Friday, February 20, 2026

Spiritual practices strongly associated with reduced risk for hazardous alcohol and drug use, A Meta-Analysis of Longitudinal Studies

Getting high on religion and religious community may indeed help!

Pray and meditate more and be better off!

"Individuals who engaged in spirituality were significantly less likely to exhibit hazardous use of alcohol, tobacco, marijuana, and illicit drugs, according to a new meta-analysis led by researchers at Harvard T.H. Chan School of Public Health.
The meta-analysis is the first of its kind to synthesize and comprehensively estimate associations between harmful or hazardous substance use and spirituality—considered any practice, religious or otherwise, through which an individual finds ultimate meaning, purpose, and connection to something greater than themselves.  ...

The meta-analysis found that broad spiritual practices, including spiritual and religious community involvement, attending religious services, meditation, and prayer, reduced individuals’ risk of dangerous alcohol and drug use by 13%. This reduction was greater (18%) among individuals attending religious services at least once per week. The results were consistent across all of the drug categories studied (alcohol, tobacco, marijuana, and illicit drugs). ..."

From the key points and abstract:
"Key Points
Question  What is the association between spiritual exposures and related drug use outcomes?

Findings  This meta-analysis of 55 rigorous studies on spirituality and harmful or hazardous drug use (alcohol, tobacco, marijuana, or illicit drugs) documented a significant protective association of 13% related to both prevention and recovery. The risk reduction, which extended across all 4 drug categories, reached 18% for individuals with greater than weekly religious service attendance.

Meaning
These results have implications for clinicians and communities regarding future strategies to address harmful or hazardous alcohol or other drug use.

Abstract
Importance
This meta-analysis examines rigorous longitudinal 21st century studies on the associations of spirituality with harmful or hazardous alcohol and other drug (AOD) use.

Objective
To synthesize findings from independent studies about spirituality and AOD use and to produce a comprehensive estimate of the overall effect size of the associated risk reduction.

Data Sources
Studies previously identified in the Balboni and colleagues review on the association between spiritual exposures (including religion) and alcohol, tobacco, marijuana, or other drugs were pooled.  ...

Study Selection
From an initial retrieval of more than 20 000 articles, a total of 55 spirituality studies (as defined by Puchalski and colleagues) that were
(1) published 2000-2022 in the English language,
(2) used validated measures of spirituality,
(3) examined longitudinal associations between spirituality and AOD use, and
(4) were either prospective cohort studies with sample sizes of 1000 or more or randomized clinical trials (eg, public health interventions) with sample sizes of 100 or more, were captured.

Data Extraction and Synthesis
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines were used for abstracting data and assessing quality and validity. Eligible studies were those that reported quantitative outcomes measuring AOD use in relation to spiritual exposures, provided sufficient data to calculate log-relative risks (log-RR) and associated error terms, and focused on either preventive effect (eg, delayed initiation) or recovery-related outcomes (eg, cessation). Effects extracted were transformed into log-RR based on the type of effect.

Main Outcomes and Measures  The primary outcome was the association between spiritual or religious involvement and AOD. Subgroup analyses examined differences by AOD use type (alcohol, tobacco, marijuana, and illicit drugs) and exposure type (spiritual or religious attendance vs broader spiritual exposures).

Results
Results from the 55 studies, which collectively included 540,712 participants, documented a significant protective association related to both prevention and recovery between spirituality and AOD use outcomes.
Specifically, a consistent 13% risk reduction extended across the studied drugs (RR, 0.87; 95% CI, 0.84-0.91), a figure that reached 18% for individuals engaging in spiritual or religious communities (defined as >weekly religious service attendance; RR, 0.82; 95% CI, 0.75-0.89).
Virtually all 134 effects extracted from the studies demonstrated protective, not detrimental, results. Multiple sensitivity analyses confirmed the robustness of evidence.

Conclusions and Relevance
The results of this meta-analysis regarding a protective association between spirituality and AOD use have implications for clinicians and communities regarding future strategies for AOD use prevention and recovery."

Spiritual practices strongly associated with reduced risk for hazardous alcohol and drug use | Harvard T.H. Chan School of Public Health


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