What does religion have to say about addiction?

The Faith-Based Solutions to Addiction Conference at the University of Chester on February 20th 2013 attempted to answer this question by offering a forum for a range of Faith-Based Organisations (FBOs) dedicated to helping addicts turn their lives around to explain their methods, and the beliefs and commitments which inform those methods.

More than a dozen organisations across half a dozen religious traditions were represented, and the conference provided a unique opportunity for those with different and even conflicting understandings of the problem of addiction to come together and learn from each other.

Professor Chris Cook from Durham University opened the conference by asking the question of what it might mean to think theologically about addiction, and suggested resources from different theological traditions which might help deepen an understanding of the presence of addiction in human life. His paper questioned simplistic interpretations of the relationship between faith and understanding in this context and urged the need for more critical theological engagement.  Keynote speaker Professor Keith Humphreys of Stanford University then drew some contrasts between the pro-faith environment of the United States and the (ironically, given the presence of a state church) more anti-faith environment of the UK. 59% of patients in recovery in the US consider God as one of their top three supports. He noted that abstinence rates were higher in the States, but this is in a context in which one third of the population don’t drink anyway. Turning his attention to FBOs he explained that as well as giving spiritual support, they also give the kind of support found in secular organisations; structure, advocacy, employability skills, individual and group therapy etc.   His paper highlighted the crucial role of choice in treatment efficacy.  Research shows that where an individual chooses a faith-based approach for personal reasons, their treatment outcomes are better than if they had taken a secular approach, and conversely when a person chooses a secular approach in line with their own views, treatment outcomes are better for them. 

Before a closer examination of a range of faith-based approaches, a context setting paper from Dr Andy Williams, a Human Geographer from the University of Exeter, presented a typology of different Christian organisations. Williams illuminated the spectrum across these organisations of accommodation with or rejection of secular understandings and methods.  Several themes emerged from panel discussions.  Muslim and Jewish contributors highlighted the need for seeing addiction treatment not so much as ‘faith-based’ i.e. containing faith elements in the treatment methods, but as ‘faith sensitive’ i.e. taking into account the faith and cultural traditions of those involved. The Buddhist contributors tracked the use already being made by secular treatment agencies and the NHS of Buddhist ideas and methods, and outlined the programme of Mindfulness-Based Relapse Prevention. Some Christian groups explored the understanding of addiction as sickness, in need of healing by the Divine Physician, whilst others focused on such themes as compassion, acceptance, surrender and empathy.   What also emerged was how these theological perspectives were reflected in a wide range of models of care;  ranging from fully-fledged alternative systems of welfare and support for those using addiction services to specialised units who were largely autonomous and self-funded. The largest Christian provider of care, namely the Salvation Army, noted that whilst churches can provide valuable support, the mediating factors in recovery are relationships and social capital (and not, as often thought, social class).

In the afternoon Dr Chris Baker of the University of Chester explored the potential for seeing eudaemonic sources of happiness as the key to understanding why faith-based approaches to addiction are effective, and the possibility for this effectiveness to be measured empirically, using qualitative as well as quantitative research tools.

 

Recovery : Trans-Atlantic Interperspectives

The conference was followed by a Public Panel Lecture given by Professor Keith Humphreys of Stanford University (US) and by Mark Gilman, Strategic Recovery lead of the National Treatment Agency (UK), exploring the differences between understandings of recovery in the US and the UK. Keith Humphreys highlighted the significance of the recovery movement numbering at 5-6 million, and claimed that 18% of Americans have used mutual help groups of one sort of another.  Mark Gilman argued that in the UK harm reduction strategies had ‘hit the target but missed the point’ with lives of crime and incarceration being exchanged for ‘methadone, booze, benzos and benefits’  as lifestyle norms for those no longer under pressure to score heroin. Whilst they were, he said, physically alive and not technically in prison, they were spiritually dead, and imprisoned in their own lives; let down by the system.  In his vision professionals should be ‘on tap, not on top.’ Recovery Orientated Integrated Systems (ROIS) should be in place, leading to asset based community development.  A key theme to emerge from this debate was the need for those working with addicts to work together, rather than to expend energy critiquing each other’s methods.  The addictions treatment field is riven by numerous political debates, which have (inadequately) linked harm reduction with the left wing and abstinence-based recovery with conservatism. Both speakers critiqued this characterisation, noting that harm-reduction in the UK was developed by Margaret Thatcher’s government, and that the rise of Narcotics Anonymous has been seen by social historians as a working-class movement with features similar to the Trades Union movement.

 

Practitioners’ Seminar

The second day was a workshop/seminar event for addictions professionals in which practitioners shared good practice.  Amongst the delegates were residential rehab and day treatment support workers, peer mentors, nurses, counsellors and psychotherapists, treatment commissioners and other professionals in the field.

The delegates heard personal stories of those in recovery using the twelve steps in Narcotics Anonymous, Alcoholics Anonymous and in Al-Anon Family Groups. Professor Keith Humphreys and Dr Ed Day highlighted the positive effect that the practice of Twelve Step Facilitation (TSF) has on treatment outcomes over time.  Ed Day’s research also identified some of the reasons why professionals are doubtful about the appropriateness of TSF, amongst which is concern around appearing to recommend a religious approach. It also emerged that as many as 60% of addictions professionals have never been to an anonymous fellowship meeting.  Dr Wendy Dossett’s report on the initial findings of the Higher Power Project highlighted the ‘negotiated’ and personal nature of the spirituality reported by people who use the twelve steps, which addresses the misperception that the fellowships are simply religious.  Reports from a GP, a Commissioner, a non-Alcoholic Trustee of Alcoholics Anonymous, and various other organisations in the field all encouraged open-mindedness and a variegated approach to addictions treatment.  Several argued that the insights of pro-social modelling might be better harnessed in the addictions treatment field, that the evidence support the arguments being made for more assertive linkage to twelve step fellowships within the system, and that a greater number of professionals in recovery themselves might have a positive impact on outcomes – based on the principle that ‘changed people change people.’

In summary, the work undertaken across the two days resulted in significant strides being made in the collective understanding of the potential role of spirituality in addictions treatment. Delegates saw the conference as the beginning of a conversation on this subject which will be contributed to over time by increasing numbers of professionals, academics, service –providers and addicts and alcoholics themselves.