Engaging in meditation, prayer, or other spiritual practices was linked to a decreased risk for alcohol and drug misuse, a new meta-analysis showed.
Harmful use of alcohol, tobacco, marijuana, or illicit drugs was 13% lower in individuals who engaged in spiritual practices, and 18% lower among those who regularly attended religious services.
The results suggest that for some patients, integrating spirituality into medical care may hold potential for substance use prevention and recovery efforts, researchers said.
“Our findings indicate that spirituality may be protective against substance misuse, one of the biggest public health challenges of our time,” lead author Howard K. Koh, MD, MPH, and Harvey V. Fineberg Professor of the Practice of Public Health Leadership at Harvard T.H. Chan School of Public Health in Boston, said in a news release.
“For many individuals and families, using spirituality as a resource — whether that be attending religious services, meditating, praying, or seeking other forms of spiritual comfort — may be an avenue to enhance their health.
The study was published online on February 18 in JAMA Psychiatry.
As reported by Medscape Medical News, previous research suggests that integrating spirituality into medicine is linked to improved mental and physiologic health and less substance use. But evidence on long-term effects, particularly with alcohol and drug use, was lacking.
To fill that gap, investigators conducted a meta-analysis of 55 longitudinal cohort studies involving 540,712 children, adolescents, and adults. These studies, published between 2000 and 2022, explored the associations between spirituality and dangerous alcohol or drug use. Most of the studies focused on prevention, and one randomized clinical trial was also included in the meta-analysis.
Spiritual practices, religious or not, were associated with a 13% lower risk for hazardous alcohol or drug use (relative risk [RR], 0.87; 95% CI, 0.84-0.91). This risk reduction was consistent across all substance types.
Individuals who attended religious service more than once a week were 18% less likely to engage in substance misuse (RR, 0.82; P < .001).
Protective benefits were found in both the prevention of substance misuse and in outcomes related to substance use disorder recovery.
“Participation in spiritual or religious communities may affect outcomes through mechanisms including social support, strong abstinence or nonintoxication or moderation social norms, meaning and purpose, and moral beliefs,” researchers wrote.
“Emerging evidence from neuroscience suggests that spiritual practices can influence brain regions associated with stress regulation, reward processing, and social connection,” they continued.
Limitations of the study were potential biases in study design and selection, as well as variability in how spirituality was identified across studies.
“Clinicians and communities can consider identifying and aligning spirituality themes to broaden future efforts in drug use prevention and recovery,” the investigators wrote, suggesting that clinicians ask patients whether spirituality is important to them for health. They also noted that efforts should respect patient autonomy and evidence-based practices