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Doctoral Dissertation Final.pdf (3.17 MB)

Christian Neurotheology and Opioid Addiction

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posted on 2022-06-18, 01:29 authored by Nathaniel Fitch, PhDNathaniel Fitch, PhD

Abstract


It has been established that the opioid epidemic and crisis is a current public health concern that warrants a multi-level approach with an aim to lower the number of those suffering from substance use disorders, as well as opioid overdose-related deaths. The statistical projection on the opioid crisis is growing in both number of reported cases of substance use disorder, as well as opioid overdose-related deaths, and will continue to rise until the year 20351,7,8,10. The burden of the opioid crisis is felt by these communities, which places further burden on local law enforcement, emergency responders, and the medical community at large. Opioid overdose-related death is an avoidable consequence of the epidemic and should be the initial focal point. Research has shown that medical-assisted therapy for emergency situations, as well as in addiction treatment is best for treating opioid related overdose and substance use disorders13. Further research indicates that the use of combination therapy, consisting of medication assisted therapy and cognitive behavioral therapy) is the most proven to be effective at sustaining retention rates of those suffering from substance use disorders, especially those with opioid use disorders12,13. Christian based ministerial  counseling services, pastoral counseling services, as well as the spiritual based twelve-step model of recovery, are all types of cognitive behavioral therapy that have started to become more popular in recent medical and psychological academic literature regarding their efficacy  in sustaining long term retention rates in patients with substance use disorder. The focus of this book is to conduct a meta-analytic and systematic review of the current literature regarding Christian based cognitive behavioral modalities in the treatment of substance use disorders and opioid use disorders and report on the efficacy of these treatment models. After conducting a thorough review of the current literature, it was found that Christian PCT and TSF recovery models were efficacious at aiding those with OUD in achieving long term abstinence. Studies further point out that spiritual based TSF is best overall in treating SUD, that Christian based PCT works better in certain demographics than it does in other, but that both work in both religious populations and non-religious populations (atheist, agonistic) when compared to other CBT.  


Methodology


Researcher conducted a search of public health and epidemiological statistical reviews of opioid epidemic in the United States through standard government agency websites. Neuroscience information was gathered through selective search on neuroscience articles published through the National Institute of Heal (NIH) Medical Library Database. Neurotheology research was searched through multiple databases. Randomized controlled trials (RCT) that utilized a double blind with t score reporting and confidence intervals were preferred. Studies that used fundamental magnetic resonance imaging (fMRI) were preferable than other imaging modalities, although others were selected based off p value reporting (p<0.05) with appropriate confidence interval banding reporting (95% CI).Combination therapy research was collected through multiple databases through the National Institute of Health medical library database for both the efficacy of medication- assisted therapy and cognitive behavioral therapy research. 

Randomized controlled studies were the preferred data selected, combination therapy data was collected and confirmed through Cochrane Review as the gold standard of therapy. The studies collected on pastoral counseling therapy and twelve step recovery models were through various databases. Studies were selected that reported statistics utilizing a double blind random controlled trial and ANOVA t scoring reporting when available, but due to limitations in specified data search some were selected only reporting standard statistical means with appropriate p reporting (p<0.05) with matching confidence interval (95% CI). Studies with large populations (n values > 100), a review of participant demographics was conducted to ensure the demographics of population observed was close to national demographic reporting to reduce validity of data application in clinical setting. This includes age range medians, race and ethnicity diversification, and reporting on personal views of religion and spirituality. For long-term studies, the time reported that was sufficient was greater than or equal to 12 months (>/= 12), as this is the standard reported in long term studies found in a wide data base search.  The INSPIRIT index for religious and spirituality was the preferred subjective reporting index when searching for studies that surveyed participants who reported on religious and spiritual psychological states. Studies that incorporated the use of INSPIRIT index and verification with neural imaging with either fMRI or PET scanning were more favored in selection due to cross validity of subjective and objective data reporting. Becker Index was preferred when searching for research on subjective reporting of acute changes in mood and depression. With these parameters in set, the author was able to conduct an appropriate review of the current literature using established search criteria applied in scientific meta-analytical reviews of comparable interventions and measured outcomes. 

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