Isolation: the curse of addiction
Loneliness and isolation are best mates of addiction. Of course, it’s not just those with addictions who suffer from loneliness. Professor John Cacioppo presented recently at a conference in Chicago, pointing out that that the impact of loneliness on premature death ‘is nearly as strong as the impact of disadvantaged socioeconomic status’ – and that variable increases risk by 19%.
Getting plugged in
When Julianne Holt-Lunstad and colleagues published their gargantuan meta-analysis of mortality risks in 2010 they found a ’50% increased likelihood of survival for participants with stronger social relationships.’ In this paper it looked like this was a stronger predictor of long healthy life than stopping smoking and we know that smoking-related disease kills half of smokers.
So, if having plenty of quality social connections is good for the next person in the street, is it also true for people trying to recover from addictive disorders?
Mark Litt and colleagues from the University of Connecticut conducted a randomised trial on alcoholics in treatment. These patients either had case management, contingency management AND social network, or simply social network connection interventions. The ones connected to sober social networks did better than the other groups. One mind-blowing statistic coming out of this was that ‘the addition of just abstinent person to a social network increased the probability of abstinence for the next year by 27%.’ If this were causal think of the impact this would have on treatment populations. You’d think we’d all be practising this like billy-o now in treatment settings. Sadly we are not.
What’s the best way to improve the social networks of those seeking recovery? Answer: Introduce them to other recovering people. Where are recovering people to be found? In mutual aid groups. There are many pathways to recovery, but one of the catalysts that is most evidenced is participation in Alcoholics Anonymous. A 2012 study found that the better outcomes associated with AA engagement were explained primarily by adaptive social network changes and increases in social abstinence self-efficacy (the belief that you can do it).
Problems & Solutions
There are problems. There is evidence from several sources of a lack of good bridges connecting treatment and mutual aid. Some staff have their own ideological objections to 12-step groups which act as barriers to clients. Some workers are not aware of the growing evidence base. Some professionals believe recovery is a passing ‘fad’. We need to challenge all of these blocks.
Getting clients/patients in treatment along to recovery communities is not rocket science and if loneliness is the best mate of addiction, getting plugged in to mutual aid must be Recovery’s best buddy. Time for treatment to take note and to take on board.
[A version of this blog was published on Recovery Review a month or two back]