Abstract
Problematic substance use (PSU) is highly prevalent within Canada. Individuals who suffer from PSU face disproportionate amounts of stigmatization. An individual achieves self-directed recovery (SDR) from PSU through a process of change where individuals improve their health and wellness, live a self-directed life and strive to reach their full potential. Negative social interactions, social supports, and demographic variables such as income are suggested to predict SDR. This concept of SDR is like the concept of flourishing within positive mental health (PMH). A flourishing individual is mentally healthy, exhibiting high levels of emotional wellbeing and positive functioning. The similarities between SDR and PMH have been noted previously, however research on the relationship is lacking. The current study aims to identify how individuals with PSU differ on PMH, social supports and negative social interactions when compared with the general population, as well as analyze if income, education, sex, age, social supports, and negative social interactions predict PMH in individuals with PSU. The sample was comprised of individuals between the ages of 20 and 64 years and who reported a lifetime history of substance abuse or dependence in the CCHS-MH database (N = 956). Participants differed from the general population on measures of PMH, social supports, and negative social interactions. Age, sex, income, social supports, and negative social interactions were found to predict PMH in individuals with PSU. This suggests the same factors that predict SDR in individuals with PSU also predict PMH. Implications of the study’s findings as well as study limitations are discussed.
This is a preview of subscription content, access via your institution.
References
Abel, K. F., Skjaervo, I., Ravndal, E., Clausen, T., & Bramness, J. G. (2018). Perceived self-control is related to mental distress in patients entering substance use disorder treatment. Substance Use and Misuse, 9, 1454-1462, https://doi.org/10.1080/10826084.2017.1413114
Ahern, J., Stuber, J., & Galea, S. (2007). Stigma, discrimination and the health of illicit drug users. Drug and Alcohol Dependence, 88, 188-196, DOI: https://doi.org/10.1016/j.drugalcdep.2006.10.014
American Psychological Association (APA). (2006). Memory Changes in Older Adults. Retrieved from: https://www.apa.org/research/action/memory-changes.
Beattie, M. C., & Longabaugh, R. (1999). General and alcohol-specific social support following treatment. Addictive Behaviours, 24, 593-606.
Bolinski, R., Ellis, K., Zahnd, W., Walters, S., McLuckie, C., Schneider, J., Rodriguez, C., Ezell, J., Friedman, S., Pho, M., & Jenkins, W. (2019). Social norms associated with nonmedical opioid use in rural communities: A systematic review. Translational Behavioural Medicine, 9, 1224-1232, DOI: https://doi.org/10.1093/tbm/ibz129
Booth, B. M., Russell, D. W., Soucek, S. & Laughlin, P. R. (1992). Social support and outcome of alcoholism treatment: An exploratory analysis. American Journal of Drug and Alcohol Abuse, 18, 87-101.
Canadian Substance Use Costs and Harms (CSUCH). (2021). CSUCH Visualization Tool. Canadian Centre on Substance Use and Addiction, Retrieved from: https://csuch.ca/explore-the-data/.
Caron, J. (1996). L’Echelle de provisions sociales: une validation Quebecoise. Sante mantale au Quebec, 21, 158-180.
Compton, P., Darakjin, J., & Miotto, K. (1998). Screening for addiction in patients with chronic pain and “problematic” substance use: Evaluation of a pilot assessment tool. Journal of Pain and Symptom Management, 16, 355-363
Cutrona, C., E., & Russel, D., W. (1987). The provisions of social support and adaptation to stress. Advance in Personal Relationships, 1, 37-67.
Evans-Lacko, S., Aguilar-Gaxiola, S., Al-Hamzawi, A., Alonso, J., Benjet, C., Bruffaerts, R., Chiu, W. T., Florescu, S., De Girolamo, G., Gureje, O., Haro, J. M., He, Y., Hu, C., Karam, E. G., Kawakami, N., Lee, S., Lund, C., Kovess-Masfety, V., Levinson, D., … Wojtyniak, B. (2018). Socio-economic variations in the mental health treatment gap for people with anxiety, mood, and substance use disorders: Results from the WHO world mental health (WMH) surveys. Psychological Medicine, 48, 1560–1571, DOI: https://doi.org/10.1017/S0033291717003336
Gerrard, M., Stock, M., L., Roberts, M., E., Gibbons, F., X., O’Hara, R., E., Weng, C-Y., & Wills, T., A. (2012). Coping with racial discrimination: The role of substance use. Psychology of Addictive Behaviours, 26, 550-560. DOI: https://doi.org/10.1037/a0027711.
Gilmour, H. (2014). Positive mental health and mental illness. Health Reports, 25, 3–9, Statistics Canada, Catalogue no.82–003-X. Retrieved from: http://campusmentalhealth.ca/wpcontent/uploads/2014/09/Positive-Health-and-Wellness.pdf.
Harris, A., McKellar, J., Moos, R., Schaefer, J., & Cronkite, R. (2006). Predictors of engagement in continuing care following residential substance use disorder treatment. Drug and Alcohol Dependence, 84, 93-101. DOI: https://doi.org/10.1016/j.drugalcdep.2005.12.010
Hartmann, D. J., Sullivan, W. P., & Wolk, J. L. (1991). A state-wide assessment: Marital stability and client outcomes. Drug and Alcohol Dependence, 29, 27-38.
Havassy, B. E., Wasserman, D. A., & Hall, S. M. (1991). Social support and relapse: Commonalities among alcoholics, opiate users, and cigarette smokers. Addictive Behaviours, 16, 235-246.
Humphreys, K., Moos, R. H., & Finney, J. W. (1996). Life domains, alcoholics anonymous, and role incumbency in the 3-year course of the problem drinking. Journal of Nervous and Mental Disease, 184, 475-481.
Hyshka, E., Butler-McPhee, J., Elliot, R., Wood, E., & Kerr, T. (2012). Canada moving backwards on illegal drugs. Canadian Journal of Public Health, 103, 125-127
Ivsins, A., Pauly, B., Brown, M., Evans, J., Gray, E., Schiff, R., Krysowaty, B., Vallance, K., & Stockwell, T. (2019). On the outside looking in: Finding a place for managed alcohol programs in the harm reduction movement. International Journal of Drug Policy, 67, 58-62. DOI: https://doi.org/10.1016/j.drugpo.2019.02.004
Kessler, R., C., & Ustun, T., B. (2004). The World Mental Health (WMH) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). International Journal of Methods in Psychiatric Research, 13, 93-121.
Keyes, C. L. M., & Simoes, E. J. (2012). To flourish or not: Positive mental health and all-cause mortality. American Journal of Public Health, 102, 2164-2172.
Keyes, C., L., M. (2009). Atlanta: Brief description of the mental health continuum short form (MHC-SF). Available: https://www.sociology.emory.edu/ckeyes/.
Keyes, C. L. M. (2002). The mental health continuum: From languishing to flourishing in life. The Journal of Health and Social Behaviour, 43, 207-222.
Krause, N. (2007). Longitudinal study of social support and meaning in life. Psychology and Aging, 22, 456-469.
Krentzman, A. (2013). Review of the application of positive psychology to substance use, addiction, and recovery research. Psychology of Addictive Behaviours, 27, 151-165, DOI: https://doi.org/10.1037/a0029897
Kulesza, M., Larimer, M. E., & Rao, D. (2013). Substance use related stigma: What we know and the way forward. Journal of Addictive Behaviours Therapy & Rehabilitation, , DOI: https://doi.org/10.4172/2324-9005.1000106
Laffaye, C., McKellar, J., Ilgen, M., & Moos, R. (2008). Predictors of 4-year outcome of community residential treatment for patients with substance use disorders. Addiction, 103, 671-680, DOI: https://doi.org/10.1111/j.1360-0443.2008.02147.x
Lin, M., Wolke, D., Scneider, S., & Margraf, J. (2020). Bullying history and mental health in university students: The mediator roles of social support, personal resilience, and self efficacy. Frontiers in Psychiatry, , DOI: https://doi.org/10.3389/fpsyt.2019.00960
Lincoln, K. D. (2008). Personality, negative interactions, and mental health. Social Service Review, 82, 223-251, DOI: https://doi.org/10.1086/589462
Link, B., Struening, E., Rahav, M., & Phelan, J. (1997). On Stigma and its consequences: Evidence from a longitudinal study of men with dual diagnoses of mental illness and substance abuse. Journal of Health and Social Behaviour, 38, 177–190, http://www.jstor.org/stable/2955424.
Livingston, J., Milne, T., Fang, M., &, Amari, E. (2012). The effectiveness of interventions for reducing stigma related to substance use disorders: A systematic review. Addiction, 107, 39-50, DOI: https://doi.org/10.1111/j.1360-0443.2011.03601.x
Lluch-Canut, T., Puig-Llobet, M., Sanchez-Ortega, A., Roldan-Merino, J., & Ferre-Grau, C. (2013). Assessing positive mental health in people with chronic physical health problems: Correlations with socio-demographic variables and physical health status. BioMed Central Public Health, 13, https://bmcpublichealth.biomedcentral.com/articles/https://doi.org/10.1186/1471-2458-13-928
McCrady, B. S., Hayaki, J., Epstein, E. E., & Hirsch, L. S. (2002). Testing hypothesized predictors of change in cojoint behavioural alcohol treatment for men. Alcoholism: Clinical and Experimental Research, 26, 463-470.
McGaffin, B., Deane, F., Kelly, P., & Ciarrochi, J. (2015). Flourishing, languishing and moderate mental health: Prevalence and change in mental health during recovery from drug and alcohol problems. Addiction Research and Theory, 23, 351-360, DOI: https://doi.org/10.3109/16066359.2015.1019346
Moore, G. F., Cox, R., Evans, R. E., Hallingberg, B., Hawkins, J., Littlecott, H. J., Long, S. J., Murphy, S. (2018). School, Peer and Family Relationships and Adolescent Substance Use, Subjective Wellbeing and Mental Health Symptoms in Wales: A Cross Sectional Study. Child Indicators Research, 11, 1951-1965
North, C., S., Eyrich-Garg, K., M., Pollio, D., E., & Thirthalli, J. (2010). A prospective study of substance use and housing stability in a homeless population. Social Psychiatry and Psychiatric Epidemiology, 45, 1055-1062, DOI: https://doi.org/10.1007/s00127-009-0144-z
Nutton, J., & Fast, E. (2015). Historical trauma, substance use, and indigenous peoples: Seven generations of harm from a “big event”. Substance Use and Misuse, 50, 839-847, DOI: https://doi.org/10.3109/10826084.2015.1018755
Parker, P., Banbury, S., & Chandler, C. (2018). The Utility of Measuring Flourishing in Substance and Alcohol Use Disorders Research: A Systematic Review. European Journal of Applied Positive Psychology, 2, Retrieved from: https://www.nationalwellbeingservice.org/volumes/volume-2-2018/volume-2-article-5/.
Pearson, C., Janz, T., & Ali, J. (2013). Health at a glance: Mental and substance use disorders in Canada. Statistics Canada. Retrieved from: https://www150.statcan.gc.ca/n1/en/pub/82624x/2013001/article/11855-eng.pdf?st=Ym4sKaFT.
Rauktis, M. E., Koeske, G. F., & Tereshko, O. (1995). Negative social interactions, distress, and depression among those caring for a seriously and persistently mentally ill relative. American Journal of Community Psychology, 23, 279-299.
Shearer, R., Howell, B., Bart, G., & Winkelman, T. (2020). Substance use patterns and health profiles among US adults who use opioids, methamphetamine, or both 2015–2018. Drug and Alcohol Dependence, 214, DOI: https://doi.org/10.1016/j.drugalcdep.2020.
Spohr, S. A., Livingston, M. D., Taxman, F. S., Walters, S. T. (2019). What’s the influence of social interactions on substance use and treatment initiation? A prospective analysis among substance-using probationers. Addictive Behaviour, 89, 143-150
Statistics Canada (2020) Canadian Health Survey on Seniors (CHSS). Retrieved from: https://www23.statcan.gc.ca/imdb/p2SV.pl?Function=getSurvey&SDDS=5267.
Statistics Canada. (2013). Canadian Community Health Survey (CCHS) – Mental health User Guide. Retrieved from: https://www23.statcan.gc.ca/imdb/p2SV.pl?Function=getSurvey&Id=119789.
Stevens, E., Jason, L. A., Ram, D., & Light, J. (2015). Investigating social support and network relationships in substance use disorder recovery. Substance Abuse, 36, 396-399, DOI: https://doi.org/10.1080/08897077.2014.965870
Substance Abuse and Mental Health Services Administration (SAMHSA) (2011). SAMHSA announces a working definition of “recovery: from mental disorders and substance use disorders. Retrieved from: http://www.samhsa.gov/newsroom/advisories/1112223420.aspx.
Thylstrup, B., Seid, A., Tjagvad, C., & Hesse, M. (2020). Incidence and predictors of drug overdoses among a cohort of >10,00 patients treated for substance use disorder. Drug and Alcohol Dependence, 206, DOI: https://doi.org/10.1016/j.drugalcdep.2019.107714
Toumbourou, J. W., Hamilton, M., U’Ren, A., Steven-Jones, P., & Storey, G. (2002). Narcotics Anonymous participation and changes in substance use and social support. Journal of Substance Abuse Treatment, 23, 61-66
Tracy, S., Kelly., J., & Moos, R. (2005). The influence of partner status, relationship quality and relationship stability on outcomes following intensive substance-use disorder. Journal of Studies on Alcohol, 497–505
Tsemberis, S. (2010). Housing first: The pathway model to end homelessness for people with mental illness and addictions manual. European Journal of Homelessness, 5, 235-240.
Visser, M., & Routledge, L-A. (2007). Substance abuse and psychological well-being of South African adolescents. South African Journal of Psychology, 37, 595-615
Wagner, E., F., Myers, M., G., & McIninch, J., L. (1999). Stress-coping and temptation-coping as predictors of adolescent substance use. Addictive Behaviours, 24, 769-779
Worsley, J. D., McIntyre, J. C., & Corcoran, R. (2019). Cyberbullying victimization and mental distress: Testing the moderating role of attachment security, social support, and coping styles. Emotional and Behavioural Difficulties, 24, 20-35, https://doi.org/10.1080/13632752.2018.1530497
Acknowledgements
This work was supported by the Social Sciences and Humanities Research Council.
Funding
This work was supported by the Social Sciences and Humanities Research Council Joseph Armand Bombardier Canada Graduate Scholarship-Master’s Award received by author C.M.
Author information
Authors and Affiliations
Contributions
All authors contributed to the study conception and design. Material preparation, data analysis, and writing proportion were performed by Christina Murphy, Jacqueline Hesson, Ross Connolly. The first draft of the manuscript was written by Christina Murphy and all others commented on previous versions of the manuscript. All authors read and approved the final manuscript.
Corresponding author
Ethics declarations
Conflict of interest
The authors have no relevant financial or non-financial interests to disclose.
Ethical Approval
The data of this study was previously collected by Statistics Canada. Approval of an ethics board by the authors of this manuscript was not necessary.
Consent to Participate
The data of this study was previously collected by Statistics Canada. The current authors did not collect data from human participants.
Consent to Publish
The data of this study was previously collected by Statistics Canada. The current authors did not collect data from human participants.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Murphy, C., Hesson, J. & Connolly, R. The Positive Side of Things: Examining Factors that Predict Positive Mental Health in Individuals with Problematic Substance Use. J. Psychosoc. Rehabil. Ment. Health (2023). https://doi.org/10.1007/s40737-023-00344-5
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s40737-023-00344-5