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The Contumacious Opioid Epidemic: The Five Pillars

Updated: May 11, 2022

(c) Leilani Radaideh

Chinese water tortue is a process by which cold water slowly drips onto the scalp or forehead of a victim who is strapped face up on an inclined platform. A person would be subjected to this for an aeonian period of time, for the sole purpose of driving the victim mad. Experiencing chronic pain is commensurate; a ceaseless drip that consumes a person’s every waking hour – whilst limiting those dormant. In attempting to cease the plague of suffering, a new epidemic was born: the opioid crisis.

There are four key waves in the rise of opioid-related overdoses. The first wave occurred right during the increased prescription of opioids in the 1990s, attributable to belligerent marketing strategies by pharmaceutical firms. Another spike re-emerging in 2010 due to a surfeit in heroin consumption; a third in 2013 as a consequence of illegally manufactured fentanyl, in addition to the deadly concoction of cocaine, counterfeit pills, and heroin. More recently however, a fourth wave has surged linked to the COVID-19 pandemic. As the world’s eyes have shifted away from this epidemic, government health experts predict that approximately 90,000 people died due to drug-related overdoses in 2020 alone in the USA. Over in Europe, the use of prescription opioids for pain management has also increased in the last two decades – more recently the confiscations of cannabis, cocaine, ecstasy and crystal meth have been higher than ever. Zooming in on The Netherlands, around 800,000 individuals in 2013 were prescribed opioids, which drastically increased to over a million individuals (6.0% of the total population) in 2017.

Isolation, anxiety, depression, economic stress, excessive drug use, homelessness, and barriers to mental or physical health treatment in cases have been impacted negatively due to COVID-19. Regarding addiction, the pandemic has impacted the supply of drugs terribly due to various lockdowns, curfews, etc. As such, unreliability has been created in getting these drugs, resulting in an increased overdose risk for some individuals. Moreover, loneliness and isolation from support groups has also caused some to use drugs more frequently and in a more careless manner.

However, amongst all these negatives, there have been some good takeaways from the pandemic regarding opioid addiction. The pandemic created a break in people’s lives allowing them to take a moment of self-reflection and to perhaps choose a different path for themselves. And with the blessing (or curse) of the need for online calling platforms, new flexibilities were created so that those that needed treatment but could not find it before the pandemic were now able to find online support very quickly. Therefore, although sequestered away physically, online we could see the opposite of this.

Yet, this doesn’t solve the whole crisis. Sure, things have been impacted by COVID-19 both negatively and positively, but looking at the bigger picture we are forced to beg: what can be done? This is where the five pillars kick in. The United Nations Office on Drugs and Crime (UNODC) has created an Opioid Strategy with such five pillars: early warning and trend analysis, medical and scientific use of opioids, prevention and treatment of opioid use disorders, international law enforcement operations to disrupt illicit trafficking of opioids, and lastly strengthening national and international counter-narcotic capacity. These pillars are further supported with an advocacy plan including active social media campaigns to bring light to what actions have occurred, successes, and current activities.

More specifically, looking at the third pillar regarding ‘strengthening and supporting prevention and treatment programmes related to opioids’, this includes investing in connecting addicts and reconnecting the youth into communities to help invest in educational and personal development. One way this is done on an international level that transcends our world of material existence, is through religion. Linking our five pillars in the UNODC Opioid Strategy, Islam has five pillars that constitute the core of the religion: the shahada (belief that there is no god but God (Allah), and Muhammad (PBUH) is the messenger of God), prayer, obligatory charity, fasting, and pilgrimage.

Islam has key principles such as moderation, self-awarness, self-discipline, and peace – as the definition of Islam – in order to restrict the use of harmful substances in the body. In living a life encompassed by these things, individuals create a strong bond between themselves and a higher power; resulting in them being disinclined towards substance abuse. Nonetheless, many followers of Islam end up suffering with addicition and due to the ‘shame’ of such ‘haram’ or ‘forbidden’ acts, are isolated and unable to get the help they need; hence, the data showing such low numbers of Muslims suffering with addiction are far from reliable. Moreover, the pertinence of ensuring that there is adequate treatment for Muslims is seen in the large number (approximately 1.9 billion) of followers of the faith in the world. With the number also constantly growing as it is one of the fastest growing religions.

Important considerations for the treatment of Muslims should be taken into account during treatment in order to ensure that the aid is effective and appropriate. Privacy is highly important, and as such Muslim addicts should have their confidentiality maintained. Any disclosures should only be made with permission of the person concerned and if applicable, their family members. As such, privacy is one of the first principles of treating individuals for substance abuse with a commitment to Islam. Moreover, it is important to use the basic principles and other relevant aspects of Islam into the program itself. Although this is not always the case in our modern times, it is often deemed more appropriate to have male counselors and physicians deal with male clients and vice versa. Going into the counseling itself, when involving religion, it is important to note that Muslims believe that life is a test from God, and as such people have free will. Therefore, change is possible, and although suffering from addiction, there is the possibility to change. On this aspect it is of the utmost importance that the doctrine that an addict has committed ‘unforgivable sins’ should not be echoed.

In creating and advocating for proper treatment programmes shaped for Muslims, we are one step closer to helping fight this epidemic. Yes, many of these topics are taboo in regions with Islam as the dominant faith and often also for those that practice the faith. Nevertheless, it is quintessential that we open up these discussions as they will help with prevention and moving forward to help fulfill these five pillars.

فَإِنَّ مَعَ الْعُسْرِ يُسْرًا ﴿٥﴾ إِنَّ مَعَ الْعُسْرِ يُسْرًا

“So verily, with the hardship, there is relief. Verily, with the hardship, there is relief”

— Surat Ash-Sharh — The Relief, 94:5-6


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