Background: More Americans than ever before are identifying as "spiritual but not religious". Both spirituality and religiousness (S/R) are of interest in the addiction field as they are related to alcohol and other drug (AOD) problems and are central to some recovery pathways. Yet, little is known overall about S/R identification among people in recovery, the role these play in aiding recovery, and whether they play more or less of a role for certain sub-groups (e.g., men/women, different races/ethnicities; those with treatment or 12-step histories).
Method: Nationally representative cross-sectional sample of US adults (N=39,809) screening positive to the question, "Did you use to have a problem with alcohol or drugs but no longer do?" (final weighted sample n= 2,002). Weighted Chi-Square and Poisson-distributed generalized linear mixed models tested for differences in S/R and for differences across subgroups on extent of: 1) religious, and, 2) spiritual, identification, and the extent to which these had aided recovery.
Results: Participants reported being mostly moderately spiritual and religious, and that, overall, religion had not helped them overcome their AOD problem. In contrast, spirituality was reported as either not helping at all, or having made all the difference. Substantial differences were observed by race-ethnicity across both spirituality and religiousness, and to a lesser degree between men and women. Black Americans reported substantially more S/R than Whites and that these often made all the difference in their recovery. The exact opposite trend was observed for White and Hispanic Americans. Prior professional treatment and 12-step mutual-aid use were both related to greater spirituality, but not religiousness.
Conclusion: Overall, spirituality but not religion, appears to play a role in aiding recovery particularly among those with prior treatment or 12-step histories, but women and men, and racial-ethnic groups in particular, differ strikingly in their religious and spiritual identification and the role these have played in aiding recovery. These differences raise the question of the potential clinical utility of S/R in personalized treatment.
Keywords: addiction; recovery; religion; spirituality; substance use disorder.