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Alcohol and Narcotics

ROLE OF THE MOSQUE IN CONFRONTING THE EPIDEMIC OF SUBSTANCE ABUSE
Dr. Jamal Madi Abut Azayem
EGYPT

This article will throw light on the experiment conducted by Prophet Mohamed in the early days of Islam to curb the epidemic of alcoholism making use of the mosque as a center of his campaign. The success he gained in minimizing the acceptance and abuse of alcohol up to the present time was and still is a model that can be adopted successfully.

The article will shed light on the experiments conducted in Egypt nowadays to make use of the mosque as a center for prevention and treatment of this epidemic giving facts and figures as well as the difficulties confronted and how they were overcome.

The Islamic Plan To Combat Alcoholism
It is well known that alcoholism was wide spread all over the Arab

Peninsula. The acceptance of the people for alcohol use was at its acme. Literature specially poetry reflects this fact. The deleterious effects of alcoholism was manifested on the social life conducting the tribes to continuous conflicts and wars

The main approach to the problem by Islam, was to adopt gradation in forbidding alcoholism. This was carried out side by side with improving the social conditions of the people. Faith played a major part in these two approaches. The time estimated from the beginning of the campaign to its end was about 15 years. The personality of the leader, "The Prophet" was revolutionary affecting this change. The model he gave as 1st step was the true example adopted by him and all his near followers and so they were respected and their pieces of advice were accepted, absorbed, well learned and maintained denoting absolute response:

"THE PROPHET GAVE TRUE EXAMPLE TO BE FOLLOWED" (S.33: V.21)

The 2nd step was disseminating knowledge about the evils of alcohol that it is deleterious and detrimental:

THE BELIEVERS ESQUIRE ABOUT SPIRITS AND GAMBLING. INFORM THEM THAT THEY HAVE THEIR EVILS AND USES FOR PEOPLE BUT THEIR EVILS OUTWEIGH THEIR USES. (S2: V.219).

Thus drawing the attention to the deleterious effects of using spirits and gambling. The 3rd step was rather decisive, it says blankly.

YOU BELIEVERS DO NOT APPROACH PRAYING WHILE YOU ARE UNDER THE EFFECT OF ALCOHOL. (S.4: V.43)

Thus minimizing the abuse during most of the day, as the five prayers extend from dawn time until nightfall. The 4th step came when the people had matured enough to accept it through the penetrating model, the persuading orientation and the partial legislation. It was related that one of believers namely "Omar Ebn El Khtab" said in a meeting in the mosque "Oh Allah give us a decisive say about alcohol". At this time of real faith and maturation the last step was declared by the verse saying:

YOU BELIEVERS, SPIRITS, GAMBLING. IDOLS AND FORTUNE TELLING ARE ALL EVILS WHICH YOU SHOULD ABANDON THAT YOU MAY PROSPER. (S.5: V.90)

These vita steady steps treating the social and the spiritual side were the two pillars upon which the plan of combat rested.

History states that since the last verse the majority of the abusers abstained and the people lived without alcohol and did not drink or touch or sell or buy or sit with abusers or even carry it. This picture is unique in history and is a witness of the success of the campaign. From the above stated example we can deduce the items of the Islamic approach.

1. The model of the leader.
2. The dissemination of information about the evils of abuse.
3. Legislative steps were gradual hand in hand with these approaches and the change was to the better of the social life of the people.
4. The law of prohibition and imposing punishment for abusers came last.

In this respect I would like to refer to the Chinese plan of combating opuim abuse in this century which followed more or less the same procedure leading to success. The U.S.A. attempt to combat alcoholism by an abrupt law led to aggravation of the situation.

Spot Lights on the Experiments Conducted in Egypt about the Role of the Mosque to Combat Drug Abuse.

1. Since 1968 a clergyman was appointed to work with the therapeutic team in treating drug abuse. This was conducted in Ataba Clinic in Cairo. This approach led to a quick increase of the number of admissions to the clinic:

It also led to the success of the group therapy sessions.

2. W.H.O. has been briefed of the new approach, which was evaluated and its validity was endorsed.

3. A clinic was annexed to Abou El Azayem mosque, which lies in a congested area. The policy of the treatment was to make use of the psycho-socio-religious-dynamics. The preachers selected were trained and given adequate information about the plan of treatment.

Analysis of the Content of the Speeches of the Preachers

When the content of their speeches were analysed, it was found out that, they were not well oriented about
(1) The psychological or the social approach to the problem. (2) The real state of the picture of addiction and the diverse types of dependence. (3) The effects of dependence physically, psychologically and socially on the patient. (4) How to make use of persuation and suggestion in an individual or group session.

Refer to the report on comparative evaluation of the voluntary treatment of opium dependents Project 03-275-A. ADAMH. 1985.

Training of the Preachers
It is worth mentioning that the result of interviewing these preachers revealed the fact that some had the same false views and misunderstanding common in the community about the causations lying behind neurotic and mental diseases as well as drug addiction in particular. Thus the training was based on scientific facts to change the concepts and attitudes of the preachers in order to communicate these facts to the community through their activities in the mosque.

Training of the Preacher Amongst The Therapeutic Team
The training was conducted on a full time scale at Dr. Abou El Azayem Hospital. W.H.O. participated in the program.

This training was a new approach in a new area of activity using the preacher in the therapeutic team. Some psychiatrists did not approve of this new step and did not show enough cooperation in this respect and so it was a burden on the organizing bodies to overcome this gap. Some preachers were not convinced and attributed a diction for example to the effect of devilish curses or other unseen powers and thus it was necessary to change their fixed ideas by coexistence training amongst the patients themselves to gain a 1st hand experience.

Others were only keen to point out the blazing hell awaiting the abusers. These were contented by pointing out the religious code connected with dependence rather than to penetrate into the depths of the problem to help the abuser to change the attitude and abstain by the power of faith and self-persuation.

Those who succeeded in their mission were those who respected the other members of the therapeutic team and cooperated with them in a friendly way towards the same goal, trying to vaccinate and inoculate faith in the treating doctor and faith in the social work side and in the same time potentiate the will power and patience of the abusers giving the sublime meaning connected with the effects of faith and patience on the secretion of hormones from the C.N.S., a mechanism which is endowed to everyone who keeps to the right path and a ability to bear the pains of abstaining.

Prayers as a Therapeutic
Tool The policy of the daily program of these clinics depended on observing the prayers at their declared time in a group all those working in the clinic and the patients participated and all led by the preacher who invited them all after the end of the prayer to the group therapy religious sessions in which all the members of the team cooperated.

In these open sessions the therapeutic team, which has been well trained in using faith as an article for therapy, participated and answered questions trying to explain the merits of the religious orders, the real meaning of cleanliness, ablution and its effect on the central nervous system; the effect of group prayers psychologically and their tranquilising effect.

These sessions widened the sphere of interest of the participants in their dally program and how to make use of their time pleasurable, constructive and recreational.

This training constituted the corner stone on which the role of the mosque was erected.

Evaluation of the Role of the Mosque
When the clinical results of the experiments were declared, the WHO asked for evaluation and suggested to approach the National Institute of Drug Abuse in Washington.

A protocol of research was prepared to evaluate two clinics, one an office clinic and the other a clinic annexed to a mosque where psycho-socio-religious approaches are used.

Ataba clinic in the center of Cairo was the office clinic. Abou El Azayem clinic annexed to the mosque was the second. A double blind experiment was conducted where 4 different modalities were used in the treatment of 4 group of male opium dependents living in the center of Cairo. The 4 groups in the office clinic (Ataba) were compared to 4 groups in the mosque clinic (Abou El Azayem). Each group of patients was comprised of about 40 cases. The 4 different modalities were: (1) Treatment with antidepressant drugs. (2) Treatment with insulin modified. (3) Treatment with antidepressant drugs and insulin. (4) Treatment with placebo. The outcome data of the treatment after about one year treatment and follow up were computerized and the results were recorded. After deciphering the outcomes, the following was found. The patients who resorted to the mosque clinic were those who were more involved in the drug abuse and were of the chronic cases who relapsed several times. Following are some initial differences.

(1) 11.50% of Ataba volunteers vs. 21.25% of mosque patients spent E.L. 4 or more daily on drugs.
(2) 9.41% of Ataba people vs. 15% of mosque patients reported taking the drug 3 or more times daily.
(3) 57.55% of those treated at Ataba vs. 70% of those at mosque reported becoming "nervy" when not taking the drug.
(4) 29.71% of Ataba takers vs. 47.50% of mosque users reported being unable to bear withdrawal symptoms (therefore resuming drug consumption) after a period of sobriety.
(5) 5.8% of Atab Ss vs. 10% of mosque Ss stated that they spent their leisure time at Cafes.
(6) 58% of Ataba patients vs. 13.75% of mosque Ss maintained that both their financial and health conditions urged them to seek treatment of drug dependence.

In their totality it is clear that the serious cases went to the mosque clinic, this denotes increase faith of the community towards the religious organization. This faith is thus a potent weapon in the combat campaign.

After thorough analysis of the withdrawal symptoms and the relief of these symptoms by the different treatment modalities the experiment declared that the Mosque clinic gained 7 score while the office clinic gained only 3 denoting a notable success in the mosque clinic.

It was also recorded that the outcomes of the placebo modality, where the cases were injected with aqua (water) an given a capsule of starch (inert substance) was to the same effect as the treatment with antidepressants and also insulin treatment.

The fact needs a stand and analysis specially that the cases who were under placebo in the mosque clinic addicted to the injections and the capsules.

They asked urgently to have this treatment when we stopped the experiment. When they were asked about its effect they stated that the treatment potentiated their abilities and gave them peace of mind and tranquilization.

This fact reveals the role of faith in the treatment. It also reflects light on the effect of patience and the role of endorphin in relieving pain and stabilizing the cases.

This is a proof of the importance of faith and it throws light on what can be achieved from the community mental health mosque.

In Egypt there are about 75000 mosques. Out of these mosques, about 1000, a community mosque where different social, educational, therapeutic and rehabilitative activities are conducted.

The move is going on though slowly to involve these mosques in the campaign. It is recommended that:

1. Extensive training should planned for the preachers to cope with that movement.
2. A central organization should be formed to plan, take care of, follow up, initiate other organizations and mosques to follow suit, and to help in convening conferences and congresses about the role of the mosque in mental health generally and combat of drug addiction specially.

Important Statistical Data which should be taken into Consideration in Planning for a Therapeutic Policy

• It has been manifested that there are waves of increase in voluntary admission to clinics seeking treatment. This coincided with the increase of the price of the drugs in the underground market. This increase of the price is usually due to active successful police campaigns.
• Statistical language says that when the police took active measures against the addicts themselves, the dependents refrained from looking for treatment, for fear of being detected. This means that applying the step by step approach paves the way for increasing the will power seeking for treatment.
• There is also and increase in voluntary admission for treatment as a result of active mass media against dependence. This means there is a need for increased orientation on all levels.
• It has been also manifested that opening clinics near or amidst the infected areas increases the move towards the seek for treatment. This means that the clinic attached to the mosques are the most appropriate places for the campaign.
• It is clear that the non-governmental associations took the initiative to tackle the problem, so we should plan to activate these non-governmental bodies to potentiate their work and to co-operate together for more productive efforts.

A call for an Urgent Legislative Step
After all the above stated facts which are the outcome of extensive research in this field it is expected that the authorities should take a legislative step to formulate the necessary articles of a manifest to combat drug dependence.

The Suggestive Articles Are
I. . A plan of five years should be drawn to
1. Open clinics in the religious centers or Mosques and Churches.
2. Train personnel needed for the campaign with special emphasis on preachers.
3. Activate mass media on all levels.
4. Potentiate police campaign.
5. Fix a time to give up dealing in or handling or trafficking or using any form of drugs and thus it will be clear that abusers will be liable to punishment if they do not observe the law.

This time should be respected and observed by the community and the authorities.

II. Execution should be the penalty for the traffickers or dealers openly and quickly.