Substance Use Disorder Treatment Research Articles

Recovery Horizons: Nature-Based Activities as Adjunctive Treatments for Co-Occurring Post-Traumatic Stress Disorder and Substance Use Disorders

Posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) frequently co-occur, and individuals with co-occurring PTSD and SUD often experience more complex treatment challenges and poorer outcomes compared to those with either condition alone. Integrative treatment approaches that simultaneously address both PTSD and SUD are considered the most effective and include both pharmacological and non-pharmacological strategies. In recent years, complementary interventions have garnered increased attention due to their broad appeal and potential therapeutic benefits in enhancing existing treatments for PTSD and SUD. This review explores the existing literature on the use of nature-based activities, such as hiking, camping, sailing, and surfing in treating individuals with co-occurring PTSD and SUD. Nature-based activities offer promising adjunctive benefits, including the reduction of PTSD symptoms and craving levels. While evidence supports the therapeutic value of nature-based activities, current research remains limited. Further research is needed to better understand their therapeutic role and to refine their implementation in clinical practice.

Ayahuasca rituals for the treatment of substance use disorders: Three narratives of former patients of a neo‐shamanic center from Uruguay

AbstractAyahuasca is a psychedelic beverage from the Amazon rainforest, used in spiritual and religious settings for medical purposes. Since the 1990s onwards, several religious and neo‐shamanic groups have been using it in Uruguay within the psychospiritual networks. Some participants go to rituals of ayahuasca looking for therapeutic alternatives to certain ailments, such as substance use disorders (SUDs). In this chapter, three cases of former patients who recovered in a neo‐shamanic center that uses ayahuasca for the treatment of SUDs are described and analyzed. The center is conducted by a psychologist trained in the Peruvian vegetalismo tradition. An ethnographic description of the ritual setting as well as the process of psychotherapeutic intervention of the center are described. In‐depth interviews were used to collect the narratives of the three patients. A medical anthropology perspective is used, focusing on different subjective trajectories: the general biographic trajectory, SUDs trajectory, spiritual trajectory, and the trajectory under the entheogenic field, ayahuasca included. As we discuss, the impact of ayahuasca rituals ceremonies should be explained not only by ayahuasca as a psychedelic compound, but as a psychotherapeutic tool immersed in a social, cultural, and spiritual setting aimed at the treatment of SUDs.

Impact of Substance Use Disorder on Tryptophan Metabolism Through the Kynurenine Pathway: A Narrative Review

Background/Objectives: Substance use disorder is a crisis impacting many people in the United States. This review aimed to identify the effect addictive substances have on the kynurenine pathway. Tryptophan is an essential amino acid metabolized by the serotonin and kynurenine pathways. The metabolites of these pathways play a role in the biological reward system. Addictive substances have been shown to cause imbalances in the ratios of these metabolites. With current treatment and therapeutic options being suboptimal, identifying biochemical mechanisms that are impacted during the use of addictive substances can provide alternative options for treatment or drug discovery. Methods: A systematic literature search was conducted to identify studies evaluating the relationship between substance use disorder and tryptophan metabolism through the kynurenine pathway. A total of 32 articles meeting eligibility criteria were used to review the relationship between the kynurenine pathway, tryptophan breakdown, and addictive substances. Results: The use of addictive substances dysregulates tryptophan metabolism and kynurenine metabolite concentrations. This imbalance directly affects the dopamine reward system and is thought to promote continued substance use. Conclusions: Further studies are needed to fully evaluate the metabolites of the kynurenine pathway, along with other options for treatment to repair the metabolite imbalance. Several possible therapeutics have been identified; drugs that restore homeostasis, such as Ro 61-8048 and natural products like Tinospora cordifolia or Decaisnea insignis, are promising options for the treatment of substance use disorder.

Psychometric Evaluation of the Dutch version of the Substance Use Recovery Evaluator (SURE-NL).

Introduction Patient-Reported Outcome Measures (PROMs) are an important source of information that allow for a patient-centered assessment. Outcome measurement of substance use disorder (SUD) treatment traditionally focuses on drug use and deficits in functioning, overlooking other aspects of the personal and dynamic process of recovery. The Substance Use Recovery Evaluator (SURE) is a PROM developed with service user input to monitor the recovery journey and assess treatment outcomes in people with SUD. The objective of this study was to examine the validity and reliability of the Dutch translation of the SURE, the SURE-NL, for measuring indicators of recovery in Dutch-speaking patients with SUD. Methods The original SURE questionnaire was translated from English to Dutch using forward-backward translation. A total of N=171 participants were recruited as part of a naturalistic multicenter study in inpatient (N=149) and outpatient (N=22) SUD treatment centers. We examined the factorial structure, reliability, and concurrent and discriminant validity of the SURE-NL. Results The original 5-factor structure of the SURE showed acceptable fit for the SURE-NL, and internal consistencies of the subscales ranged from .61 to .76 and internal consistency of the total score was .83. Concurrent validity was confirmed through positive correlations of the SURE-NL total and subscale scores with the WHOQoL-BREF subscales, but correlations varied depending on subscale and treatment setting, with higher correlations for the outpatient compared to the inpatient subgroup. Discriminant validity was confirmed through low, mostly non-significant correlations between the SURE-NL and the DASS-21. Conclusions Although the SURE was originally designed for outpatient settings, our findings in a predominantly inpatient sample indicate that the SURE-NL is suitable for assessing personal recovery and recovery capital in Dutch-speaking Belgian patients with SUD. However, subscales should be used and interpreted with caution. Further research is needed with larger Dutch-speaking outpatient samples and the development of a tailored SURE for inpatient settings should be considered.

ASAM affirms pharmacists are needed in SUD treatment

After a spate of reports showing that physicians don't want to or can't prescribe treatment for opioid use disorder (OUD) (see ADAW https://onlinelibrary.wiley.com/doi/10.1002/adaw.34212), the American Society of Addiction Medicine (ASAM) has reiterated its July recommendations that pharmacists play a greater role in providing medications. In “The Role of Pharmacists in Medications for Addiction Treatment,” ASAM noted that pharmacists already help by dispensing buprenorphine. However, some pharmacies are reluctant to provide it, “possibly conflating harms associated with diversion of medications like oxycodone and alprazolam with buprenorphine's diversion risks,” ASAM wrote in the introduction to the policy statement. “Pharmacies are crucial to accessing and improving the utilization of medications for addiction treatment, however.”

Changes in legal referrals to specialty substance use disorder treatment from 2015–2019

BackgroundThe policy landscape around substance use has changed dramatically in the past decade, which may have affected the number and characteristics of treatment episodes for substance use disorder (SUD). In this study, we examine changes in the volume of SUD treatment referrals from the legal system and compare changes in the composition of substances used by referral source. We used publicly available discharge data on specialty SUD treatment episodes in the U.S. from 2015–2019 and included episodes involving adults that are discharged from specialty SUD treatment facilities during the study. We calculated descriptive statistics of specialty SUD treatment discharges in each year and aggregated across all years by referral source and substance(s) reported upon admission. To test differences by year and referral source, we conducted z-tests of proportions.ResultsThe proportion of referrals to specialty SUD treatment from the legal system declined between 2015 and 2019 (p < 0.001). However, referrals from probation/parole and diversionary programs grew over time (p < 0.001) in number and proportion over time. Legal referrals were most often associated with alcohol or cannabis use, though referrals for these substances declined from 2015–2019.ConclusionsThis research lays the groundwork for future investigations to evaluate the effect of important policy changes on referral sources to specialty SUD treatment and the quality and outcomes associated with referrals to treatment from the legal system.

Daily cigarette smoking among inpatients for substance use disorders in France, 2010-2020: Commonalities and specificities across substances.

This study aims to estimate the prevalence and factors associated with cigarette smoking among patients in treatment for substance use disorders (SUD) in France. We analyze a nation-wide dataset retrieving information on patients entering treatment for alcohol, opioid and stimulant use disorders between 2010 and 2020. We conduct multilevel Poisson regressions to determine the main factors associated with daily cigarette smoking among all patients who entered treatment for alcohol (n=607122), opioid (n=283381) or stimulant (n=57189) use disorders, and zero-truncated negative-binomial regressions to predict the average number of cigarettes per day. Daily cigarette smoking remains a widespread behavior among patients with SUD (overall prevalence: 72.2%, 95% CI: 72.1-72.3), with lower prevalence of daily cigarette smoking among patients treated for alcohol use disorders (69.9%, 95% CI: 69.8-70.0), and higher for patients treated for opioid (78.8%, 95% CI: 78.6-79.0) or stimulant use disorders (75.8%, 95% CI: 75.4-76.2). There was an overall increase in daily cigarette smoking over time (69.9%, 95% CI: 69.8-70.0 in 2010 vs 76.8%, 95% CI: 76.5-76.9 in 2020); however, the average number of cigarettes per day decreased (17.8 per day, 95% CI: 17.7-17.9 in 2010 vs 16.3 per day, 95% CI: 16.2-16.4 in 2020). The higher the education level, the fewer number of cigarettes per day; conversely, the higher the occupational status, the higher the number of cigarettes. The high prevalence of smoking among patients treated for SUD in France departs from the decreasing trend observed in the general population and remains a source of concern. It is necessary to implement tailored prevention strategies that target specific patient subgroups and increase staff awareness.

Nurse led models of care for outpatient substance use disorder treatment: A scoping review.

To map key characteristics and describe nurse led models of care for the treatment of persons with substance use disorders (SUDs) in the outpatient setting. A scoping review. Conducted in accordance with the JBI methodology. The PRISMA-ScR checklist was used. Pubmed, CINAHL Complete (EBSCOhost), Cochrane Library, APA PsycNet and Scopus were searched from 1999 to May 2022 and updated on 28 November 2023. A handsearch and a grey literature search was conducted. Title and abstract screening was performed on 774 articles resulting in 88 articles for full text screening. Full text screening yielded 13 articles that met inclusion criteria. Existing nurse-led models of care for SUDS are scarce and limited in scope, with the majority focused on treating opioid use disorder. Additional research is needed to develop, test, and implement efficacious nurse-led models of care for the treatment and management of SUDs. Nurse led models of care have demonstrated their efficacy and quality in the management of other chronic diseases. As we move forward with innovative solutions for individuals with addiction, nurse led models of care can be a mechanism to deliver high quality, evidence-based care for SUDs. SUDs are chronic diseases that impact individuals, families, and communities. SUDs require a biopsychosocial approach to treatment. Globally, nurses are well positioned to provide high quality care to mitigate the impact of SUDs. This scoping review mapped the extant literature on nurse led models of care for substance use disorder treatment in the outpatient setting finding that additional research is needed to develop, test and implement evidence-based interventions to care for individuals, families, and communities experiencing SUDs. PRISMA checklist for scoping reviews. No patient or public contribution were part of this study. Open Science Framework accessible at: https://doi.org/10.17605/OSF.IO/NSW7V.

Impact of substance type and patient characteristics on the choice of treatment setting for substance use disorder in Belgium

BackgroundSpecialised addiction treatment centers (SAC) and general mental health centers (GMHC) both offer care to people with substance use disorders (SUD) in Belgium, but these sectors often operate in parallel, with little collaboration. This fragmented system may lead to inefficiencies, particularly in the treatment of individuals with dual diagnoses. Despite the recognized challenges, there is limited understanding of the factors that influence whether patients with SUD are treated in SAC or GMHC. ObjectivesThis observational study has two main objectives:1.To examine whether and how the primary substance of abuse influences the choice of either SAC or GMHC.2.To assess whether other factors (e.g. sociodemographics, institution or person who orientated the patient to treatment) play a significant role in determining the type of center where the patient is treated. MethodsThe study used routinely collected data from treatment centers in Belgium from 2019 (Belgian Treatment Demand Indicator). Logistic regression evaluated the weight of drug use and sociodemographic variables for people entering treatment for SUD for the first time (n = 8322). A random forest algorithm was used to study all patients' orientation toward both sectors, across all treatment episodes (n = 29,658). ResultsThe study found that the primary substance significantly influences sector choice. Patients using illicit substances like cannabis, opiates, cocaine, and stimulants are 6–12 times more likely to be treated in an SAC than those using alcohol. Factors such as income source and referral source (e.g. self-referral, general practitioner, etc) also significantly impact patient orientation. ConclusionThese findings highlight the need for better integration between SAC and GMHC to adequately address the complex needs of people with SUD, especially with dual diagnosis.

Cariprazine in Bipolar Disorder and Substance Use: A Dual Approach to Treatment?

Bipolar disorder (BD) is characterized by recurrent episodes of mania, hypomania, and depression and is often complicated by comorbid substance use disorders (SUDs). Up to 60% of individuals with BD experience SUDs, which exacerbate mood instability and increase the risk of rapid cycling, suicide, and poor clinical outcomes. Current treatment strategies, including lithium and valproate, show limited efficacy in treating both BD and SUD. Psychotherapeutic approaches such as cognitive behavioral therapy (CBT) offer benefits but lack a specific focus on substances such as cannabis and cocaine. Since there is still debate on how to treat this comorbidity, there is a need to find new therapeutic options; this mini-review examines the pharmacological properties of cariprazine and its emerging role in the treatment of comorbid BD and SUD. Cariprazine, an atypical antipsychotic with partial agonism at dopamine D2 and D3 receptors, has shown promise in treating both mood symptoms and cognitive dysfunction in BD. Its unique affinity for D3 receptors, which are involved in motivation and reward processing, may offer advantages in reducing drug craving. Clinical trials indicate that cariprazine effectively treats manic, depressive, and mixed episodes in BD with a favorable side effect profile, particularly at lower doses. Preliminary results suggest its potential to reduce craving and substance use in individuals with co-occurring BD and SUD. Therefore, cariprazine, with its unique pharmacodynamic mechanism, could be further studied for the treatment of BD in comorbidity with SUD. However, evidence on the role of cariprazine in the treatment of SUDs remains limited, based primarily on case reports and animal studies. Further research, including large-scale clinical trials, is needed to determine its full efficacy in this dual diagnosis.

A Holistic Harm Reduction Center Model: A Commentary

Substance addiction is a chronic, relapsing disorder characterized by compulsive drug seeking, loss of control over consumption, and a negative emotional state when access to the drug is restricted. Substance Use Disorders (SUDs) are associated with severe health issues including suicide and co-occurring diseases like HIV and hepatitis C, and mental health problems. Although the present SUD treatment models prioritize abstinence, achieving abstinence during a treatment episode is challenging as majority of individuals with SUDs continue using drugs during treatment. To address this challenge in the current SUD treatment model, harm reduction has emerged as a strategy that focuses on interventions such as naloxone distribution, syringe services, safe drug use education and other strategies that reduce harmful outcomes such as substance-related overdose death and disease transmission while improving quality of life. This commentary proposes a Holistic Harm Reduction Model that can be incorporated by harm reduction centers aimed at reducing risky drug use behavior and overdose deaths, and ultimately improving public health outcomes in the community. The proposed holistic model includes new components such as trauma-informed care and referral and a brief mindfulness intervention along with the already existing harm reduction approaches such as Licensed Practical Nurses (LPNs) and harm reduction managers to provide comprehensive healthcare services, distribution of supplies; education; referral and linkage to other services, including medications for substance use disorder; and participant data collection and analysis.

Examining the Potential Impact of Recreational Cannabis Legalization on Individuals Receiving Treatment for Substance Use Disorder: An Interrupted Time Series Study in Guelph, Ontario, Canada

Objective: The present research evaluated the impact of legalizing recreational cannabis among individuals with substance use disorders (SUDs) who may already use cannabis at high rates. Method: Using an interrupted time series study design, we evaluated the potential impact of legalizing recreational cannabis among individuals seeking treatment for SUD within a hospital-based treatment setting in Guelph, Ontario. We examined 2,925 individuals who entered an inpatient SUD treatment program between April 2017 and December 2021. We performed segmented regression analyses using both the date of cannabis legalization and the date of edibles legalization as the interruption time point. We also performed stratified analyses to examine potential sex differences. Results: We found no significant changes in the frequency of cannabis use using either of the interruption time points. However, among the subsample who had used cannabis, there was evidence of increasing CUD severity post-legalization of edibles, as well as an overall decreasing trend in readiness to quit over time. Stratified analyses also suggested possible sex differences in frequency of cannabis use, CUD severity, and readiness to quit. Conclusions: Results point to some small but potentially important impacts of recreational cannabis legalization that may only continue with time. Nevertheless, there is a need to continue to monitor cannabis use trends over time to understand any potential lagged effects.

A mindfulness-based intervention for Substance Use Disorder in a Brazilian vulnerable population: a feasibility mixed method study.

Substance Use Disorder (SUD) is a chronic condition that impacts various facets of an individual's life, and society as a whole. The Mindfulness-Based Relapse Prevention (MBRP) protocol is an innovative intervention that can help to prevent relapse, particularly when used as a post-treatment approach. However, although there is significant evidence of its effectiveness in studies from high-income countries (HICs), there is a dearth of studies examining its feasibility and efficacy in low- and middle-income countries (LMICs). Thus, this study investigates the feasibility of MBRP as an adjunct to outpatient treatment for SUD in a socially vulnerable Brazilian population. The study employed a mixed-methods design in eight Psychosocial Care Centers for Alcohol and Drugs (CAPS-ad) in the city of São Paulo, and involved 140 participants, 24 healthcare professionals and 7 CAPS-ad managers. In total, 17 MBRP intervention groups were conducted. The study assessed qualitative indicators of acceptability, demand, implementation, adaptation, integration, and limited efficacy testing through group interviews, in-depth interviews and field diary records. It also included limited efficacy testing of the protocol using a quantitative pre-post pilot study to investigate consumption behavior, using the Timeline Followback (TLFB) assessment method; depression, using the Center for Epidemiologic Studies Depression (CES-D) scale; anxiety, using the state trait anxiety index (STAXI-2); craving, using the Penn Alcohol Craving Scale (PACS); readiness to change, using the Readiness-to-Change Ruler (RCR); and severity of dependence, using the Severity of Dependence Scale (SDS). The qualitative data were triangulated with the quantitative data to comprehensively evaluate the feasibility of the intervention. The sample comprised socially vulnerable participants with a high dropout rate, primarily due to social factors. Despite facing challenges in respect of regular engagement and initial cultural misperceptions of meditation, the intervention showed positive acceptance and mental health benefits, including impacts on consumption behavior. The study emphasizes the importance of adapting the format of the protocol to better suit vulnerable populations, and to ensure its effective integration into the public healthcare system. Future research should explore protocol modifications, assess its effectiveness in different contexts, and conduct cost-benefit analyses for broader implementation.

EFFECTIVENESS OF AN ALTERNATIVE PROTOCOL TO FACE SUBSTANCE USE DISORDER AND SYMPTOMS OF COMORBID DEPRESSION

Introduction: There is scarcity of studies in the national and international literature on alternative protocols to pharmacological and psychotherapeutic intervention for the treatment of Substance Use Disorder (SUD) and symptoms of comorbid depression. This study aimed to develop a protocol based on alternative therapies through mindfulness meditation, reiki, acupuncture and auriculotherapy to improve substance use problems and symptoms of comorbid depression. Method: This is a randomized single-blind controlled study. The final sample consisted of 18 participants randomized divided into two groups of nine participants: experimental and control. Participants were evaluated by four validated instruments during the screening process and after the intervention. The instruments were: Beck Depression Scale (BDI), Depression, Anxiety and Stress Scale (DASS-21), Alcohol Use Disorders Identification Test (AUDIT), Drug Abuse Screening Test (DAST-10) and Brazilian Economic Classification Criteria (CCEB). Results: the results of the analysis indicate a significant reduction in the pattern of alcohol consumption (p &lt;0.001); other drugs related problems (p&lt;0.001); symptoms of depression (p&lt;0.001); anxiety (p&lt;0.001) and stress (p&lt;0.001) between the two distinct groups (experimental and control) after the intervention. Conclusion: The protocol proposed in this study was effective in reducing the pattern of problems related to alcohol and other drugs, in addition to being effective in reducing symptoms of depression, stress and anxiety.

“One can’t Occur without the Other”: How Men Describe the Connection Between Healing from Childhood Sexual Abuse and Addiction Recovery

ABSTRACT The role that healing from childhood sexual abuse (CSA) plays in the context of substance use disorder (SUD) recovery is not well understood, particularly in male survivors. Building on interviews with 25 men and using grounded theory, this qualitative study explored the connection between healing from CSA and SUD recovery among male survivors. The findings reveal a cyclical nature in the connection between healing from CSA and addiction recovery, where sobriety enables healing and healing from CSA enables long-term recovery. This study highlights the importance of acknowledging and addressing sexual trauma in the treatment of SUD, particularly in male survivors.

Idaho libraries to provide private spaces for SUD telehealth treatment

Called the “Third Space Project,” Idaho libraries will provide space for telehealth treatment for substance use disorders (SUDs), with an emphasis on serving rural and high‐need communities. The state Division of Behavioral Health Substance Use Disorder Unit is leading the project in partnership with the Idaho Commission for Libraries (ICfL), with funding by a $500,000 grant from the American Rescue Plan Act's 2021 Substance Use Prevention, Treatment, and Recovery Services Block Grant supplemental.

Ayahuasca drinking using a two-bottle choice procedure in male mice

Ayahuasca has been proposed as a treatment for substance use disorders. However, because of its hallucinogenic properties, studies investigating its abuse potential are needed. The aim of the present study was to investigate voluntary ayahuasca drinking in male mice using a two-bottle choice procedure. Male mice were exposed to two bottles, one of water and one of ayahuasca (0.01, 0.03 or 0.1 mg/ml), for 15 h/day, under 3 protocols (acquisition): (1) every other day access; (2) access every 3 days; (3) access every 5 days. Animals were then submitted to a 14-day drug-free period, followed by 3 re-exposure phases (same conditions as during acquisition), with 7 drug-free days between each. Regardless of the ayahuasca concentration, animals showed a preference for ayahuasca over water when exposed to ayahuasca every other day during the acquisition and re-exposure phases. Extending the period between ayahuasca exposures changed the expression of ayahuasca preference, with the longest break (every 5 days) being associated with preference for water over ayahuasca (i.e., ayahuasca aversion), an effect that was more predominantly observed at higher ayahuasca concentrations. A significant interaction was observed between frequency of exposure to ayahuasca and ayahuasca concentration for total ayahuasca intake during the later re-exposure phase. Our findings show that both the frequency of exposure and the ayahuasca concentration are critical when determining ayahuasca preference in a two-bottle choice model in mice, which can help guide therapeutic/ritualistic ayahuasca use.

04 Care for adolescents with substance use: A national survey of paediatric hospitals

Abstract Background Substance use is a recognized Paediatric health care issue. More than 9 in 10 individuals receiving treatment for substance use disorders report that their first use of substances occurred by young adulthood. The Canadian Institute for Health Information reported that 5% of hospital stays among Canadian youth in 2017-2018 were related to harmful substance use. In a study of youth with a first-time emergency department visit for a mental health problem between 2010 and 2014, most visits were due to substance related disorders. Despite this, little is known about practices relating to substance use in children's hospitals. Objectives 1. To describe how adolescents who present to Paediatric hospitals with substance use disorders or substance-related health issues are identified, assessed, and treated. 2. To identify best-practices that can inform national standards of care. Design/Methods An online questionnaire was utilized to obtain information on: 1. Clinical practices in the emergency department, inpatient services and ICU; 2. Hospital policies and practice guidelines; and 3. Hospital and community programs and resources. Recruitment emails were sent to hospital leaders (CEO or equivalent) at all 13 Paediatric hospitals. Leaders were asked to identify one individual to complete the survey on behalf of their hospital with input from relevant stakeholders in the various clinical areas. The survey was developed iteratively by a national group of 9 adolescent medicine clinicians and 2 Paediatric trainees. The survey was piloted at a single Paediatric hospital and refined. The survey was administered via RedCap technology. Results Survey response rate was 70% (9/13 hospitals). The mean number of contributors to each survey was 9 (range of 1-35). Overall, few hospitals utilized best practices consistently. There was inconsistency in the use of validated screening tools, use of clinical practice guidelines for monitoring and ongoing care and prescribing of nicotine replacement therapy and opioid agonist therapy. These inconsistencies were noted within each clinical setting (emergency department, inpatient services, and ICU), across services in each hospital, and between hospitals. With respect to hospital services, 5/9 had some type of consult team related to substance use (e.g., adolescent medicine), 4/9 had specialized substance use outpatient services, and 2/9 offered partial hospitalization/day treatment for patients with substance use issues. Local community-based substance use resources were identified as insufficient to address needs by 8/9 hospitals. Conclusion Inconsistencies in the care of adolescents with substance use disorders or substance-related health issues highlights the need for national guidelines for Paediatric hospital-based assessment and care, and enhanced coordination between services and systems of care for this patient population.

A Systematic Review and Critique of Recreational Therapy-Specific Literature Regarding Substance Use Disorders

Just over four out of 10 Certified Therapeutic Recreation Specialists (CTRS®s) identify that they work with people who have substance use disorder (SUD); however, there are few SUD-specific recreational therapy (RT) resources available to guide practice with this population. A systematic review and critique of SUD-specific RT literature was conducted to examine the basis for the current state of practice of RT within SUD treatment. Peer-reviewed journal articles from 1981-2021 and current RT textbooks and manuals from four publishers were reviewed to highlight the existing evidence base for SUD-specific RT practice, and critiqued for shortcomings. Gaps and needs in research are discussed, as well as recommendations for the development of SUD-specific evidence-based practices in RT.

A Systematic Review and Critique of Recreational Therapy-Specific Literature Regarding Substance Use Disorders

Just over four out of 10 Certified Therapeutic Recreation Specialists (CTRS®s) identify that they work with people who have substance use disorder (SUD); however, there are few SUD-specific recreational therapy (RT) resources available to guide practice with this population. A systematic review and critique of SUD-specific RT literature was conducted to examine the basis for the current state of practice of RT within SUD treatment. Peer-reviewed journal articles from 1981-2021 and current RT textbooks and manuals from four publishers were reviewed to highlight the existing evidence base for SUD-specific RT practice, and critiqued for shortcomings. Gaps and needs in research are discussed, as well as recommendations for the development of SUD-specific evidence-based practices in RT.