Meditation BY
and
MOHAMMAI)
the
SHAFII.
Prevention M.D..
RICHARD
of Alcohol LA\ELY,
AND
The authors surveyed thefrequency ofalcohol use in individuals identified as practitioners of Transcendental Meditation (N= 126) and a matched control group (N= 90). No control subjects reported discontinuation of beer and wine use; 40 percent ofsubjects who had meditated f or more than 2 years reported discontinuation within the first 6 months. After 25-39 months ofmeditation, this fi gure increased to 6Opercent. In addition, 54 percent of this group,
versus
1 percent
ofthe
control
stopped drinking hard liquor. The authors meditation could be an effective preventive area ofalcohol abuse.
group,
had
suggest that tool in the
15 one of the country’s major health problems, ranking third as a cause of death. Each year, 13,000 individuals die of cirrhosis of the liver caused by alcoholism. Half of all automobile fatalities and more than half of the major injuries in car accidents are directly related to the use of alcohol. Automobile accidents are the major cause of death in individuals aged 16-24, and 60 percent of these accidents are related to alcohol use ( 1). Half of all homicides in this country are committed under the influence of alcohol, and one-fourth of all suicide victims have a significant amount of alcohol in their bloodstreams. Marital disharmony and divorce are 7 times higher in alcohol abusers than in the general population (2). In a careful survey of drug and alcohol use among American youth, Johnston stated, “Alcohol . . . is the nation’s number one drug problem. Alcohol is probably the most widely used psychoactive substance in America today, with the exception of caffeine, and this fact is as true among young people as it is among their elders” (3, p.9). Data from 1970 indicate that approximately 50 perALCOHOLISM
.
.
.
When this work was done, Dr. Shafli was with the University of Michigan Medical Center, Ann Arbor, Mich., where Mr. Lavely is a medical student and Mr. Jaffe is a premedical student. Dr. Shafli is now Associate Professor of Psychiatry, Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine; and Mcdical Director, Bingham Child Guidance Clinic and Ackerly Child Psychiatric Service, Norton-Children’s Hospitals, Louisville, Ky. 40202. This work was supported by training grant 360515 from the National Institute of Mental Health, by theUniversity of Michigan Office of Research Administration, and by the University of Michigan Medical Center Computer Fund. authors wish to thank Sidney Cobb, M.D., Program Director, Inof Social Research, University of Michigan; Robert Kline, Howard Ando, and Judith Muench; and Richard D. Jaffe, Director, Institute for Social Action, Chicago, Ill.
Abuse ROBERT
JAFFE
cent of college students surveyed had used hard liquor or wine in the previous month, and 60 percent had consumed beer (4). The Purdue Opinion Panel reported that 27 percent of high school students surveyed in 1957 indicated
that
they
had
had
their
first
drink
by
age
14;
by
1969, this figure had increased dramatically to 55 percent (5). The annual per capita consumption ofalcoholic beverages in the United States increased by the following percentages from 1950 to 1971: hard liquor, 92.5 percent; wine, 44 percent; and beer, 14 percent (6). There has also been a considerable increase in the number ofdrinkers: in 1940, 38 percent of women and 64 percent of men were drinking regularly (i.e., consuming 3 ounces of hard liquor or the equivalent per day); by 1965, the figures were 60 percent and 77 percent, respectively (1). Our orientation is similar to that of Chafetz and associates
who
emphasized
the
need
for
preventive
methods
in the area of alcohol abuse in the First Special the U.S. Congress on Alcohol and Health. No battle against a public nificant victory if it attends ate
treatment
of persons
health only
who
problem
to
are
the
Report
can gain
casualties.
abusing
to
a sig-
Appropri-
alcohol-the
pri-
mary condition that may lead to alcoholism-can intercept the development of many cases of alcoholism. Yet much of the work in the field of alcoholism has been focused on treating late-stage victims of the disorder. Programs that are cxclusively
therapeutic
or
rehabilitative
will
not
result
in
term conquest of the problem unless ways of preventing cases ofalcoholism are developed. (1, p. ix)
long-
new
It is essential to find both better therapeutic techniques to treat alcoholic patients and means for decreasing or discontinuing the automatic and socially sanctioned use of alcohol in the young and middle-aged. This study was designed to assess the potential of Transcendental Mcditation (TM)’ as a preventive tool in alcohol abuse.
MEDITATION
AND
ALCOHOL
ABUSE
In a study on the effect of TM on drug abuse, Benson and Wallace reported, “In the six-month period before starting the practice of Meditation, 60% of the subjects took hard liquor and, of these, about 4% were heavy users. After twenty-one months of the practice of Meditation approximately 25% took hard liquor and only 0.1% were heavy users” (7, p. 373). Unfortunately, the authors did not have a matched control group, their sub-
The
stitute
942
Am
J Psychiatry
132:9, September
1975
‘Transcendental Meditation Executive Council-United
and States.
TM
are
trademarks
of the
World
Plan
SHAFII,
LAVELY,
AND
JAFFE
jects were not a representative sample of meditators, and their findings were presented in a somewhat confusing manner. In our earlier studies (8, 9) we found that 77 percent of subjects who had been meditating more than 2 years stopped using marijuana and 57 percent stopped smoking cigarettes. These findings led us to wonder whether TM could also help an individual to decrease or discontinue
jects to indicate the frequency of their use of wine and beer and/or hard liquor for the preceding 4 years. Frequency categories were the same as those used for meditators. Time periods were 0-3, 4-6, 7-12, 13-24, 25-36, and 36-48 months before time of response to the questionnaire.
the
RES
use
of alcohol.
ULTS
METHOI)
The system
Subjects
Demographic
Data
Meditators
were
Our sample selection procedures have been described in detail previously (8). We contacted by telephone all individuals who were initiated to TM under the auspices of the Student International Meditation Society from its inception in 1969 in the Ann Arbor and Ypsilanti, Mich., area until June 1972. Of the 525 initiates on record, we were able to contact 187 (this community is highly mobile and the months when Thirty percent
study was conducted during many people may have been of the group contacted had
the summer on vacation). stopped medi-
tating and were not included in our sample. Of the 130 meditators (i.e., those who had practiced TM for at least 1 month), only 4 refused to participate in the study. The participation rate was 97 percent; the yield rate for the return of the questionnaires was 100 percent. (Because we were unable to contact 338 of the 525 TM initiates and because 30 percent of those contacted were no longer meditating, it is possible that this sample may not be truly representative ofall TM initiates.) We used a method of selecting control subjects similar to that described by Detre and Wyshak ( 10), in which the experimental subject provides his own matched control. As Detre and Wyshak noted, this method has the potential to increase the probability of comparability of the two groups on subtle traits related to lifestyle and possibly on demographic factors of social class, ethnicity, religion, etc. A total of9O control subjects were found in this way. Procedure Meditation
subjects
naire
how
drugs, period
cigarettes, ranging
often
tation
to 3 years
were
they
asked
used
in a detailed
marijuana,
nonprescription
wine and beer, and hard liquor from 12 months before initiation or
more
after
initiation.
question-
(This
during a to medipaper
re-
ports only the findings on the effects of TM on alcohol use-other results have been published previously [8].) Categories of usage of wine and beer and/or hard liquor were as follows: not at all (nonuser), 3 times a month or less, 1-6 times a week, and once a day or more. Frequency assessment was divided into the following time periods: 12-7 and 6-0 months before initiation to TM and 0-3, 4-6, 7-12, 13-24, and 25-36 months after starting TM. If a subject had meditated for more than 36 months, we inquired about his current use of alcohol. In a similar questionnaire, we asked the control sub-
University was used
of Michigan IBM for analysis of data.
evenly
distributed
360-67
by
computer
sex.
In the
con-
trol group, there were slightly more females than males. Most of the subjects (76 percent of the meditators and 77 percent of the controls) were under 30. Approximately 25 percent of both groups had a professional degree, and 41 percent of the meditators and 46 percent of the control subjects were undergraduate or graduate students. Thus, more than two-thirds of the combined groups were already
professionals
or
Approximately tant, 20 percent ish. Grouping The the
were
ofMeditators meditators
length
working
50 percent of both were Catholic, and
of time
and
toward
Comparison
were
placed
they
had
a degree.
groups were Protes15 percent were Jew-
Techniques
in five groups
practiced
TM.
according This
to
classifica-
tion enabled us to compare drinking habits within each group, between meditation groups, and between meditators and control subjects. In all ofthe results that follow, time periods used for comparisons between control and meditation subjects were the 1 -3 and 4-6 month postinitiation periods for the meditation group and the 1-3 and 4-6 month prequestionnaire periods for the control group. Table I presents the groupings of the meditation
subjects
and
the
and control subjects lated questions. Wine
and
Beer
distribution
who
All nificant
consumption
of the
(see
meditation
decreases
both
to
the
meditation
alcohol-re-
Consumption
Of the 1 15 meditators who on wine and beer consumption, ported that they drank wine they started meditation; in the responded to this question, 90 regular
of
responded
table
groups
ranging
from
responded to the question 87 percent (N= 100) reand beer regularly before control group, all of whom percent (N 8 1) reported
=
I).
reported 25
to 33
statistically percent
sigin their
use of wine and beer in the first 3 months of meditation compared to the 1-3 month prequestionnaire period for control subjects. Of the meditation subjects in group I who had been regular users, 25 percent reported a decrease in the frequency of their beer and wine con sumption as compared with 2 percent of the regular users in the control group (p
and
MOHAMMAI)
the
SHAFII.
Prevention M.D..
RICHARD
of Alcohol LA\ELY,
AND
The authors surveyed thefrequency ofalcohol use in individuals identified as practitioners of Transcendental Meditation (N= 126) and a matched control group (N= 90). No control subjects reported discontinuation of beer and wine use; 40 percent ofsubjects who had meditated f or more than 2 years reported discontinuation within the first 6 months. After 25-39 months ofmeditation, this fi gure increased to 6Opercent. In addition, 54 percent of this group,
versus
1 percent
ofthe
control
stopped drinking hard liquor. The authors meditation could be an effective preventive area ofalcohol abuse.
group,
had
suggest that tool in the
15 one of the country’s major health problems, ranking third as a cause of death. Each year, 13,000 individuals die of cirrhosis of the liver caused by alcoholism. Half of all automobile fatalities and more than half of the major injuries in car accidents are directly related to the use of alcohol. Automobile accidents are the major cause of death in individuals aged 16-24, and 60 percent of these accidents are related to alcohol use ( 1). Half of all homicides in this country are committed under the influence of alcohol, and one-fourth of all suicide victims have a significant amount of alcohol in their bloodstreams. Marital disharmony and divorce are 7 times higher in alcohol abusers than in the general population (2). In a careful survey of drug and alcohol use among American youth, Johnston stated, “Alcohol . . . is the nation’s number one drug problem. Alcohol is probably the most widely used psychoactive substance in America today, with the exception of caffeine, and this fact is as true among young people as it is among their elders” (3, p.9). Data from 1970 indicate that approximately 50 perALCOHOLISM
.
.
.
When this work was done, Dr. Shafli was with the University of Michigan Medical Center, Ann Arbor, Mich., where Mr. Lavely is a medical student and Mr. Jaffe is a premedical student. Dr. Shafli is now Associate Professor of Psychiatry, Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine; and Mcdical Director, Bingham Child Guidance Clinic and Ackerly Child Psychiatric Service, Norton-Children’s Hospitals, Louisville, Ky. 40202. This work was supported by training grant 360515 from the National Institute of Mental Health, by theUniversity of Michigan Office of Research Administration, and by the University of Michigan Medical Center Computer Fund. authors wish to thank Sidney Cobb, M.D., Program Director, Inof Social Research, University of Michigan; Robert Kline, Howard Ando, and Judith Muench; and Richard D. Jaffe, Director, Institute for Social Action, Chicago, Ill.
Abuse ROBERT
JAFFE
cent of college students surveyed had used hard liquor or wine in the previous month, and 60 percent had consumed beer (4). The Purdue Opinion Panel reported that 27 percent of high school students surveyed in 1957 indicated
that
they
had
had
their
first
drink
by
age
14;
by
1969, this figure had increased dramatically to 55 percent (5). The annual per capita consumption ofalcoholic beverages in the United States increased by the following percentages from 1950 to 1971: hard liquor, 92.5 percent; wine, 44 percent; and beer, 14 percent (6). There has also been a considerable increase in the number ofdrinkers: in 1940, 38 percent of women and 64 percent of men were drinking regularly (i.e., consuming 3 ounces of hard liquor or the equivalent per day); by 1965, the figures were 60 percent and 77 percent, respectively (1). Our orientation is similar to that of Chafetz and associates
who
emphasized
the
need
for
preventive
methods
in the area of alcohol abuse in the First Special the U.S. Congress on Alcohol and Health. No battle against a public nificant victory if it attends ate
treatment
of persons
health only
who
problem
to
are
the
Report
can gain
casualties.
abusing
to
a sig-
Appropri-
alcohol-the
pri-
mary condition that may lead to alcoholism-can intercept the development of many cases of alcoholism. Yet much of the work in the field of alcoholism has been focused on treating late-stage victims of the disorder. Programs that are cxclusively
therapeutic
or
rehabilitative
will
not
result
in
term conquest of the problem unless ways of preventing cases ofalcoholism are developed. (1, p. ix)
long-
new
It is essential to find both better therapeutic techniques to treat alcoholic patients and means for decreasing or discontinuing the automatic and socially sanctioned use of alcohol in the young and middle-aged. This study was designed to assess the potential of Transcendental Mcditation (TM)’ as a preventive tool in alcohol abuse.
MEDITATION
AND
ALCOHOL
ABUSE
In a study on the effect of TM on drug abuse, Benson and Wallace reported, “In the six-month period before starting the practice of Meditation, 60% of the subjects took hard liquor and, of these, about 4% were heavy users. After twenty-one months of the practice of Meditation approximately 25% took hard liquor and only 0.1% were heavy users” (7, p. 373). Unfortunately, the authors did not have a matched control group, their sub-
The
stitute
942
Am
J Psychiatry
132:9, September
1975
‘Transcendental Meditation Executive Council-United
and States.
TM
are
trademarks
of the
World
Plan
SHAFII,
LAVELY,
AND
JAFFE
jects were not a representative sample of meditators, and their findings were presented in a somewhat confusing manner. In our earlier studies (8, 9) we found that 77 percent of subjects who had been meditating more than 2 years stopped using marijuana and 57 percent stopped smoking cigarettes. These findings led us to wonder whether TM could also help an individual to decrease or discontinue
jects to indicate the frequency of their use of wine and beer and/or hard liquor for the preceding 4 years. Frequency categories were the same as those used for meditators. Time periods were 0-3, 4-6, 7-12, 13-24, 25-36, and 36-48 months before time of response to the questionnaire.
the
RES
use
of alcohol.
ULTS
METHOI)
The system
Subjects
Demographic
Data
Meditators
were
Our sample selection procedures have been described in detail previously (8). We contacted by telephone all individuals who were initiated to TM under the auspices of the Student International Meditation Society from its inception in 1969 in the Ann Arbor and Ypsilanti, Mich., area until June 1972. Of the 525 initiates on record, we were able to contact 187 (this community is highly mobile and the months when Thirty percent
study was conducted during many people may have been of the group contacted had
the summer on vacation). stopped medi-
tating and were not included in our sample. Of the 130 meditators (i.e., those who had practiced TM for at least 1 month), only 4 refused to participate in the study. The participation rate was 97 percent; the yield rate for the return of the questionnaires was 100 percent. (Because we were unable to contact 338 of the 525 TM initiates and because 30 percent of those contacted were no longer meditating, it is possible that this sample may not be truly representative ofall TM initiates.) We used a method of selecting control subjects similar to that described by Detre and Wyshak ( 10), in which the experimental subject provides his own matched control. As Detre and Wyshak noted, this method has the potential to increase the probability of comparability of the two groups on subtle traits related to lifestyle and possibly on demographic factors of social class, ethnicity, religion, etc. A total of9O control subjects were found in this way. Procedure Meditation
subjects
naire
how
drugs, period
cigarettes, ranging
often
tation
to 3 years
were
they
asked
used
in a detailed
marijuana,
nonprescription
wine and beer, and hard liquor from 12 months before initiation or
more
after
initiation.
question-
(This
during a to medipaper
re-
ports only the findings on the effects of TM on alcohol use-other results have been published previously [8].) Categories of usage of wine and beer and/or hard liquor were as follows: not at all (nonuser), 3 times a month or less, 1-6 times a week, and once a day or more. Frequency assessment was divided into the following time periods: 12-7 and 6-0 months before initiation to TM and 0-3, 4-6, 7-12, 13-24, and 25-36 months after starting TM. If a subject had meditated for more than 36 months, we inquired about his current use of alcohol. In a similar questionnaire, we asked the control sub-
University was used
of Michigan IBM for analysis of data.
evenly
distributed
360-67
by
computer
sex.
In the
con-
trol group, there were slightly more females than males. Most of the subjects (76 percent of the meditators and 77 percent of the controls) were under 30. Approximately 25 percent of both groups had a professional degree, and 41 percent of the meditators and 46 percent of the control subjects were undergraduate or graduate students. Thus, more than two-thirds of the combined groups were already
professionals
or
Approximately tant, 20 percent ish. Grouping The the
were
ofMeditators meditators
length
working
50 percent of both were Catholic, and
of time
and
toward
Comparison
were
placed
they
had
a degree.
groups were Protes15 percent were Jew-
Techniques
in five groups
practiced
TM.
according This
to
classifica-
tion enabled us to compare drinking habits within each group, between meditation groups, and between meditators and control subjects. In all ofthe results that follow, time periods used for comparisons between control and meditation subjects were the 1 -3 and 4-6 month postinitiation periods for the meditation group and the 1-3 and 4-6 month prequestionnaire periods for the control group. Table I presents the groupings of the meditation
subjects
and
the
and control subjects lated questions. Wine
and
Beer
distribution
who
All nificant
consumption
of the
(see
meditation
decreases
both
to
the
meditation
alcohol-re-
Consumption
Of the 1 15 meditators who on wine and beer consumption, ported that they drank wine they started meditation; in the responded to this question, 90 regular
of
responded
table
groups
ranging
from
responded to the question 87 percent (N= 100) reand beer regularly before control group, all of whom percent (N 8 1) reported
=
I).
reported 25
to 33
statistically percent
sigin their
use of wine and beer in the first 3 months of meditation compared to the 1-3 month prequestionnaire period for control subjects. Of the meditation subjects in group I who had been regular users, 25 percent reported a decrease in the frequency of their beer and wine con sumption as compared with 2 percent of the regular users in the control group (p
