- Substance abuse is far more common in the Muslim community than we realize; A 2015 study by The FYI found that among American Muslim students surveyed, 44% ever smoked hookah and 51% ever used tobacco.
- A 2010 study found that 47% of Muslim students consumed alcohol in the last year.
In this blog post, we sat down with Mohammad Hasan, LMHC to discuss his take on some of the common myths and misconceptions holding us back from prevention and treatment of addiction to harmful substances. 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.
What is Substance Abuse?
There are a lot of terms that are being thrown around related to substance use. Substance abuse is when someone misuses a harmful or addictive chemical substance in a way that hurts themselves or others. The misuse usually leads to problems in their daily life, such as at work, school, or in their relationships.
Now, what is a substance? To put it briefly, a substance is any chemical that can change the way your body or mind works. Not all substances are necessarily addictive or harmful– water, fiber, vitamins and minerals like omega 3, for example, are substances. However, when we talk about substance abuse, we’re talking about substances that are addictive and harmful in nature.
There are a lot of phrases we hear associated with this: substance abuse, substance use, substance dependence, and substance use disorders. What are the differences between all these terms?
To start, substance abuse is overusing an addictive and harmful substance, causing harm and significant issues in life and relationships.
Substance use is using any substance at all. Using a substance is not always a bad thing, because the substance may not be addictive, it may not be harmful, and you may not be misusing or overusing it to the extent that it’s affecting your life. You could be a substance user of coffee, for example, which isn’t necessarily harmful.
Substance dependence is when you start to develop tolerance, so that you need more and more of a substance, and start to experience withdrawal when you reduce your use. When you’re dependent on a substance, you start to experience issues when you do not use it. For example, if someone who is a heavy alcohol drinker tries to quit drinking cold turkey, they will experience physical reactions and withdrawal will show up on their body. They may tremble intensely, for example. When someone is dependent on a harmful substance, it can actually be life threatening for them to try to quit this way.
Substance abuse and substance dependence are terms we actually no longer use in the field of psychology and psychotherapy. They are instead points on this spectrum under substance use disorder. Substance abuse disorder is the compulsory use of a substance despite its harm. It could be at a mild level of compulsion, or a severe level. It is a medical condition that’s characterized by a range of problems and causes various impairments. We get this term from the guidelines for diagnosing mental health conditions: the DSM, which is the diagnostic manual the American Psychiatric Association publishes. According to the DSM5, the latest edition, substance use and abuse exists on a spectrum.
What’s the difference between an addiction and a bad habit?
Habits are common and normal. In fact, over 40% of our daily behaviors are habitual. (1) When you learn how to drive a car, for example, and it’s your first time behind the wheel, you’re constantly noticing the gas pedal, the mirror and every car around you. After a few years of driving, however, you can drive all the way home, and recall nothing specific about the drive. Your brain short-circuits behaviors that are useful, common, and repeated into a habit. You can usually stop a habit, even if there is some distress in the process.
With substance use disorder, an addiction that is chronic and compulsive, it’s not as simple as “just stopping” the behavior. Our community sometimes doesn’t understand addiction; they may say, “How come they don’t just stop? I can stop eating bad food or waking up late. Why can’t they just stop drinking alcohol?” Addiction is fundamentally different from a bad habit. There is biochemistry involved that makes the individual want and need more, and may even make it dangerous for them to quit all of a sudden without medical support. It is a medical condition. I know a brother who struggled with an addiction to medication; he went to Hajj, made dua, and made istighfar (seeking Allah’s forgiveness), but he went right back to the substance he was addicted to because it is a disease, not just a habit.
Many people in the community view substance abuse as sinful, something that Allah is displeased with, but you’re saying it’s an illness. Is addiction sinful?
This is a loaded question. Addictions, especially those recognized clinically, are illnesses. Which aspects of this are haram? Ultimately, that’s a fiqh (jurisprudence) discussion for scholars. We know from scholars that most harmful substances are haram (forbidden) unless medically prescribed. THC (Tetrahydrocannabinol), for example, is a component of cannabis which is haram (forbidden), but if it’s medically prescribed for a health concern, THC is acceptable. Beyond these general principles though, it’s not my field to comment on the permissiblity of specific substances.
The question we’re really asking is: is a person who is addicted to a harmful substance sinning? All the scholars that I have consulted on this issue have explained this distinction: An addiction could have started as a sin – for example, bad company, poor choices, making a mistake, or a certain time of your life. Once already addicted, however, they have an illness.
Scholars have also said that as long as an individual struggling with addiction is actively seeking treatment, they’re not sinful – even in relapse. In fact, 70% of recovering addicts have recurrences – what many know as a relapse – during their treatment journey. They slip back into drinking, smoking, or using the substance temporarily. It’s normal and common to go through this, and so a recurrence while you’re in treatment is not sinful either.
This brings up a bigger discussion: the Muslim community was at the forefront of psychiatric treatment, including addiction, in the past. In 8th-century Baghdad, Muslims had the first psychiatric ward while Western societies still believed that illnesses were related to demons. Al-Razi, Ibn Sina, Ghazali, and others considered mental health challenges as similar to physical ailments that required medical attention. Muslims understood that there is physical and emotional wellness, and both are intertwined. It’s unfortunate our community has misunderstood mental health, considering the fact that Muslim scholars were trailblazers of the field of mental health.
Allah has not let any disease exist without providing its cure. (2) We should make dua – the Prophet (PBUH) taught us dua for our pain (3) and even our anxiety (4) – but we also must seek the cures Allah has provided.
Does therapy actually help someone struggling with addiction? What’s the difference between talking to a therapist and talking to a sheikh?
This is another misconception that we have: how does talking to someone actually help you? With other illnesses, I could do a blood test and I could tell you your sugar level of cholesterol is up. Similarly, there is a test – a clear criteria – for identifying and dealing with depression or addiction, too.
People with mandated treatment for addiction would come to my clinic and say, “What’s the point of me talking to all these strangers in group therapy? What’s that going to do for me?” I would explain to them that talking to all the strangers about your past, about why you’re addicted, about the choices you make – that is your antibiotic. Your pill is sitting in a circle with a bunch of strangers who are struggling the same way as you and opening up and being vulnerable and accountable. There are particular types of therapy, such as group therapy, to deal with addiction. You cannot just go to a therapist once a week or a one-hour session, and expect that it will help your addiction. That is not how addiction recovery happens.
I have also had patients come to me and say, “Can you give me a contact of a good sheikh? I just need a sheikh to talk to me.” A sheikh can give you spiritual advice, but when you have an addiction, you have an ailment in your body. Of course, read the Quran, play Surah Baqarah in the house, and take those spiritual measures, but ultimately there is an ailment of the body that also needs to be addressed.
We must distinguish between the spiritual and the psychological. There is a difference between your soul, mind, and body. Fasting is not going to help you to pass a final exam if you’re not studying. Working out your legs will not help you with taraweeh if you don’t have the iman and the love of Allah to stand and pray. The Prophet (S) taught us to tie the camel and have tawakkul; (5) take care of the physical while turning to and relying on Allah. There are clear differences between each of these elements, even if they are all connected.
What would you say to someone struggling with substance abuse right now?
If you feel like you’re struggling with addiction, seek support. We have gotten better as a community in seeking therapy in general, but find those addiction programs and treatment centers. I don’t recommend working on addiction with one individual therapist. You really do need a center or program which specializes in addiction, because addiction is a unique challenge requiring unique treatments.
If you have a family member who is struggling with addiction, it can be helpful to do what’s known as family intervention. Basically, you work with a therapist and call for a family meeting with this person who doesn’t want to get help. Everyone sits and talks about all the ways they’ve been noticing this person going down a really bad path. You share that you all love this person and would like them to check themselves into rehab.
Some people who need to get treatment say, “I know some people drink alcohol or smoke. They’re just fine with their lives.” I’d ask them: what about the quality of their lives? We’re a culture that is so addicted to chemicals. We often hear or say things like, “Oh, I’m going to need a drink after this.” What that’s really saying is that “I cannot tolerate normal life challenges.” Every time I smoke nicotine or have a three-hour hookah session, I’m teaching my brain and my body that I cannot manage with the normal anxiety or challenges of life, and I need a chemical to get me through.
Finally, I’d remind them that addiction is something that can impact people from any walk of life. There were Companions of the Prophet (S) who struggled with alcoholism. Nu’man ibn Amr, for example, was repeatedly given a penalty for drinking publicly in the city of the Prophet (S). But when someone would curse him, the Prophet (S) would remind them, “No, you don’t know how much he loves Allah and His Messenger.” If you are someone dealing with addiction, know that you’re not a bad person. You’re not inherently evil. You have an illness, no matter how it started, and you can recover from it. The odds of recovery are very good if you seek the right treatment.
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: https://www.apa.org/monitor/2020/11/career-lab-habits
2: Sunan Ibn Majah 3436, https://sunnah.com/ibnmajah:3436
3: Sahih Muslim 2202: https://sunnah.com/muslim:2202
4: Hisn al-Muslim 137: https://sunnah.com/hisn:137
5: Jami` at-Tirmidhi 2517, https://sunnah.com/tirmidhi:2517
