Purpose of review There have been many debates, discussions, and published writings about the the... more Purpose of review There have been many debates, discussions, and published writings about the therapeutic value of cannabis plant and the hundreds of cannabinoids it contains. Many states and countries have attempted, are attempting, or have already passed bills to allow legal use of cannabinoids, especially cannabidiol (CBD), as medicines to treat a wide range of clinical conditions without having been approved by a regulatory body. Therefore, by using PubMed and Google Scholar databases, we have reviewed published papers during the past 30 years on cannabinoids as medicines and comment on whether there is sufficient clinical evidence from well-designed clinical studies and trials to support the use of CBD or any other cannabinoids as medicines. Recent findings Current research shows that CBD and other cannabinoids currently are not ready for formal indications as medicines to treat a wide range of clinical conditions as promoted except for several exceptions including limited use of CBD for treating two rare forms of epilepsy in young children and CBD in combination with THC for treating multiplesclerosis-associated spasticity. Summary Research indicates that CBD and several other cannabinoids have potential to treat multiple clinical conditions, but more preclinical, and clinical studies and clinical trials, which follow regulatory guidelines, are needed to formally recommend CBD and other cannabinoids as medicines.
Spirituality is a construct that is reflected in a diversity of strongly felt personal commitment... more Spirituality is a construct that is reflected in a diversity of strongly felt personal commitments in different cultural and national groups. For persons with substance use disorders (SUDs), it can serve as a component of the recovery capital available to them. This position statement reviews empirical research that can shed light on psychological, social, and biological aspects of this construct. On this basis, the Spirituality Interest Group of the International Society of Addiction Medicine (ISAM) makes recommendations for how this construct can be incorporated into research and clinical care.
The American journal of drug and alcohol abuse, Jan 25, 2016
Many individuals with alcohol-use disorders who had experienced alcohol craving before joining Al... more Many individuals with alcohol-use disorders who had experienced alcohol craving before joining Alcoholics Anonymous (AA) report little or no craving after becoming long-term members. Their use of AA prayers may contribute to this. Neural mechanisms underlying this process have not been delineated. To define experiential and neural correlates of diminished alcohol craving following AA prayers among members with long-term abstinence. Twenty AA members with long-term abstinence participated. Self-report measures and functional magnetic resonance imaging of differential neural response to alcohol-craving-inducing images were obtained in three conditions: after reading of AA prayers, after reading irrelevant news, and with passive viewing. Random-effects robust regressions were computed for the main effect (prayer > passive + news) and for estimating the correlations between the main effect and the self-report measures. Compared to the other two conditions, the prayer condition was ch...
In this review, we highlight recent developments in the pharmacological treatment of alcohol and ... more In this review, we highlight recent developments in the pharmacological treatment of alcohol and other substance use disorders and in programs designed for those with dual diagnosis disorders. The depot formulation of naltrexone, which recently received U.S. Food and Drug Administration approval, presents a more effective alternative to oral administration for alcohol dependence. Inconsistent support for the efficacy of acamprosate, however, underscores the need for more research concerning its optimal use. Recent testing of a depot naltrexone preparation for opioid-dependent patients shows promise for its clinical use. Buprenorphine represents a viable treatment option for opioid-dependent patients when combined with psychosocial modalities such as network therapy or contingency management. There has been an increase in the number of integrated programs for patients with a dual diagnosis, incorporating evidence-based psychosocial treatments combined with mutual self-help approaches, including 12-step-based and more global peer-led approaches.
The prominence of Twelve-Step programs has led to increased attention on the putative role of spi... more The prominence of Twelve-Step programs has led to increased attention on the putative role of spirituality in recovery from addictive disorders. We developed a 6-item Spirituality Self-Rating Scale designed to reflect a global measure of spiritual orientation to life, and we demonstrated here its internal consistency reliability in substance abusers on treatment and in nonsubstance abusers. This scale and the measures related to recovery from addiction and treatment response were applied in three diverse treatment settings: a general hospital inpatient psychiatry service, a residential therapeutic community, and methadone maintenance programs. Findings on these patient groups were compared to responses given by undergraduate college students, medical students, addiction faculty, and chaplaincy trainees. These suggest that, for certain patients, spiritual orientation is an important aspect of their recovery. Furthermore, the relevance of this issue may be underestimated in the way treatment is framed in a range of clinical facilities.
The Journal of Behavioral Health Services & Research, 2013
National data indicate that patients treated with buprenorphine for opiate use disorders are more... more National data indicate that patients treated with buprenorphine for opiate use disorders are more likely to be White, highly educated, and to have greater incomes than those receiving methadone, but patterns of buprenorphine dissemination across demographic areas have not been documented in major metropolitan areas where poverty, minority populations and injection heroin use are concentrated. Rates of buprenorphine and methadone treatment are compared among areas of New York City defined by their income and ethnic/racial composition. Residential social areas (hereinafter called social areas) were defined as aggregations of ZIP codes with similar race/ethnicity and income characteristics, and were formed based on clustering techniques. Treatment rates were obtained for each New York City ZIP code: buprenorphine treatment rates were based on the annual number of buprenorphine prescriptions written, and the methadone treatment rate on the number of methadone clinic visits for persons in each ZIP code. Treatment rates were correlated univariately with ethnicity and income characteristics of ZIP codes. Social area treatment rates were compared using individual ANOVA models for each rate. Buprenorphine and methadone treatment rates were significantly correlated with the ethnicity and income characteristics of ZIP codes, and treatment rates differed significantly across the social areas. Buprenorphine treatment rates were highest in the social area with the highest income and lowest percentage of Black and Hispanic residents. Conversely, the methadone treatment rate was highest in the social area with the highest percentage of low income and Hispanic residents. The uneven dissemination of 0pioid maintenance treatment in New York City may be reflective of the limited public health impact of buprenorphine in ethnic minority and low income areas. Specific policy and educational interventions to providers are needed to promote the use of buprenorphine for opiate use disorders in diverse populations.
Background: Narcotics Anonymous is a worldwide fellowship that employs the Twelve-Step model for ... more Background: Narcotics Anonymous is a worldwide fellowship that employs the Twelve-Step model for members dependent on drugs of abuse. The spiritual orientation of its program of abstinence has not been subjected to empirical study. Methods: Responses of 527 American Narcotics Anonymous meeting attendees to a structured questionnaire were evaluated for the roles of cognitive and psychosocial aspects of spirituality in their recovery. Results: Respondents had last used drugs or alcohol on average 6.1 years previously. They were found to be more oriented toward a spiritual than a formally religious orientation than probability samples of the general population. Aspects of membership such as affiliation toward other members and the experience of spiritual awakening were associated with lower rates of drug or alcohol craving, whereas scores on depression were associated with higher craving scores. Conclusions: Spiritual renewal combined with an abstinenceoriented regimen in the Narcotics Anonymous social context can play a role in long-term recovery from drug addiction.
The American Journal of Drug and Alcohol Abuse, 2009
Background: Relapse among patients in substance abuse treatment has generated interest in identif... more Background: Relapse among patients in substance abuse treatment has generated interest in identifying attitudinal factors that sustain recovery. Objective: To assess the relationship of attitudes toward approaches to motivation for treatment and Twelve Step beliefs. Methods: Dually diagnosed patients (N = 100) completed a survey assessing treatment attitudes, motivation, and Twelve Step beliefs. Results: Endorsement of medical services was positively correlated with motivation but unrelated to Twelve Step beliefs. Endorsement of religious services was unrelated to motivation but was associated with Twelve Step beliefs. Conclusions: Patients may have differing perceptions regarding routes to recovery based on preferences for professional services or spiritual resources.
The accuracy of the Content should not be relied upon and should be independently verified with p... more The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden.
Background: In the course of achieving abstinence from alcohol, longstanding members of Alcoholic... more Background: In the course of achieving abstinence from alcohol, longstanding members of Alcoholics Anonymous (AA) typically experience a change in their addiction-related attitudes and behaviors. These changes are reflective of physiologically grounded mechanisms which can be investigated within the disciplines of social and cognitive neuroscience. Objective: This article is designed to examine recent findings associated with these disciplines that may shed light on the mechanisms underlying this change. Method: Literature review and hypothesis development. Results: Pertinent aspects of the neural impact of drugs of abuse are summarized. After this, research regarding specific brain sites, elucidated primarily by imaging techniques, is reviewed relative to the following: Mirroring and mentalizing are described in relation to experimentally modeled studies on empathy and mutuality, which may parallel the experiences of social interaction and influence on AA members. Integration and retrieval of memories acquired in a setting like AA are described, and are related to studies on storytelling, models of self-schema development, and value formation. A model for ascription to a Higher Power is presented. Conclusion: The phenomena associated with AA reflect greater complexity than the empirical studies on which this article is based, and certainly require further elucidation. Despite this substantial limitation in currently available findings, there is heuristic value in considering the relationship between the brain-based and clinical phenomena described here. Scientific Significance: There are opportunities for the study of neuroscientific correlates of Twelve-Step-based recovery, and these can potentially enhance our understanding of related clinical phenomena.
Objectives: Face-to-face meetings are key components of Twelve Step (TS) fellowships’ support of ... more 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 (x¯ = 4.13[SD4.64]) than they had attended both face-to-face meetings before COVID-19 (x¯ = 3.35[SD2.05]), and also face-to-face meetings during COVID-19 (x¯ = 0.75[SD1.8]). Many of the meetings were accessed from sites remote from their homes (44.4%), even overseas (21.5%). The majority (64.9%) found virtual meetings at least as effective in promoting their abstinence as were face-to-face meetings, and 41.8% estimated the same for newcomers. A shorter period of antecedent abstinence from drugs and increased loneliness were associated with increased craving during the transition period. Relative to Whites, Black respondents were less distressed, with a lesser increase in craving, and currently attended more virtual meetings. Data provided by a national program reflected a large increase in virtual TS attendance since the onset of the pandemic. 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.
Objective: Narcotics Anonymous (NA), a nonprofessional 12-step fellowship for people seeking reco... more Objective: Narcotics Anonymous (NA), a nonprofessional 12-step fellowship for people seeking recovery from addiction, reports 27,677 meetings in the USA, where it was founded, but there is limited literature on its adaptability cross-culturally. We studied NA within the Islamic Republic of Iran to ascertain its relative adaptation in a different cultural setting. Method: We surveyed 262 NA members in Iran, supplemented by member interviews, and compared demographic and substance userelated characteristics of members, and also the nature of their respective involvement in NA, to the survey results of a previous US survey (n ¼ 527). Results: NA in Iran reports 21,974 meetings. The Iranian respondents surveyed differed relatively little (d < 0.50) from US members on demographics and prior ambulatory substance use disorder treatment, but did have fewer female members (means for Iran and US: 42.4 vs 39.0 years; 77% vs 87%; 6% vs 28%, respectively). They were, however, more involved in the fellowship (d > 0.50) in terms of reporting service as sponsors, experience of spiritual awakening, and achievement of diminished craving (scores of 1-10) (85% vs 48%; 95% vs 84%; 1.03 vs 1.89, respectively). Surveyed NA members in Iran publicized the fellowship with public (36%) and religious (20%) figures, and systematically worked the 12 steps in large sponsor-led groups (X ¼ 19 members). Conclusion: NA, a 12-step program developed in a Western, predominantly Christian-oriented country, was adapted widely in the Islamic Republic of Iran, a setting different in culture, language, ethnicity, and religious orientation. The growth in its membership derives, in part, from specific innovations that may have broader applicability in other settings.
The choices of answers were those used for the Neurotic Distress Scale. 3. General Well-Being Sch... more The choices of answers were those used for the Neurotic Distress Scale. 3. General Well-Being Schedule.
Although India and Israel differ dramatically in size, population, and affluence, there are many ... more Although India and Israel differ dramatically in size, population, and affluence, there are many important similarities. Each is the contemporary vehicle of an old and resilient civilization that expresses a distinctive, influential and enduring arrangement of the various facets of human experience. Each of these cultures underwent a prolonged colonial experience in which its traditions were disrupted and subordinated to a hegemonic European Christian culture; each had an earlier experience with victorious, expansive Islam; each has reached an uneasy but flourishing accommodation with the secular, scientific modernity of the West.In each case this was achieved by a movement that embraced “Enlightenment” values and in turn provoked a recoil from modernity/rediscovery of tradition. In each there is a conflict between those with “modern” secular views of civil society and those revivalists or fundamentalists who seek to restore an indigenous religiously based society. The secular natio...
Embase, and other services. This has already provided access to our articles in almost all univer... more Embase, and other services. This has already provided access to our articles in almost all university libraries. Medline and Index Medicus, however, represent an important vehicle for indexing, often turned to first in settings such as university centers, and immediately available on the Internet. Along with general addiction topics, Substance Abuse has always sought out a selection of submissions related to addiction education; few other journals are responsive to this topic. Because of our new indexing, we will have an opportunity to put forward the importance of addiction education in an augmented manner.
The aim of this study was to assess patterns of alcohol consumption and alcohol related problems ... more The aim of this study was to assess patterns of alcohol consumption and alcohol related problems in a sample of lesbian and gay NYC residents. There were no differences between lesbian (n = 93) and gay (n = 90) subgroups with regard to alcohol use and health related variables. The average number of drinking days reported for the previous 30 day period was 6.87 (SD 7.0) and 16% of the sample reported consuming more than 4 drinks per drinking day. Age, educational level, and feelings of excessive restlessness were associated with alcohol use. Although there have been reports of increased rates of alcohol use and alcohol related problems in the lesbian and gay population, this is not reflected in this sample.
Purpose of review There have been many debates, discussions, and published writings about the the... more Purpose of review There have been many debates, discussions, and published writings about the therapeutic value of cannabis plant and the hundreds of cannabinoids it contains. Many states and countries have attempted, are attempting, or have already passed bills to allow legal use of cannabinoids, especially cannabidiol (CBD), as medicines to treat a wide range of clinical conditions without having been approved by a regulatory body. Therefore, by using PubMed and Google Scholar databases, we have reviewed published papers during the past 30 years on cannabinoids as medicines and comment on whether there is sufficient clinical evidence from well-designed clinical studies and trials to support the use of CBD or any other cannabinoids as medicines. Recent findings Current research shows that CBD and other cannabinoids currently are not ready for formal indications as medicines to treat a wide range of clinical conditions as promoted except for several exceptions including limited use of CBD for treating two rare forms of epilepsy in young children and CBD in combination with THC for treating multiplesclerosis-associated spasticity. Summary Research indicates that CBD and several other cannabinoids have potential to treat multiple clinical conditions, but more preclinical, and clinical studies and clinical trials, which follow regulatory guidelines, are needed to formally recommend CBD and other cannabinoids as medicines.
Spirituality is a construct that is reflected in a diversity of strongly felt personal commitment... more Spirituality is a construct that is reflected in a diversity of strongly felt personal commitments in different cultural and national groups. For persons with substance use disorders (SUDs), it can serve as a component of the recovery capital available to them. This position statement reviews empirical research that can shed light on psychological, social, and biological aspects of this construct. On this basis, the Spirituality Interest Group of the International Society of Addiction Medicine (ISAM) makes recommendations for how this construct can be incorporated into research and clinical care.
The American journal of drug and alcohol abuse, Jan 25, 2016
Many individuals with alcohol-use disorders who had experienced alcohol craving before joining Al... more Many individuals with alcohol-use disorders who had experienced alcohol craving before joining Alcoholics Anonymous (AA) report little or no craving after becoming long-term members. Their use of AA prayers may contribute to this. Neural mechanisms underlying this process have not been delineated. To define experiential and neural correlates of diminished alcohol craving following AA prayers among members with long-term abstinence. Twenty AA members with long-term abstinence participated. Self-report measures and functional magnetic resonance imaging of differential neural response to alcohol-craving-inducing images were obtained in three conditions: after reading of AA prayers, after reading irrelevant news, and with passive viewing. Random-effects robust regressions were computed for the main effect (prayer > passive + news) and for estimating the correlations between the main effect and the self-report measures. Compared to the other two conditions, the prayer condition was ch...
In this review, we highlight recent developments in the pharmacological treatment of alcohol and ... more In this review, we highlight recent developments in the pharmacological treatment of alcohol and other substance use disorders and in programs designed for those with dual diagnosis disorders. The depot formulation of naltrexone, which recently received U.S. Food and Drug Administration approval, presents a more effective alternative to oral administration for alcohol dependence. Inconsistent support for the efficacy of acamprosate, however, underscores the need for more research concerning its optimal use. Recent testing of a depot naltrexone preparation for opioid-dependent patients shows promise for its clinical use. Buprenorphine represents a viable treatment option for opioid-dependent patients when combined with psychosocial modalities such as network therapy or contingency management. There has been an increase in the number of integrated programs for patients with a dual diagnosis, incorporating evidence-based psychosocial treatments combined with mutual self-help approaches, including 12-step-based and more global peer-led approaches.
The prominence of Twelve-Step programs has led to increased attention on the putative role of spi... more The prominence of Twelve-Step programs has led to increased attention on the putative role of spirituality in recovery from addictive disorders. We developed a 6-item Spirituality Self-Rating Scale designed to reflect a global measure of spiritual orientation to life, and we demonstrated here its internal consistency reliability in substance abusers on treatment and in nonsubstance abusers. This scale and the measures related to recovery from addiction and treatment response were applied in three diverse treatment settings: a general hospital inpatient psychiatry service, a residential therapeutic community, and methadone maintenance programs. Findings on these patient groups were compared to responses given by undergraduate college students, medical students, addiction faculty, and chaplaincy trainees. These suggest that, for certain patients, spiritual orientation is an important aspect of their recovery. Furthermore, the relevance of this issue may be underestimated in the way treatment is framed in a range of clinical facilities.
The Journal of Behavioral Health Services & Research, 2013
National data indicate that patients treated with buprenorphine for opiate use disorders are more... more National data indicate that patients treated with buprenorphine for opiate use disorders are more likely to be White, highly educated, and to have greater incomes than those receiving methadone, but patterns of buprenorphine dissemination across demographic areas have not been documented in major metropolitan areas where poverty, minority populations and injection heroin use are concentrated. Rates of buprenorphine and methadone treatment are compared among areas of New York City defined by their income and ethnic/racial composition. Residential social areas (hereinafter called social areas) were defined as aggregations of ZIP codes with similar race/ethnicity and income characteristics, and were formed based on clustering techniques. Treatment rates were obtained for each New York City ZIP code: buprenorphine treatment rates were based on the annual number of buprenorphine prescriptions written, and the methadone treatment rate on the number of methadone clinic visits for persons in each ZIP code. Treatment rates were correlated univariately with ethnicity and income characteristics of ZIP codes. Social area treatment rates were compared using individual ANOVA models for each rate. Buprenorphine and methadone treatment rates were significantly correlated with the ethnicity and income characteristics of ZIP codes, and treatment rates differed significantly across the social areas. Buprenorphine treatment rates were highest in the social area with the highest income and lowest percentage of Black and Hispanic residents. Conversely, the methadone treatment rate was highest in the social area with the highest percentage of low income and Hispanic residents. The uneven dissemination of 0pioid maintenance treatment in New York City may be reflective of the limited public health impact of buprenorphine in ethnic minority and low income areas. Specific policy and educational interventions to providers are needed to promote the use of buprenorphine for opiate use disorders in diverse populations.
Background: Narcotics Anonymous is a worldwide fellowship that employs the Twelve-Step model for ... more Background: Narcotics Anonymous is a worldwide fellowship that employs the Twelve-Step model for members dependent on drugs of abuse. The spiritual orientation of its program of abstinence has not been subjected to empirical study. Methods: Responses of 527 American Narcotics Anonymous meeting attendees to a structured questionnaire were evaluated for the roles of cognitive and psychosocial aspects of spirituality in their recovery. Results: Respondents had last used drugs or alcohol on average 6.1 years previously. They were found to be more oriented toward a spiritual than a formally religious orientation than probability samples of the general population. Aspects of membership such as affiliation toward other members and the experience of spiritual awakening were associated with lower rates of drug or alcohol craving, whereas scores on depression were associated with higher craving scores. Conclusions: Spiritual renewal combined with an abstinenceoriented regimen in the Narcotics Anonymous social context can play a role in long-term recovery from drug addiction.
The American Journal of Drug and Alcohol Abuse, 2009
Background: Relapse among patients in substance abuse treatment has generated interest in identif... more Background: Relapse among patients in substance abuse treatment has generated interest in identifying attitudinal factors that sustain recovery. Objective: To assess the relationship of attitudes toward approaches to motivation for treatment and Twelve Step beliefs. Methods: Dually diagnosed patients (N = 100) completed a survey assessing treatment attitudes, motivation, and Twelve Step beliefs. Results: Endorsement of medical services was positively correlated with motivation but unrelated to Twelve Step beliefs. Endorsement of religious services was unrelated to motivation but was associated with Twelve Step beliefs. Conclusions: Patients may have differing perceptions regarding routes to recovery based on preferences for professional services or spiritual resources.
The accuracy of the Content should not be relied upon and should be independently verified with p... more The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden.
Background: In the course of achieving abstinence from alcohol, longstanding members of Alcoholic... more Background: In the course of achieving abstinence from alcohol, longstanding members of Alcoholics Anonymous (AA) typically experience a change in their addiction-related attitudes and behaviors. These changes are reflective of physiologically grounded mechanisms which can be investigated within the disciplines of social and cognitive neuroscience. Objective: This article is designed to examine recent findings associated with these disciplines that may shed light on the mechanisms underlying this change. Method: Literature review and hypothesis development. Results: Pertinent aspects of the neural impact of drugs of abuse are summarized. After this, research regarding specific brain sites, elucidated primarily by imaging techniques, is reviewed relative to the following: Mirroring and mentalizing are described in relation to experimentally modeled studies on empathy and mutuality, which may parallel the experiences of social interaction and influence on AA members. Integration and retrieval of memories acquired in a setting like AA are described, and are related to studies on storytelling, models of self-schema development, and value formation. A model for ascription to a Higher Power is presented. Conclusion: The phenomena associated with AA reflect greater complexity than the empirical studies on which this article is based, and certainly require further elucidation. Despite this substantial limitation in currently available findings, there is heuristic value in considering the relationship between the brain-based and clinical phenomena described here. Scientific Significance: There are opportunities for the study of neuroscientific correlates of Twelve-Step-based recovery, and these can potentially enhance our understanding of related clinical phenomena.
Objectives: Face-to-face meetings are key components of Twelve Step (TS) fellowships’ support of ... more 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 (x¯ = 4.13[SD4.64]) than they had attended both face-to-face meetings before COVID-19 (x¯ = 3.35[SD2.05]), and also face-to-face meetings during COVID-19 (x¯ = 0.75[SD1.8]). Many of the meetings were accessed from sites remote from their homes (44.4%), even overseas (21.5%). The majority (64.9%) found virtual meetings at least as effective in promoting their abstinence as were face-to-face meetings, and 41.8% estimated the same for newcomers. A shorter period of antecedent abstinence from drugs and increased loneliness were associated with increased craving during the transition period. Relative to Whites, Black respondents were less distressed, with a lesser increase in craving, and currently attended more virtual meetings. Data provided by a national program reflected a large increase in virtual TS attendance since the onset of the pandemic. 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.
Objective: Narcotics Anonymous (NA), a nonprofessional 12-step fellowship for people seeking reco... more Objective: Narcotics Anonymous (NA), a nonprofessional 12-step fellowship for people seeking recovery from addiction, reports 27,677 meetings in the USA, where it was founded, but there is limited literature on its adaptability cross-culturally. We studied NA within the Islamic Republic of Iran to ascertain its relative adaptation in a different cultural setting. Method: We surveyed 262 NA members in Iran, supplemented by member interviews, and compared demographic and substance userelated characteristics of members, and also the nature of their respective involvement in NA, to the survey results of a previous US survey (n ¼ 527). Results: NA in Iran reports 21,974 meetings. The Iranian respondents surveyed differed relatively little (d < 0.50) from US members on demographics and prior ambulatory substance use disorder treatment, but did have fewer female members (means for Iran and US: 42.4 vs 39.0 years; 77% vs 87%; 6% vs 28%, respectively). They were, however, more involved in the fellowship (d > 0.50) in terms of reporting service as sponsors, experience of spiritual awakening, and achievement of diminished craving (scores of 1-10) (85% vs 48%; 95% vs 84%; 1.03 vs 1.89, respectively). Surveyed NA members in Iran publicized the fellowship with public (36%) and religious (20%) figures, and systematically worked the 12 steps in large sponsor-led groups (X ¼ 19 members). Conclusion: NA, a 12-step program developed in a Western, predominantly Christian-oriented country, was adapted widely in the Islamic Republic of Iran, a setting different in culture, language, ethnicity, and religious orientation. The growth in its membership derives, in part, from specific innovations that may have broader applicability in other settings.
The choices of answers were those used for the Neurotic Distress Scale. 3. General Well-Being Sch... more The choices of answers were those used for the Neurotic Distress Scale. 3. General Well-Being Schedule.
Although India and Israel differ dramatically in size, population, and affluence, there are many ... more Although India and Israel differ dramatically in size, population, and affluence, there are many important similarities. Each is the contemporary vehicle of an old and resilient civilization that expresses a distinctive, influential and enduring arrangement of the various facets of human experience. Each of these cultures underwent a prolonged colonial experience in which its traditions were disrupted and subordinated to a hegemonic European Christian culture; each had an earlier experience with victorious, expansive Islam; each has reached an uneasy but flourishing accommodation with the secular, scientific modernity of the West.In each case this was achieved by a movement that embraced “Enlightenment” values and in turn provoked a recoil from modernity/rediscovery of tradition. In each there is a conflict between those with “modern” secular views of civil society and those revivalists or fundamentalists who seek to restore an indigenous religiously based society. The secular natio...
Embase, and other services. This has already provided access to our articles in almost all univer... more Embase, and other services. This has already provided access to our articles in almost all university libraries. Medline and Index Medicus, however, represent an important vehicle for indexing, often turned to first in settings such as university centers, and immediately available on the Internet. Along with general addiction topics, Substance Abuse has always sought out a selection of submissions related to addiction education; few other journals are responsive to this topic. Because of our new indexing, we will have an opportunity to put forward the importance of addiction education in an augmented manner.
The aim of this study was to assess patterns of alcohol consumption and alcohol related problems ... more The aim of this study was to assess patterns of alcohol consumption and alcohol related problems in a sample of lesbian and gay NYC residents. There were no differences between lesbian (n = 93) and gay (n = 90) subgroups with regard to alcohol use and health related variables. The average number of drinking days reported for the previous 30 day period was 6.87 (SD 7.0) and 16% of the sample reported consuming more than 4 drinks per drinking day. Age, educational level, and feelings of excessive restlessness were associated with alcohol use. Although there have been reports of increased rates of alcohol use and alcohol related problems in the lesbian and gay population, this is not reflected in this sample.
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Papers by Marc Galanter