A groundbreaking meta-analysis conducted by Harvard T.H. Chan School of Public Health reveals compelling evidence that engaging in spirituality significantly reduces the risk of hazardous substance use. This comprehensive study, the first of its kind to rigorously synthesize longitudinal data on spirituality’s impact on substance misuse risk, highlights a notable 13% decrease in dangerous drug and alcohol consumption among individuals practicing spiritual behaviors. Among these, those attending religious services weekly experienced an even greater risk reduction, up to 18%. These findings arrive amid escalating global concerns over addiction and the public health crises associated with substance use.
The study represents a pivotal advancement in addiction science, bridging social and behavioral epidemiology with prosocial and spiritual dimensions of human experience. By encompassing a wide spectrum of spiritual practices—from attending congregational rituals to private meditation and prayer—the researchers broadened the conventional understanding of spirituality beyond organized religion. The scientific community has long sought to identify protective factors against substance misuse, and this meta-analysis provides a novel empirical foundation, illustrating how meaning, purpose, and connection to transcendent entities or values might mitigate addictive behaviors.
To achieve these insights, the researchers meticulously reviewed over 20,000 studies published between 2000 and 2022 concerning spirituality and health. After stringent selection, 55 high-quality studies meeting criteria such as robust cohort sizes and longitudinal methodologies were chosen, collectively following more than 500,000 individuals over extended periods. This vast dataset enabled examination of how spirituality influenced use patterns across a range of substances, including alcohol, tobacco, marijuana, and illicit drugs, controlling for confounding variables and ensuring results’ reliability and generalizability.
The meta-analysis revealed that engagement in spiritual practices functions as a significant protective factor across all substance categories studied. Attending religious services regularly emerged as the single most efficacious behavior, correlating with the greatest reductions in harmful substance use risk. The mechanisms underlying these correlations are multifaceted: communal support, structured routine, existential meaning, and coping enhancement all likely contribute to decreased susceptibility to substance misuse. Notably, meditation and prayer—often considered personal and introspective practices—also demonstrated meaningful associations with reduced risk, underscoring spirituality’s broad functional scope.
Senior author Tyler VanderWeele, a leading authority on epidemiology at Harvard, underscored the rarity and importance of this meta-analytical approach to spirituality. Unlike prior cross-sectional studies, which provide limited insight into causality, this synthesis integrates longitudinal evidence, revealing durable associations over time and from diverse populations, including international samples beyond the United States. The robust consistency across heterogeneous study designs and population demographics reinforces spirituality’s potential as a universal protective health factor, challenging prior assumptions that spirituality’s effects might be culturally or contextually constrained.
From a clinical perspective, these findings carry profound implications for addiction prevention and treatment paradigms. Healthcare providers are encouraged to explore patients’ spiritual beliefs and practices as part of holistic assessment and intervention. For individuals for whom spirituality is salient, integrating spiritual resources and community participation may enhance resilience against relapse and support sustained recovery trajectories. Such approaches address crucial psychological dimensions like stress reduction, identity reconstruction, and social integration, often insufficiently targeted by standard pharmacological or behavioral therapies.
Community and public health agencies stand to benefit from forming strategic partnerships with spiritual and religious organizations to amplify addiction prevention efforts. These institutions often provide invaluable social networks, purpose-driven engagement, and moral frameworks conducive to health-promoting behaviors. Developing programs that foster spiritual well-being may concurrently alleviate key drivers of substance misuse such as loneliness, despair, and disconnection. This interdisciplinary synthesis of epidemiology, psychology, and spirituality invites innovative, culturally attuned strategies to complement conventional addiction services.
The study’s methodology merits special attention due to its meticulous control for biases and confounders that often plague observational research. By selecting only large cohort studies with repeated measures, the analysis minimizes reverse causation concerns and enhances temporal inference. Advanced statistical models were employed to calculate pooled effect sizes, adjusting for demographic factors, mental health comorbidities, and sociocultural variables. The transparency and rigor of these methods elevate confidence in the causal interpretation of spirituality’s protective role.
While the meta-analysis establishes a compelling link between spirituality and reduced hazardous substance use, the authors acknowledge that further research is necessary to elucidate underlying biological and psychosocial mechanisms. Neurobiological studies exploring how spiritual experiences modulate reward pathways, stress responses, and executive functioning could deepen understanding. Similarly, qualitative investigations into individual subjective experiences may unravel how spiritual meaning-making processes fortify motivation to abstain from addictive substances. Longitudinal experimental studies testing spiritual interventions are a promising next frontier.
In sum, this pioneering meta-analysis contributes a transformative perspective to addiction science, advocating that spiritual engagement is a critical but often overlooked dimension in the fight against substance misuse. It situates spirituality not merely as a private or religious matter but as a potent health asset with implications for policy, clinical care, and community programming. By expanding the addiction prevention toolkit to include spiritual resources, societies can harness an ancient human capacity—searching for meaning and connection—to foster resilience and well-being amidst modern public health challenges.
The publication of this study in JAMA Psychiatry, a leading scientific journal, underscores the growing recognition of interdisciplinary approaches that integrate epidemiology, psychology, and spirituality. Funded by the Templeton Religion Trust and the Lee Family Fund, the study’s significance is amplified by its ability to influence both academic discourse and practical addiction interventions worldwide. The findings herald a paradigm shift where addiction is not only seen through the lens of pathology but also through holistic human experience and existential wellness.
Ultimately, this research invites clinicians, policymakers, and communities to reimagine addiction prevention and recovery through a lens that honors human spirituality as an essential resource. As substance misuse continues to challenge global health infrastructures, embedding spiritual dimensions within treatment and public health initiatives offers a hopeful and empirically supported pathway to mitigate this crisis. Harnessing spirituality’s preventive potential represents a promising frontier in fostering individual and collective resilience against hazardous substance use.
Subject of Research: Not applicable
Article Title: Spirituality and harmful or hazardous alcohol and other drug use: A meta-analysis of longitudinal studies
News Publication Date: 18-Feb-2026
Web References: http://dx.doi.org/10.1001/jamapsychiatry.2025.4816
References: Howard K. Koh, Donald E. Frederick, Tracy A. Balboni, et al., JAMA Psychiatry, February 18, 2026
Keywords: Substance abuse, Addiction, Alcoholism, Drug addiction, Narcotics addiction, Alcohol abuse, Drug abuse, Self medication, Spirituality, Religion
