Growth in Recovery: Psychological, Spiritual and Relational

Alcoholism Treatment Quarterly, Editorial, 42–3

This issue emphasizes the theme of individual growth within the context of recovery. While numerous studies have explored factors that influence and maintain recovery, the articles featured in this edition delve into the personal journey of individuals in recovery and their evolving understanding of it. Zmuda and Wells surveyed adults in recovery and found that new romantic relationships in early recovery may be negatively framed by participants who have exposure to 12-Step groups. There was a slightly higher agreement with the view that relationships are risky versus the view of relationships as supportive. The authors posit that this may be impacted by the narrative that relationships are deleterious to recovery efforts, despite limited empirical support for this belief. At the same time, the authors also acknowledge that some women in recovery have experienced sexual harassment and intimate partner violence victimization. Devassy et al., presented a mixed-method study that assessed psychosocial variables among individuals who received treatment and therapy for SUD, and found that impulsivity, association with gangs, and deviant peer relationships were prevalent among those who relapse after treatment and therapy.

Ohayon and Ronel offered a Kantian perspective to free will and its role in autonomy among individuals with substance use disorder and their recovery journey. They describe the process by which individuals with substance disorder would transition from a state of reduced self-control to becoming moral agents, with their goals evolving through stages of diffused heteronomy to autonomy, moral identity and spiritual freedom. Webb et al., explored the constructs of forgiveness, resentment and self-forgiveness in college students with substance use and substance misuse issues. They found that self-forgiveness was associated with lower levels of resentment, and that less resentment is associated with lower levels of psychological distress and vulnerability for use. This research provides empirical evidence to the commonly held assumptions about the significance of forgiveness and resentment in recovery and as a treatment approach for people who struggle with substance use disorder.

The next section in this issue presents topics in training and education of care providers. Calleja and Kondili conducted a study on the impact of an interprofessionally delivered substance use curriculum for primary health-care professionals, and nurse and physician assistant trainees that showed significant improvement in knowledge and attitudes regarding substance use disorders. The study results support the effectiveness of the interprofessional substance use curriculum for trainees in both undergraduate and graduate levels. El-Nagdy et al., proposed a new assessment scale and a predictive score for requiring intensive care unit admission for patients presenting with alcohol intoxication. Their proposed assessment scale, acute physiology and chronic health evaluation (APACHE II) score, took into consideration previous assessment criteria for ICU admission and includes 12 physiological and laboratory parameters with the aim of predicting severity and outcome in alcohol-intoxicated patients.

Vickery, Mason-Kennedy, and Emerman utilized the national Epic COSMOS database to evaluate mortality rates among inpatients with alcohol withdrawal syndromes. They found that among these patients, over a quarter receive antipsychotic agents; and among those who receive antipsychotics there is a mortality rate of 1.5%. Men are more likely to be prescribed antipsychotics, to receive a typical antipsychotic alone, and have a higher mortality rate compared to women. There were differences in antipsychotic use and the type of antipsychotic use (typical versus atypical) found among different demographic groups.

We close this issue with a study among university students in recovery. Burns et al., conducted a reflexive thematic analysis from qualitative interviews exploring the experiences, meanings, and barriers or facilitators to recovery from substance use disorders. Several themes emerged including multiple recovery pathways and identities, stigma and disclosure and the significance of proximity to campus resources and community.