Academic journal article Journal of Alcohol & Drug Education

Social Support Influences on Substance Abuse Outcomes among Sober Living House Residents with Low and Moderate Psychiatric Severity

Academic journal article Journal of Alcohol & Drug Education

Social Support Influences on Substance Abuse Outcomes among Sober Living House Residents with Low and Moderate Psychiatric Severity

Article excerpt

There is extensive literature supporting the contention that social support has a beneficial impact on a variety of health conditions, including substance abuse (Bond, Kaskutas, & Weisner, 2003; Cohen & Wills, 1985; Cutrona & Russell, 1990). However, despite the consensus about the benefits of social support for persons with alcohol and drug disorders, there is limited research on the effects of different types of social support in different contexts. For example, the effects of social support might vary in different treatment programs, at different time points in the recovery process and among different subpopulations of persons with substance use disorders.

Studies of alcohol and drug treatment have also shown that psychiatric severity predicts worse outcome (Broome, Flynn, & Simpson, 1999; Compton, Cottier, Jacobs, Ben-Abdallah, & Spitznagel, 2003; Ritsher, McKeller, Finney, Otilingam, & Moos, 2002). However, there are a variety of significant limitations in these studies. One is that most of these studies only measure the influence of psychiatric symptoms in a limited context. For example, most studies assess psychiatric symptoms in formal treatment programs at baseline and their influence on subsequent outcome. Thus, we have limited information about how psychiatric symptoms change over time and how changes impact longitudinal outcome. In addition, there are few studies that assess how the impact of psychiatric problems on outcome is influenced by a variety of factors, such as social support for recovery in one's social network and involvement in 12-step recovery groups. Overall, there has been a tendency in the literature to emphasize the study of persons with co-occurring disorders who have severe mental illnesses such as schizophrenia and substance abuse (e.g., Drake et al., 2016; Somers, Moniruzzaman, Rezansoff, Brink & Russolillo, 2016) and most of these studies have been conducted in treatment programs designed to address multiple problem areas in addition to psychiatric and substance abuse disorders. We have limited information about the influence of less severe psychiatric disorders in non-treatment settings that are being increasingly emphasized as vital resources for sustaining long-term recovery from substance abuse disorders. Sober living recovery homes are good examples of such services (Polcin & Henderson, 2008).

Sober Living Houses (SLHs) are alcohol- and drug-free living environments for persons with substance use disorders that's emphasize social support for recovery as the primary therapeutic factor for sustaining long-term recovery (Polcin & Henderson, 2008). They do not provide on-site professional treatment services, but typically require or strongly encourage attendance at 12-step recovery groups. Studies of residents entering SLHs have documented significant, sustained reductions in substance use and legal problems and an increase in employment (Polcin, Korcha, Bond, & Galloway, 2010) over 18 months. Importantly, improvements were maintained over 18 months even though by that time most of the residents had left the houses. Although psychiatric symptoms improved over time, they were a significant predictor of worse substance use outcome (Polcin, Korcha, Gupta, Subbaraman, & Mericle, 2016). Consistent with the philosophy of recovery in SLHs, studies showed measures of social support predicted better substance use outcomes (Polcin et al., 2010). Specifically, higher involvement in 12-step recovery groups, lower levels of drinking in the residents' social network and lower levels of drug use in the residents' social network predicted better substance use outcome.

The purpose of this study was to test whether social support variables operated differently for residents experiencing low and moderate psychiatric distress. Psychiatric problems were strong, consistent predictors of worse outcomes, so we were particularly interested in understanding social support factors that benefit persons with higher psychiatric severity. …

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