Perspectives on Drug Addiction in Islamic History and Theology

Abstract

How does Islam view substance addiction? What happens to the soul of the person suffering from addictive disorder? What happens to their relationship with God? These are some of the questions that this article tries to answer. Three models on drug addiction from an Islamic theological perspective will be explored here. Two of them are preventative models based on an understanding of society rooted in shame-culture, while the third model, called Millati Islami, practiced in the USA, is founded on the Islamic understanding of tawba (repentance). Furthermore, drugs and addiction in scripture, as well as medieval Muslim society’s attitude towards them, are explored. As a whole, the models discussed in the article demonstrate that Islamic theology possesses the intellectual and theoretical tools to develop fully-fledged theological models of addiction. This paper concludes by suggesting that one model should be explored.

1. Introduction

How does Islam view substance addiction? What happens to the soul of the person suffering from addictive disorder? What happens to their relationship with God? These are some of the questions that this article tries to answer. Three tentative models on drug addiction from an Islamic theological perspective will be explored here. Theological reflections on what Islam says about substance use and why people become addicted will provide a good starting point for religious professionals offering pastoral support to Muslims suffering from substance dependence. Identifying the belief system and theological stance of people suffering from addictive disorder may prove to be an advantageous point to begin from in order to understand how to help them [1]. The literature examining the theology of substance addiction in Islam is scarce; therefore, this is a tentative essay on the topic and a platform for the author and others to further develop their thoughts and writing.

From the outset, it should be made clear that within this article, drug use is intended to refer to recreational drug use and not as a part of medical treatment. It is argued that in order for drug use to take place, two preconditions need to be present: (1) predisposition and (2) availability. These conditions are necessary but not sufficient to explain why people use and abuse drugs. Various theories have been proposed to explain the causes of drug use from a variety of disciplines, such as biology, sociology, and psychology. One such model, which is controversial among scientists, is called the “disease model” [2]. The model’s central thesis is that addiction is a biological phenomenon and, thus, genetically passed from parents to children. One of the positive aspects of the model is that it helps to remove social stigma and blame from the addict and encourages the view that users are victims who need help and not condemnation [1]. In contrast to the “disease model”, an unpopular model in medical circles is the “moral model”. The focal point of this model is that people become addicts out of their own volition. It is criticized as being blindly prejudiced and judgmental, although it lays the burden of responsibility for rehabilitation on the shoulders of the addict [1].

These models are based on a Cartesian distinction between the body and the mind/soul. They do not take into consideration existential issues related to the nature of human beings, their religiosity and spirituality. Research has shown that spirituality and religion are protective factors ([3], p. 171) that can reduce substance abuse and function as mechanisms against relapse [4]. Cook contends that there is an intrinsic relationship between substance dependence and spirituality [2]. The former is a spiritual problem in the sense that it affects relationships and impacts values and beliefs. Similarly, religion has been associated with positive drug-related outcomes in a number of ways, such as altering behaviour-influencing value or by functioning as external control factors [5]. Studies show that people who believe religion is important are less likely to use tobacco, alcohol, and illicit drugs [5]. Research carried out on Muslim populations show that religiosity and spirituality benefit the mental health of Muslim adherents [6,7,8,9]. Muslims recovering from substance abuse found that rediscovery of their faith has often acted as the much-needed catalyst to abstain from drug use [4]. My own research has shown that for Muslims, talking about their religion and religious beliefs during therapy is welcomed and appreciated [8,10]. Malik Badri, a world-renowned Muslim psychologist, claims that the great majority of Muslims who practice abstinence from alcohol and drugs do so due to religious reasons [11].

How has religion understood addiction? What theological models are available to explain addiction? These can be answered by looking at the perspective of different faiths and religions. Most theories are found from within the Christian tradition [1,12]. Cook identifies a number of these, such as “addiction as sin”, which is similar to the “moral model”, and argues that people become addicts as a result of their sins [1]. Other models include incarnational theology, which is also known as the theology of presence [13]. There are a number of models in other faith traditions, such as Buddhism (cited in [1]) and Islam; however, these are few and far between. Badri proposes a model in which he blames the West’s liberal attitude towards sex as being the cause of drug addiction and even the AIDS crisis [11]. He argues that misuse of the word “abuse” has led to a toleration of drugs and substance use in the West; which can only be rectified by developing programs that are rooted outside of Western models of non-judgmental therapy, and which are based on solid Islamic foundations. This model, Badri argues, should not take a non-judgmental stance towards condoning promiscuity and substance use. According to him, Islam’s very purpose is to intervene in human affairs for the betterment of society. Some have criticized Badri to be an essentialist and his approach to be a mask for the Islamization of knowledge [14]. According to them, Badri’s approach is apologetic and should be read as a representation of Islamic opposition to Western modernity, a “Fanonian inversion of discourse” [14], as opposed to a theological model explaining substance addiction.

This article attempts to fill this lacuna by first discussing attitudes towards intoxicants from the vantage point of scripture and Islamic society. It then deliberates on two models of substance abuse from a theoretical perspective and ends with exploring a third, called Millati Islami, which is modeled on the twelve steps of Alcoholics Anonymous and is used in therapy in the USA.

2. All Intoxicants Are Prohibited: Intoxicants in the Qur’an and Islamic Society

The Qur’an is reticent regarding drug use, although it discusses intoxicants (khamr) and, more specifically, alcohol. Any discussion on narcotics and addictions must start from the Qur’an, since it is the foundation of Islamic law, ethics, and theology ([8], p. 25). Alcohol is prohibited in the Qur’an for recreational reasons; the Qur’an calls alcohol the “Handiwork of Satan” ([15], al-Ma’ida 5:90).1 Prior to being forbidden by divine decree through a Qur’anic revelation, the early Arab Muslims indulged in wine and took much delight in inebriation. It was gradually forbidden in three phases [16], with the final prohibition being revealed in the fifth hijri (ca. 627 CE) after the siege of Medina, nearly seventeen years after the inception of Islam [16]. Initially, the Arabs consumed alcohol in their parties and gatherings. Some Muslims, seeing the effect that alcohol had on a person’s cognitive faculty and the social consequence of that, asked Muhammad to provide them with some Qur’anic guidance on it [16]. God responds in the Qur’an by saying, “They ask you (Prophet) about intoxicants (khamr) and gambling: say, ‘There is great sin in both, and some benefit for people: the sin is greater than the benefit.’” ([15], al-Baqara 2:219). After this verse was revealed, some of Muhammad’s followers, out of personal piety, refrained from drinking alcohol, since God mentioned that the harm in alcohol is greater than the good, while acknowledging that He did not prohibit it. Even then, many of Muhammad’s Companions still consumed alcohol. The second phase of prohibition was revealed when the leader of a prayer, after a heavy drinking session, recited the Qur’an so incorrectly, the act amounted to blasphemy [16]. God revealed, “You who believe, do not come anywhere near the prayer if you are intoxicated, not until you know what you are saying...” ([15], al-Nisa 4:43). This was the second phase of prohibition, where believers were able to drink so long as they were sober during prayer times. Muhammad’s Companions used to hold their drinking sessions after the night prayer, which gave them enough time to sober up prior to the dawn prayer. In one such night gathering, under the influence of alcohol, a person from one tribe recited offensive poetry about another tribe. The members of the second tribe were infuriated and retaliated, leading to a fight, which resulted in a person being hit on the head with a camel’s skull [16]. This was the proverbial straw that broke the camel’s back. The final revelation came down, which made alcohol prohibited for Muslims.

You who believe, intoxicants (khamr) and gambling, idolatrous practices, and (divining with) arrows are repugnant acts—Satan’s doing—shun them so that you may prosper. With intoxicants and gambling, Satan seeks only to incite enmity and hatred among you, and to stop you remembering God and prayer. Will you not give them up? ([15], al-Ma’ida 5:90–91).

There are a number of points in this verse of the Qur’an that could be used to develop a model of addiction from the Qur’an; this will be explored later on in the article. At the moment, it is sufficient to say that this is the verse that has the final say on matters related to recreational alcohol drinking. The previous two verses have been made ineffective as far as social drinking is concerned through a process known as the rules of abrogation (al-nasikh wa al-mansukh). The rules of abrogation apply to certain verses and passages in the Qur’an, which had particular functions in the early days of Islam, but are no longer needed and are believed by Muslims to have been abrogated in their application by Muhammad through revelation from God. Nevertheless, Muslim practitioners see in the gradual banning of alcohol a reflection of Islam’s deep understanding of human nature, addiction and the possible negative effects of withdrawal symptoms. They take inspiration from the three phases of alcohol banning to develop a Qur’anic justification for rehabilitation, where the amount of alcohol one consumes or substance one uses is gradually decreased.

However, what does the Qur’an say about drugs and other forms of intoxicants? Some, such as the translator, Abdel Haleem, are of the opinion that the use of the word “khamr” (alcohol/intoxicant) in the Qur’an is a composite term, which includes all forms of intoxicants, despite the fact that the specific contexts in which the three verses were being discussed relate to alcohol drinking. Al-Tabari (d. 923) writes that “khamr” is every drink that intoxicates the mind, veils it, and covers it [16]. It may be that during Muhammad’s time in Arabia, alcoholic beverages, such as khamr (wine made from grapes or dates), bit’ (wine from honey), and mizr (beer from barley), were the only available forms of intoxicants [17]. There is no evidence of drug abuse resulting from recreational drug use, such as hemp (hashisha), henbane (banj) or opium (afyun), during the formative period of Islam [18,19]. The Qur’an does not mention them nor were they a social problem, such that Muhammad had to give specific guidance about them. However, there is evidence of their medicinal use in the earliest treatises on medicine in Islam ([18], p. 41). Cannabis (al-qinnab al-hindi) was introduced into the Arab mainland mainly from India through Persia and through acquaintance with Greek physicians [19]. Doctors considered cannabis and poppy as potent medicines only to be used when therapeutic need arose [19]. It was eaten rather than smoked, which assisted digestion (hadim al-aqwat) and brought clarity to thoughts (ba’ithat al-fikir) ([18], p. 25). There is also evidence to suggest that people died of drug overdose, for example from the drug used to treat forgetfulness; the drug is known as either baladhur (marking-nut) or habb al-fahm (the nut of apprehension) [20]. However, this was more a result of medical malpractice and incorrect dosage than drug abuse ([20], p. 234).

The sources do not provide us with evidence that proves that Muslims were using cannabis and other narcotics for recreational purposes during the formative period of Islam. They were not discussed by the legal scholars, as they were not seen as a legal and social problem [18]. However, by the eleventh century, there are textual sources that suggest people were gradually becoming addicted to cannabis. Al-Biruni (d. 1048), the polymath scholar, observes that this habit has also seeped in to the heart of the Muslim land, Mecca. He writes,

People who live in the tropics or hot climates, especially those in Mecca, get into the habit of taking opium daily to eliminate distress, to relieve the body from the effects of scorching heat, to secure longer and deeper sleep, and to purge superfluitie [sic] and excesses of humors. They start with smaller doses which are increased gradually up to lethal dosages (cited in [19], p. 240).

Hamarneh believes that this extract is the first documented evidence at our disposal of the use of recreational drugs and its harmful effects. The Persian historian, Abu al-Fazl Bayhaqi (d. 1077), claims that the famous Ibn Sina (Avicenna) (d. 1037) was an opium addict and may have died as a result of an opium overdose ([21], p. 98). According to Ibn Taymiyya (d. 1328), cannabis became widespread by the end of the 13th or the beginning of the 14th century as a punishment for Muslim indulgence in sins. He writes,

The news had first reached us that it (cannabis) appeared among Muslims by the end of the 7th or the beginning of the 8th century when Tatars came into power.2 Its emergence was concomitant with the sword of Genghis Khan. When people started to commit sins that God and his Prophet forbade, God gave power to the enemy to overcome them, and this wretched cannabis is its worst negative externality. It is worse than drinking alcohol in many ways, whereas alcohol is worse than it in other ways. In addition to its intoxicating effects it causes effeminacy (takhnith) and cuckoldry (diyatha) [22].

It was only when the harmful effects of drugs became a social problem that scholars began to take interest in it from a legal perspective. Some legal scholars made an analogy with alcohol to provide a basis by which to offer a legal ruling on drugs ([18], p. 105); others, without having any precedent to compare, engaged in drug use for themselves before passing a ruling [23]. Any religious prohibitions were often disputed by detractors on the basis that there is nothing unequivocally mentioned in the Qur’an or Muhammad’s words regarding drugs being forbidden. An oft-cited verse in favor of drugs has been mentioned by Rosenthal:

Hashish intoxication contains the meaning of my desire,

You dear people of intelligence and understanding.

They have declared it forbidden without any justification on the basis of tradition and reason.

Declaring forbidden what is not forbidden is forbidden ([18], p. 101).

The author of the above verses of poetry roots his contentions in an Islamic legal axiom. It is not within the juristic remit of a Muslim lawyer to declare something that is not forbidden by the shari’a as forbidden. This practice itself is illegal. Pro-hashish users exploited this fact to their advantage. Hashish was highly associated with Sufi guilds, who employed it to help them meditate [18]. Some believed that by taking hashish to meditate, one is visited by the mystical wandering dervish, al-Khidr (which literally means green man) [18,24], and that hashish connects the heart with God (musilat al-qalb) [18]. Even today, some shrines of Muslim dervishes, like the shrine of Data Ganj Bakhsh al-Hujwiri (d. 1077), are places where drugs and other forms of intoxicants can easily be found [25].

3. Models of Addiction in Islam

Within Islamic theology, a Muslim is both personally responsible to God and also part of the wider Muslim community. In addition to contributing to the life of the community, they derives their identity from it. Nasr writes:

In the debate between those who claim the primacy of society and those who emphasize the primal significance of the individual, Islam takes a middle course and believes that this polarization is in fact based on false dichotomy. There is no society without the individual; nor can the individual survive without society ([26], p. 159).

Community members’ support is not only confined to their immediate family, but extends to the wider community. “People are dependent on God”, said Muhammad, “and the most beloved to God are those who are caring towards God’s creation” [27]. Teachings like the above have influenced the way Muslims organize their lives vis-à-vis each other and vis-à-vis God. Cultural anthropologists have divided societies into two cultures: a shame-based culture and a guilt-based culture [28]. Scholars argue that both shame and guilt are emotions that occur when transgression has taken place (or is to take place), which will result in the doer being negatively evaluated. However, the emotions differ in their orientation to self and others [28]. Shame-based cultures have their deterrent mechanisms to do wrong exterior to the person. “What will people say?” is a common feature of a shame-based culture. The fear of being negatively exposed in front of people stops one from doing wrong. In contrast, guilt-based cultures have their mechanisms built in to the individual conscience, which leads to remorse, pity, and reparative actions.

Traditional Muslim societies are mainly based on a shame-based culture [29]. However, Islamic notions of shame include one’s sense of shame in front of God. For Muslims, God is fully aware of thoughts hidden in the deepest chasms of the heart: “No leaf falls without His knowledge, nor is there a single grain in the darkness of the earth, or anything, fresh or withered, that is not written in a clear Record.” ([15], al-An’am 6:59). Having shame (haya’) and humility, as well as being fully cognizant of God’s omniscience is to show etiquette (adab) towards God. In the case where one forgets this aspect of Islam, the fellow Muslim should function as a mirror. In this manner, Islam views a person suffering from an addictive disorder not only as an individual failing, but the failing of society as a whole. Guilt also has its place in Muslim societies. Once a sin/crime has been committed, a person is required to repent (tawba) to God for his or her sins. Tawba literally means to return. When person feel true remorse for their sins and try to reform themselves, according to the Qur’an, God accepts their repentance and gives them the ability to rectify the wrong done ([15], al-Anbiya 21:87). In the Qur’anic narrative, when the Prophet Jonah ran away from Nineveh, God’s punishment for his transgression came in the form of being swallowed by a whale. Having felt immense guilt at his offence, Jonah prayed to God in the belly of the whale:

And remember the man with the whale, when he went off angrily, thinking We could not restrict him, but then he cried out in the deep darkness, “There is no God but You, glory be to You, I was wrong.” We answered him and saved him from distress: this is how We save the faithful ([15], al-Anbiya 21:87).

The teachings in the above narrative are strong and clear: no one should despair from God’s mercy, as long as they understand their faults and try to rectify them. Below, three models of addiction according to the Islamic scriptures and the teachings of the theologians are provided. Two of these are preventative models based on a shame-based understanding of human nature. The final model is one that is currently being used in therapy and is a non-judgmental model based on the Islamic understanding of guilt, where the incentive to rectify comes from within the deepest recesses of the human being. No one model is without problems, but at least they are steps forward toward developing a fuller and more comprehensive Islamic theology of drug addiction.

4. Jurm: Addiction as Crime

Reference was made above that when the use of drugs became a social problem in traditional Muslim societies, Muslim scholars started to look into its legal status in the shari’a. Scholars have divided all actions into five categories, known as legal norms: either something is necessary (wajib) to do, forbidden (haram) to do or permissible (halal) to do. Those that are permissible are either recommended (mandub) or disliked (makruh) [8,30,31]. Violating any legal norms entails a sin, but not necessarily a crime. The punishment for sin is soteriological, and thus, God may forgive it out of divine grace when one sincerely repents. All crimes are deemed as sins, but are distinguished from sins in that they have legal, as well as theological implications. By way of example, sexual intercourse with one’s wife during her menstruation is seen as a sin that has no legal implications ([15], al-Baqara 2:222). In contrast to that, murder is deemed both a sin and crime, which is punishable by law. With regards to drugs, most scholars with the exception of a few (like al-Qarafi d. 1285) viewed hashish to be prohibited in the law; thus, it is both a crime and sin, since, according to them, it has the same intoxicating effects as alcohol. They used a number of criteria to establish that it is forbidden, such as: harm to health, harm to the health of others, waste of wealth, the presence of sedative effects, the taking of one beyond one’s senses, the distortion of rational thinking, intoxication and clouding of the mind, and distortion of physical and motor skill [4].

What are the legal consequences of drug intoxication? I will briefly discuss two of them. The Qur’an clearly mentions that the use of intoxicants is forbidden and is sinful. Muhammad stipulated forty lashes for one caught under the influence of intoxicants (al-Zarkashi, Zahr al-Arish, cited in [18]). Ibn Taymiyya is of the opinion that there is no difference between alcohol and all other types of intoxicants, and that the user is to be subject to corporal (hadd) punishment. He forcefully argues this point:

As for hashisha, the cursed intoxicant, it is similar to other intoxicants, and all intoxicants are prohibited (haram) by scholarly consensus. [...] Consumption of intoxicants is subject to corporal (hadd) punishment. [...] The Prophet’s words, “All intoxicants are forbidden” include the date wine that was found in Medina in his days. It also includes the alcohol found in the Yemen made from wheat, barley, and honey. Furthermore, his statement will also include all forms of intoxicants found after his days, such as alcohol made from horse milk by the Turks [22].

However, is drug use similar to the intoxicant “al-khamr” mentioned in the Qur’an? Some scholars are more cautious, since it has not been overtly mentioned in the sacred texts of Islam. According to the Hanafi school of law, discretionary punishment (ta’zir) is to be meted out to the person who eats3 hashish rather than implementing the corporal punishment (hadd) of forty lashes on him [32]. Nevertheless, in both cases, scholars agree that some form of punishment should be carried out.

Another topic discussed by the scholars is whether a divorce that takes place under the influence of an intoxicant is valid. According to shari’a law, a couple does not need to obtain a divorce from a court of law. The right to divorce remains mainly with the husband, provided that the wife does not request having divorce rights or stipulates in the marriage contract that she wants divorce rights and the husband agrees. The divorce takes place by the husband merely announcing “I have divorced you” [33]. Scholars from the Hanafi school of law are of the opinion that the pronouncement of divorce by a person under the influence of drugs or other forms of narcotics is legally binding on the basis that it acts as a punishment for one’ crime, provided it is not taken for medical reasons ([32], 1:144, 3:239, 6:457).

This model is preventative and is based on a shame-culture. By emphasizing its legal implications over the theological, scholars attempt to protect society from the harmful consequences of drugs. The model may have functioned as a deterrent in Islamic societies, although Rosenthal’s study disagrees [18]; also, the model fails to provide a solution in the modern era. Currently, most Muslim countries do not carry out corporal punishment for crimes committed, and the ones that do implement it are discriminatory and selectively biased [34]. Second, this model may prove to be discriminatory against the wife. In the case when the intoxicated husband pronounces divorce, why should the wife be disadvantaged for the doings of her husband (unless she sees this as a means of getting out of the marriage)? As such, this model is unlikely to be instrumental in preventing substance abuse. A more robust theology is needed that addresses the users’ spirituality, as well as their religious conscience.

5. Mard Ruhani: Addiction as Spiritual Disease

In Islam, the physical heart is seen as the seat of the spiritual heart [29]. A clean and healthy spiritual heart is the recipient of God’s mercy and grace. The Qur’an says, “On the Day of Judgment no one is safe save the one who returns to God with a pure heart.” ([15], al-Shu’ara 26:89). In another verse, God says, “It is only through God’s remembrance that the heart becomes calm.” ([15], al-Ra’d, 13:28). Muhammad is reported to have said, “Surely in the breast of humanity is a lump of flesh, if sound then the whole body is sound, and if corrupt then the whole body is corrupt. Is it not the heart?” [17]. When does the spiritual heart become corrupt? In the same report Muhammad, says that prohibitions (sins) are God’s sanctuary, and grazing too closely to these sanctuaries will inevitably lead one to violate them [17]. The hypocrites are branded as spiritually diseased in the Qur’an, for they are perpetually committing sins due to their double standards. God says that as a result of their continuous sinning, he increases the disease in their hearts ([15], al-Baqara 2:10). This then begs the question, “What is it about the heart that so much emphasis is placed on it?” To answer this question, we need to explore how the Qur’an views the nature of human beings.

The Qur’anic human is a paradoxical being. It is written in the Qur’an that God created Adam from clay formed from dark mud ([15], al-Hijr 15:29). He then breathed in him His spirit, and all the angels and those present were ordered to prostrate to him. All, but Iblis, prostrated, who argued that he is better than Adam, since God created Adam from dirt and him from fire. God exiled Iblis from the heavens for this disobedience, and he became the rejected Shaytan (Satan). The nature of human beings, as described in the Qur’an, is paradoxical, although Satan has failed to grasp it. By focusing on human being’s earthly nature, Satan was able to make claims of superiority. The divine provenance in the human, God’s spirit, was not something Iblis recognized as part of human nature. In fact, human’s themselves often fail to realize this aspect of their nature, thus falling prey to the temptation of Satan. This is the contradictory nature of human beings in Islam. People are an amalgamation of the sacred and the profane: a holy union, which allows them to walk on Earth and yet to be saluted by angels in the heavens.

The earthly body easily succumbs to temptations and desires to commit sins. The Qur’an makes reference to Adam and Eve’s time in paradise and how both of them together were tempted by the whispering of Satan to transgress the one thing God forbade them to do. God banished them from the heavens for this transgression and decreed Satan the immortal enemy of Adam, Eve, and their progeny ([15], al-A’raf 7:20–24). The perpetual battle between good and evil, between Adam and Satan is mirrored in the human being, who is locked in an everlasting tension between the profane and the sacred. The profane aspect of the human being, known in Arabic as the “nafs” (self), desires unrestricted pleasure, even at the risk of committing sins, whereas the sacred spirit, the “ruh”, the location of which is the physical heart, desires to go towards its pure origins. Muhammad says that when a person commits sins, a black dot falls on his or her heart. If that dot is not washed away through repentance and asking for forgiveness from God, it starts to build up in the heart, until it overtakes it [35]. Yusuf [29] writes that when people commit sins, their ruh (spirit) is severed from the nafs (self). Committing a crime (which is also a sin) is first and foremost to commit a crime against the heart, which then has an effect on the whole person. The person enters a spiritual agitation, which is then covered (kufr, the same word used to denote disbelief) by agents, such as alcohol, drugs, and other illegal substances.

Having expounded quite extensively on the paradoxical nature of human beings in Islam, the discussion on drug addiction will be continued from the perspective of this model. The Qur’an calls intoxicants the “handiwork of Satan”; according to this model, substance dependence will mean that the addicted person’s “self” has succumbed to their satanic impulses, thus severing it from the “spirit”. A dead, spiritless heart does not remember God and does not yearn to return to God. The Qur’an says, “Is the one who was dead and then We revived [with faith] and made for him a light by which to walk among the people like one who is in darkness from which he cannot exit?” ([15], al-An’am 6:122). The exegetes have said that the phrase “Is the one who was dead” refers to having a dead heart [29]. Al-Zarkashi mentions in his famous tract on hashish called Zahr al-Arish that the evil effects that drugs have on the spirit are that:

It diminishes the powers of the soul, destruction of the mind (fikr), forgetfulness (nisyan al-dhikr), vulgarization of secrets, commission of evil actions, the loss of modesty (haya’), great stubbornness, the lack of manly virtue, the suppression of jealously, wastefulness, keeping company with the devil, the omission of prayer, and the falling into unlawful activities ([18], pp. 86, 89, 178).

This is echoed clearly in the verse of the Qur’an cited below where God says that intoxicants sever the relationship with God, as well as family and community. It views intoxicants as the cause for disruptive social behavior. It urges believers to shun and reject the habit, so that they may prosper both in their horizontal relationship with kith and kin, as well as in their vertical relationship with God. Furthermore, prosperity can mean both spiritual and financial prosperity, which are drastically affected, due to substance addiction. The Qur’an says:

You who believe, intoxicants and gambling, idolatrous practices, and [divining with] arrows are repugnant acts—Satan’s doing—shun them so that you may prosper. With intoxicants and gambling, Satan seeks only to incite enmity and hatred among you, and to stop you remembering God and prayer. Will you not give them up? ([15], al-Ma’ida 5:90–91).

It should be noted here that the “spiritual disease model” is different from the controversial scientific “disease model”, which suggests that addiction is genetically passed from parents to children. The “spiritual disease model” explored above is more in line with the “moral model” and like the “addiction as crime model” in that it is mainly preventative and based on a cultural (Islamic) understanding of shame. It explains what will happen to the human soul and spirit and their relationship with God and family in the case of substance addiction. Both models together should be enough incentive for God-fearing, God-loving Muslims to refrain from substance use. However, neither are they particularly helpful to those who are already suffering from drug addiction nor instrumental in changing people’s attitude towards those who are addicted to drugs. A practical model, based on guilt-culture and personal redemption, can work better for people wanting to escape from addictive disorder. Below, one such model that is practiced in the USA is explored with regards to its theological underpinnings.

6. Millati Islami: A Model in Practice

Millati Islami: the path of peace (MI) is a fellowship founded for Muslims suffering from addiction disorder in USA. Its 12 steps are modelled on the 12-step model of Alcoholics Anonymous (AA) and its sister fellowships, such as Narcotics Anonymous (NA), but rejects some of their points, which directly contradict the Islamic faith. Below in Table 1, the extent to which Millati Islami islamacized the AA 12 steps can be observed. AA began in Akron, Ohio, USA, in 1935 and was influenced by the Oxford Group, an evangelical movement, as well as being influenced by religious and medical thinking. Despite the fellowship’s Christian roots, its concept of turning to a Higher Power, whether it is Jesus, Allah, Jehovah, a Group of Drunks (GOD), one’s grandmother or an inanimate object, resonates well with many people [4]. However, some Muslims suffering from addiction disorder may find AA and NA’s emphasis on people being life-long addicts and their belief that addiction is a disease rather than a test from Allah as irreconcilable with their faith. A former Muslim heroin user on the NA 12 step-programme relates his experience with his non-Muslim counsellor:

Table 1. A comparison between the Millati Islami and Alcoholics Anonymous 12-step programmes.

Millati Islami 12 Steps [36]	Alcoholic Anonymous 12 Steps [37]
1. We admitted that we were neglectful of our higher selves and that our lives have become unmanageable.	1. We admitted we were powerless over alcohol—that our lives had become unmanageable.
2. We came to believe that Allah could and would restore us to sanity.	2. Came to believe that a Power greater than ourselves could restore us to sanity.
3. We made a decision to submit our will to the will of Allah.	3. Made a decision to turn our will and our lives over to the care of God as we understood Him
4. We made a searching and fearless moral inventory of ourselves	4. Made a searching and fearless moral inventory of ourselves.
5. We admitted to Allah and to ourselves the exact nature of our wrongs.	5. Admitted to God, to ourselves and to another human being the exact nature of our wrongs.
6. Asking Allah for right guidance, we became willing and open for change, ready to have Allah remove our defects of character.	6. Were entirely ready to have God remove all these defects of character.
7. We humbly ask Allah to remove our shortcomings.	7. Humbly asked Him to remove our shortcomings.
8. We made a list of persons we have harmed and became willing to make amends to them all.	8. Made a list of all persons we had harmed, and became willing to make amends to them all.
9. We made direct amends to such people wherever possible, except when to do so would injure them or others.	9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
10. We continued to take personal inventory and when we were wrong promptly admitted it.	10. Continued to take personal inventory and when we were wrong promptly admitted it.
11. We sought through Salaat * and Iqraa * to improve our understanding of Taqwa * and Ihsan *, Salaat: Prayer service in Islam Iqraa: Reading and studying Taqwa: G-d consciousness; proper Love and respect for Allah Ihsan: Though we cannot see Allah, He does see us.	11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
12. Having increased our level of Iman (faith) and Taqwa, as a result of applying these steps, we carried this message to humanity and began practicing these principles in all our affairs.	12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs.

Table 1. A comparison between the Millati Islami and Alcoholics Anonymous 12-step programmes.

Millati Islami 12 Steps [36]	Alcoholic Anonymous 12 Steps [37]
1. We admitted that we were neglectful of our higher selves and that our lives have become unmanageable.	1. We admitted we were powerless over alcohol—that our lives had become unmanageable.
2. We came to believe that Allah could and would restore us to sanity.	2. Came to believe that a Power greater than ourselves could restore us to sanity.
3. We made a decision to submit our will to the will of Allah.	3. Made a decision to turn our will and our lives over to the care of God as we understood Him
4. We made a searching and fearless moral inventory of ourselves	4. Made a searching and fearless moral inventory of ourselves.
5. We admitted to Allah and to ourselves the exact nature of our wrongs.	5. Admitted to God, to ourselves and to another human being the exact nature of our wrongs.
6. Asking Allah for right guidance, we became willing and open for change, ready to have Allah remove our defects of character.	6. Were entirely ready to have God remove all these defects of character.
7. We humbly ask Allah to remove our shortcomings.	7. Humbly asked Him to remove our shortcomings.
8. We made a list of persons we have harmed and became willing to make amends to them all.	8. Made a list of all persons we had harmed, and became willing to make amends to them all.
9. We made direct amends to such people wherever possible, except when to do so would injure them or others.	9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
10. We continued to take personal inventory and when we were wrong promptly admitted it.	10. Continued to take personal inventory and when we were wrong promptly admitted it.
11. We sought through Salaat * and Iqraa * to improve our understanding of Taqwa * and Ihsan *, Salaat: Prayer service in Islam Iqraa: Reading and studying Taqwa: G-d consciousness; proper Love and respect for Allah Ihsan: Though we cannot see Allah, He does see us.	11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
12. Having increased our level of Iman (faith) and Taqwa, as a result of applying these steps, we carried this message to humanity and began practicing these principles in all our affairs.	12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs.

The counsellor told me that my belief in Allah as my Higher Power was not working for me and that I should be more open-minded towards choosing another God. We battled over this until it caused me to leave the rehab (cited in [4]).

MI was founded to pre-empt this sort of problem from occurring. The fellowship was founded by Zayd Imani in 1989 in Baltimore, Maryland [38]. In 1993, it held its first annual fundraiser, the proceeds of which went towards writing the handbook of MI 12 steps by the founder. By 1996, 42 MI groups had been established across 16 American states. Although their website has not been updated since then, a Facebook group created in 2012 is still active today [39]. In 2012, they had their 23rd annual conference. On their website, they write;

Just as Narcotics Anonymous was founded out of its need to be non-specific with regard to substance, so Millati Islami was born out of our need to be religiously specific with regard to spiritual principles [38].

They further comment that MI “is not for everyone, but truly for those who want to be free from addiction AND an Islamic way of life” [38]. Despite this commitment to Islam, any mention of God on their homepage is written as “G-D” [38]. It may be that although they want to be rooted within an Islamic paradigm, they do not want to exclude others from using their services. Below, their 12 steps are presented side-by-side with AA’s 12 steps for easy comparison. It can be observed that alongside modelling on AA’s 12-step program (which are worded to appeal to universal human values), their 12 steps are rooted in many points of the theological models discussed above. A brief commentary on some of the steps will help accentuate this point better.

7. Commentary on MI’s 12-Step Programme

There is a stark difference between MI’s and AA’s Step 1. MI emphasizes that addiction is due to humans neglecting their purpose of creation to worship God. By admitting their addiction, one comes to the realization that humans are dependent on many factors in their life. Children are dependent on their parents; this understanding leads one to the realization that their parents are also dependent on many things, including God. Coming to these realizations, one begins to feel that being dependent on substances and not Allah has caused their life to become unmanageable. They argue that their addiction is due to their not having read and internalized the Qur’anic guidance related to intoxicants, mentioned above in the “addiction as spiritual disease model” [40].

Step 2 directly mentions Allah, as opposed to a “Greater Power.” It contends that true belief in the powers of God, and his mercy, is the only thing that can save one from addiction. Not being mindful of God is what leads one into addiction in the first place. Step three is an interesting comparison. It can be noticed that the phrase “as we understood him” is missing from MI’s step. The authors argue that this phrase contradicts Islamic belief. In Islam, God is transcendent beyond all comprehension. The human brain is not capable of understanding God. The authors point out that trying to understand God without the guidance of scripture will lead one to catastrophes, such as drug addiction, unwed mothers, diseases, escalation in greed, wars, etc. [40]. Although this may be a theologically correct point, it lacks the personal closeness of God that one needs during times of crisis. I have argued elsewhere [8] that God’s immanence needs to be reclaimed back from his transcendence if we are to develop a model of pastoral care that emphasizes God being with people, rather than aloof from them.

The wordings of point four are the same for both programs. Taking stock of one’s actions and faults is a step towards recovery. AA fellows at this point emphasize resentment as the number one offender. The authors of MI identify the culprit to be sins and their own doing by quoting the Qur’an, “Whatever misfortune befalls you [people], it is because of what your own hands have done” ([15], Shura 42:30). Taking stock of this and being aware of this short-coming will lead one to repent (tawba) and return to God [41].

Point five is an interesting contrast. MI’s point omits the mention of “admitting to another human being.” This is rooted in the Islamic traditions, where it is highly encouraged that one’s sins are not to be made public. “God does not forgive the one who discloses his sins (mujahir) that He has concealed from people’s eyes,” said Muhammad [17]. Islam does not believe in confession of sins to others other than God. However, in a situation where one is grappling with addiction, MI authors suggest that they may find solace by expressing their emotions and feelings to their close and loved ones, but never to make their sins a public affair [41].

The model, as can be observed, is deeply rooted in Islamic teachings. It is a culturally sensitive and sensible program for those who take their religious beliefs seriously, even though they have fallen into a temporary lapse of judgment. One MI fellowship member shares her experience:

Being in this community offers me hope and allows me to understand that Muslims are not perfect. However, we strive to be pleasing to Allah. The literature reinforces the evidence that using drugs is not permissible or pleasing to Allah. It also provides me information on how to not use mind- or mood-altering substance. One of the most profound things for me in the MI literature is that “we recover from salat to salat [prayer to prayer].” I am more aware of Allah in the MI meetings than the other Twelve Step fellowship I attended (cited in [4]).

8. Conclusions

In this article, I attempted to explore three models that can be employed to understand drug addiction from an Islamic perspective. Viewing these models as an aggregate, it can clearly be observed that Islamic scripture and theology have the tools to develop robust theological models to explain addiction, which can then be used to develop programs to help Muslims suffering from an addictive disorder. The first two models are theoretical and, if developed fully, can be used to underpin a theologically-based program of therapy. The Millati Islami is a good working example of this. The choice to explore these models is purely functional. In the absence of any fully-fledged Islamic models, I have attempted to focus the models on the exterior of the human being (addiction as crime) moving towards the interior (addiction as spiritual disease); or to put it another way, I’ve focused on the “shame” aspect of Islamic theology, as well as its guilt aspect. Islam takes the protection of society from moral pollutants seriously; hence, it has stipulated corporal and capital punishment (hadd) where it feels that these boundaries have been violated; although the threat of corporal punishment in reality is often conceptualized as a deterrent and not to be implemented [8,42]. Similarly, the spiritual status of the human being is given primacy. The Qur’an mentions, “Prosperous are those who purify themselves, remember the name of their Lord, and pray” ([15], al-A’la 87:14–15). Sins are viewed as a fracturing of the self, the detachment of the human from its higher being. Once the self is detached from the spirit, it no longer takes pleasure from God and religion, but from artificial agents, such as drugs, alcohol, religion, but from artificial agents, such as drugs, alcohol, and other illegal substances. Together, both models address the social and spiritual aspect of the human being and can be used as good models of intervention and prevention, although the models fail on a number of levels, as highlighted above. The Millati Islami model is a good place to observe the Islamic theological model in practice. Its success as a practical Islamic model for helping Muslims deal with addiction-related problems can be gauged from the number of organizations, both within the USA and internationally, who have included it verbatim in their drug support programs. Some of these organizations include Texas [43] and California [44] correctional facilities, the Birmingham, U.K.-based Pathways to Recovery program (called KIKIT) [45], and the Australian, Sydney-based Mission of Hope program (called Hayat House) [46]. Nevertheless, it will be interesting to hear statements of those who have used the service and did not benefit from it. A more robust model can be developed that incorporates many aspects of the models discussed in this article by focusing on the Qur’an’s gradation of the self (nafs) in to different levels, such as: (1) the commanding self (nafs al-ammara); (2) the blaming self (nafs al-lawwama); (3) the inspired self (nafs al-mulhama); (4) the certain self (nafs al-mutma’inna); (5) the content self (nafs al-radiyah); (6) the all-pleased self (nafs al-maridiyya); and (7) the completed self (nafs al-kamila) [47]; the “commanding self” being the furthest away from spirit (ruh), while the “completed self” is the one closest to the spirit, which is living by Divine love [47]. This model will be explored in a subsequent article, as space does not allow an exploration of it here.