Are There Islam-Based Addiction Treatment Options?
Islamic law seeks to protect the belief in Allah by promoting life, the maintenance of property, and the maintenance of a healthy state of mind. The Islamic view of the use of drugs or alcohol is quite clear that drugs or alcohol should be avoided (with some reservations for the use of wine).
Substance Use in the Muslim Community
Because of the cultural difficulties with obtaining survey data from individuals with strong Islamic convictions, there is little reliable data on the prevalence of substance abuse in individuals who describe themselves as Muslim. Most of the data comes from clinical samples (sample participants that are in hospitals or other treatment centers).
Best-guess estimates suggest that overall substance abuse rates of individuals in Muslim communities are typically reported as being lower than for individuals in other religions, with a few countries showing a little more variance. For example, alcohol use is often lowest among Muslims than any other religion. However, due to the severe restrictions on substance use that is part of the Islamic doctrine, these reports may not be reliable. Moreover, other substances that are not viewed as prohibited, such as khat, may have higher use rates than traditional drugs of abuse and alcohol in these populations.
The research does suggest that drug and alcohol use among individuals identifying as Muslim is far lower in those who have stronger commitments to their faith than those who do not. In addition, there may be a geographical variation in substance use and Muslims. For instance, higher rates of past-year alcohol use are reported by college students who describe themselves as Muslims in the United States compared to those in other countries. Thus, actual prevalence rates of substance abuse among individuals describing themselves as Muslims are most likely lower than in the general population, but reliable estimates are not available.
Factors That Increase the Risk of Substance Abuse
The major risk factors that appear to contribute to an increased risk of substance abuse among Muslims are their level of acculturation in a particular area (e.g., the United States) and their commitment to Islam. The greater the level of acculturation (identifying with the predominant culture in the area where the individual lives as opposed to their own traditional cultural norms) and the lower the level of commitment to their religious beliefs, the higher the likelihood of substance abuse.
Individuals with the highest levels of acculturation and the lowest levels of commitment to their religious beliefs are often younger individuals who may attempt to hide potential substance use from family members, thus hindering the identification of substance use disorders in these individuals.
It is generally considered that tobacco and alcohol are the major substances of abuse among individuals who identify as Muslims, particularly males. There may also be increased rates of prescription drug abuse in this population, but again, reliable data does not appear to be available.
The formal treatment of any substance use disorder will attempt to follow empirically validated approaches. The use of medications, therapy, and support group participation are all considered to be important components of substance use disorder treatment in all individuals; however, it is also considered crucial to adjust the overall approach to fit the needs of the individual. This personalized adjustment includes understanding the cultural background of the individual who is seeking treatment and adjusting the program to fit the person’s needs.
One of the findings in the research literature is that treatment is equally effective for individuals who voluntarily enter treatment and those who are coerced or forced to enter treatment. There is much individual variation in how individuals who are forced into treatment respond, and whether or not these individuals experience more difficulty in recovery. Because of the strong prohibition on substance abuse in Islam, it may very well be that Muslims will not voluntarily seek professional treatment due to the stigma associated with substance abuse in this group. Instead, they may be “forced” into seeking help by family members, friends, employers, or even the legal system.
Considerations for Treatment
Treatment providers need to understand the characteristics of the person in treatment before they finalize the treatment plan for that individual. One of the first principles of treating individuals for substance abuse with a commitment to Islam is that the treatment should be extremely private. It is important that their confidentiality be strictly maintained and disclosures regarding the person’s participation in treatment only be made with the permission of the person and their family members.
According to Counseling Muslims: Handbook of Mental Health Issues and Interventions and the Handbook of Arab American Psychology, there are certain considerations that should be made when Muslim individuals seek addiction treatment.
- It is crucial to incorporate aspects of Islam into the treatment program. For example, specialized 12-Step groups should focus on Islamic adoptions of the 12 Steps, such as using the Islamic conceptualization of Allah.
- There should be an emphasis on Islamic principles. Counselors and therapists should be individuals the client can identify with. Most often, male counselors should work with male clients, and female counselors should work with female clients, although this may not always be the case.
- Family counseling with an Islamic-based approach to treatment can be extremely helpful.
- Development of goals and helping the person to invest their energy in goals associated with the afterlife as conceptualized by Islam may be useful.
- Concentrating on rote learning of principles and relapse prevention techniques without using complicated explanations of psychological theories/principles that may be contrary to the teachings of Islam should be considered.
- Encouragement to perform obligatory prayers and other customs associated with Islam is extremely important.
- The use of medications during treatment should have sufficient justification.
- Like therapists, consulting physicians should be of the same faith and gender if possible.
- If possible, getting religious leaders to talk to clients and convince them that repentance, treatment, and abstinence can result in forgiveness is extremely important.
- Avoidance of the doctrine that the client has committed unforgivable sins by having a substance use disorder is crucial.
- Clients should be encouraged to share their experiences in recovery with others.
- The use of a positive, caring, and concerned approach integrated with the positive principles and practices of Islam appears to be the best approach for these individuals.
Abstinence should be the goal for recovery in substance use disorder treatment. This is consistent with the tenants of Islam and will often be accepted by clients who are in treatment for substance abuse problems.
It is important to include a significant psychoeducational component to the program in order to ensure that the client understands that even though they are on a positive road to recovery, the potential for relapse can still be high. Helping them to commit to their philosophical beliefs and adjust these to recovery is crucial.
Getting them to remain in treatment-related activities once they believe they have addressed their issues can be problematic. It is suggested that these individuals focus on adherence to their religious commitment as a form of ongoing treatment-related activity over the long-term.