Methadone & Mosques?
The intersection of religion with substance use disorder (SUD) treatment and recovery has a long-standing place in history.
In many communities, religious affiliation and involvement may be culturally normative and part of everyday experience, and religious institutions have long been a refuge for those stigmatized by addiction problems.
In the current pilot study, Rashid and colleagues examined the feasibility and preliminary benefit of a novel treatment for opioid users living in Malaysia,where the majority of individuals identify as Muslim. The treatment was delivered in an Islamic mosque, and combined methadone maintenance with religious interventions.
For example, in group sessions led by a peer counselor, patients would cite Quran passages and their relevance to maintaining abstinence and a healthy lifestyle. Other strategies included Zikr, which is characterized by recitation of the various names of god or Quran passages, with a particular focus on using it to address drug cravings or other relapse risks.
Authors found of the 36 men who participated in the treatment, 12 months after enrollment 80% remained in treatment and only one tested positive for an illicit drug (down from over 50% at baseline).
There were several large self-reported improvements in functioning including:
- drug use
- social functioning
- physical and psychological health
- overall quality of life.
Interestingly, there was no change in religiosity from baseline to 12-month follow-up and religiosity was not associated with any of the above-mentioned functioning measures. Qualitative interviews with participants showed marked consensus around satisfaction with the program and its impact on their functioning.
Developing treatments and recovery management resources consistent with community-level cultural norms could improve the likelihood of patient engagement and the intervention’s ultimate benefit.
This pilot study shows that a novel treatment incorporating SUD-oriented religious interventions into a traditional model at a place of worship is a promising strategy in a community where religious affiliation is the norm.
Of note, while religious in kind, the therapeutic techniques also appear to parallel “psychological” interventions from cognitive therapy (e.g., reframing negative thinking) and mindfulness-based relapse prevention (using a variety of strategies to focus on the here and now when faced with a craving).
Despite the study’s encouraging results, authors highlighted the negative views of some members of the community toward the study and study participants, pointing to the international stigma surrounding patients with SUD.
According to the World Health Organization, drug addiction and alcoholism are the 1st and 4th most stigmatized conditions worldwide.
This has and will continue to require shifts in domestic and international social and health care policy to make progress toward reducing the stigma and discrimination associated with addiction and recovery.
Rashid, R. A., Kamali, K., Habil, M. H., Shaharom, M. H., Seghatoleslam, T., & Looyeh, M. Y. (2014). A mosque-based methadone maintenance treatment strategy: Implementation and pilot results. International Journal of Drug Policy, 25(6), 1071-1075.