JAMA Psychiatry

Spirituality linked to lower risk of harmful substance use, meta-analysis finds

February 20, 2026

A meta-analysis in synthesizing 55 rigorous longitudinal studies (540,712 participants) found that higher spirituality or religious involvement was consistently associated with lower harmful or hazardous alcohol and other drug use. Across 134 extracted effects, nearly all showed a protective association, with an overall 13% reduced risk (RR) of substance use (RR, 0.87; 95% confidence interval, 0.84–0.91). Risk reduction was even greater—18%—among individuals engaged in spiritual or religious communities (defined as at least weekly religious service attendance).

Clinical takeaway: Consider integrating brief questions about spiritual community, meaning, or purpose into assessments. These factors may help identify protective influences relevant to prevention or recovery.

Source:

Koh HK, et al. (2026, February 18). JAMA Psychiatry. Spirituality and Harmful or Hazardous Alcohol and Other Drug Use: A Meta-Analysis of Longitudinal Studies. https://pubmed.ncbi.nlm.nih.gov/41706493/