“God put weed here for us to smoke”: A mixed-methods study of religion and spirituality among adolescents with cannabis use disorders

Abstract

Background: A growing literature on adults with substance use disorders (SUDs) suggests that religious and spiritual processes can support recovery, such that higher levels of religiosity and/or spirituality predict better substance use outcomes. However, studies of the role of religion and spirituality in adolescent SUD treatment response have produced mixed findings, and religiosity and spirituality have rarely been examined separately. Methods: The present study examined religiosity and spirituality as predictors of outcomes in an outpatient treatment adolescent sample (N = 101) in which cannabis was the predominant drug of choice. Qualitative data were used to contextualize the quantitative findings. Results: Results showed that higher levels of spirituality at posttreatment predicted increased cannabis use at 6-month follow-up (β = .237, p = .043), whereas higher levels of baseline spirituality predicted a lower likelihood of heavy drinking at posttreatment (odds ratio [OR] = .316, P = .040). Religiosity did not predict substance use outcomes at later time points. When asked to describe the relation between their religious/spiritual views and their substance use, adolescents described believing that they had a choice about their substance use and were in control of it, feeling more spiritual when under the influence of cannabis, and being helped by substance use. Conclusions: Together, findings suggest that for adolescents with SUDs, religion and spirituality may not counteract the use of cannabis, which may be explained by adolescents’ views of their substance use as being consistent with their spirituality and under their control.

Keywords:

• Adolescent
• cannabis
• mixed methods
• religion
• spirituality

Notes

* Participants in Stage 1b also completed a 9-month follow-up. As participants in Stage 1a did not complete a 9-month follow-up, only data from baseline to 6-month follow-up were utilized, in order to maximize the sample size.

† Growth models were considered as a data analytic method, as these would allow for an examination of the impact of religiosity and spirituality on the growth trajectories of substance use over the 6-month period. However, due to the small sample size, there were problems with model convergence when predictors were added to the models. Thus, simpler models (i.e., regressions) were identified as being more appropriate for this sample.

‡ Separate regression analyses were run controlling for gender, treatment condition, and number of treatment sessions attended. These covariates did not significantly predict outcomes, and inclusion of these covariates did not meaningfully alter the pattern of results. As such, these results are not presented.

Additional information

Funding

Research reported in this paper was supported by the National Institute on Drug Abuse of the National Institutes of Health under Award Number F31DA035030 and the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health under Award Number R01AA019664. The funding organizations had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.