Alcoholism Treatment Quarterly

Substance use disorders (SUD) and addiction, in general, present a spectrum of recovery challenges that are affected by individual circumstances. In this first issue of Alcoholism Treatment Quarterly (ATQ) for 2019, we highlight gender, family, the justice system, and collegiate educational program influences on recovery processes and outcomes. Although alcohol use disorder (AUD) has long been the primary focus of ATQ, we include consideration of other substance use disorders, eating disorders, and gambling disorder.

Gender is becoming widely recognized as playing a larger role than previously thought in both the development and recovery of AUD and other SUDs. National Institutes of Health grant applications now include review of whether applicants have appropriately addressed gender influences and mandate that for clinical trials men and women be included in sufficient numbers to determine statistically significant differential outcomes. Sanders explores the importance of gender in the “singleness of purpose” of Alcoholics Anonymous (AA) and gives perspective on how women with dual addiction hide their prescription drug use and are hesitant to discuss sex-specific abuse in mixed gender meetings. Addressing the feelings of shame and potential exclusion from AA could enhance an incredibly important program, which has helped women gain and retain sobriety without losing focus on its primary purpose, to help all individuals with AUD. Attendance in 12-Step mutual help groups by women in the justice system is explored by Schonbrun and colleagues who recommend guidance to enhance interest in participation.

The next section of the issue looks at the significance of family involvement in treatment and recovery. In a qualitative study of the perspectives of AUD patients, families and clinicians, McCrady et al. provide recommendations for piloting new training structures and materials. A case example is illustrated by Smith and coauthors in proposing an integrated treatment program that includes 12-Step with Internal Family Systems Therapy (IFS) for young adults with SUDs. Near-infrared spectroscopy (fNIR) analyses reported in the Shumway article revealed functional differences in prefrontal cortex of family members with a primary relative diagnosed with SUD in the past 10 years.

Collegiate Recovery Programs (CRP) provide an essential service to college students with SUDs. Ashford and colleagues identify the prevalence of subclinical disordered eating (DE) in a CRP on a U.S. campus. They report that a majority of students felt CRPs can support mental health and DE recovery concurrently with SUDs. In a perspective, Brown and Bohler review important collegiate recovery and physician health programs factors that facilitate recovery and reduce relapse.

An exploratory observational study by Rogers provides a perspective of Gambler’s Anonymous (GA) from the United Kingdom. Several themes were highlighted including differences in gender and cultural emphasis in GA meetings. Rogers recommends increasing openness of GA as an organization and support for increasing ‘women preferred’ meetings. He also notes that these GA meetings “make recovery,” and it is imperative to improve access for as many people as possible with this behavioral addiction.

As always, we hope that individuals experiencing addiction, in particular, as well as their families and society, in general, will be helped by the diverse issues captured in the articles of this volume. We welcome comments and suggestions from our readers to advance the relevance and impact of ATQ.