 So the way that we want to really navigate today is we're going to invite Dr. Hassan and Dr. Rahimullah to address some of these questions that we had. We had prepared these questions based on a lot of what we saw from our communities, responses on social media about addiction. And it seems to be a very hot topic, of course, and I'm sure Dr. Ahmed and Dr. Ahmed will walk us through that. But I'm really going to pose it as more of a Q&A. So I'm going to post questions to both our speakers, and we'll hear a little bit from both of them in terms of their individual work within addiction. And then, inshallah, we will take questions from the Q&A box. So if you do drop any questions, and if you do drop questions in the Q&A box, I will try to pair them in and kind of consolidate them, or I will tag them onto one of these six questions that we have on our screen. Again, we'll answer questions periodically throughout, but we won't really get to individual questions or the utilization of the microphone until after we've gone through these six major questions with our speakers, inshallah. So with that, I want to go ahead and introduce our speakers. So Dr. Ahmed Hassan, who's a clinical scientist and addiction psychiatrist at Canada Center for Addiction and Mental Health. Thank you, Dr. Hassan, for joining us today. And Dr. Ahmed Rahimallah, who's a clinical associate professor in the Department of Psychiatry and Behavioral Sciences at Stanford University, is the executive director of Medina House, a nonprofit organization focused on Muslims with substance abuse disorders. So with that, inshallah, we will invite both our speakers and we will go ahead and get started with our first question. So we would love to hear from both of you. And Dr. Ahmed, if you want to start us off, what is substance abuse when we talk about it in the context of our community and just overall from a medical perspective? So what is substance abuse? That's the question, right? So substance abuse is basically it's a behavior that can lead to, let's call it an addiction or any medical term substance use disorder, which I think we're all here because we're concerned about this potential outcome, which can be defined as a really it's a condition that lead to several diseases. I would say a lot of dysfunctional, biologically, psychologically, and even socially. It might not start at this disease. A lot of people there, there's different models of addiction, even if in the scientific community. And there's a lot of debate and agreement. It's a learning model, it's a disease model, it's a tomorrow model. But eventually, I see them as all incoming at once. It does start with a behavior. And all of us do have sometimes do bad choices. But then with certain circumstances, certain environments, along with many of the other factor, it can progress repeatedly until the condition developed, which what we call substance use disorder. And that by itself, then we left the initiation phase and going and maintaining phase that can lead to several, I think there's you want me to talk separately about the psychological or the consequences, leave that a layer. So in a nutshell, this is as we define it's a condition and it's a chronic condition that relapses. It has period where improvement, but also a period of decline. That's the best I can describe it. Yeah. Thank you so much, Dr. Hassan. Dr. Ahmed, is there anything that you wanted to add? No, that's great. I'm so sorry. I think I confused Dr. Ahmed with Dr. Hassan and I took your question, Dr. Ahmed. I'm so sorry. No, no, no, that was an excellent answer. I have nothing to add. All right. So our second question is really if each of you can talk about the prevalence that you've seen in your work and your research about the prevalence of substance use and abuse in our Muslim community and why in your professional and expert opinion are Muslims turning towards substances and it seems to be happening more and more? So Dr. Ahmed, did you want to start us off? Sure. Yeah, absolutely. I mean, Muslims turning to substance use problems is really just based on when we look at protective factors and risk factors for drug use and addiction. It's no different than the Muslim community. So a lot of data shows that faith participation, religious participation, high scores on spirituality are all protective of drug use and of addiction and are helpful from recovering from these problems as well. But when we talk about Islam, Muslims, it's a really low threshold to come into Islam. The only thing that takes you out of Islam is denying what brought you into Islam. And so when you have people in Islam, there's different levels of practice. So people will have different levels of engagement with Islam. And so in turn, they'll have different levels of utilizing that as a protective factor. But put that aside, one of the most important risk factors for drug and alcohol problems in our day and age is just access. So the access to substances is just unlike anything that we've had before. If you look at nicotine or smoking, hundreds of years ago, when you had a hand-roll cigarettes, you can only roll a certain amount. Smoking wasn't an issue as much of a wide-scale global issue as it is now. I mean, now it's the number one preventable cause of death in the US. And so after then you see that these rolling machines come into play, you're able to produce thousands and thousands of cigarettes a minute smoking access increases. Probably a better example is the opioid epidemic. So you have an opioid problem, but then now you have increased access to opioids. And as opioids access increases, now you have increasing uses of opioids. You can literally see as prescription opioid prescribing increases treatment, engagement in rehabs for opioid use disorder increases and opioid overdose death increases. It's all aligned. And so there's like geographical access and then there's psychological access. So now what's interesting is that you have drugs that many people would just not try like heroin or crystal meth. And but maybe they tried an opioid. So they may not try heroin, but they tried something like an opioid, which is you know, medically similar. It's just a pill form of opioid that's prescribed, but they won't try heroin, but it's less stigma around trying opioids or they won't try meth, but there's less stigma around trying stimulants. And so there's less of a barrier to entry into substance use problems because you have a lot of people that will have these medications prescribed to them, have it be sort of blessed by a physician, but you can still lose control over these types of substances. And then marijuana, of course, you know, you'll have people that will not use marijuana recreationally anymore. There's a whole slew of reasons why people use marijuana and the advertising isn't helpfully helping. Like in California, you drive down the highway, you see all these Chicago, you drive down the highway, you see all these advertisements of what marijuana helps for. So you have this decreasing in these barriers to substances. You can get them instantly over your phone, increased access. And we know with increased access, there's increased use in drug and alcohol problems. And then also stress. So stress, different forms of stress. So we have adverse childhood experiences. Many studies show that this is associated with higher likelihood of substance use problems later in life. So adverse childhood experiences like physical abuse, child abuse, emotional abuse, parental conflict and other things. So when we say Muslims are at different levels of practice, it's important to recognize this is a half glass full situation. We don't look at that as an opportunity to criticize Muslims or judge Muslims. It's really an excellent opportunity that people have this sort of DNA to develop to help them treat the problem. So when you see Muslims turning to addiction, just in short, the short answer Muslims turning to addiction, it's really just I see a person with all of these protective factors and risk factors just coming together in the human being to make them more susceptible to drug and alcohol problems. So a clear example is let's say a Muslim growing up in a society that's plagued with drug and alcohol problems, increased access and or a community with increased access, and they go through a stressful event, maybe a divorce. Now that child, that teenager, he's going to be at a level of practice. A seven year old is going to have a different understanding of Islam, a different practice of Islam than a 12 year old than an 18 year old than a 25 year old. It's impossible to learn it all at once. So you have different levels of practice just simply do the way that life occurs. And then you have stressors that can occur. And in the in the, you know, you can have this perfect storm of access stress and existing to develop problems. Yeah, Michelle, thank you so much, Dr. Ahmed for the very, you know, realistic, I think, reality that a lot of folks, you know, live, whether it's underprivileged communities under resourced communities and just how the increase of access can really impact our Muslim brothers and sisters. Thank you. Dr. Hassan, was there anything that you wanted to add? No, I think I think Dr. Ahmed described it a very excellent way. It is so the risk factor can really be summarized as a biological factor, psychological factor and social factor. They really interact together. And yes, like stress interact, for example, with the availability, which is I think it's a huge problem growing on right now, not just the availability, but also the variety of things that you come in, like the cannabis all the time is used, like exactly what Dr. Ahmed described, you have to roll a joint. Now it comes in a variety of choices, edible, vaping, smoking, and it's very tempting because you see how it advertising the colors and what it does and the dispensary everywhere, open dates, all of that play into a factor we cannot ignore. It does play a major factor. If you're asking specifically about prevalence, like numbers of how much of this is a problem, we do have lake of data that support this to really represent. And it's really, I think it will make a difference if you're looking to Muslim into a Muslim countries or Muslims in Western countries. It's a lot of variability play. Stigme is a big thing that's coming in the way from us to get a number, but I can give you, I can give the whole audience a little bit of early releases result of our research that we're doing and we're preparing it for publication. It's coming from a United States national data from the 2013. So it's a little bit outdated. It's almost coming to 10 years. So we looked into the Muslim population, which is not a lot. It's about 372 people, but we matched it with non-Muslim people on the same risk factor. That's exactly what I would describe it. Not all of them, but a lot of majority. Maybe family history of addiction, stress, psychiatric disorder. And then we looked into the prevalence. Is it the same? So the alcohol was lower for sure. So in general, what we got a sense is about 11% for problem with alcohol. We're talking about alcohol use disorder. So the biggest problem was substance. So even though the people are Muslim or non-Muslims have the same risk factor, the Muslim have lower risk of developing alcohol, which was what we expecting exactly like Dr. Amher said, that we have tons of data to support that spirituality or religiosity actually plays a protective factor. But other substance use was actually the same prevalence as the population. And some people might just say, okay, that's okay, that's expected. Actually, that was not expected. That means that it might be showing a sign of a growing problem. If I think, me personally, I think that the filter of the made alcohol had a lower prevalence is not persistent. Maybe the way of how people perceive it or rationalize it in their head, and maybe they're debating is kind of as halal or as haram, maybe if the other substance is abused or can be used, does it really veil the brain or does not? So all of that might be playing a factor of what we see. The substance that I think have been historically at high rate and still exist, can you expect which substance would that be? How can you guess it? The background. We have a big problem in the Muslim countries and even in the western. So it's about 18% of Muslims and it's higher than the general population. And it's probably, if we got it to look at it from a spiritual lens, it's probably again is how Muslim perceive it. I mean, there's still maybe it's not doing the same harm or not the same harm. So it's coming into a different factor. So the bottom line, there is a growing problem and you need further investigation. But we can see definitely a variety of prevalence across Muslim and across a variety of substance use as well. Sorry, I took one wrong. No, not at all, Dr. Hassan. Thank you. And you kind of alluded to the next question, which is if you can kind of support us as an audience and understanding the biological, behavioral and environmental and social consequences that individuals who might struggle with a substance use disorder face. If you don't mind telling us a little bit about that. Yeah, sure. So you're definitely some reason others biological factors, psychological, social, even spiritual consequences. And usually these consequences of factor is what we diagnose, how we diagnose a patient in clinic wise. It's not really about how long is the patient, how long, let me say, how long is the individual using it or how much they use it. It's really about how much it affected the individual. So biological part has to do something with actually the development. And for example, the addiction is really about learning. It's a learning association between response cues, positive and negative reinforcement, exactly like Dr. Amaro said, it might be a stress, I take the substance, it goes away, that's like a reinforcement, a negative reinforcement. Or I took the substance, it made me high, it made me feel better. I'm going to use it. So that craving, the longer we use it, that's a biological actually a problem. Because when we crave it, we taught our brain to think this way at the same times of a trigger. And stress is means equal substance. So that's a biological consequences. Another one is what we call tolerance. So most substances really hijack their brain reward system. And it might change some physiological changes. That means it changed chemical on the cellular level. Meaning after a while of using the substance or even maybe a short while, I'm going to start. Yeah, yeah, you're still here. I think we just created this. Oh, we just open it up. That's good. So after the substance will stop working. It won't do the same effect as it used to do before. And as you can guess, the person will have to increase the substance over and over. And then the problem is, when the substances get stopped suddenly, it can lead to withdrawal symptoms. And that's because like the body's always tried to develop something called homeocesis. And what that means is the body's always balanced. If you give it a substance like alcohol, for example, if it's sedative, it will stop producing the natural sedative. But then you stop it all together. Let's say the person decided to quit. That sedative won't be secreted. It will eventually be secreted but after a while. But that period could be sometimes painful and sometimes actually fatal. So you devolve the withdrawal symptoms and that will lead some people to use more. So you probably heard of people talking about hangover, for example. So the hangover they get after drinking in the morning. So that's a type of a withdrawal symptom, a headache to get a headache. So some people will just take Advil or Tectaninol and sleep it over and get over the withdrawal symptoms. But some people might need to take alcohol that time just to get over. So that's a lot, like basically a physical dependence on the body. So that's one of the biological consequences that substances need. And of course, the health consequences is a big one. And it depends on what substance that we're using. Is it alcohol and affecting the liver? Amiculosis? Amiculose, cancerous, pancreatitis? We all know the dangers of debacle and the health and cancer almost every part of the body. Cannabis itself, there's very good data of how it affects the lung causing bronchitis. And it can cause infertility. New name, it's stimulant can affect the heart, can affect the brain, causing stroke or a heart attack. And opioid is epidemic, it's causing a lot of death nowadays in North America specifically. And then there's also the psychological and social effect. And it is also part of what we know how we know it's a problem. So it's very, very common. I see how the substances can affect the relationship in the family between the individual and his or her parents, partners, children, relative friends. It might go to social factor and affect work or studying. It really has interfered with people's career a lot. And it also depends on the substance because if it actually interfered with the judgment, it might make the individual do things that he would not or she would not do when in a normal state of mind, such as abuse, for example, abuse for their family or something else. Problem of love, problem of driving, which can have a very long consequences as you can imagine. And the most important factor I want to mention before I ended, sorry, I'm taking long to explain it is just too much to say, is part of the biological slash psychological slash social as well, which is the psychiatric symptoms that we get after using substance. It is well known that a lot of people are self-medicating. I'm not going to ignore that part of my research is I have seen how people like self-medicate if they already and self-medicate what I mean is if I have a problem untreated and anxiety, and I tried cannabis, for example, and I read that I took an anxiety. It's understandable that you will continue. I understand that completely. But after a while, because of what I just described biologically, the changes in your body, it actually contribute to the anxiety. And the anxiety you feel when you stop is not really the anxiety because the existing anxiety comes, it's actually more of a withdrawal anxiety comes in. So it really complicates things more further. I feel this is just an important point that I wanted to bring in awareness because yes, we understand it is a response, but it eventually become a disease and complicate things. And instead of one problem, we have two problems, right? That's what I have to say for that. That's fantastic. Thank you so much, Dr. Hassan. Dr. Ahmed, is there anything you wanted to add? No, those are all great points. And that last point is so important, making the distinction between substance-induced mental health problems and then mental health problems that are not substance-induced. And then, of course, people with underlying mental health problems are going to have an exacerbation of that once you add substance-induced substances to the mix. So that's such an important issue and concept, and it's something that comes up often. So just to kind of play off of that last part as well is, do you find a difference in the substance use or the substance of choice for individuals when it's induced by a different mental health disorder? Or is it kind of just viewed more coping and stuff like that? If you don't mind just commenting on that. Dr. Ahmed, I have you on my screen. Please go ahead. Yeah, I mean, I think a lot of the choice to use drugs and alcohol is just based on availability, access, and then also the people that you're around. So if you have a family member that uses drugs or alcohol, you may be more likely to use that drug or alcohol or vice versa. If you have a parent that was an alcoholic or had alcohol use disorder, you may be averse to that, but then also be prone to using another substance problem. But in terms of just mental health problems, meth and stimulants commonly induces psychosis, and then cannabis is also a culprit. But the best way to address mental health issues when substances are involved is to just manage both of them simultaneously. So if you manage one without managing the other one, you just don't get traction. And a lot of times what we'll get is calls from family members who are conceptualizing it just as a mental health problem and the substance use is peripheral thing or vice versa. Substance use is the problem and the mental health is this peripheral thing like the anxiety, the bipolar disorder, the psychosis is a peripheral thing. It's only a problem when it's a crisis. And that the issue is, and the important thing is taking this dual diagnosis model where we're managing both things simultaneously. And to that extent, patients substance use problems along with their medical problems as well. So you have a lot of people with chronic pain who have an opioid use disorder. Both of those things can simultaneously exist. It's not one or the other. I have chronic pain. I don't have an opioid addiction. I have an opioid use disorder. I don't have chronic pain. So once you have both of those, there's treatments that exist that should address both of those. It's so important to just address comprehensively all of the factors that are involved with a substance use problem. Family factors, trauma, mental health conditions, drug and alcohol, medical factors, withdrawal, so on and so forth, and dressing them all at once in order for us to get traction on the problem. Yeah, I mean, it sounds, you know, I think sometimes it's difficult to remember that there's so many complex parts and intersecting really parts around a substance use, you know, or a disorder that an individual could be struggling with. So thank you for touching on that. So we kind of wanted to also understand right now what is being used in the field. So you both kind of work with addiction. What are our evidence-based practices and treatments that you find are working with our Muslim brothers and sisters in addiction overall? Dr. Hessen, do you want to join us? Sure, okay. I thought maybe I'll give Dr. Amir a chance since I stole his first one. There is a variety of treatment, just like how every individual has a different risk factor, we have a variety of treatment. We usually, like when a person presents to, for health, we tailor the treatment according to their need and where this stage are. It's just like taming a suit on the suitor person, because if a person presented, for example, if a person presented an emergency overdose, that's a very completely management as a person that comes to the clinic that's have a hard time stopping a substance. So it's like, it really depends on what stage are there, what they need, how motivated. Even for unmotivated people, we can do a harm reduction, we can do, try to have a conversation that might enhance their motivation by increasing their awareness of the problem or what they really want to achieve. So yeah, it's a variety of things, but in a nutshell, there's medication. There's some medication that works for certain substances, such as like we have a great medication for alcohol, essential medication for opioid that's actually saved lives. Some other medication for a variety of other substances of a problem, we can use it as a, as we call anti-graving, that's basically, like I mentioned earlier, when the brain is craving something that's usually suitable for a person who already quit, but struggle to maintain that abstinence. So that can work or sometimes we can provide a medication that can help with withdrawal symptoms that are also mentioned earlier. There is therapy, whether groups or individual, and there's detox center, there's a long-term rehab center, and we're seeing like, fortunately, we're seeing more method of delivery. There's virtual, there's individual. So it really would depend on where's the person, how motivated there is. Again, another example is if a person is struggling with stop in the substance, because every time they stop, like there's a bad withdrawal symptoms, we see this all the time with alcohol, so we will have to send to a detox center first. We detox from the alcohol, and then the second stage of treatment of management, what was the risk for this person? Okay, let's try to overcome risk. If there is a psychiatric illness exactly like Dr. Amerset, we will have to treat this simultaneously. So it's a variety of ways. So it starts with an assessment, but then it branches out depending on the need, and it's because of the chronic nature, it will require some follow-up and some management as well. Sure. Thank you so much, Dr. Hassan. Dr. Ahmed, is there anything you wanted to add? Yeah, no, I think that's excellent. I mean, really, that's so important to highlight for everybody listening that it really starts with the level of motivation that that person's adds. If you have a family member struggling with the drug and alcohol problem, the way that we approach it is that first we assess, is this person even thinking about changing? If are they locked into place and not even thinking about it? You can think about it like an egg shell. The chicken isn't even cracking out of the egg shell looking out, and then the next stage would be like, are they contemplating it? Okay, maybe they're thinking about changing. So they break a little bit of the egg and they peek out, but there are two minds about it. They want to use, but there's also problems that are associated with use, family problems, so on and so forth. So they're too minded about it, and then there's a stage where they're ready to take action, and then based on all these three stages, we tailor that treatment and family members should recognize that that's also important to tailor their treatment. So if there's somebody that's just not ready to get in treatment, then the family member needs to adjust their strategy in order to live with that, to deal with that, and then the goal is to then move them to another stage of motivation and change, and certainly how we address it, and it's wise to address it that way for family members as well. Thank you, Dr. Amen. There's a comment in the chat, which I think this is a great opportunity to address, and it's taking medication for something like this Hadam. Are we permitted to utilize these medications for recovery? Yeah, I mean, I can talk from a perspective, like a medical perspective, and I think it's important to consult people of knowledge. Certainly before I venture into this field, that's something that I did, and I think that's an important process. All right, so when we talk about medications for cravings like alcohol, that's just a medication. It doesn't affect the mind. It's not causing intoxication. So you have the medications for alcohol that are just reducing your cravings. They've just been shown to reduce cravings. For example, naltrexone or a camperset, or there's another medication called Antibuse. Antibuse works by preventing alcohol use. So you take the medication, and if you drink on it, you become ill on it. So it's almost like a deterrent. You know you can't drink, so you don't. You just have to make a decision not to drink once that day by taking that medication, because now you can't for the rest of the day. But there's the two better medications naltrexone and a camperset or associated reductions in cravings. They don't affect the intellect. You don't feel a sense of euphoria from it. Then there's other medications, and this is important like for opioid use disorder, opioid addiction, like buprenorphine and methadone. I think the important thing to recognize that when we're talking about these medications, it's important to talk to a medical professional. So an addiction psychiatrist and addiction medicine, addiction professional, medical professional, and also somebody of knowledge. So the Sharia is very deep, and so you want to get an expert opinion from somebody who can really understand the objectives of the Sharia, the foundations of the Sharia, so on and so forth. You don't want to ask your uncle who reads a lot or something like that. You want to, because it's such a high state, when you talk about opioids, we're talking about we're in the midst of an opioid epidemic, and the decision you make can be the decision between life and death. So for example, buprenorphine, there's a very important study by some Johns Hopkins researchers that came out a few years ago that showed in a large population that medications like buprenorphine reduce overdose death risk by 80% versus not taking medications. So when you think about this problem, it's not a problem about just making it comfortable. It's not about making life comfortable. It's about reducing your risk of death. It's not about preserving the intellect. It's about preserving life. And so when we think about how we need to discuss this problem, certainly from the medical field, we are incredibly, it's incredibly important to use this essential medication for people with an opioid disorder to stabilize them, treat the withdrawal, treat the cravings, reduce their chance of overdose death risk, and then eventually move on with their life, and then taper off of it, get that opportunity to stay on their medication, develop some coping skills, stabilize, and then the driving point, the bottom line is there's so much evidence showing that these medications are important in preserving life across continents, across decades. That's just something that we can't ignore. Thank you so much, Dr. Ahmed. I think that was a very important part here. And I have one more for you, Dr. Ahmed. And I know you've touched on this in some of your previous talks on this topic as well. But can you can you talk to us about CBD oil and CBD pills and any perspective that you have on the, not just like how permissible it might be, but also just giving us an understanding of why might people resort to CBD oil or pills, or even I think there are CBD gummies as well, so or diversifying upon a lot. Yeah. So a lot of the indications that CBD is marketed towards, there's no evidence for it. So it's not, it's not medically valid for a lot of conditions that it's being marketed for. Now CBD is not psychoactive. So, you know, it's not, it doesn't affect the intellect. And it has some properties that are helpful on a physiological level. So that's something to keep in mind. But the other thing you want to keep in mind is that for a lot of the conditions that CBD is encouraged for or marketed towards, there's first line medications, there's second line medications, there's third line medications, THC, and there's other molecules within cannabis that are, that do affect the intellect, that do cause euphoria, those, that's something separate. So, but CBD, what you should keep in mind also is that a lot of these preparations are FDA approved. And when researchers actually test samples of CBD only treatments, some studies show that up to 20% have THC in it. And I can tell you from our clinical experience, we have people in our clinic that we work with, that I work with that are really stable. We have no reason to believe that they're using THC. They tell us that they're using CBD. These are people that we've come to know over a long period of time. They say they're using CBD and THC shows up when they're here in drug screen. So it's really more so about, are you really getting CBD? And also, is it really helping? So those are some questions that you want to ask yourself. Thank you so much, Dr. Ahmed. That was a benefit. That was incredible. Okay. So I think we're, we want to ask, so what treatments, are there any treatments that exist that are specifically tailored to the Muslim community? Or are we kind of working with taking already existing models of treatment and incorporating faith into that? What, what do you find? So Dr. Hassan, what do you find yourself turning to in your practice? So, yeah, this is an area, again, that needs to be hopefully invested in by scientists and the donation so one can able to to tailor it for the need of the Muslim. In the beginning, like, obviously, so, so I'm doing up a practice of like addiction and ambulatory clinic, but not not a big proportion at all are Muslims. And so there's many reasons for that could be, but I believe what stigma is one of them. So we that I want to start with this beginning, because I feel that there's a lot of people on need Muslims on need, but they're not coming in for for many stigmatized reason. That could be social or culture or systematic as well. So we started to try to fight that stigma a little bit stuff like what the webinars like what we're doing right now, this is great. This is excellent. So we try to do as much because when we get more people, then we will hear more voices, more voices that we're able to more tailor like without this, it's really assuming that this will work and might one size fit all, but we know that like everybody needs specific things. So yes, it is, we definitely need more. But we have the, for example, you heard Dr. Amir saying that we need to treat the coexist in psychiatric illness with this. So if there is a depression, we do have an Islamically incorporated psychotherapy, which is one of the famous ones is cognitive behavior therapy. So that can be can be done or incorporated. I do know about there is so the alcohol anonymous, which is a famous 12 step therapy for treating alcohol, there has been focus with an Islamic length into it. It's not that common, at least not in Canada, but it is certainly growing. There is some area like this when it when it comes to therapy or it comes to having anything with the psychology in the beginning, but I feel that we should start by the stigma first to get people on the awareness, the knowledge, the enhanced, come into treatment. And then after that, we can tailor some of the treatment to it. One of my colleagues, for example, today in Canada here, so she's doing an excellent group about mindfulness only for women in an Islamic base way. Mindfulness can be great use. I know she uses only for anxiety so far, but mindfulness can be a great tool that will benefit people with addiction. It will regulate a lot of the emotions and standard. Me myself, I do an inner research study, a therapy, we call it mantram therapy. So we got it from California actually. And then we started to tailor it for people with PTSD and with addiction. But if you get to look into it, like what actually excites me about this, like you hear everybody almost heard about mantra and what I looked deeply into it. This is what we know in the Islam is vikr. This is what we've been doing historically for many years. It is just that people have brought it and brought it into a scientific way. And now I'm trying to test it for addiction and mental illness. I'm having great success with it. And people might understand me just, oh, they got to do this all the time, just a few things after prayer in the morning. I know it has a great, if you look to more deeper than it actually helps with the concentration and with the focus, if we do it in the right way, you have to really be using all the minds from the skills of bringing your attention back to the vikr every single time. And if we do it over eight weeks to teach people and do it a certain way. And we have a portion just specifically for Muslims or for non-Muslims to choose from well-known vikr that can be chosen. So there is a lot of options that we actually can be tailored for this. So I hope that that's a question. It did. Thank you so much, Dr. Hassan. And I'm actually hoping in the study that you did with the psychoeducational programming at the Massajid, you guys saw pretty high numbers in reduction of stigma among community users. Can you tell us a little bit about your study and why that finding was so important? And I understand it was just a 90-minute seminar. So I would love to hear a little more about that. I think, thank you very much. Yes, again, coming back to the point of how stigma can really affect the whole community. And it's almost infectious. It can be transmitted from one person to another. And the problem is it can be fatal sometimes because you can see the more the person doing the substance and not seeking help, the more the use to the substance, the chemical, the dependence on it, which can lead to fatal sometimes, if things progress very severely. So we know there is an issue because there is many various. So we decided that we do a psychoeducational program. That is tailored for Muslim. So we are appropriated all the Islamic teaching showing how really the current science does not contradict what we know about Islam. They actually are very much matching. Something like exactly what doctor we heard in the video that I wanted, Allah Azza wa Jalla, let no disease but that there is a treatment for it. So that's an important statement, how there is one companion at that time, I've seen that to the Prophet Sallallahu alayhi wa sallam and he asked, how can I use this alcohol as a medicine? But no, it's not a medicine. It's a disease. He called it a disease. So all of this, many with many others, the gradual prohibition of this. So all of the, there is many, many stories in Islam that we can look into it and we incorporated it into the psychoeducation with the aim of reducing stigma by enhancing the knowledge for the public about what is addiction and the consequences and the treatment, improving the attitude toward people with addiction. This is an important because I've heard many, many times and I'm sure others have heard that, oh, this person, he drink wine. This is a weak, weak, weak religion. And they've been linked into this, not considering any other factors. And the third factor that we try to help people is to help enhance professional help seeking. So these are, we're able to manage that. So we went to mosque, we, we, we tried different times in Jomana after Jomana in different days. And Alhamdulillah, there was a great response and how even people immediately say, oh, okay, because we tested them before and after and we see how, how, how things will be different. For example, if an individual show up drunk in the mosque, how we see, how we see that. And they started, they started to look at it in a different way, which can be very helpful for the personal affected. So that's what we did. And we're trying to right now to upscale this, we kind of pause with the COVID pandemic, but we're trying to upscale it a bit to bring it again on a national level. Thank you for bringing this up. No, of course, I actually had just one more question about that is how important did you find was the integration of Islam? So, you know, where when people come to seek, whether it's education around addiction or whether it's, you know, just treatment, how important was it that you and your team of researchers were Muslim and that the, the concepts that you were integrating into, into kind of like the medical model of addiction and understanding was also grounded in Islamic fundamentals. So I'll tell you, I remember one quote from one participant. So he or she, I can't remember or I don't know, said, I understand how addiction can affect someone, but with Islamic integration, I understand more and it's more clear now. So it's, so this is, and it's been 100% like from people, they preferred integration Islamic material into it, rather than just presented from a secular or scientific piece. So it was, it was, yes, and eventually that's for every practice in Muslim, that's usually what we want to hear or what we want to do. Myself, if I got sick, I usually go to it, usually go to the doctor or prescribe something for myself and take it, but I would also like to read Quran. I'll pray, I'll make a du'a for myself. I like to supplement things that are happening and ask Allah as for a cause, which is going to be the medicine or something else that helped me reach Shifat. So, so we all as Muslim like want this integration because our Dean is usually not separate from our life. It's, it's our life. It's, it's so it, it makes things better for, for understanding and enhancing as well, looking things differently and enhancing coming from people. JazakAllah and for those interested in reading Dr. Hassan's study him and his colleagues, we put the the link in the chat. So if you do have academic access, if you don't, please send us an email info at mayorsand.org and we'll try to support you, inshallah, and getting that paper. Dr. Ahmad, I, we want to give you an opportunity. So you're the executive director of the Medina House. If you can tell us a little bit about Medina House and the work that you do there and the impact that you have found so far in that work in the community. Yeah, absolutely. So, so Medina House nonprofit organization, where we're focused on two main initiatives. One is recovery housing, so sober living homes. They're open to the public, but we have a Muslim track for Muslims who are struggling with substance use disorder. So the Muslims that join our homes, we have one home in the Bay Area in Richmond, California and one home in Chicagoland in Waukegan, Illinois. They're both close to the Masjid and the Muslims that live in those homes utilize the local Masjid for different classes like zero classes and in other classes that occur in that Masjid. And we also have gatherings that are based on what is spirituality, what is it, slum, how is that integrated into addiction recovery. The second initiative we have is just kind of focusing on this, like how do we address stigma? How do we provide education to the community? So we've done several community workshops that's on our website. You can check us out MedinaHouse.org. Thanks for posting that. Yeah, so you can check it out on the there's a in the chat. It's just been posted essentially what you can see is the workshops that we've done in the past. But importantly, one of the initiatives that we've started is family classes. So basically, you know, one of the most frequent calls we get from the Muslim community is like family members asking what do I do about my loved one. And so my loved one has an addiction. They're using marijuana. They have a drug problem. How do I help them? They don't want help. Like for example, in my day job at Stanford at the hospital, where we have a casement where we see the whole community, you know, we'll talk with people and it's usually the individual themselves coming to us for help. And when we are working with the broader community to this nonprofit organization, it's usually the individual themselves coming for help. But when with our community outreach in the Muslim community at Medina House, the calls in the Muslim community are all from family members. And so we talk to their family, we talk to the individual with addiction. Individual with addiction is like not motivated at all to treatment. And so like we mentioned before, our interventions in this is all tailored to the stages of change that that person's in. So if you have a family member who has an addiction and is not motivated to treatment, then your next play as a family member is to focus on what you can change. And, you know, what we see is when family members go from what should I control to what can I control, they start to gain traction. So as opposed to what should I control, should I control talking to them like this, or, you know, they're doing this with their schooling or their work or should I give them this ultimatum so on and so forth. When they move from that to what can I control and they realize that really it's themselves that they can control. That's when we see people get traction. So what we do at this family class, we have this family class, it's virtual, it's open to anybody. It's on Thursdays, it's open to Muslims, it's specifically for Muslims struggling with a family member that has addiction. We use a specific intervention called CRAFT. We use this intervention because it's we just looked at the interventions out there, we looked at the literature, we looked at what has the best numbers behind it and CRAFT had the best numbers behind it. So what we essentially do is we break the class up into three parts. One is a foundational concept in Islam that leads into what we're about to talk about. Then the second concept is we go into like an evidence-based intervention, like what is enabling, how does that boundary so on and so forth. Then we open the rest of the class up to questions and answers. So one of the issues we face is we have people that are motivated, they're at a point where it's like they're like, I don't care about saving my face, I just want to save the situation. Then they come, they take the leap and they show up to the virtual classes. But then we have other people that are at a place where they're just not ready for that and that's completely fine. We've all been there. And so what we're offering for those people is we just livestream our classes, they just come to our website, they listen to the first portion of the class, see what we're about. When the time comes, if they want to enter to the class, they can absolutely come to the class. So they can find details of that in the recovery homes on our website. And that's sort of some of the efforts we're trying to do. Thank you so much, Dr. Ahmed. And I do want to ask if you don't mind giving us perhaps a few practical areas for, there's a lot of questions around, my loved one doesn't want to seek help or there's a lot of shame in seeking help too. Somebody started an addiction a decade ago and now has seen their life just pass by and it's too late for me and my time is gone. And how do we, any advice for family members when you're saying, when you can control, you can really only control yourself. What are some steps that family members can take? And if you have any kind of words of advice for folks who feel like their time for recovery is past? Yeah. So I would say that it's never too late. It's never too late. We see people that we think are really early on in their addiction and that it's very treatable and they don't make it. And we see people that are really towards like the end of their progression on the spectrum of substance use disorder and they make it simply because they have more motivation. And so, and then the vice versa is true. I think the most important thing is to focus on what you can control and family members that focus on the topics that have been shown to help motivate their loved one do well. So the main question that people have is how do I get my loved one sober? And that's the question that we try to address in this class. And then there's classes that exist that address this like smart recovery has a family class and then they have an online program. You have Alanon that has family classes and they have that MCC, a mustard in the Bay Area in the East Bay, actually has these classes in the mustard. They're housed in the mustard. So really amazing, innovative work. But the number one thing people can do is start educating themselves and how did they disable the addiction as opposed to enabling the addiction? Because a lot of the stories we hear when people call in from all over from every different background in every different substance, a lot of the conversations are from people who are unconsciously enabling the addiction. They're creating the perfect circumstances for addiction to thrive. And with a little bit of education, they start to make traction. Alanon, thank you so much for that. I think before we head into Q&A, I did want to just pose this final question to both. Sorry, Dr. Hassan, did you want to add something? I just wanted to say to Dr. Amer, thank you so much for this amazing work. This is exactly what I think we need in the community. So thank you very much. Thanks so much. I really appreciate that support. Actually, you know, Dr. Amer, just to recap, are your services open to folks in Canada as well? I know you said they were virtual. Yeah. So the community workshops, they're mostly been done in the Bay Area in Chicago because that's where recovery homes are. But we have a lot of them recorded and online, and you can see them at our website. And then the family classes are virtual. So anybody can, you know, from any country, any state can join. We have people from all over the U.S. right now, but not other countries. But of course, they're welcome to come as long as they have internet connection. And then our recovery homes, they're in the Bay Area and in Chicago. But, you know, people are welcome to come from out of state and from other areas in that state. Fantastic. Thank you so much. And inshallah, we will all keep Medina House in our doors and pray for its, you know, thriving and like benefit to the community based in that. All right. So I think before we go into Q&A, just to kind of wrap up our incredible discussion today, it's what do we do, you know, like folks who are in the community who are seeing this, we might have loved ones, you know, mashallah, there's 75 participants in the room right now. How can we support and we'll kind of just keep, you know, just kind of more closing remarks so that I make sure to get to some of the Q&A from our participants. But any words that kind of come to mind or pieces of advice for folks who are just like, you know, I want to support this, but I'm at a loss as to how I even get started. Dr. Hassan, do you maybe want to start us off? I was going to give it to Dr. Hammer, since this is one of the main hot topics. And definitely it is like a big question that even I get asked, I would say once every two weeks, we get a call of what can I do, what can I do to this. And then it just tells how much of when an individual is effective, it affects the whole family. And it's a really a problem that if we get together and just to fix it, I think we can make a big improvement and big change in the field. So general advice, if you have, it's really have to be patient and persistent, patient but persistent. You got to keep being persistent on trying to help the patient to get to treatment, because that's the first thing, the motivation, to get the assessment, get to speak to someone, basically get help. But being patient, meaning no call and names. One of the big things is what we try to do is destigmatize. That can also happen in the home, like avoid using the word junkie or even addict or any word of that. It's very clear. And that's also matching our Quranic and Islamic teachings. No people shall ridicule other people or call them names. This is very clearly present in Quran. So even having a condition like that does not help. You have to be looking into their point of view and try to understand what is it that keep attracting them into the substances and then trying your best for give them, I will say the best that the mission is to give them into treatment. And then maybe we can initiate the rest or initiate a little bit of a break from the substances, give them to see the positive and the benefit out of it. Yes, this is one of the main things. But it depends again on where they are. Are they actively using every day, what substances, how many substances, there's general advice about that. But as I mentioned, just be careful because not every individual under the same level, they might be so, their body is so dependent on it. And just pulling yourself to leave it and lock the door on him, that can be actually more harmful than doing good. So, but I'm sure Dr. Amir has better advice than the mind. I don't know about that. But yeah, I mean, I think the community working together, I mean, we have such an amazing community. We have medical professionals. We have therapists. We have life coaches and peer mentors. We have people with lived experience. We have gone to this and survived it. We have imams and religious leaders and chaplains. We have process lines. We have so much infrastructure. I think the important thing is that this is a problem that's not going away. And it's going to continue to get worse. There's no, there's no, it's not in the horizon. It's not looking like it's getting better. It's looking like it's getting worse. So I think it's important for us to work together. I don't think any of us can do this individually. And everybody has a part to play and working together to address this problem is going to be key. And I think the way that we talk about this, I totally agree that we need to address the stigma around this and that that can really be done just through a lot of education. So people may think, you know, why, why should we not stigmatize drugs and how values it's bad? I think what we're talking about is something different here. What we're talking about is when the drug and alcohol use gets out of control, that person wants to stop, but they can't want help. They're looking to us for help. And, you know, they have a lot of these things that have led them to a drug problem. I think that's where we need to step in and show that compassion and then get them connected to all the help that's out there within our community, outside of our community, so on and so forth. So I think, you know, working together and embracing people with this problem and getting them into treatment, embracing them, people with this problem does not mean enabling them. So somebody that doesn't want help, it's important that we help to disable that addiction. We don't want to, somebody that comes to the mustard looking for money and have a drug problem. We don't want to give them money. Maybe we can help them find a job. Maybe we can nudge them towards treatment. Maybe we can nudge them towards something that's going to be able to help them. So we want to embrace them, get them into treatment, and then getting that, embracing them doesn't mean necessarily enabling their addiction. Michelle, I thank you both so much for, you know, kind of just the support. It's a lot. I think there's, there's a lot of work as a community we have to do and I want to be, you know, I'm going to just piggyback Dr. Ahmed. You know, this is kind of you, you've spoken to you and Dr. Hassan, the importance of standing behind work like the Medina House or continuing to do research on this topic. And why is it important for us to constantly have data on Muslim populations? And a lot of questions revolve around, you know, a lot of the questions that we're getting is like, well, what is out there for Muslims? They're, you know, kind of, we want more resources in more areas. And, you know, I'm glad to see the chat kind of going, going off with just various resources. So please making sure that you're looking at the chat and if it's in an area that you live in, reaching out and utilizing those services, but also supporting those services when feasible and in any way that you can to ensure the longevity of this work. I think collectively as a panel, we know the work that we all do, whether it's an addiction or mental health, we want to kind of last beyond us and our years in the field. You know, Subhanallah, we want this to be, to be available for, for our kids and their kids and ongoingly and like Dr. Ahmad touched on, this isn't necessarily going away. So almost in a way, the sooner we can back work like this and the sooner there's like this communal realization of where we are, the more we can work together, inshallah, with, you know, one hand and one kind of achievable goal, bismillah, to support Muslim brothers and sisters dealing with this. So thank you for that. So I think I'll turn to some of the questions in the Q&A box. Masha'Allah, there's a lot of people and a lot of questions about this. And one of the questions that I'm sure you, you both get in your work as well is more like behavioral addictions. Is that something you come across? Is it the same? Is, is the psychology behind or the psychiatry behind behavioral addiction similar? I don't know if one of you prefers to take the question over the other, but please feel free. I can also just pick some. Yeah, so a lot of the principles with behavioral addictions are similar to chemical addictions. So, you know, you have peer support groups for behavioral addictions, you have professional treatment for behavioral addictions, and you have medications for some behavioral addiction. So those three dimensions of treatment still come in and play with behavioral addiction. And it's interesting in the Quran, Allah says, يسألونك عن الخمر والميسر. This is so fascinating that gambling, which is now recognized as a, as an addiction. It wasn't previously is as recognized as an addiction. And then intoxicants, like chemical intoxicants, there's a connection between that. And then other areas in the Quran, there's a connection between that, which is really fascinating, because if you think about it, we've just sort of come to start recognizing gambling as an addiction. I think clinically, we've always recognized gambling pornography as an addiction. But, you know, even in our diagnosis and categorization of now, gambling addiction is considered an addiction. All right. So what, how do you treat that? So you have many behavioral addictions, pornography addiction, and then, you know, gambling addiction, sort of being the, the common addictions. And now with the prevalence of the internet, you know, that's, that's changing the way all addictions are, are panning out, specifically, internet pornography addictions, and gambling addiction. So, you know, I think the best advice I can get in a concise way is that, you know, a lot of times, people will approach these behavioral addictions with this attempt at just phasing out of it. So for example, with pornography addiction, you know, it's something that people try to phase out of or marry out of. And what I find is when people conceptualize it as an addiction, with some of the same risk factors that a chemical addiction would have, and with the same gravity of the situation, and with the same approach to treatment, then they can make a lot of traction. So for example, with like professional treatments, that would be something like CBT, or a mindfulness based interventions for pornography addiction. And you have people that specialize in this area. And then for peer support groups, you have 12 step groups, and other peer support groups for pornography addiction, and other gambling, and other behavioral addictions. And then the third dimension would be medications. You can explore those medications. Those medications don't require specialists to prescribe. You can explore them, learn about them, and then come prepared to your primary care doctor's visit and let them ask them about getting on some of these medications, or you can see somebody that's trained in addictions. But yeah, gambling, I'm sorry, behavioral addictions are a serious problem. They cause a lot of distress in people's lives. And when you conceptualize it as an addiction, it can be really helpful to start gaining traction on the problem. Thank you so much, Dr. Ahmed. Dr. Hassan, the next question that we have in the box is can you speak to towards any gender differences in addiction? Is there like a stigma within a stigma when we look at specific genders? So specifically the question touched on women and females who are struggling with an addiction. Do you know if there's more stigma surrounding that due to it being perhaps a less acceptable behavior for women over men? Yeah, it's a good question. So historically speaking, and the way when we teach medical students and etc. academically, so substances have been always more in men than maybe for variety of reasons of house scenes, availability, access, the groups that we wanted to fit in several reasons. But now I'm going to speak a little bit about the epidemic like from the prevalence part. There is concern and a report I've actually seen it from now I'm talking about more Canada now with legalization of cannabis, the more access, more availability, where actually that gap is closing down. So also the more female are equal to male, which is kind of a concern. Because again, now it comes to the why is it a concern? Biologically, there could be some difference in the gender health role of the intoxication. So for example, women in general easily get intoxicated than men if they drink the same amount. That has to do with a lot of the metabolism about the distribution of fat, distribution of body muscles, a lot of a lot of things. So if you get intoxicated easily, it might lead obviously to the biological consequences are hurtful. So this is myself, but there's also a term called telescoping in medicine. And what that means is that women when they initiate a substance, the ease it so that gap from initiation until the development of problems or substance is much shorter in women than men. So this is a problem. So if you are initiating more repetition, you can go into jump into a problem very, quite easily. And it has to do with a lot of factor, including the vulnerability that already exists for like stress or how to tell the stress on maybe to develop the depression. Okay, again, as we spoke earlier with Dr. Hammer, I will need more of that drink or more of the substance just to keep it going and just to avoid that which can lead to a bigger problem and problem. So yes, it's a big, it's a big issue. There is changes epidemiological and we can see it. And it really needs to be addressed. So that's why I would emphasize on a key factor is psycheditation. Dr. Hammer has such a net that I cannot agree more, especially when it comes to this, because there might be a lot of misconceptions. No, no, no, I'm saying it's only, only in boys, we can try many times is no, no, no, it can really lead to a lot of significant problem actually much more in the faster way. So we have to be very cautious and aware of this problem. Thank you so much, Dr. Hassan. Dr. Ahmed, was there anything you wanted to add specifically to that question? Oh, yeah. No, that's great. Oh, that's great. All right. So I think we'll end with one more question. And, you know, I think a lot of the things that we hear is in order to get to some of these catered programs, you know, there's very high costs involved with any recovery programs. And at times it is going to come up the requirement of a primary care physician referral. And so how can we, do you guys have, you know, much a lot of both MDs? Is there any advice for non-psychiatrists or other physicians who have not specialized in addiction on the reduction of stigma to support actual follow through with referrals to clients to seek out care, like you both have kind of, you do in your everyday life really. Yeah, I think physicians play an important role when it comes to addiction. So, you know, there's a lot that physicians can do themselves. So a lot of these medications that require that are helpful for substance use disorder that have been shown to reduce cravings, they don't need a specialist to prescribe them, they just need somebody who is interested. And we have residents that come on our service, they learn how to prescribe all these medications within a week or two. And they really do a great job. I'm always surprised with just such a short exposure to it, how much they learn and how much they're able to incorporate into their primary care practice and all their practices. We have primary care doctors, we have infectious disease doctors that incorporate this into their treatment, emergency department doctors that incorporate this into their, into their usual treatment. So physicians themselves can provide this really important piece, which is that medication management about two to three percent of doctors actually go ahead and prescribe medications for opioid addiction in the, in the, in California. And like 70% of rural areas don't have access to, to opioid addiction medications. So it, you know, that's one huge place where physicians can help. There's a, there is a tradition of medicine and healing within our tradition and within Islam, there's a lot of Muslim doctors, so they can really play a part here. Second, part of that question of like, how can we refer people to treatment? You know, the healthcare system in a lot of ways does not incentivize time with the patient, but with substance use disorder. It's, it's what I would encourage is, you know, coming at it with a non-judgmental attitude with empathy, asking open-ended questions about their substance use, and then trying to build rapport with, with your patient, and then just affirming any progress they've made. So if they made the decision to discuss it with you, you know, affirming that, cheerleading that, you know, praising that, and if they've made any progress to reduce their substance use, cheerleading that, praising that, and that can really, you know, serve to open up the conversation more. And then what I meant by the healthcare system really not providing a lot of time for addressing addiction, you know, what you want to do with somebody who then does open up to you about this conversation as a physician, you can set up a separate appointment just to do a brief intervention or do motivational interviewing, or just have a conversation around their substance, or, you know, a conversation around medication management around their substance use disorder. And the physician can absolutely take a part in playing with this, take a part in, in nudging that, that patient towards getting into treatment. So in that visit, you can work towards uncovering the problem, because it does take time and a conversation to uncover the problem, the extent of the problem, and set up follow-up visits, and then also dedicating a visit towards organizing treatments. If you have a social worker in the community, great. In your, in your clinic, you have a social worker in your clinic, great, handing them off to the social worker. Otherwise, you know, helping that patient navigate into how to get into treatment. We have a little bit of information on this on our website. It's a lengthy conversation about how you help people navigate the treatment. Thank you so much, Dr. Ahmad. Dr. Hassan, anything you wanted to add? No, that's excellent. Yes. De-sigmatize, initiate treatments and treat them. Okay. Well, Alhamdulillah, I think we wanted to, I know it's seven o'clock, we just wanted to allow both of you a minute to make a closing dua for us and everybody in the room and everybody kind of struggling with this incredible issue, whether it's themselves, their families, you know, overall the community we know is struggling. For those who are able to view the screen right now, we've put up some resources. We've also dropped a lot of them in the chat. So please make sure that you've gone through that. But Dr. Hassan, did you want to go ahead and get us started with dua? Okay. Thank you. Thank you. I will give it a shot. No problem. So maybe I'll do dua in Arabic and then English. Is that okay? Okay. Absolutely. Thank you. Alhamdulillah. Allahumma zidna al-na. Allahumma nisadak. Al-Nafi'a wa naudi bi-kim. Al-Nayamfa. Allahumma shfiq. Al-Mari'id. Allahumma a'in. Kul abin. Al-Umin. Al-Akhun. Al-Uqtun. Al-Ibn. Al-Ubna. Allahumma fukh. Al-Qubayna. Al-Qurub. Al-Mislimin. Al-Alamat. Al-Hubu. Al-Watallah. Wa Allah. Mek, all our gathering, a blessed gathering. Increase, enhance our knowledge, the knowledge that benefits us and benefits our community and places you, Allah. O Allah, may I bring shifa and pureness for every individual and any individual affected, whether by addiction or any other illness. May Allah be in support for any father, any mother, any brother, any sister, any son or any daughter who has a loved one affected with us. And may Allah bless our meeting and the knowledge we, we try to, to pass on to people. I'm here. Bismillah, Alhamdulillah. Nassaluka al-afwa wa al-afya. Fid dunya wa al-akhirah. O Allah, we ask you to give our community well-being and protect our community and keep us safe. Allahumma wa fiqan al-ima tuhibbu wa tarablah. Allah, we ask you to create the circumstances for those of us that are struggling with this problem, families and individuals with addiction. We ask you to cure them. We ask you to help them, guide them along their steps. Allahumma arina haqqan haqqa wa rezukna tiba'a. Wa arina baltila baltila wa rezukna tiba'a. Allah, we ask you to help us be honest with ourselves, honest about this problem and honest about what's within our control to fix this problem and help us focus on things we can control and grant us the wisdom to know the difference between what we can control, what we can't control. Allahumma nabi ba'diqas saliheen waj'al na minhum. Allah help us with connections, help us guide us to people who can help and family members who can help, community members who can help to help heal us from this problem.