Substance Abuse News

Teenagers who drink alcohol spend more time on their computers for recreational use, including social networking and downloading and listening to music, compared with their peers who don’t drink.

Results of an anonymous survey of 264 teenagers were reported in the online edition of the journal Addictive Behaviors in a study authored by Weill Cornell Medical College public health researcher Dr. Jennifer Epstein.

Early Exposure to the Internet

“While the specific factors linking teenage drinking and computer use are not yet established, it seems likely that adolescents are experimenting with drinking and activities on the Internet. In turn, exposure to online material such as alcohol advertising or alcohol-using peers on social networking sites could reinforce teens’ drinking,” says Dr. Epstein, assistant professor of public health at Weill Cornell Medical College. “Children are being exposed to computers and the Internet at younger ages. For this reason it’s important that parents are actively involved in monitoring their children’s computer usage, as well as alcohol use.

“According to a national study conducted by the Pew Internet and American Life Project, more than half of parents of teenagers had filters installed on the computers their child uses to block content parents find objectionable, yet many parents do not use any form of parental monitoring, particularly for older teens,” continues Dr. Epstein.

Drinking Linked to Computer Use

The Weill Cornell survey was completed by participants aged 13 to 17 and residing in the United States. Results showed that teens who reported drinking in the last month used a computer more hours per week excluding school work than those who did not; however, there was no demonstrated link between alcohol use and computer use for school work. Drinking was also linked to more frequent social networking and listening to and downloading music. There was no strong link between video games and drinking or online shopping and drinking.

“Going forward, we would like to collect more detailed and longer-term data on adolescent alcohol and computer use, including the degree and duration of their drinking habit,” says Dr. Epstein.

Teenagers typically first experiment with alcohol at age 12 or 13. Family risk factors include lax parental supervision and poor communication, family conflicts, inconsistent or harsh discipline and a family history of alcohol or drug abuse.

Impact of New Media

“Parents may also need to reinforce their family ground rules on alcohol use and computer use,” Dr. Epstein says.

“This is an innovative study that is an important first step to understanding the potential impact that the Internet and new media may have on today’s youth,” says Dr. Gil Botvin, professor of public health and chief of the Division of Prevention and Health Behavior at Weill Cornell Medical College. “The Internet offers a wealth of information and opportunities for intellectual and social enrichment. However, it is becoming clear that there may also be a downside to Internet use. More systematic research is needed to better understand to those potential dangers and how to combat them.”

Binge drinking is prevalent among university students, especially in the United States. One brain structure particularly sensitive to alcohol’s neurotoxicity during development is the hippocampus, which plays a key role in learning and memory. A study of the association between binge drinking and declarative memory – a form of long-term memory – in university students has found a link between binge drinking and poorer verbal declarative memory.

“In northern European countries, there is a strong tradition of a sporadic, drunkenness-orientated, drinking style,” explained María Parada, a postdoctoral researcher at the Universidade de Santiago de Compostela, Spain and first author of the study. “In contrast, countries on the Mediterranean coast, such as Spain, have traditionally been characterized by a more regular consumption of low doses of alcohol. In recent years, the pattern of binge drinking among young people has become more widespread throughout Europe, hence the growing concern about this issue.”

Binge Drinking and Memory

“I think it´s important to examine alcohol´s effects on the hippocampus because in animal studies, particularly in rats and monkeys, this region appears sensitive to the neurotoxic effects of alcohol, and this structure plays a main role in memory and learning,” said Marina Rodríguez Álvarez, a senior researcher at the Universidad de Santiago de Compostela. “In other words, binge drinking could affect memory of young adults, which might affect their day-to day lives.”

“Our interest in studying the effects of binge drinking patterns on declarative memory results from the well-established role of the hippocampus – a small seahorse-shaped brain structure located in the medial regions of the cerebral hemispheres – in this cognitive function,” added Parada. “Both animal studies as well as some neuroimaging studies in humans have shown the hippocampus to be particularly vulnerable to the effects of alcohol, so we wondered whether hippocampus-dependent learning and memory could be affected by heavy episodic drinking.”

Parada and her colleagues examined 122 Spanish university students between 18 and 20 years of age divided into two groups: those who engaged in binge drinking (n=62; 32 men, 30 women) and those who did not (n=60; 31 men, 29 women). All were administered a neuropsychological assessment that included the Rey Auditory Verbal Learning Test and the Wechsler Memory Scale-3rd ed. (WMS-III) Logical Memory subtest to measure verbal declarative memory, as well as the WMS-III Family Pictures subtest to measure visual declarative memory.

College Students Affected

“Our main finding was a clear association between binge drinking and a lower ability to learn new verbal information in healthy college students, even after controlling for other possible confounding variables such as intellectual levels, history of neurological or psychopathological disorders, other drug use, or family history of alcoholism,” said Parada.

“Young adults with a binge drinking pattern of alcohol consumption who have poorer verbal declarative memory will need more neural resources to perform memory tasks and to learn new information, which probably would affect their academic performance,” observed Rodríguez Álvarez.

Parada was a little more cautious. “Although it seems reasonable to expect that these differences in declarative memory affect academic performance – because it depends on the ability to learn new information – there are many other variables that may modulate and explain this relationship, for example, student effort or class attendance,” she said. “We are currently carrying out a longitudinal study of these young people, and collecting information on their academic achievements, so we hope to be able to answer this question more definitively in the near future.”

One of the strengths of this study, added Parada, is that it controlled for confounding variables such as psychiatric comorbidity, genetic vulnerability, or other drug use, such as marijuana. “This allowed us to establish a clearer association between binge drinking patterns and poorer performance on memory tasks,” she said.

An additional strength, said Rodríguez Álvarez, was the finding that women are not more vulnerable than men to the neurotoxic effects of binge drinking.

Both Parada and Rodríguez Álvarez noted the importance of prevention programs and policies to address this issue.

Low Perception of Risk

“One of the factors that appear to be behind this pattern of consumption is the low perception of risk,” said Parada. “Whereas most attention has focused on negative consequences such as traffic accidents, violence or public disorder, society and students themselves are unaware of the damaging effects binge drinking may have on the brain. Policies and prevention programs in Europe aimed at controlling this pattern of consumption on campus are still rare.”

Yet the opposite should be occurring, added Rodríguez Álvarez. “These results should be taken into account by parents, clinicians, university administrators, and also governments because it is vital to address all that surrounds the brain’s development in our adolescents and young adults.”

Results will be published in the August 2011 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

Teenagers who drink alcohol spend more time on their computers for recreational use, including social networking and downloading and listening to music, compared with their peers who don’t drink.

Results of an anonymous survey of 264 teenagers were reported in the online edition of the journal Addictive Behaviors in a study authored by Weill Cornell Medical College public health researcher Dr. Jennifer Epstein.

Experimenting With Drinking

“While the specific factors linking teenage drinking and computer use are not yet established, it seems likely that adolescents are experimenting with drinking and activities on the Internet. In turn, exposure to online material such as alcohol advertising or alcohol-using peers on social networking sites could reinforce teens’ drinking,” says Dr. Epstein, assistant professor of public health at Weill Cornell Medical College. “Children are being exposed to computers and the Internet at younger ages. For this reason it’s important that parents are actively involved in monitoring their children’s computer usage, as well as alcohol use.

“According to a national study conducted by the Pew Internet and American Life Project, more than half of parents of teenagers had filters installed on the computers their child uses to block content parents find objectionable, yet many parents do not use any form of parental monitoring, particularly for older teens,” continues Dr. Epstein.

More Computer Use

The Weill Cornell survey was completed by participants aged 13 to 17 and residing in the United States. Results showed that teens who reported drinking in the last month used a computer more hours per week excluding school work than those who did not; however, there was no demonstrated link between alcohol use and computer use for school work. Drinking was also linked to more frequent social networking and listening to and downloading music. There was no strong link between video games and drinking or online shopping and drinking.

“Going forward, we would like to collect more detailed and longer-term data on adolescent alcohol and computer use, including the degree and duration of their drinking habit,” says Dr. Epstein.

Teenagers typically first experiment with alcohol at age 12 or 13. Family risk factors include lax parental supervision and poor communication, family conflicts, inconsistent or harsh discipline and a family history of alcohol or drug abuse.

Reinforce Ground Rules

“Parents may also need to reinforce their family ground rules on alcohol use and computer use,” Dr. Epstein says.

“This is an innovative study that is an important first step to understanding the potential impact that the Internet and new media may have on today’s youth,” says Dr. Gil Botvin, professor of public health and chief of the Division of Prevention and Health Behavior at Weill Cornell Medical College. “The Internet offers a wealth of information and opportunities for intellectual and social enrichment. However, it is becoming clear that there may also be a downside to Internet use. More systematic research is needed to better understand to those potential dangers and how to combat them.”

Allowing adolescents to drink alcohol under adult supervision does not appear to teach responsible drinking as teens get older. In fact, such a “harm-minimization” approach may actually lead to more drinking and alcohol-related consequences, according to a new study in the May 2011 issue of the Journal of Studies on Alcohol and Drugs.

“Kids need parents to be parents and not drinking buddies,” according to the study’s lead researcher, Barbara J. McMorris, Ph.D., of the School of Nursing at the University of Minnesota. Allowing adolescents to drink with adults present but not when unsupervised may send mixed signals. “Adults need to be clear about what messages they are sending.”

Drinking Responsibly?

In general, parents tend to take one of two approaches toward teen drinking. Some allow their adolescent children to consume alcohol in small amounts on occasion if an adult is present. The thinking is that teens will learn to drink responsibly if introduced to alcohol slowly in a controlled environment. This has been the predominant approach in many countries, including Australia.

A second approach is one of “zero tolerance” for youth drinking, meaning that teens should not be allowed to drink alcohol under any circumstances. This less permissive position is predominant in the United States, with local laws and national policies often advocating total abstinence for adolescents.

Alcohol-Related Consequences

To test how these different approaches are related to teen drinking, McMorris and colleagues from the Centre for Adolescent Health in Melbourne, Australia, and the Social Development Research Group in Seattle surveyed more than 1,900 seventh graders. About half were from Victoria, Australia; the rest were from Washington State. From seventh to ninth grade, investigators asked the youths about such factors as alcohol use, problems they had as a result of alcohol consumption, and how often had they consumed alcohol with an adult present.

By eighth grade, about 67% of Victorian youths had consumed alcohol with an adult present, as did 35% of those in Washington State, reflecting general cultural attitudes. In ninth grade, 36% of Australian teens compared with 21% of American teens had experienced alcohol-related consequences, such as not being able to stop drinking, getting into fights, or having blackouts. However, regardless of whether they were from Australia or the United States, youths who were allowed to drink with an adult present had increased levels of alcohol use and were more likely to have experienced harmful consequences by the ninth grade.

The researchers suggest that allowing adolescents to drink with adults present may act to encourage alcohol consumption. According to the authors, their results suggest that parents adopt a “no-use” policy for young adolescents. “Kids need black and white messages early on,” says McMorris. “Such messages will help reinforce limits as teens get older and opportunities to drink increase.”

Alcohol Available in the Home

In a related study in the May issue of JSAD, researchers from The Netherlands found that, among 500 12- to -15-year olds, the only parenting factor related to adolescent drinking was the amount of alcohol available in the home. In fact, the amount of alcohol parents themselves drank was not a factor in adolescent drinking. These results suggest that parents should only keep alcohol where it is inaccessible to teens. In addition, parents should “set strict rules regarding alcohol use, particularly when a total absence of alcoholic drinks at home is not feasible,” according to lead researcher Regina van den Eijnden, Ph.D., of Utrecht University in The Netherlands.

“Both studies show that parents matter,” McMorris concludes. “Despite the fact that peers and friends become important influences as adolescents get older, parents still have a big impact.”

Researchers know that there is a strong link between parental alcohol use disorders and the risk for developing an alcohol use disorders among their offspring. This study looked at the risk of alcohol use disorders in the offspring of a large population-based sample of Danish parents. Findings confirmed that parental alcohol use disorders were associated with an increased risk of alcohol use disorders among the offspring.

“Few studies have used a broad population-based approach to examine associations between a parental history of alcohol use disorders and risk of an alcohol use disorders in offspring,” said Erik Lykke Mortensen, associate professor in medical psychology at the University of Copenhagen and corresponding author for the study. “Longitudinal population studies are both expensive and take a long time to complete. In some countries it may also be a problem to follow several generations through decades. But in Denmark we have personal identification numbers and national health registries.”

Population Based Study

Mortensen and his colleagues gathered data on 7,177 individuals (3,627 men, 3,550 women) born in Copenhagen between October 1959 and December 1961: information on alcohol use disorders was gathered from three Danish health registers, and information on other psychiatric disorders (OPDs) was gathered from the Danish Psychiatric Central Register. Offspring registration with an alcohol use disorders was analyzed in relation to parental registration with an alcohol use disorders and/or OPD. The gender of the offspring and parental social status were also noted.

Results showed that parental alcohol use disorders were associated with an increased risk of alcohol use disorders among the offspring, independent of other significant predictors such as gender, parental social status, and parental psychiatric hospitalization with other diagnoses.

“Furthermore, this association appeared to be stronger among female than male offspring, which suggests that inherited factors related to alcohol use disorders are at least as important among daughters as among sons,” said Mortensen. “This finding is important because some early studies suggested that a genetic load played a stronger role in males than in females.”

Increased Risk for Alcoholism

One of the important aspects of this study, added Mortensen, is that contrary to a number of previous adoption and twin studies – often based on relatively small and selected samples – these findings represent risk estimates from a population-based study.

“The key message for the general public is that there is an increased risk associated with parental alcoholism,” said Mortensen, “but obviously many other factors determine whether an individual develops an alcohol use disorder.”

Results will be published in Alcoholism: Clinical & Experimental Research.

Heavy alcohol consumption, specifically three or more glasses of liquor a day, is associated with an increased risk of death from pancreatic cancer, according to a report in the March 14 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

“Alcoholic beverage consumption – a modifiable lifestyle factor – is causally related to several cancers, including oral cavity, pharynx, larynx, esophagus, liver, colorectum and female breast,” the authors write as background information in the article. “Heavy alcohol consumption causes acute and chronic pancreatitis but has never been linked definitively to pancreatic cancer.”

1 Million Patients Studied

Using data from the Cancer Prevention Study II (CPS-II), Susan M. Gapstur, Ph.D., M.P.H., and colleagues from the American Cancer Society, Atlanta, examined the association between alcohol intake and pancreatic cancer. The CPS-II is a long-term prospective study of U.S. adults 30 years and older. Initial data on alcohol consumption was gathered in 1982, and based on follow-up through 2006, there were 6,847 pancreatic cancer deaths among one million participants.

Of the million participants (453,770 men and 576,697 women), 45.7 percent of men and 62.5 percent of women were non-drinkers. The analyses of men only and of men and women combined showed statistically significant increased risk of pancreatic cancer death for consumption of three drinks per day and four or more drinks per day, whereas for women only the estimated risk of death from pancreatic cancer was statistically significant for consumption of four or more drinks per day.

Compared with non-drinkers, consuming three or more drinks of liquor per day was associated with an increased risk of pancreatic cancer death in the total study population, and consumption of two or more drinks of liquor per day was associated with an increased risk in both never smokers and in those who had ever smoked. This association was observed for liquor consumption but not for beer or wine.

Greater Risk for Smokers

In never smokers, there was a 36 percent higher risk of pancreatic cancer death associated with consuming three or more drinks a day compared with non-drinkers for men and women combined. In those who had ever smoked, there was a 16 percent higher risk of death from pancreatic cancer after adjustment for smoking history and other variables.

“Findings from the prospective study presented herein strongly support the hypothesis that alcohol consumption, in particular heavy intake, also is an independent risk factor for pancreatic cancer, the fourth most common cause of cancer mortality [death] in the United States,” the authors conclude.

A new study by the Substance Abuse and Mental Health Services Administration (SAMHSA) indicates that 5.9 percent of adolescents aged 12 to 14 drank alcohol in the past month and that the vast majority of them (93.4 percent) received their alcohol for free the last time they drank.

About 317,000 (44.8 percent) 12 to 14 year olds who drank in the past month received their alcohol for free from their family or at home. This includes 15.7 percent (or an estimated 111,000) who were provided alcohol for free by their parents or guardians.

Increased Risk for Alcoholism

“People who begin drinking alcohol before the age of 15 are six times more likely than those who start at age 21 and older to develop alcohol problems. Parents and other adults need to be aware that providing alcohol to children can expose them to an increased risk for alcohol abuse and set them on a path with increased potential for addiction,” said SAMHSA Administrator Pamela S. Hyde, J.D.

SAMHSA Data Spotlight: Young Alcohol Users Often Get Alcohol from Family or Home is based on the combined data from SAMHSA’s 2006 to 2009 National Surveys on Drug Use and Health (NSDUH) and involves responses from more than 44,000 respondents ages 12 to 14.

NSDUH is a primary source of information on national use of tobacco, alcohol, illicit drugs (including non-medical use of prescription drugs) and mental health in the United States. The survey is part of the agency’s strategic initiative on behavioral health data, quality and outcomes.

Atrial Fibrillation (AF) is the most common cardiac arrhythmia (abnormal heart rhythm). Its name comes from the fibrillating (i.e., quivering) of the heart muscles of the atria, instead of a coordinated contraction. The result is an irregular heartbeat, which may occur in episodes lasting from minutes to weeks, or it could occur all the time for years. Atrial fibrillation alone is not in itself generally life-threatening, but it may result in palpitations, fainting, chest pain, or congestive heart failure.

There is no doubt that heavy alcohol intake and binge drinking can lead to cardiac arrhythmias, with the “Holiday Heart Syndrome” being known for more than three decades. This syndrome often includes atrial fibrillation; the syndrome is usually not associated with long-standing heart disease and the arrhythmia tends to resolve when drinking stops.

Heavy Drinking and Atrial Fibrillation

Members of The international Scientific Forum on Alcohol Research comment ‘This paper, Alcohol consumption and risk of atrial fibrillation. A meta-analysis. J Am Coll Cardiol 2011;57:427-436. analyzing the results of 14 papers suggests that even moderate drinking can lead to this syndrome, but others find no effect for moderate alcohol intake, only for heavy drinking.

One of the best studies on alcohol consumption and risk of atrial fibrillation is a Danish cohort study (the Danish Diet, Cancer and Health Study) examining the issue among 22,528 men and 25,421 women followed over 6 years. The study included a large number of cases with atrial fibrillation, detailed information on potential confounding factors, and complete follow up through nationwide population-based registries.

The results included a modest increase in risk of atrial fibrillation in men drinking more that 2 drinks/day and no association between alcohol consumption and risk of atrial fibrillation in women.

Binge Drinking Dangers

There is much evidence that heavy alcohol consumption is associated with an increased incidence of atrial fibrillation, among other health risks. The pattern of consumption (speed, time frame and without food), not often addressed, affects risk too – we know that binge drinking is associated with a greater incidence of arrhythmias, especially atrial fibrillation.

A weakness of this paper, and of essentially all meta-analyses, is that there were varying definitions for categories of alcohol consumption, and the highest category of alcohol intake included alcoholics and 6 or more drinks/day for some studies, while the highest category of alcohol intake was = 1-2 drinks/day in other studies.

Inherent Health Risk

The consistent message is that there is a difference between heavy and moderate use of alcohol, between binge drinking and a healthy pattern of drinking, and inherent health risk. The most important question would be: Does light to moderate drinking increase the risk of AF? The conclusion of the authors of this paper seems to be yes, while many other studies find little effect of such drinking’.

Overall, the scientific evidence from many studies suggests that heavy drinking may increase the risk of atrial fibrillation, although whether light-to-moderate intake increases the risk seems unlikely. Previous basic scientific data of mechanisms of atrial fibrillation have suggested that alcohol has little effect on this arrhythmia.

Addiction researchers at Washington University School of Medicine in St. Louis have found that a risk for alcoholism also may put individuals at risk for obesity.

The researchers noted that the association between a family history of alcoholism and obesity risk has become more pronounced in recent years. Both men and women with such a family history were more likely to be obese in 2002 than members of that same high-risk group had been in 1992.

“In addiction research, we often look at what we call cross-heritability, which addresses the question of whether the predisposition to one condition also might contribute to other conditions,” says first author Richard A. Grucza, PhD. “For example, alcoholism and drug abuse are cross-heritable. This new study demonstrates a cross-heritability between alcoholism and obesity, but it also says — and this is very important — that some of the risks must be a function of the environment. The environment is what changed between the 1990s and the 2000s. It wasn’t people’s genes.”

Obesity Rates Have Doubled

Obesity in the United States has doubled in recent decades from 15 percent of the population in the late 1970s to 33 percent in 2004. Obese people – those with a body mass index (BMI) of 30 or more – have an elevated risk for high blood pressure, diabetes, heart disease, stroke and certain cancers.

Reporting in the Archives of General Psychiatry, Grucza and his team say individuals with a family history of alcoholism, particularly women, have an elevated obesity risk. In addition, that risk seems to be growing. He speculates that may result from changes in the food we eat and the availability of more foods that interact with the same brain areas as addictive drugs.

“Much of what we eat nowadays contains more calories than the food we ate in the 1970s and 1980s, but it also contains the sorts of calories — particularly a combination of sugar, salt and fat — that appeal to what are commonly called the reward centers in the brain,” says Grucza, an assistant professor of psychiatry. “Alcohol and drugs affect those same parts of the brain, and our thinking was that because the same brain structures are being stimulated, overconsumption of those foods might be greater in people with a predisposition to addiction.”

Grucza hypothesized that as Americans consumed more high-calorie, hyper-palatable foods, those with a genetic risk for addiction would face an elevated risk because of the effects of those foods on the reward centers in the brain. His team analyzed data from two large alcoholism surveys from the last two decades.

Family History of Alcoholism

The National Longitudinal Alcohol Epidemiologic Survey was conducted in 1991 and 1992. The National Epidemiologic Survey on Alcohol and Related Conditions was conducted in 2001 and 2002. Almost 80,000 people took part in the two surveys.

“We looked particularly at family history of alcoholism as a marker of risk,” Grucza explains. “And we found that in 2001 and 2002, women with that history were 49 percent more likely to be obese than those without a family history of alcoholism. We also noticed a relationship in men, but it was not as striking in men as in women.”

Grucza says a possible explanation for obesity in those with a family history of alcoholism is that some individuals may substitute one addiction for another. After seeing a close relative deal with alcohol problems, a person may shy away from drinking, but high-calorie, hyper-palatable foods also can stimulate the reward centers in their brains and give them effects similar to what they might experience from alcohol.

“Ironically, people with alcoholism tend not to be obese,” Grucza says. “They tend to be malnourished, or at least under-nourished because many replace their food intake with alcohol. One might think that the excess calories associated with alcohol consumption could, in theory, contribute to obesity, but that’s not what we saw in these individuals.”

Change in the Food Environment

Grucza says other variables, from smoking, to alcohol intake, to demographic factors like age and education levels don’t seem to explain the association between alcoholism risk and obesity.

“It really does appear to be a change in the environment,” he says. “I would speculate, although I can’t really prove this, that a change in the food environment brought this association about. There is a whole slew of literature out there suggesting these hyper-palatable foods appeal to people with addictive tendencies, and I would guess that’s what we’re seeing in our study.”

The results, he says, suggest there should be more cross-talk between alcohol and addiction researchers and those who study obesity. He says there may be some people for whom treating one of those disorders also might aid the other.

Addictions, whether it is to drugs or alcohol, are a very difficult hurdle for individuals to overcome. But, there are ways to help people with their recovery through 12-step programs like Alcoholics Anonymous (AA). Many of these organizations, including AA, highlight spirituality as a very important factor, but the data surrounding its effectiveness have often been contested.

However, new research shows that as attendance of AA meetings increase, so do the participants spiritual beliefs, especially in those individuals who had low spirituality at the beginning of the study.

Important Aspect of Recovery

John F. Kelly, lead author of the study, Associate Professor in Psychiatry at Harvard Medical School and the Associate Director of the Center for Addiction Medicine at Massachusetts General Hospital, said that while spirituality is an important aspect of AA recovery, it is not the only way they can help individuals.

“I’ve heard it said that AA is too spiritual, and I’ve also heard it said that AA is not spiritual enough for some people. Although this is not the only way that AA helps individuals recover, I think these findings support the notion that AA works in part by enhancing spiritual practices,” Kelly said.

The researchers assessed more than 1,500 adults throughout their recovery process, with data being gathered at three, six, nine, 12, and 15 months. The study utilized data on their attendance to AA meetings, their individual spirituality/religiosity practices and overall alcohol-use outcomes to determine if spirituality is indeed a mechanism of behavior change.

Decrease in Alcohol Use

The results indicated that there was a robust association between an increase in attendance to AA meetings with increased spirituality and a decrease in the frequency and intensity of alcohol use over time. One of the most interesting aspects of the research was that the same amount of recovery was seen in both agnostics and atheists, which indicates that while spirituality is an important mechanism of behavioral change for AA, it is not the only method used.

“Many people will be surprised that alcoholic patients with little or no interest in spirituality attended AA and seemed to change even more than did those who had a pre-existing, strong sense of spirituality,” said Keith Humphreys, a Career Research Scientist with the Veterans Health Administration and Professor of Psychiatry at Stanford University. “AA is thus much more broad in its appeal than is commonly recognized.”

The researchers also noted that while spirituality is an important aspect of recovery, it is still not known how these beliefs work in complement or competition with other recovery methods, as there are multiple.

Changing Social Networks

“We have also found that AA participation leads to recovery by helping members change their social network and by enhancing individuals’ recovery coping skills, motivation for continued abstinence, and by reducing depression and increasing psychological well-being,” said Kelly.

“Down the road it will be important to conduct more qualitative research as well as further quantitative replication of our findings in order to understand more about how exactly spiritual practices and beliefs influence coping and behavioral change in recovery from addiction”