Joseph A. Califano, Jr.
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If ever the sum is greater than the parts, it is in combining the power of God, religion and spirituality with the power of science and professional medicine to prevent and treat substance abuse and addiction. That’s the good news from So Help Me God: Substance Abuse, Religion and Spirituality, the two-year study recently released by the National Center on Addiction and Substance Abuse at Columbia University.

The bad news is how few clergy receive any substance abuse training and how many psychiatrists and other health care providers refuse to take advantage of the power of spirituality and religion to prevent and treat this disease. The best news is that the Vatican has stepped up to the plate with a manual setting out the church’s responsibility in preventing and treating drug abuse.

The United States has a unique tradition of religious commitment: almost all our people profess a belief in God and 92 percent affiliate with a particular religion. An astonishing array of churches and cathedrals, synagogues, Islamic centers and mosques, Hindu and Buddhist temples enrich our states.

America is the most medically advanced nation in the world. Cities across the country house the most sophisticated hospital and health care complexes and equipment. Our physician training has given us the finest medical professionals. Yet clergy and physicians, religion and science are too often ships passing in the night. When we separate the worlds of medicine and spirituality, we deny a host of individuals help that may aid their recovery and ease their painespecially with respect to substance abuse and addiction. One need only listen to the eloquent voices of recovery as they speak about the role of God and spirituality in their own healing processes.

The CASA report, which includes unprecedented surveys of clergy and heads of schools of theology, documents the enormous power of God, religion and spirituality in preventing and treating substance abuse.

Adults who do not consider religious beliefs important are more than one-and-a-half times more likely to smoke, more than three times likelier to binge-drink, almost four times likelier to use an illicit drug other than marijuana and more than six times likelier to smoke pot than adults who believe that religion is important.

Adults who never attend religious services are three times more likely to smoke, more than five times likelier to use an illicit drug other than marijuana, almost seven times likelier to binge-drink and almost eight times likelier to smoke pot than those who attend religious services at least weekly.

Teens who do not consider religious beliefs important are almost three times more likely to drink, binge-drink and smoke, almost four times likelier to use marijuana and seven times likelier to use illicit drugs than teens who believe that religion is important.

Teens who never attend religious services are twice as likely to drink, more than twice as likely to smoke, more than three times likelier to use marijuana and binge-drink and almost four times likelier to use illicit drugs than teens who attend religious services at least weekly.

College students with no religious affiliation are more likely to binge-drink than those who identify themselves as Catholics or Protestants.

The one-third of prison inmates who participate in religious activities exhibit lower rates of recidivismand recidivism is due almost entirely to drug and alcohol abuse.

Religion and spirituality can be important, sometimes determinative, companions to the treatment and recovery process. Many recovering alcoholics and addicts attribute their motivation to seek treatment and their ability to maintain sobriety to their religious beliefs and the support of a community of believers. Individuals who attend spiritually based 12-step programs such as Alcoholics Anonymous and Narcotics Anonymous, in addition to receiving treatment, are likelier to maintain sobriety. Individuals in successful recovery commonly display greater levels of faith and spirituality than those who relapse.

In view of the significance of religion in prevention and treatment, the most troubling discoveries of the CASA study are two profound disconnects: one, between the extent to which clergy see substance abuse as a problem among congregations they serve and their lack of knowledge and training in the area; the other, between the importance of God, religion and spirituality to effective treatment and the medical profession’s failure to tap into this resource when treating substance abusers and addicts.

The Clergy Disconnect

Of the priests, ministers and rabbis surveyed, 94 percent of front-line clergy and 98 percent of theology school presidents consider substance abuse and addiction an important problem in their congregations. Yet only 12.5 percent of clergy received any training about substance abuse during their theological studies. Only 36 percent said they preach a sermon addressing the issue more than once a year. (I have attended Mass more than 4,000 times during my life and I can remember only once hearing a priest discuss the subject in a sermon, the Rev. Thomas Bennett of Our Lady of Perpetual Help in Washington Depot, Conn.) These survey responses are deplorable, since alcohol and drug abuse are so tied to child and spousal abuse, violent crime, rape, teen pregnancy, sexually transmitted diseases, family breakup and divorce, school dropout and failure, debilitating accidents and job lossall problems that clergy confront every day among their congregations.

This past December, the Vatican’s Pontifical Council for Health Care Workers released a 200-page manual on drugs and drug addiction. Four years in the making, the manual focuses on the church’s role in prevention and treatment. It promotes youth programs that discourage drug use and calls upon church workers to be positive role models. It outlines suggestions for church-sponsored treatment programs and even describes in detail the effects of commonly used drugs. Members of the clergy are urged to listen to their parishioners’ concerns, and parents are encouraged to talk to their children about alcohol and drug abuse. The document, seeing substance abuse and addiction for the serious problem it is, finds that experiments conducted in certain countries to liberalize or legalize drug use have been disastrous and condemns legalization as a policy of despair. The Vatican publicationa clear recognition of the importance of spirituality in prevention and treatmentis a wake-up call for Catholic clergy.

The Provider-Patient Disconnect

Standing in sharp relief is the lack of recognition among health care providersespecially psychiatrists, psychologists and other mental health professionalsof the importance of God, religion and spirituality to treating patients struggling with substance abuse and addiction. Only 40 percent to 45 percent of mental health practitioners believe in God. Only 37 percent of psychiatrists responded affirmatively to the question, If it were scientifically demonstrated that the use of a spiritual intervention (e.g., prayer) improved patient progress, would you perform that intervention? Only 57 percent of psychiatrists would recommend that a patient consult a member of the clergy. Sixty-five percent of psychiatrists report that religion and spiritual issues were rarely or never included in their training.

For a sense of the chasm between these mental health care providers and patients, consider these facts: 95 percent of Americans believe in God; 79 percent believe that spiritual faith can help people recover from disease including addiction, and 63 percent think that physicians should talk to patients about spiritual faith.

The Combination Opportunity

Clergy are a barely tapped resource in preventing and treating substance abuse and addiction. Priests, ministers, rabbis, imams and other religious leaders should become more engaged in addressing this problem; they should preach about substance abuse issues and incorporate prevention and recovery messages into their ministry. Many individualsespecially Catholics and some Protestantsturn to their parish priest or minister for help in dealing with substance abuse problems. Schools of theology and seminariesProtestant, Catholic, rabbinical and othersshould educate their students to recognize the signs of substance abuse and deal with them. Clergy should familiarize themselves with treatment services in their communities.

Archbishop Michael J. Sheehan of Santa Fe is showing the way. He has held a forum on drug abuse in four cities in New Mexico and last November issued a pastoral letter on the feast of All Saints setting out action plans for individuals, young persons, families, parishes and the archdiocese based on the good news...that people who are enslaved and blinded by drugs [including alcohol] can be freed through the amazing saving grace of Jesus Christ. This remarkable spiritual leader urges parishes to keep a list of treatment centers and their phone numbers handy for referral purposes when the need arises. Archbishop Sheehan sees substance abuse as the number one health problem in New Mexico and is mounting a program that sets an example for every archdiocese of how to combine the power of the spiritual and the scientific.

Psychiatrists and other mental health providers are of course free to hold agnostic and atheistic beliefs, but all should be better informed of the potential for God, spirituality and religion to help prevent and treat substance abuse and addiction. They should learn of the spiritual and religious resources available in their local communities and how to take advantage of them. Health care providers should not shy away from discussing their patients’ spiritual needs and desires; they should be prepared to refer patients to appropriate clergy or spiritually-based programs to assist their recovery. Perhaps the head of some local chapter of a mental health organization, like the American Psychiatric Association, will take a cue from Archbishop Sheehan’s outreach effort in New Mexico.

A better understanding by the clergy of the disease of alcohol and drug abuse and addictiontogether with a better appreciation by the medical profession, especially psychiatrists and psychologists, of the power of God, religion and spirituality to help patients with this diseaseoffer a gold mine for prevention and treatment that can help millions of Americans and their families. For many individuals working to shake the shackles of addiction and hang on to sobriety, sound advice might well be: work at it as though everything depended on you and pray as though everything depended on God. That is not bad advice for priests and physicians as well. At least one archbishop, Michael J. Sheehan of Santa Fe, has taken it to heart.

Action Plan by Archbishop Michael J. Sheehan
What You Can Do

As an individual

  • Frequent the sacraments
  • Reach out to the addicted
  • Stop using drugs or abusing alcohol and seek help
  • Advocate improved resources in your neighborhoods

As a young person

  • Learn about illegal drugs and alcohol abuse
  • Avoid friendships with drug and alcohol abusers
  • Join parish youth groups
  • Go to Sunday Mass

As a family

  • Stay involved, eat together, do things together
  • Have fun without alcohol and drugs
  • Forbid illegal drugs in the home or at family celebrations
  • Use alcohol moderately or not at all
  • Do not tolerate drugs in your schools
  • Pray as a family

As a parish

  • Speak about substance abuse in homilies
  • Provide professional counseling and support groups
  • Open parish facilities to Al-Anon, A.A. and N.A.
  • Keep a list of treatment centers
  • Provide a youth minister and youth group activities
Joseph A. Califano Jr. is president of the National Center on Addiction and Substance Abuse at Columbia University. He was the U.S. secretary of health, education and welfare from 1977 to 1979.

Comments

mellisa | 4/2/2009 - 7:44am
Alcoholism is a disease, a gene passed on from one generation to the next, not a character defect that can be cured with a pill or by attending Mass. I went to a pastor when first becoming sober and was told that AA used a "generic God," and that I would have to choose the "right" God soon. ------------------------------------------ mellisa Substance Abuse Center
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Daniel A. Kidd<BR>President, Guest House | 1/26/2007 - 1:33pm
Thank you, America and Joseph A. Califano Jr., for the wake-up call to clergy and professionals regarding the importance of attention to the substance abuse problem and the need for collaboration in fighting the damage done by addiction (2/11).

Mr. Califano rightly points out the need for training clergy on substance abuse and for professionals on the vital role of religion and spirituality in successful treatment and recovery. It is significant that addiction counselors have the highest percentage of belief in God among counseling professional groups, probably for good reason.

Training for the clergy and future clergy is important. It might interest Mr. Califano to know that in the past year, Guest House, which has treated Catholic clergy for alcoholism and other drug addiction since 1956, presented training programs to 10 percent of all Catholic seminarians in the United States and will do so again this year. This is prevention activity, but also pastoral training for seminarians in dealing with the real situations that they will see in their ministries. Several dioceses and religious orders have also requested and received education on substance abuse for their active clergy and religious.

Some dioceses, like Lansing, Mich., and Palm Beach, Fla., have growing and active parish-based substance abuse services.

Many clergy graduates of Guest House do extend their own recoveries into their ministries, sometimes in homilies but also in the confessional and counseling and even in establishing treatment services themselves. I have personally been able to see this in my time working at Guest House. One of the clearest examples of this was Fred Harkins, a Jesuit of Worcester, Mass., who was eulogized in 1999 for having counseled over 100,000 people after his treatment at Guest House in 1959 until his death. There are many others.

Denial, of course, is inherent in the problem of substance abuse, and Catholics are not immune. I would suggest, though, that much service has been contributed by the church to foster prevention and treatment of substance abuse since the Jesuits John Ford, Edward Dowling and John Hardon helped to gain Catholic acceptance of Alcoholics Anonymous and the disease of alcoholism. Much more remains to be done. I hope that Mr. Califano’s article can help precipitate more needed activity.

Debbie E. | 2/15/2002 - 9:01am
I read, with appreciation and some dismay, the article by Joseph Califano, Jr. regarding substance abuse and the role religion can play. "My name is Debbie and I am a grateful recovering alcoholic." I have stayed sober with no help from organized religion or clergy, but with much help from AA, my Higher Power, who I choose to call God, and my re-established spirituality. Your article implies that if one goes to Church, the chances of becoming a substance abuser can be prevented. Explain to me then, the incidence of alcoholic priests and nuns? Alcoholism is a disease, a gene passed on from one generation to the next, not a character defect that can be cured with a pill or by attending Mass.

I went to a pastor when first becoming sober and was told that AA used a "generic God," and that I would have to choose the "right" God soon. So, you are correct in stating that the clergy need to become educated on this subject. Organized religion and spirituality are two different things. Some of the most blessed, faith-filled people I know are in AA, while some of the most religious, devout Catholics (insert any religion here) I know lack faith and appreciation for all of God's gifts. Many an AA member has jokingly stated that they were also "recovering Catholics."

So, although Church has helped some, the only thing it has done for me, personally, is provided a basement for my AA meetings, which I do appreciate.

Debbie E. | 2/15/2002 - 9:01am
I read, with appreciation and some dismay, the article by Joseph Califano, Jr. regarding substance abuse and the role religion can play. "My name is Debbie and I am a grateful recovering alcoholic." I have stayed sober with no help from organized religion or clergy, but with much help from AA, my Higher Power, who I choose to call God, and my re-established spirituality. Your article implies that if one goes to Church, the chances of becoming a substance abuser can be prevented. Explain to me then, the incidence of alcoholic priests and nuns? Alcoholism is a disease, a gene passed on from one generation to the next, not a character defect that can be cured with a pill or by attending Mass.

I went to a pastor when first becoming sober and was told that AA used a "generic God," and that I would have to choose the "right" God soon. So, you are correct in stating that the clergy need to become educated on this subject. Organized religion and spirituality are two different things. Some of the most blessed, faith-filled people I know are in AA, while some of the most religious, devout Catholics (insert any religion here) I know lack faith and appreciation for all of God's gifts. Many an AA member has jokingly stated that they were also "recovering Catholics."

So, although Church has helped some, the only thing it has done for me, personally, is provided a basement for my AA meetings, which I do appreciate.