A comprehensive global study has revealed that spirituality plays a crucial role in reducing substance abuse and relapse rates. This research aligns with long-held beliefs in organizations like Alcoholics Anonymous, highlighting spiritual practices’ positive impact on recovery from addictions to alcohol, marijuana, and other drugs.
The study, published in JAMA Psychiatry on February 18, 2026, synthesized data from 55 rigorous longitudinal studies encompassing over 540,712 participants. These investigations followed individuals for periods ranging from six months to over 20 years. The findings indicate that higher levels of spiritual engagement correlate with a 13 percent reduction in the risk of harmful or hazardous substance use in both prevention and recovery contexts. Notably, individuals attending religious services more than weekly experienced an even greater risk reduction of 18 percent.
According to lead researcher Tyler VanderWeele, PhD, the consistency of results across diverse populations and countries was striking. Most studies demonstrated a protective effect of spirituality rather than a detrimental one. The study broadly defined spirituality to include various forms of engagement, such as attending religious services and private practices like prayer.
The protective role of spirituality is particularly significant for young people. Early initiation into alcohol or drug use is strongly linked to adverse developmental outcomes, higher addiction risk, and severe long-term consequences. Spiritual engagement may provide valuable support mechanisms, including social networks, internalized ethical systems that discourage substance use, and a sense of purpose that diminishes reliance on substances for mood regulation.
Emerging neuroscientific research supports the notion that practices such as meditation and prayer can positively affect mental health. These findings reinforce the existing body of work surrounding spiritually oriented mutual-help organizations like Alcoholics Anonymous, which combines peer support with spiritual principles. While AA is often viewed primarily as a peer-support model, it also emphasizes reliance on a higher power, as understood by each individual.
Earlier meta-analyses comparing 12-step facilitation to other treatments have shown significant benefits, with a 2020 Cochrane review concluding that AA and similar approaches are at least as effective as established treatments, and in some cases, superior in promoting long-term abstinence.
Research conducted by Kelly and Greene in 2014 suggested that increases in spirituality during participation in AA were linked to improved alcohol outcomes. Gains in meaning and connection to a higher power were associated with reductions in drinking, highlighting identifiable psychological processes such as enhanced coping skills and reduced negative mood.
The sociocultural context of spirituality also matters. Previous studies indicated differences in AA affiliation at treatment intake between Black and White Americans. Over half of African American respondents viewed spirituality and religion as central to their recovery, compared to only one in four White respondents. This emphasizes that phrases commonly heard in AA, like “One day at a time,” serve as behavioral micro-interventions that can significantly aid recovery.
Recovery capital, which encompasses the resources supporting sustained remission—including organized religions, social networks, and psychological health—shows that spiritual well-being is a vital component. Longitudinal cohort studies suggest that individuals with higher spiritual well-being experience fewer substance use issues, particularly in the early stages of recovery.
Unlike pharmacotherapies, which target neurobiological pathways, and psychotherapies that focus on maladaptive behaviors, spiritual pathways address existential dimensions of suffering that are often overlooked in clinical settings. Many individuals who engage in heavy drinking may not meet the criteria for alcohol use disorder. Screening and brief interventions in primary care settings can reduce risks and prevent progression. The new data suggests that spirituality and religious engagement could serve as effective early interventions, potentially preventing the transition from casual use to addiction.
The study does not advocate for physicians to direct patients toward specific religious beliefs. Instead, it highlights the importance of assessing spirituality as a protective factor. Engaging patients in discussions about the role of spirituality in their lives can foster patient-centered care. For individuals already valuing spiritual practices, encouragement to connect with supportive communities may enhance their recovery efforts.
Substance use and addiction continue to pose significant public health challenges globally. If spiritual engagement is linked to even modest reductions in substance use, collaborations between health systems and community spiritual organizations could broaden access to prevention and recovery resources. This pivotal study underscores the importance of spirituality as a protective factor in managing substance-related issues, offering a pathway to better health outcomes for many individuals.