A mosque-based methadone maintenance treatment strategy: Implementation and pilot results

Highlights

• Heroin users received MMT and Islamic-religious practices and counseling.

• The intervention was offered in a mosque setting.

• Baseline and 12 month data show that the intervention was effective.

• Mosques offer a promising setting for community-oriented addiction recovery.

Abstract

Background

This paper describes the rationale, implementation and operation of a “world first” Islamic inspired methadone maintenance treatment project delivered in a mosque setting and presents the outcome for the first group of participants. The project explored the viability of expanding addiction recovery services through the network of mosques in Muslim communities.

Methods

The project combined methadone maintenance with peer and religious counseling. Participants consisted of 36 male Muslim heroin users who went through the project. Urine tests and self-reported measures on various dimensions relevant to drug use and quality of life were collected at baseline and 12 months.

Results

The project had a 12 month retention rate of 80%. At 12 months all but one participant tested negative for opioids and other substances. Self-report measures showed significant reductions in the degree and variety of drug use, improvements in general health, and psychological and social functioning of participants. Qualitative data showed that availability of methadone, convenient location and religion were the main reasons drawing participants to the program.

Conclusions

Mosques are viable venues for offering medication assisted recovery services and offer an alternative approach for managing addiction in Muslim communities. The prospect of mobilizing community resources to offer community-oriented long-term recovery management programs in mosques and other places of worship deserves consideration.

Introduction

Malaysia is a religiously and culturally diverse country with a population of 28 million, a vibrant economy, and a serious illicit drug use problem. Heroin was introduced to the country in the 1960s and became the drug of choice among the majority Muslim Malays. This paper describes a “world first” Islamic inspired methadone maintenance treatment (MMT) project delivered in a mosque in Malaysia and presents the outcome for the first group of participants.

The project was recognized as Best Practice in Asia for harm reduction and fighting HIV/AIDS by the World Health Organization (WHO, 2011). It has received local and international media attention (Aljazeera, 2011, Bernama, 2013, CCTV, 2013, NYTimes, 2012) and has attracted the interest of addiction specialists and health officials from different faiths and countries.

There are compelling reasons for considering mosques as a suitable setting for offering addiction rehabilitation services. The idea of using mosques, and potentially other religion's places of worship, for addiction recovery is a logical extension of the mounting evidence pointing to the positive role of religion, spirituality, and psycho-religious approaches to the treatment of physical and mental health problems (Borras et al., 2010, Galanter et al., 2013Galanter, 2006, Hill and Pargament, 2008, Miller and Thoresen, 2003, Seeman et al., 2003). Historically, religious rites and places of worship with rich traditions and symbols have offered a medium for reflection, devotion, redemption, and physical as well as emotional healing. In all faiths, religious pilgrimage is as old as the religion itself. Mosques have always served as a base for religious as well as community activities, social services and in recent times family counseling (Ali, Milstein, & Marzuk, 2005). The network of mosques in Muslim communities offer economical and readily accessible venues for drug rehabilitation that can attract and engage drug users in early treatment, reintegrate them into the community and help to sever ties with the drug culture. Also mosque-based services present a unique opportunity to project a constructive image of recovery from addiction reducing stigma and marginalization of drug users (Luoma, Kohlenberg, Hayes, Bunting, & Rye, 2008).