Introduction to the special issue: sleep and substance use

Sleep plays a crucial role in health and well-being, but most people in the U.S. do not get enough of it. According to the National Sleep Foundation (2022), as many as 35% of adults get fewer than the seven hours of recommended sleep, and almost half report daytime sleepiness between three and seven days per week. The U.S. Centers for Disease Control and Prevention (CDC) has even called the lack of sleep a public health epidemic given its link to negative health and behavioral health outcomes (Pinholster, 2014). Most mental health issues such as depression, anxiety, and post-traumatic stress have been associated with sleep problems (Conroy & Arnedt, 2014). Poor sleep was once thought to be a symptom of these issues, but research has shown that the relationship is more complex and bidirectional (Vargas et al., 2019). Likewise, substance use problems have a similar complicated relationship with sleep disturbances. Problems with sleep can lead to substance use, with drugs and alcohol sometimes even misused as a sleep aid, but substance use can create significant problems with getting adequate and quality sleep (Ara et al., 2016). Sleep issues can also make substance use recovery more difficult. A longitudinal study of polysubstance users in recovery found that persistent sleep problems were observed in 61% of participants, and 33% of participants reported significant sleep problems after one year of abstinence (Erga et al., 2022). Poor sleep has been linked to greater drug and alcohol cravings, which is a major risk for relapse during recovery (Freeman & Gottfredson, 2018). Overall, the already significant challenges of substance use recovery seem to be compounded by poor sleep. Despite what has been learned about the relationship between substance use and sleep, more research is needed to ensure that those with substance use problems are receiving effective assessment and treatment. To further develop this understanding, this collection of articles in the Journal of Social Work Practice in the Addictions contributes to the knowledge base on the relationship between sleep and substance use. In the first article ‘A Primer on Sleep and Substance Use,’ Cseriniek and Pirie provide a comprehensive overview of how psychoactive drugs, including depressants, stimulants, hallucinogens, and cannabis, impact sleep. This paper discusses the stages of sleep, sleep disorders, and how drugs affect sleep architecture. The authors highlight that more research is needed to develop an evidence base for substance use treatment that considers the importance of sleep. The second article, ‘Sleep and Substance Use: Practice Considerations for Social Workers,’ is authored by Spadola and colleagues, an interdisciplinary team of clinicians