finding suggests that practitioners may need to consider reappraising their view of 12-Step recovery. The discussion will therefore focus on the agency-structure dialectic that seemed to be at the heart of participant constructions of addiction and recovery. It is also a finding which points to an urgent need for more qualitative studies in the currently under-researched, and hence perhaps poorly understood, area of 12-Step recovery from addiction. [ABSTRACT FROM AUTHOR]

Background: Cognitive-behavioral therapy is an umbrella term which encompasses a wide range of distinct, yet related interventions, several of which have been shown to be efficacious in the treatment of substance use disorders. However, 12-Step programs (including Alcoholics Anonymous and Narcotics Anonymous) are traditionally the most widely known and commonly used approaches to managing alcohol and substance abuse. Objectives: Therefore, this paper attempts to offer a summary of the compatibility of CBT-based approaches and 12-Step philosophy, in order to assist clinicians who work with patients with a strong adherence to 12-Step ideology. Results: Specific passages from AA's Big Book, NA's Basic Text, and ancillary 12-Step literature will be highlighted where appropriate. Moreover, common roadblocks to synthesis (e.g. belief in a "higher power;" acceptance of one's "powerlessness") will also be addressed. Conclusions: Clinicians who are committed to evidence-based, CBT-related practices are ultimately advised to adopt flexibility when working with patients who identify with the cultural values of 12-Step programs. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Possession and use of illegal drugs carry harsh penalties in Japan if an individual is apprehended by authorities. These severe legal restrictions stigmatize drug use while failing to eliminate narcotics from Japan. This makes individual efforts to take on recovery difficult, as admissions of past use are often met with fear and disdain. Drug Addiction Rehabilitation Center (DARC) is a Japanese organization that helps individuals work a program based on Narcotics Anonymous (NA), while providing members a place to spend their days free from temptation or judgment. Underestimated in this program is how DARC members drug use is often a symptomatic response to interpersonal trauma and struggles to meet societal expectations of success. I argue here that an NA influenced approach to recovery, typically the only option available to those seeking help in Japan, struggles to acknowledge contextual and societal factors that motivated members to begin using drugs. In doing so, I show the necessity for comprehensive change to the ways in which Japan understands, perceives, and treats those labeled as addicts. [ABSTRACT FROM AUTHOR]

Background: Substance use disorders have a multifactorial aetiology and are widespread in all parts of society. Long-term abstinence from all psychotropic substances, including substitutes, remains an elusive goal for many addicts. Aim: For a number of previously active drug addicts, the spiritual programme of Narcotics Anonymous (NA) seems to be an important support mechanism for a drug-free life. As spirituality is one assumed foundation of NA support group effectiveness, the influence of spiritual content and practices on successful abstinence will be examined. Methods: We investigated to what extent polytoxicomanic patients (PP0, n = 43, 12f, 31 m), who were in in- and outpatient treatment at an addiction clinic, differed in their Religious/Spiritual Well-Being (RSWB) from a sample of patients (NA, n = 55, 26f, 29 m) who had not been consuming psychotropic substances for at least 12 months and who attended NA meetings regularly. In addition, we investigated whether an increase in the intensity of self-reported RSWB is related to the duration of abstinence. Results: Our results show significantly higher values in RSWB for the NA compared to the PP0 group. However, there was no significant relationship between the length of abstinence and RSWB. Conclusion: Polytoxicomanic patients, who successfully reached abstinence, differ in the extent of RSWB from those who are still dependent, but the underlying mechanisms remain unclear. Experimental and longitudinal research is needed to further explore the causal relationships between spirituality and abstinence in people with (multiple-) substance use disorders. [ABSTRACT FROM AUTHOR]

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Narcotics Anonymous (NA) supports long-term recovery for those addicted to drugs. Paralleling social dynamics in many small-scale societies, NA exhibits tension between egalitarianism and prestige-based hierarchy, a problem exacerbated by the addict’s personality as characterized by NA’s ethnopsychology.  We explore how NA’s central principle of anonymity normatively translates into egalitarianism among group members.  Turning to the lived reality of membership, building on Carr’s (2011) concept of script-flipping (2011), we identify script-embellishment as speech acts that ostensibly conform to normative therapeutic discourse while covertly serving political ends.  We argue that, in spite of the overtly egalitarian context, NA members differ dramatically in prestige, with more experienced members being admired and emulated. Critically, prestige acquisition occurs via structural functions that are central to the maintenance of the institution, as experienced members serve a central role in the transmission and enforcement of cultural norms, paradoxically including norms of egalitarianism.

Much of what has been written about prison masculinity has focused on the hypermasculine climate of prisons that rewards aggression and the concealment of vulnerability. However, the findings of more recent studies have indicated a more varied ideal of masculinity in this environment. The present research examined how inmates construct and understand masculinity within the domain of reformatory intervention. Interpretative phenomenological analysis was performed on fourteen transcribed interviews with inmates who participated in Narcotics Anonymous (NA). The results indicated that hypermasculinity ideals hindered the participants' ability to apply the tenets of NA that threatened their masculine identity, such as admitting powerlessness. However, they sought to negotiate these threats by employing three main discursive strategies. First, they affirmed hegemonic masculinity notions by presenting themselves as pragmatic agents, offsetting criticism of their submission to higher authorities, constructing recovery as a masculine act, and othering drug-using men. Second, they reformulated ideas of masculinity by adapting the concept to include feminine notions of caring and admitting vulnerability, in line with their NA experience. Third, they rejected their former ideologies and their current dominant localized sociocultural constructions of hypermasculinity that stigmatized them by noting the superiority of NA as a space of support, egalitarian relationships between inmates, and trust relationships with prison staff. By focusing on the dynamic of stigma, marginalization, and masculinity, the research informs both the theoretical understanding of masculinity and the development of reformatory interventions in prison. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to investigate factors affecting on relapse of addiction in substance abuse patients referred to Malayer Narcotics Anonymous Population. Methods:This cross-sectional study was performed on 340 substance abuse patients from Narcotics Anonymous population of Malayer recruited with a simple sampling method, in 2014. The standard questionnaire was used for data collection including demographic variables and causes of relapse via self-report method. Data analysis was performed using SPSS18 by Pearson Correlation test. Results: Age of respondents ranged from 13 to 71 year; with a mean age of 36.47 years (SD=11.4). According to the results, 58.2 percent of the respondents had 1-3 relapse, 30.9 percent 4-10 relapse and 10.9 percent more than 10 relapse. The participants reported their viewpoints regarding the other factors as follows: Among individual factors; enjoyment and fun (%46.2), and among familial factors, poor parental relationships (%25.6) had been reported by the addicts. With regard to the social factors, the existence of addicts’ friends (52.4%), and related to the economic factors, lack of job was the major element with (34.1%). Considering cultural factors, recreational use of drugs and loss of function obscenity (%55) were leading factors mentioned by the addicts. Findings indicated that all factors related with relapse (personal factors, family factors related to spouse, social factors, economic factors and cultural factors) are significant positive correlation with each other at level in 05/0 and 01/0 respectively. Conclusion: According to the findings, exploring these correlates may predict the likelihood of relapse among drug users.

Background: Mutual aid organizations, such as Narcotics Anonymous (NA), can provide support in substance use disorder (SUD) recovery processes. However, research on NA and its recovery-supportive elements is scarce and perspectives of NA-members remain understudied, in particular outside the US. Therefore, this study aims to gain insight into recovery-supportive elements of NA, as experienced by its members.Methods: To explore the perspectives on and experiences with recovery-supportive elements in NA, 11 in-depth interviews with NA-members were conducted in Flanders (Belgium). Interviews were audio-taped, transcribed verbatim and analyzed by using CHIME-D, a personal recovery framework (Connectedness, Hope, Identity, Meaning in life, Empowerment, Difficulties) developed by Leamy and colleagues in 2011.Results: Various recovery-supportive elements of NA were highlighted, with Connectedness as a key component including opportunities for building up a social network and for providing a safety net or sounding board. Elements that enabled Connectedness were 1) a non-judgemental approach, and 2) mutual understanding through sharing in NA. Other elements of the CHIME-D framework were less frequently mentioned, although these were inextricably linked to Connectedness.Conclusions: Connectedness appeared to be the crucial recovery-supportive element in NA, emphasizing the relational character of SUD recovery. Although other elements of the CHIME-D framework were identified, these were closely related to and intertwined with the concept of connectedness. [ABSTRACT FROM AUTHOR]

Background: For persons with substance use disorders (SUDs), 12-step groups (TSGs) are the most available and used peer-based recovery resource, worldwide. However, disengagement is common, and attrition may partly be due to practices and procedures within these groups that are unacceptable to a portion of the population with SUDs. Our overall aim was to identify problematic issues related to Narcotics Anonymous (NA) participation in Norway, to inform addiction professionals' strategies when referring persons to addiction-related self-help groups (SHGs). Methods: In this qualitative study, we interviewed ten individuals who had previously participated regularly in NA for at least 6 months, to examine their reasons for disengagement. We interpreted the interviews using thematic analysis. Results: We identified three themes: (1) 'The model did not fit', either the strategies utilized in NA (e.g., meeting format and step working) or NA's explanatory model of addiction, (2) 'Negative experiences spurred frustration', and (3) 'The safe place can become a cage'. The respondents believed that a main aim of recovery was reintegration into society, such that SHG participation should not be an end goal, but rather a platform for normalization back into society. Despite their negative experiences and strong critique, respondents still regarded NA as a valuable recovery resource, but pointed out that one size does not fit all. Conclusion: Addiction professionals should recognize possible problems related to TSG participation, to help prevent negative experiences and possible harms to individuals. Professionals should also inform individuals about alternative support groups, to help them find the recovery resource best suited to them. [ABSTRACT FROM AUTHOR]