Associations of spirituality and craving among individuals in substance use disorder treatment: A latent change score modeling approach.

Abstract

Using a latent change score modeling approach, we tested the bidirectional relationships between spirituality and craving during the first month of substance use disorder (SUD) treatment. Specifically, we examined whether higher spirituality levels predicted greater reductions in craving over the first month of treatment and explored whether higher craving predicted smaller increases in spirituality. Participants (N = 25,735) included patients admitted to one of 73 SUD treatment centers in 2021 (either inpatient, outpatient, or withdrawal management) in the United States. Craving was assessed using substance-specific questionnaires and spirituality was assessed via the modified Religious Background and Behavior scale, which participants completed weekly for the first four weeks of treatment. Spirituality levels increased and craving levels decreased during the first month of treatment. The proportional effects of change in these processes became stronger over time such that magnitude of change became smaller from week to week. Spirituality did not predict changes in craving, although higher levels of craving at week 1 predicted smaller increases in spirituality from week 1 to week 2. Findings highlight the first week of SUD treatment as a critical window of therapeutic recovery whereby patients may exhibit the greatest amount of change in spirituality and craving processes. However, overall, results from this study do not support modulation of craving through spirituality, suggesting spirituality-focused interventions may not be universally beneficial. However, further research is needed to explore whether such interventions may be helpful for specific patient subgroups or influence other treatment outcomes.