Drug abuse issues are no longer being a new thing and continues to be a major problem in Malaysia. This issues has become a global issue. The most frequently abused drugs in Malaysia include heroin, methamphetamine and amphetamine type of stimulants, kratom, cannabis and ketamine. The growing popularity of methamphetamine was becoming very concern. Over the last few years, seizures as a result of this substance abuse were the highest on record. However, opioid continues to be the most widely abused drug in this country but the other types of substances abused are also increasing (Norliza Chemi, MMed, Norni Abdullah, MMed, Anandjit Singh & Mohd Fadzli Mohamad Isa, 2014).
In this context, it happens regardless of race, age, religion, gender, educational status, employment status, and ideological understanding. What is troubling now is that children and teenagers are also be targeted as vulnerable to the negative effects from their environment (Hazlina, 2016). Reports from the United Nations Office on Drugs and Crime (UNODC) in 2002 show that nearly 185 million individuals worldwide are involved with drug abuse problems. In Malaysia, these symptoms have not been addressed despite reports issued by the National Anti-Aging Agency (AADK) in 2012, indicating a drop in drug addiction cases in Malaysia by 19.74% compared to 2011 (11,194 persons) (Siti Norlina Muhamad, Farahwahida Mohd Yusof, Tamar Jaya Nizar, Mohd Al’ikhsan Ghazali, Akmaliza Abdullah ; Azlida Mamat (2015).
The question raised now is why addiction behavior is very difficult to treat. There are a lots of approaches and modalities which have been introduced by the government, but the problem still continue to exist and unsatisfactorily resolved. Abdul Halim, 2010; Scorzelli, 2009; Sabri, 2007; Abdul Rani, 2007; Reid, Adeeba ; Sangeeta, 2007;Mohd Rafidi, 2003; Mohamad Hussin, 2003; Mohamad Hussin ; Mustafa, 2001 state that the majority of addicts which is around 50% to 90% who have been completed their treatment programs will return to their old habits (relapse) after discharge from drug rehabilitation centers (Mohd Rafidi Jusoh, Abd. Halim Mohd Hussin ; Saedah Abdul Ghani, 2015).
Apart from that, the national treatment and rehabilitation program in Malaysia has evolved through many phases in the past 30 years (B.Vicknasingam ; Mahmud Mazlan, n.d). The national drug policy which aims to create Malaysia the nation that free from the threat of drug symptoms to ensure the well-being of the people and to maintain national stability and resilience stated that it is important to ensure the well-being of the community and in maintaining the national stability by emphasizing in the need for treatment strategies and recovery in drug addiction (Dasar Dadah Negara, 2014). However currently, existing policies are not comprehensive in dealing with drug issues in the country. This national drug policy needs to be updated as there is a change in the current drug scenario (National Anti-Drug Agency, 2018).
In this context, treatment and rehabilitation efforts are aimed at stopping the dependency of a drug addict and preventing the relapse among them are very important. The treatment is needed to make people to become productive functioning in the family, workplace, and community. According to National Institute of Drug Abuse (2018), the research that tracks individuals in treatment over extended periods shows that most people who get into and remain in treatment is stop using drugs, decrease their criminal activity, and improve their occupational, social, and psychological functioning.
1.2 Research Background
The issue of addiction involves various aspects of the individual. Drug addiction is considered as a chronic disease with high relapse rates. The trend of drug abuse in Malaysia shows an increase in terms of the number of consumers as well as the decline in their ages for those who are involved with drug symptoms. According to the report issued by the National Anti-Drugs Agency (NADA), for the first six months of 2010, Muslim Malays ranked highest for drug abuse as compared to other ethnics (Siti Norlina Muhamad et al, 2015).
Apart from that, also in 2016, according to National Anti-Drug Abuse (2016), those who are in rehab centers around the country are 30,844 addicts. Then, from 30,844 addicts, 22,923 were detected as new addicts and 7921 addicts were detected as relapsed addicts. In addition, out of the 30,844 cases detected, it was found that a total of 24,901 drug addicts were 80.73% Malay Muslims compared to the other races. This statistic shows how serious the problem of drug addiction in Malaysia in general and especially among the Malays.
Various efforts are always made in improving the effectiveness of existing drug treatment and rehabilitation programs. According to the Laporan Tahunan 2016 by Agency Anti-Drug Abuse (2016), there are two types of rehabilitation program in drug abuse which are in institution and community. In this context, treatment and rehabilitation in the institution is one of the main services of AADK in helping to treat and rehabilitate individuals involved with drug addiction problems. This service is divided into Cure ; Care Rehabilitation Center (CCRC) and 1Malaysia Cure ; Care Clinic (C;C). AADK has 22 CCRCs and 10 C ; C 1Malaysia clinics throughout Malaysia.
In addition, the Treatment and Rehabilitation Program provided at CCRC and C ; C Clinics is based on the Psychosocial Model which consists of Religious ; Spirituality, Relapse Prevention, Social Support, Family Program, Guidance and Counseling, Sports ; Recreation, Skills ; Vocational and Physical Rater. In addition, the program is also implemented through Community Therapy Module (TC), Inabah Module and Module Halaqah. Each element and component in the model plays a role in providing clients with the skills and knowledge to deal with drug addiction problems, dealing with relapse, guiding changes to more positive behavior and also applying self-discipline to each client (Laporan Tahunan 2016, 2016).
Other than that is community rehabilitation program. Treatment and Rehabilitation in the Community is a recovery approach implemented outside the recovery institution. Provides the services needed by individuals with drug addiction problems, the individuals affected from them and the community itself. In this context, Community Based Treatment refers to a specific integrated model of treatment for people affected by drug use and dependence in the community which provides an ongoing of care from outreach through detoxification and stabilisation to aftercare and integration, including maintenance pharmacotherapy. Community Based Treatment is the most cost-effective approach to support people affected by drug use and dependence. Evidence from across the world has shown that patients using community-based services have a significant decrease in the number of hospital stays, emergency-room visits and criminality (United Nations Office on Drugs and Crime, n.d).
Besides that, Psycho-spiritual therapy which is based on the Islamic teachings is well-known in drug rehabilitations and can overcome addictions. A number of treatment centers which using psycho-spiritual therapy based on Islamic teachings have shown a great success (Zohdi Amin MZM, Abdulloh Salaeh, Mahsor Yahya, Zamrie [email protected], Adnan Mohamed Yusoff, Norhasnira Ibrahim, Syed Najihuddin Syed Hassan, Robiatul Adawiyah Mohd, Tazul Islam, Siti Abas ; Mohd Syakir Arifin (n.d).
The diversity in this psycho-spiritual therapeutic method if combined can result in the best drug addictions therapy model. Each treatment center has its own approach and is different from each other. The National Anti-Drug Agency also introduced the Islamic Module Rehabilitation Approach (ISRA) approach based on the Inabah model or religious spirituality in rehabilitating drug addicts for a long time. The implementation of ISRA starts at the Sungai Ruan Cure ; Care Rehabilitation Center (CCRC) since 2015 and will expand the use of this module approach in other CCRCs (Mohamad Isa Amat, Nurfarhah Mohd Najib ; Muhammad Khairi Mahyuddin (2017).
The use of Quranic verses, Remembrance, the application of Sunnah and the concept of appreciation and treatment process are different from one center to another. This is based on persistent experiences, trials and improvements that are made continuously to produce positive output. The Quranic verse recited to the patient has different effects on the patient. Hence, the selection of the appropriate Qur’anic verse for treatment therapy is important in ensuring its effectiveness (Zohdi Amin MZM et al., n.d) .
According to Muhammad Yusuf Khalid (n.d), one of the leading Islamic institutions which utilizes psycho-spiritual therapy is pondok remaja Inabah. The curriculum of Inabah based on ten Qur’anic verses and ten Hadis (the traditions of the Prophet Muhammad SAW.). The practical aspect of the approach in Inabah is mainly on shower, prayer and remembrance of God, which were conducted strictly every day. The successful of Inabah method based on field research conducted in 1989-1993 at eight Inabah branches was no doubt which were the total number of patients were 2722 persons, 2284 or 83,91% of them recover completely, 280 or 10,29% patients are still under treatment, 235 or 8,63% patients went home before recovery, 123 or 4,52% patients run away and 35 or 1,29% patients passed away.
Some other studies related to drug rehabilitation also see that the value of Islamic spirituality giving the affects towards the healing from drugs dependence. Mosque institutions have the potential to be a long-term community-based rehabilitation center. Adam Bin Mohamed (2006) reports on the survey of 45 respondents who are undergoing drug addiction rehabilitation programs from the point of relapse addictions behaviour. The study found that moral support, consistent spiritual understanding from family members and local communities as well as fellow members helped to avoid relapse.
Other than that, in 7 steps of recovery in addiction approach, it also addresses steps using the Islamic religion as the basis for the recovery journey. Among the steps examined in this approach are self-acceptance, surrendering to Allah S.W.T, Self-recognize and confessing to Allah S.W.T, Responsible for correcting mistakes, The efforts and tawakkal (surrender), Self-strengthening to Allah S.W.T and also Maintain and improvement in recovery (Abd Halim Mohd Hussin ; Muhammad Khairi Mahyuddin, 2014).
Most of the addicts which involved in tabligh pilgrim program have successfully avoided from relapse in addiction (Adam Mohamed, 2006). However, no empirical studies have been conducted on tabligh pilgrim programs or psychospiritual aftercare programs of these 7 steps of recovery. Research on this 7 steps aftercare program is considered appropriate as a measure of the effectiveness of the Inabah Module which has commenced at CCRC Sg Ruan in 2015.
Moreover, according to the Islamic perspective, Islam emphasizes the well-being and health of its people. Therefore in the aspect of health, Muslims are required to take care of their body that given by Allah s.w.t. and always need to be in a good health. In this context, bear in mind that drug is in the form of self-harm and when the term intoxicant is used, it also encompasses narcotics, because they too, among other things, result in the loss of self-control. It can be proved that Islam prohibits the use of all types of intoxicants, whether it is in the form of a drink, pills, drops, inhaled substances, needles and so on and the evidences for the prohibition are as follows:
“O you who have believed, indeed, intoxicants, gambling, sacrificing on stone alters to other than Allah , and divining arrows are but defilement from the work of Satan, so avoid it that you may be successful”.
Surah Al-Maidah (5:190)
Allah SWT has described that the use of intoxicants, amongst other things, as being bad, awful, despicable and hateful behaviours of Satan, and He has commanded us to abstain from them. Muslims take from this verse of the Qur’an to mean that Allah SWT has forbidden any intoxicant that can confuse and cloud the mind by removing one’s normal faculty of reason and discernment that leave people with little or no control over their actions. It is Allah who has given this command, and like the rest of the commands, it is for the benefit of human beings. Drug-users can be a danger to themselves and others and therefore Islam has forbids any kind of self-harm and harm to others such as drug abuse.
Then, Allah says in the Quran in Surah Al-Araaf:
“Those who follow the Messenger, the unlettered prophet, whom they find written in what they have of the Torah and the Gospel, who enjoins upon them what is right and forbids them what is wrong and makes lawful for them the good things and prohibits for them the evil and relieves them of their burden and the shackles which were upon them. So they who have believed in him, honored him, supported him and followed the light which was sent down with him – it is those who will be the successful”.
Surah Al-Araaf (7:157)
According to this verse, this conditions require us to follow the Prophet Muhammad SAW, since refusal to follow him after his advent is disobedience to Allah SWT. The Prophet Muhammad S.A.W ask us to do good things and avoid things which are not good for us. So what our Prophet gives, we need to take and follow but things which are unlawful and bad require us to abstain from it. In terms of this, that is why the drug abuse is prohibited.
1.3 Problem Statement
Nowadays, we can see that drug problem is a serious issue and often occur in chains which are starting from the smuggling and distribution, leading to abuse and then to drug addiction. Usually the cause of drug abuse is still remains the same and has never changed, but what can we observed is the solution to this drug issue is still can be said as less effective. The problem of this drug is not only faced by Malaysia but has become a global problem although drug treatment and rehabilitation program have been in place since 1975 to help recovering addicts to free from drugs (Fauziah, Bahaman, Mansor ; Mohamad Shatar, 2012).
Also according to the study of Adam Mohamed (2006), his study notes that relapse rates is increasing in every year. Although the government has spent a huge amount of allocation and introduce a lots of activities to reduce the amount of addictions, this effort has not yet been successful. It shows that existing programs need to be reviewed. He also stated that efforts to rehabilitate drug addicts are not just treatment and rehabilitation but it also should be followed by guidance programs after leaving which is aftercare.
Then, there is no specific Islamic therapy modules have been developed for aftercare program in community-based program toward the drug addicts rather than in the institution. This is because before this, there are rehabilitation program who run in community such as 12 steps in recovery but the origins of 12 steps of recovery is actually a western spiritual based and it was used in Malaysia (Katherine S. Michael MA and MDiv ,2008).
Apart from that, there is the new approach that have been introduced for the community rehabilitation treatment in Malaysia which is the 7 steps of recovery in addiction which use Islamic approach in recovery. In this context, the differential between the 12 steps program and 7 step approach is in 12 step approach believe that strong ideology is can be based on the idea that only through spiritual belief and conversion, personal change can be achieved, believe in superior power and so on (Atkins, R. G., ; Hawdon, J. E , 2007) whereas the 7-step recovery program have use Islamic approach which is based on the psycho-spiritual of application and also will serve as a catalyst for recovery.
Hence, it is important to fight against drugs as the main enemy of the country with the suitable approaches that suit the issue. Even this modules (7 steps of recovery) have been validate by the expert but it do not get feedback from the facilitators who run this module, so this study will be conducted to know the significant feedback especially from the drug addict themselves who undergo the 7 steps of recovery in addiction program.
This study is a form of qualitative study which is going to be conducted through interview method towards 3 siblings who were involved in 7 steps of recovery in addiction modules. This research is going to be conducted at AADK Hulu Langat, Selangor Darul Ehsan. However, the findings of this study is to look into the depth on the experience of the 7-Step of recovery, their interpretation and the ways of client manage their challenges in their recovery as a family.
1.7 Significant of the study
Throughout the study, the researcher could know about the client’s experiences and their understanding especially in terms of their interpretation and the researcher also know the ways of client manage their challenges in their recovery as a family. Moreover, it will give some additional information to the researcher, society and also government about how the effectiveness of the 7 steps of recovery’s implementation.
1.8 Limitation of Study
The limitation of this study is the qualitative study which more focused on the least number of participants. The number of participants that researcher will interview is less than the number of participants if do the quantitative method of study. Besides, the researcher may experience intrusive than the quantitative methodologies in which the respondents may say more than they planned to say. Besides, qualitative study may be more open in terms of the mind-sets and the interpersonal elements between the interviewer and the interviewee than method such as surveys. Moreover, this type of study required a lots of procedures and rules to be followed with AADK especially in terms of when the interview process is going to be conducted with the clients who were involving in 7 steps of recovery in addiction modules.
Summary of Chapter 1
This chapter provides an overview of the areas of research and the importance of this study. The general objectives of the study and three specific objectives have been established to ensure that this study ran smoothly. Research questions and limitations were also included.