The Impact of Social Support On Quality of Life Among Women with Substance Use Disorders

Purpose: Building support for abstinence and relapse prevention are primary goals of substance abuse treatment. Quality of life (QOL) and Social Support have emerged as key components of recovery for women with substance use disorders, as research suggests an association between QOL, social support, and relapse prevention. In this NIDA funded study the role of social support and recovery support in predicting quality of life satisfaction, controlling for demographic variables and trauma history, were examined among women in treatment for substance use disorders (SUD) and dual substance use/mental disorders.

Methods: Data were collected from a diverse group of 289 women one week post- intake at three county-funded substance abuse treatment programs. The World Health Organization Quality of Life Measure abbreviated version (WHOQOL-BREF), assessed women's perceived quality of life in the following four domains- (1) Psychological (2) Physical health (3) Environment, and (4) Social Relationships. Social support was assessed using both the Social Support for Recovery Scale and Friends Support for Abstinence Scale. Control variables of recent violence exposure and trauma symptomatology were measured using the Exposure to Violence Scales and the Trauma Symptom Checklist 40. Hierarchical regression was performed to assess the unique and relative contributions of friend's support and recovery support, demographics (education, race, presence of dual disorder), and trauma (trauma symptoms, exposure to violence) on quality of life.

Results: Participants were 59.3% African American and 34% Caucasian with a mean age of 37.2 years (SD=10.32). The majority (74.4%) were dually diagnosed, and 56.6% had not graduated from high school. More than half (58.2%) reported alcohol dependence and cocaine dependence (63.3%), and 49.5% were dependent on more than one drug. Social support significantly contributed to Quality of Life. When entered into the final regression model social support accounted for a significant (p < .05) R²Δ of .027 in the Physical Domain, R²Δ of .084 in the Psychological Domain, R²Δ of .087 in the Social Domain, and R²Δ of .062 in the Environmental Domain. Trauma symptoms also significantly predicted all four QOL domains, with β coefficients ranging from -.248 to -.473. Presence of a dual disorder was a significant predictor initially in all four QOL domains, but lost significance when trauma and social support were added to the model. The hierarchical regression model accounted for between 30% on the Physical Domain and 47% on the Psychological Domain of the variance in Quality of Life.

Implications: Findings suggest the importance of both friend's support for abstinence and recovery support as predictors of quality of life in women with SUD. Interventions that focus on social support and quality of life, as well as abstinence, in treatment with women with SUDs have the potential to enhance treatment outcomes. The WHOQOL appears to be an effective tool in understanding the social/environmental contexts of women with SUDs, allowing practitioners to target their interventions toward problematic life domains that may increase women's vulnerability to relapse. Future research will examine quality of life and social support as predictors of post treatment functioning for women with SUD.