Substance use addiction is defined as chronic and compulsive use of a chemical that is harmful, creating a level of tolerance, loss of control, strong urges and cravings, and impacts on daily life. In our previous episode on this topic, we broke down common misconceptions about substance use. In this episode with our guest Mohamad Hasan, LMHC, we’ll cover the following questions:
- How do I know if I’m addicted?
- Is recovery really possible?
- What treatment options are available?
You can listen to the audio episode above, or read the blog below.
Mohammad Hasan, LMHC, is a licensed psychotherapist and emotional intelligence coach. With over a decade of experience, he has helped hundreds of patients manage mental health and addiction. He formerly served as the Clinical Director of an outpatient addiction and mental health clinic in NYC, training and supervising therapists and social workers. Mohammad is currently a senior organizational strategist and human capital consultant with Slalom, advising Fortune 500 companies. He also is an instructor and subject-matter expert with Oaktree Institute, consulting on emotional intelligence, communication, productivity, and habit psychology for Muslim organizations and masjids nationwide. He holds a graduate degree in Counseling Psychology.
How can someone know that they’re addicted?
If you are using a substance and you feel that your use is getting out of control – meaning that it’s causing issues in your relationships, work, and daily life – then consider that a sign that you should probably get help. This applies to alcohol, nicotine, weed, or even harder drugs. As Muslims, we know that these substances are forbidden. If you find yourself using a substance despite your belief and moral code, that’s also a sign that you might be dealing with some sort of addiction.
Clinically, substance use disorder is a medical condition with specific criteria in the DSM-5 (reference book used by health care professionals to diagnose mental disorders). For a formal diagnosis, working with a clinician is necessary. There are about 11 conditions, and if you meet at least 2 of them within a 12-month period, that’s probably a sign that you’re dealing with a substance use disorder. It could be mild if you meet 2 or 3 criteria. It’s moderate if you are meeting 4 to 5, and if you’re meeting more than 6, then your addiction could be severe.
Before starting the recovery process, what are some mental barriers that a person may need to work through?
We went into the myths and misconceptions that we have about addictions in the Muslim community in the previous episode, so I encourage everyone to listen to that episode if you haven’t already. Here, we are focused on the treatment and recovery for individuals who may be dealing with addiction.
For someone who thinks that they can never recover – you can. Take a look at the statistics. About 30 percent of US adults have used cannabis at some point; about 9 percent or so have developed dependency, (1) but over 50-60 percent recover. (2) With the right treatment, it definitely is possible to recover. Some think, “I heard some people who went to recovery or who tried and it didn’t work.” Many people don’t recover because they keep trying the wrong things. Maybe you felt guilty and you read a few resources, but didn’t act on them, or you went to counseling without proper addiction treatment. Recovery is possible, but you need to take the right steps.
Some get stuck in the thought process of, “Something is wrong with me.” We talked about how addiction may have started because of a sin, but once you have the addiction, it is an illness and most scholars are in agreement that as long as you’re seeking treatment, you’re not sinful. Allah loves us and Allah loves to forgive us. Allah loves when we are working to come back to Him. No matter how many mistakes you have made in your life, if you decide today to go through the recovery process, God-willing, Allah will find a way for you. Allah said in a Hadith Qudsi, “O son of Adam, were your sins to reach the clouds of the sky and were you then to ask forgiveness of Me, I would forgive you.” (3)
In a 12-step program, one of the first steps of recovery is to say, “My life is unmanageable and I cannot control it.” It’s to give up your pride. This is an Islamic approach, except we tie our humility to Allah. If you come to Allah fully submitting, Allah says He will guide and help you. Know that it’s not about you being a bad person. The fact that you’re here looking for resources and a way out says otherwise.
We talked in the last episode about the companion who struggled with addiction during the life of the Prophet (S). When people would judge him, the Prophet (S) would say, “You don’t know how much this person loves Allah and His Prophet.” Your iman is separate from the disease that’s there in your brain. As long as you’re trying to find a solution then God-willing, you’re in the right place. It’s not something you can just ignore or cut cold turkey. That which is buried stays alive. We see it over and over again – someone addicted tries to quit for Ramadan, Hajj, or marriage. Maybe they were even mandated treatment and forced to stay clean throughout therapy. But they come back to substance use within a year or two because they didn’t address the core of why they have the addiction. It’s not enough to have external things keeping you clean – you need to want to recover AND to take the proper steps – with addiction programs. This is a comprehensive journey and it’s a process that takes time, but it is more than doable.
What does addiction treatment look like?
For severe addictions (e.g. alcoholism or hard drugs) which cause severe withdrawal symptoms, rehab programs are necessary (also called detox or in-patient rehab). These kinds of symptoms require consistent monitoring and medical support to manage safely. Rehab is usually a few weeks long, but it also depends on your insurance.
In rehab, most of your triggers are removed; you’re away from the places you do drugs and the people that you do drugs with. You just get clean for a few weeks or months and it gives you a head start. Some facilities will also give you medically assisted treatment. Some types of addictions respond really well to certain medications that reduce cravings and aid the recovery process. The specifics depend on the level of addiction, the type of substance used, and the facility.
The other typical gateway to treatment is an outpatient setting. Similar to a mental health clinic, you attend a recovery center or clinic and they put you on a regiment of staff, and sometimes medically assisted treatment. Usually, you’ll do individual sessions with a counselor about once a week and group sessions about 2-3 times a week. Group therapy is so critical to recovery across the board because addiction is an issue of accountability and connection. The opposite of addiction is not just recovery; it’s actually your connection to others. During group therapy, you have to share about your past and your journey with addiction – and you have to be accountable. Addiction counselors will also typically give you their contact info so that you can call them if you’re feeling the urge. Others who have been through a similar journey are in this group with you. This reminds you that you’re not alone in this journey in ways individual therapy alone does not give you. You might also find that a lot of the social workers, psychologists, and especially the therapists in addiction clinics have also been through addiction, particularly those who run the group counseling.
On the side, there are 12-step programs. You attend about once a week with a community of people who have been in recovery for a long time – 15, 20, even 30 years – and they tell their stories. There’s a process to staying off substances that they guide you through. A lot of my old patients and clients also join 12-step programs outside their individual and group therapy sessions.
These are all models for abstinence. There are other models of treatment like harm reduction, where they help you reduce the harm of a substance you take without necessarily getting you off it. Because I’m talking to a Muslim audience, I’m making the assumption that anyone here struggling with addiction wants to reach abstinence in their recovery. In sum, that would typically consist of a combination of the individual therapy, group therapy, and 12-step program, and possibly medically-assisted treatment if needed.
What practical steps can people take to address addiction?
If you’re dealing with addiction, it’s on you to get started. You can even just search outpatient addiction clinics in your area. If you have a therapist already, you could talk to your therapist about wanting to seek addiction treatment. If you’re dealing with an addiction much more severe than that, then explore detox and inpatient rehab.
If you have a family member or friend dealing with addiction, it may help to talk with them, show them resources, and sit with them while they make an appointment for treatment. If that doesn’t work, you can try family intervention, which we discussed briefly in the last episode. At the end of interventions, typically a person will be more receptive to the prospect of treatment.
Ultimately, no treatment for yourself or for a loved one will work until you can break through the shame of hiding it. You can do everything else but until you open up about what you’re experiencing, you will likely not succeed in conquering your addiction.
What’s the difference between group therapy and individual therapy for addiction?
Individual therapy is just like mental health therapy. It’s the one-on-one, what we associate with therapy for anxiety or depression. You’re talking about your past, your triggers, and about what’s working.
Group therapy is unique. It really usually begins with everyone spending a few sessions talking about what got them addicted, and their trigger points. What’s amazing is when people in recovery relapse, then they come to the group to talk about it. The group will challenge them to be honest about what happened. They’ll ask, “Did you feel the urge? How did the urge show up?” Group therapy requires a vulnerability and rawness that draws out intense emotions from people. It is a very different kind of therapy; it’s tough because addiction is tough. It’s also a space to heal in ways you cannot replicate in a one-on-one setting.
The length of treatment depends on the type of addiction, but it could be anywhere from three months to six months. We don’t recommend less than that, but as you get to the end your treatment, frequency will decrease. For medically-assisted treatment, it depends on the severity of the addiction.
Some people decide to continue with a 12-step program when they’re done with regular clinical treatments, and these programs can be lifelong. If you ever join one of these programs, you’ll see that people are there for many, many years. Many people have heard that they start with introducing themselves like this: “My name is____,and I’m an alcoholic.” They say this is because if you ever have been an addict, you always have the propensity for the addiction, even after you are no longer addicted. It’s to remind yourself not to get ahead of yourself or to get too comfortable. As a Muslim, this shouldn’t be a surprise. We’re always on the lookout for Shaytan until we pass away. We have to be humble and vigilant for the rest of our lives.
Ultimately, I think a mixture of individual addiction therapy and group therapy is best for addiction.
Do you have any stories of recovery that you’ve seen as a clinician that you’d like to share?
There are so many individuals in the Muslim community struggling with addiction to substances. I have seen an Imam, a Hafiz of Quran, a mother of three, a 50-year old businessperson, a young entrepreneur… But many, alhamdulillah, have been in recovery for several years. I have seen that they often come out a better person than they were when they stepped in – even better than they were before the addiction.
Addiction is not something that you were born with. There is some evidence of genetic predisposition to addiction, but generally speaking, you didn’t come out of your mother’s womb doing drugs – it’s a learned behavior. People often forget this when they’re deep in addiction and begin to conflate themselves with the addiction. Remember: getting clean is coming back to your natural state. You are not your addiction. You are an individual with a soul and all the talents, skills and the amazing blessings Allah has given you.
Inshallah, as you go through the journey, you will find beauty and healing. You will go through some ups and downs. That’s a normal part of recovery, but, you can and you will, Inshallah, recover.
Additional Resources
- American Addiction Centers: https://americanaddictioncenters.org/faith-based-addiction-recovery/islam
- Substance Abuse Mental Health Services Administration (SAMSHA) National Helpline: https://www.samhsa.gov/find-help/national-helpline
- National Alliance on Mental Illness: https://www.nami.org/Support-Education
Please note: The FYI team selected relevant resources from a variety of platforms while keeping cultural and religious sensitivities in mind. Content and views expressed on these platforms do not necessarily reflect the vision and views of The FYI.
This post was written by Huda Khwaja and adapted from a recorded conversation with Mohammad Hasan, LMHC.
Footnotes:
1: Budney, A. J., Roffman, R., Stephens, R. S., & Walker, D. (2007). Marijuana dependence and its treatment. Addiction science & clinical practice, 4(1), 4–16. https://doi.org/10.1151/ascp07414; Although this is the widely accepted statistic in the addiction and mental health treatment spaces, recent reports have found the percentage of dependency may be higher, closer to 1 in 8 people: The Prevalence of Cannabis Use Disorder Among Cannabis Users | Psychology Today
2: Budney, A. J., Roffman, R., Stephens, R. S., & Walker, D. (2007). Marijuana dependence and its treatment. Addiction science & clinical practice, 4(1), 4–16. https://doi.org/10.1151/ascp07414
