 Assalamu alaikum everyone. Hi. Thank you for coming. It's nice to see people And then I know there are people on the live stream as well. So I'm gonna just I'm gonna take a little bit of time and begin just for myself Bismillah ar-Rahman ar-Rahim God grant me the serenity to accept the things I cannot change The courage to change the things I can and the wisdom to know the difference. I mean Okay, so the title of this talk is is very straightforward. It's that addiction is in our community Because it is and I wanted to get that out there and Right there for my talk. So my name is Ariana Abed. I'm a family medicine addiction medicine doctor I'm going to talk a little bit about me because I am new to the community I was born and raised on the west coast of Florida My education was of course Medical school in Florida. All of it was on the east coast and family medicine training in Daytona Beach Addiction medicine training for at UCLA. So that was my first time in California And then now I'm going to be working with Kaiser permanent is the head of their addiction medicine service and in Fremont Hospital, thank you for that I've done some work already So I've created a drug withdrawal protocols for multiple hospitals in different states. I also contributed to the LA substance use and prevention controls mass media campaign for meth and fateming use I Provided some consultation for education on their website And then I've also trained primary care providers in treating opioid use disorder patients So the objectives for my presentation today Is going to be first to define what addiction is and how it differs from other? Just regular drug use because there is a difference and then also signs of addiction How do you know somebody is addicted or if you're addicted and most common substances and behaviors that are associated with addiction? I'm also going to review how Addiction is diagnosed and treated so I'm going to get you into the mind of a doctor of me what I'm thinking when I see these patients and then We're going to continue along that vein and I'm going to talk about how I View addiction in a broader scope The importance of approaching it with humility and what kind of humility and Then also reflect on what contributes to addiction and most importantly what you can do and what you shouldn't do At the end. We're going to have a Q&A. I Started with a slide. I'm not gonna. This is not what my talk is all about But I did want to say that addiction isn't strange or unique to the Islamic world or the Muslim world at a certain point well opioids have been used by Muslim physicians and at a certain point It did get to a level where people were they were realizing that people were needing higher and higher doses and getting tolerant So this was a quote from our beer but be runy. It was a contemporary. I've even seen I had I did a little research into Islamic history and He had said that people who live in the tropics are hot climates, especially those in Mecca Get into the habit of taking opium daily to eliminate distress To relieve the body from effects of scorching heat to secure longer and deeper sleep They start with smaller doses which are increased gradually up to lethal doses. So there was a realization that that that people can achieve tolerance and Also, there would need to be a limitation of how these substances were being used by doctors And also people other people recreationally So straight to the most common addictions Substances it's alcohol That's the most common one and I'm talking about the United States To the second one is nicotine and then marijuana After that, there's prescription pills namely opioids and then sedatives like benzodiazepines Common names, you know when I say these words benzodiazepines people still don't know what I'm talking about when I say Xanax or Advan people know what I'm talking about. Those are Those are pills that people will take if they feel panicky or anxious And because they act so quickly it has an addictive effect there are also Addictive behaviors the most common from what I saw Reviewing the literature is Sex addiction and that includes that related to pornography. The second is internet and video games. That's rising And then also the shopping gambling eating disorders so the important thing to know about addiction is what fuels it and Part of what and I'm gonna go into this a little bit more. It's it's we're gonna go on a journey but the first thing is is that Addiction is fueled by a feel-good feeling. It's a euphoria the sense of happiness. And so we add our baseline without any food any Substances we have a a low level of dopamine release to maintain our body It's interesting as you can see here food is a little bit more than that baseline And then as you get into the substances you get to 1300% of an increase in Dopamine levels So at that point when the body experience is such a huge euphoria such a huge huge surge It's hard to To bounce back from that So I wanted to show this image to show just the effect that these substances have that even if you can think of the best thing that the thing that feels Amazing so like for me, I love food. So food is like I you know, I eat a good dish When you get to to substances just one ingestion some people it's a dopamine rush unlike they've it's out of this world So so how do we diagnose addiction or substance use disorder? So Now we're getting into the medical perspective When I assess a patient I Have to look for two or more of the following on this list So there's craving their substances that they're taking larger larger amounts. So they may say, okay I was only in their head. They can think I'm only taking one drink or two drink two drinks And then at the end of the night, it turns out that they've had five drinks A great deal of time is spent in obtaining the substance or using it or recovering from the effects That can be a hangover that can be, you know Finding the drugs itself going through a friend spending time hiding it from family members Important social recreational occupational activities are given up. So that's like going to you know, volunteering with the mosque This person used to volunteer a lot now. They're not volunteering as much anymore They used to spend time with friends now. They're isolating I'm continued use despite experiencing harmful physical or psychological effects So that's like the person is becoming it's trying to get panic attacks trying to get anxious from it and they're still continuing to use or They are not as active as they used to be they're laying in bed most of the time or somebody sustained an injury, let's say from from using substances from a crazy night or They have liver disease and they're still continuing to use. So this would be a sign of substance use disorder Which we I Addiction and substance use disorder. Those are used interchangeably We're trying to get away from addiction because it has a stigma attached to it. So I'm going to use those words interchangeably use of substances in situations which are physically dangerous like DUI DUI type situations Continue use despite causing Worsening problems with others. So a lot of times when I see people it's been multiple friends family or the workplace that has ordered them to come and see me And then tolerance and withdrawal. So tolerance is Needing more and more of the substance to get the same effect and then withdrawal is once they stop using the drug They start to get sick now I Get I'm trained to assess substance use because we don't just take a list in when we see somebody and say, okay You have this year have substance use problem. There's a spectrum. So as you can see at the end here We have mild moderate and severe so That is something that we Determined when we see somebody and then Behind all of that. There are people who will use experimentally recreationally or they will binge they may You know not drink or use the whole week and then on the weekends They it's like they have no work. They call it the work hard play hard mentality. They'll binge the whole weekend So that's not necessarily addiction that would be Binging or we determine if that's risky use that does Usually require a different approach and then of course we have no use But I gave this slide to just to show that it's a spectrum and that's why it's important to have a human being You know who's who's an expert or who has had training in the field to? Assess a person and then treat a person Okay, so this is the The side slide that I spent the most work on it's it's really interesting because Figuring out what contributes to addiction isn't is ever-evolving in our field, but what we've determined is that there are Contributors related to the person's own constitution or own body Then there's the environment then there's life events and then there's spiritual now I have There are hundreds of people around the country and I have friends in recovery who call this a spiritual disease and I would I personally agree with that. I feel like I deal in a field with spiritual diseases But there are also The way the medical field looks at it is they look they call it a medical disease and a brain disease And I feel that there is one that comes before the other so You know in the way that Islamic medicine looked at things is that there is always in the unseen or the The things that happen on a smaller level and in the spirit and then they Evolve if they don't if they are not attended to they evolve into physical manifestations We believe in the unseen world and then the physical world medicine is more physical that deals with the physical world so I would agree that I think it starts out Spiritual and then we start to see the physical manifestations, but there are Like I mentioned other contribute contributors. So with the body you have it We've found that people have a genetic predisposition in the case of alcohol It's about 50% probability of addiction if you have anybody in your family With alcohol use disorder or alcohol addiction the more severe the more severe the person inherits it Also, we find that risk-taking personalities also have more of a predisposition to addiction and Then also those with personality disorders rather mental disorders tend to have a higher risk in the environment the Risk factors as you can see there There's parental substance use if you have friends that use substances or the word is deviant into other behaviors risk-taking behaviors that can increase the chance I put a star next to things that I personally have seen to be the most common so the biggest things that I see with my patients especially and In a lot of the you know when I speak with other physicians and I've read through the literature Especially with those who are severe and the ones that you know, we drive by we're on the street homeless ones is a history of family or parental conflict and then a lack or Disruption of a healthy support system So these these are broken-hearted people. I were dealing with people who have broken spirits They they're early experiences with the world were We're not good. So they they Learned they were not able to learn healthy trusting relationships and when you have that as a foundation It seems that that's through that crack if there isn't light that comes through then then It's also an area for darkness Life events is there's there's a similarity here as well childhood emotional physical Psychological sexual abuse or neglect Is another common one that we see another form is Trauma so those who have experienced traumatic events this also Can relate to adult as well. So patients who have PTSD. We tend to see those as more severe or developing Addiction or having a higher chance of adult developing addiction with the spiritual I Mentioned the spiritual deficit and I'm going to talk about that a little bit later in the presentation but also self-deception which in the in Another word for that is denial. So Not being able to To see things clearly, I think that's that's a way that I can describe denial And and as we go through the presentation, you'll get a better sense of what I'm talking about So the cycle of addiction It begins with Intoxication then there's the negative or the withdrawal effect and then craving so What happens first the person gets in gets the first taste of the drug or the substance or the behavior and it Releases a feel-good surge like I described before it's it's an amazing feeling and some people Well, some people experience more of a high than others So what we believe is that everyone's different everybody's as unique as a fingerprint everybody's body deals with a substance differently So one person may try heroin and you know not really feel anything is you know They had a little fun and that was it another person may try heroin and they get this amazing surge they get this amazing euphoria and The terrible feelings that they were carrying before in their life have suddenly disappeared If you're following me on this you can get a sense that maybe some people might actually see this as a medicine for themselves So this feeling this intoxication state we say is associated with the reptilian brain Which is the oldest part of our brain and that's the brain that's associated with survival what it works with is food sleep and even breathing so The dangerous thing about a drug or a substance I keep it using different words, but a drug or a behavior is that when it's tied to the survival part of your brain It's very hard to overcome then the substance To the brain is I need this to survive. I need this to live So the brain learns from this experience. So what happens next well The drug rose off and then the body decides to compensate for this what it sees as a huge stressor So even though it feels amazing It's a huge stress for the brain because it's a change in normal behavior So the body secretes chemicals that are associated with what we call a pro stress system Which it tries to balance this it it kind of tries to put a damper dampener on it And so what that feels like to the person is a huge low Followed by the high so it'll be like a hangover. It can be depression fatigue They'll have changes in eating and sleeping. They'll become really irritable. We see that with cocaine And then this may actually lead to because the depression being so bad the suicide attempts So this then fuels the next stage, which we call the craving stage So what happens with drug use? Is is damage to the brain and it can start as early as the first couple times of using the substance So the frontal part of the brain as you can see I highlighted in this slide is the part of the brain That's involved in decision-making. It's involved in What we perceive as the intellectual part of ourselves the human part of ourselves, so the rational the Insight awareness Like I said making good decisions self-control Tell it Consciousness or conscientiousness and over time when this gets damaged as you can see the The person the person's Lifestyle starts to change so they may start being lying more may getting more involved in criminal behaviors. They're unable To make a decision or will themselves that I'm not going to do this anymore. This is not a good idea I might have a problem that those types of thoughts are no longer going to be able to override their behaviors because Unfortunately, it's damaged So I I present these to give give people an awareness of the state that the person is in This isn't just a person who is choosing to be bad is choosing to Engage in the forbidden or to break God's laws, you know, I didn't start this presentation saying drugs are forbidden in Islam alcohol is forbidden in Islam These people know that everybody who uses these substances knows that it's harmful and People who continue to do you use substances every they they know that these are drugs they know that they're but that in the back of their head that They may be going on a bad track, but the sense of Insight and awareness. It's not It's that area has not only been damaged, but then it's also been replaced with this enormous sense of shame So adding to that and saying You are doing Haram you are doing forbidden you are being bad. It just sets. It just adds to the fire So I want people to see what is that the person who's going through all this is actually suffering tremendously the brain starts out being able to experience normal feelings or as Much as they can normal feelings of healthier feelings of pleasure now if the person has a history of trauma If they grew up in a very stressful environment, they're not going to be Producing as much of the feel-good chemicals as maybe someone who didn't but the levels of Pleasure are higher than over time with using the substance They're not any longer able to reach those same levels of pleasure Their baseline for feeling good becomes lower and lower and lower because the brain is sustaining staining damage It's rewiring itself. It doesn't want you to get back to that amazing surge You went to because the way the brain saw it was very very stressful. Am I making sense? Okay, I'll do that at the end. That's okay. I'm just use I You know I love talking about this so I can get really into it, but I want it to be really clear So as you can see here the it's very clear It says misery so the person is living in a very low state and the drug is after a while There becomes them being able to reach a new level of normal. That's what we call tolerance So what's inside the mind of a person? What how are they walking around a person who has addiction because I used to wonder this what are they thinking? so they These people have a huge amount and when I say these people I don't mean to be offensive with this I'm I I get a sense that a lot of the people who are interested in this talk are loved ones and family members so that's why I'm referring to People with addictions or substance use disorders in this way So just keep that in mind But there's a tremendous amount of guilt shame and that also that fuels that what we call the denial There's also emptiness. I've talked to Or I've heard a lot of patients talk about how when they stop using substances they feel this empty feeling a Lot of self-hate and poor self-esteem. This is with somebody who's actively using again Like I said fear anger depression especially with alcohol It's been associated with high levels of Depression and then they there's a tendency for blame and obsession as well resentments I'm it's kind of hard. It's you can't see it on the slide, but resentments also And then inside the mind of The loved ones so as you can see There's some similarities So there's guilt. There's shame. There's denial. There's fear. There's anger There's blame. There's obsession not necessarily over the substance, but over the person the other person who's using Depression or exhaustion perfectionism and self-righteousness. Why can't they do that? Why can't they act like this? Why can't they be better? You know, I'm able to do this this this they're not able to do this that that hyper vigilance and out of these types of environments especially with people who've grown up with in an environment of alcoholism or addiction or just in general dysfunction There tends to be and when I say dysfunction, I mean chaos But there tends to be hyper vigilance and we describe that as walking on eggshells, you know trying to see the person what move they're in how they come home What time that they tend to get into a bad mood or when they start to drink Empaths can come out of this environment people who are highly emotionally sensitive to others That comes out of the environment of having to constantly walk on eggshells or You know not do the wrong thing not say the wrong thing so I don't end up getting hit or I don't end up But getting yelled at or I don't get food taken away from me, you know in the case of a child also the loved one and the friend can also become very resentful too, so If it's a spouse a lot of times the resentment is that against the family member the other person if it's someone who's been affected by Dysfunction when they were a child they may have a tendency to form resentments in general against people So, you know in Islam we talk about the importance of forgiving. Well, it's hard to do that when You you have a natural Disposition to hold on and you say okay, why can't I'm trying so hard to forgive this person I'm trying so hard to let go. I can't let go. Well, it may have had to do with your early childhood That and you know I can talk more and more about this but Resentments can be a type of survival holding onto resentments can be a type of survival mechanism or something we learned from our family members, so What I hope you can see is that there isn't that much of a difference between the person who uses in some ways and the family members and I'm I'm making a point about this because Addiction is a family disease. It's contagious So the person may not end up if you're living with somebody who uses you may not end up with the drink in your hand or using the substance but We don't call the substance or the drug necessarily the problem It's a symptom of the problem and there are behaviors and there's beliefs In attitudes that are actually the problem and that is the spiritual disease And that's the part that a doctor can't walk in and take your temperature and say that's what it is You can't see it. You can't write it down. This is where we're dealing with an area that is a Little bit to the naked eye a lot a little bit more complex so How can a person? What what to do about the person with the addiction or the substance use disorder? Well, the only the only way they can be successful is when they make their own decision to seek recovery for Themselves they should not do it because they want to make you happy They cannot do it because of their kid they may say they will they may end up sober for a couple years But there isn't extremely high chance and most of the time what we see happens is that? They end up Going back to use we call it relapse so Oops Got you're kind of popular So when can the person make this decision it can occur when they reach high levels of distress or when they're critical life events So it can be you know in a divorce when they've lost everything when they've lost their job when they're no longer Living in their house when no one will talk to them it can sometimes also result because of Going to jail It can occur as a result of therapy from a specially licensed provider. I wouldn't say this is common But there is a certain type of therapy We try to employ with these patients to help them reach their own decision to do it for themselves again We don't tell them what to do What I found is telling somebody what to do rarely works in fact it in just increases the resistance Of the person and ends up Making you feel that I mean it ends up taking your energy So And what that is is really what I've listed here is the type of mothering or managing So these are the things to avoid manipulation managing mother mothering martyrdom So I've done so much for you. I've done this and this look at everything. I'm doing That you know my life is so terrible because of your disease. Why can't you be better? So This type of approach is not not a good approach because like I mentioned earlier. This is a person who's suffering This is a person who's having damage and effects to their brain When you approach them in this way you are Worsening their levels of stress And also contributing to dysfunction in the environment And then you are also assuming a role that is not yours and that is acting as their Lord or guardian This is why I reflect back to the Quran that there are so many verses that talk about how you know That prophet Muhammad peace be upon him Addressing him that you are not a guardian over them now. These are in reference to him spreading the message to people who wouldn't believe But I would say that this also if you look at it in the context of the verses in the bigger picture is that We do we can't control other people We can give a message if we're giving the message more than one time then that's controlling But we can we can provide a message to the person and if they decide to take it That's great. And if they don't that's not that's not in our control God is the one who is That person has their has their own relationship with God and if we respect that we have a high Chance and if we if we're able to put things right in with that We have a high chance of contributing to their seeking recovery if we don't respect that then we Have to we sort of have to look at what this is an action that we're doing that we're putting out and I would say that it's a type of disrespect to the spirit of the person into other creation so I'm saying this because I think a lot of us in this field we We work really hard on our we try to work really hard on ourselves. We are very We're looking for answers. We are looking a lot of us, you know, have prayed a lot. We look through the Quran We're diligent. We have some of that perfectionism. We may have been affected by the disease and and Sometimes we are experiencing such a high level of discomfort and desperation and hopelessness and we're wondering What is it that we're doing at least that's where I got to at a certain point is You know, what is it? What can I do? That's better. What is what is something is going? What is going on because? You know when we put things in the right place and we have a good relationship with God life is easy But when it isn't there's something wrong and I think that's where We need to look at our behaviors that to us may seem not like a big deal or may seem subtle But they actually are a very big deal It's the attitudes and the beliefs that we carry around with us. They affect the people around us I have to conclude this slide by saying that for some people some people who are using substances or drugs or engaged in unhealthy behaviors, they may never Come to a decision or a realization that that they want recovery. This is really sad This is a hard thing for me to say It's an occasion for grief some people Will go through a grieving process regarding this It may seem like your loved one is slowly killing themselves. I Want to say about that that it is important that but it may this may be An occasion to to do that to grief to let go of that person because I don't know about you, but I've met a lot of people who have worked much much harder than then Just gone to amazing lengths to try to save a person and the more that they tried And these and I'm talking about hundreds of people. I attend the 12-step meetings and the conventions and I hear their stories That they've never succeeded and people who are much more intelligent much more accomplished even than I am I may not even than I am then I am Have not been able to get somebody sober. So You if some of you here who are here today think that you still have some techniques and some strategies that you think would work or that You think you may be able to To still have a chance. I encourage you to to try but I would say that I don't think you're going to succeed This is a cunning baffling in powerful disease and it can end up We it can end up draining and contributing to the development of Mental disorders and problems and in the people who are trying to Change these people. So and I've seen that so recovery is a lifelong process that what it looks like is For people who are actively using and who are extremely addicted or have severe addiction hospitals or detox facilities may be a first option to help address the Sick symptoms they feel when they're getting off the drug Then there's rehabilitation programs that involve intensive therapy. Sometimes this can be done outpatient We call it Intensive outpatient program And then there's the others that you may have heard of when somebody goes to act an actual rehab and lives there for a while They do behavioral therapy. They do meditation. They'll do individual therapy 12-step type group meetings And it's multiple meetings a day. It's pretty intensive and then once they leave they're expected to continue to follow up Participating in groups and seeing a specialist. They also may end up being put on medications to help with cravings there's a long history and tradition of giving medications to people for cravings actually Had read that it was a tradition in Native American culture so For some people it is a Medication it's not another drug for them to be a dependent on they need it in order to be able to function and it doesn't Convade the same high as the substance so one thing that I'll see is family members will give the person in recovery a hard time because they're now Taking like suboxone which is a medicine to help them with cravings and they're a family member saying well You're now on a different drug and you should be on no drugs and I would I would say that that is not helpful To people who are trying to find recovery that some people do need Medications, it's not getting them dependent on another substance. They need it to function like I said, it doesn't give them the high and You know, we want to encourage them when they're seeking recovery. So we don't want to criticize them Mutual support groups like a NA or smart recovery are also options There's also mutual support groups for family members and friends of people with addiction The most popular one in the most the longest standing one is Alan on which is for those with a loved one with an alcohol problem People who have loved ones with addiction problems will also attend Alan on as well Nobody will turn you away because of that And that's one that I encourage family members to attend so Into relapse relapse is common in addiction just like it is with other chronic diseases In fact, if as you can see here with hypertension and asthma, there's the relapse level is a bit higher so That is something to keep in mind and also we want to avoid Shaming a person when they have a slip up the way that we see it in the field is it's another Relapse just like with another chronic disease. We get them on the medicines if they need to be back on them We engage with them more frequently We try to to support them During that process. So back to the spiritual deficit the phrase that I hear a lot the emptiness inside that people refer to I Consider that the spiritual deficit that we all carry so All of creation is dependent on God and we were not created any differently We have a little a little hole that That is the vehicle for our link to our higher power to God to Allah and What has happened with how things have evolved industrialization is that now with the way our medic our Education in our institutions look at things is that if you can't be seen or measured it doesn't exist so spirituality has taken a backseat and When people mention the emptiness I automatically hear is the spiritual deficit, but they don't know what that is They don't know that that is normal that there's nothing wrong with that And then that is an opportunity for connecting to what their body and their spirit needs, which is God which is the spiritual water which I refer to at the the end of this slide spirituality and this is one of my friends who's been 30 years sober From alcohol and cocaine had said this to me that spirituality is the she said the only healthy replacement for addiction of sessions and unhealthy behaviors So when I'd mentioned before that the brain sustains damage, and it's no longer able to override the craving and the compulsion That for some people can last they may not get their frontal lobe completely back to normal so So what can happen is is that the addiction? switches from from the substance to God can you become addicted to God? Well, I would say When when you the going to God constantly the people that I work with are people who are going to God Constantly throughout the day so that that replacement is sort of I need a sip or I need a drug It's that I talked to God. I I sit with God. That's a beautiful thing Does everybody hear that? When I heard that I was like this is I I'm the I'm going to follow you I'm going to follow you around. I need to hear more about this. I need to know more about this If anybody here who is listening has a problem with addiction or substance use disorder I want you to know that you are not a terrible Low person that you have the opportunity to be an amazing gift to our communities and to our world You have so much to give us and that you know through directing this emptiness to God that you can Help show the rest of us who are seeking the same thing What is the antidote to the distressed caused by thinking of oneself is self-sufficient? This happens with the person who's using the substance. I'm okay. I don't need help I'm I can control my substance. They don't know they're not even thinking about God And we are thinking about them the whole time or we're if we're not even thinking about them Let's say that we are not even with somebody who has an addiction at all But we are thinking about controlling our kid, you know, I they have to become a doctor They have to become a lawyer. They have to get straight A's they have to you know we're on our kids or we're on our husband or You know I'm coming from the sister point of view. So or the the husband is Obsessed with you know, I'm constantly worried about not having enough money Let's say something like that constantly worried about the finances always worried about the job I'm not at that position that I want to be yet and And and thinking that I can I can get that, you know Thinking about the job or the thing first and then God is kind of afterwards I mean, let's be honest like we've all been there. We were all we all think like that. Well That's a type of self-sufficiency And that shows up very strongly when you're dealing with people with mental illness or people who have substance use is we try to control them and the antidote to that is, you know, I I love Sura Mulk and I read the the last two verses. I always take extra time to read the last two verses because It's it's it's it's unique to me where it says 67 Chapter 67 verse 29 in the name of God most gracious most merciful say to them He is all merciful. We have believed in him alone and upon or not Let me go back up here regarding those who so this is regarding those who say in contempt when Will the divine promise be fulfilled if indeed you believers are truthful and the verse says say to them He is all merciful. We have believed in him alone and upon him alone. Do we rely? Thus you shall most surely know who is utterly lost in clear error Say oh prophet Have you considered that if suddenly one morning you found that your water had become deeply sunk in the ground? Who then would bring you water fresh flowing and clean when I read this verse? I feel like it knocks a bit of that self-sufficiency away from me and the water traditionally From the water can can be a reference to the spirituality the spiritual the water of the unseen So when I when I think of this I think of how we can build so much we can have so many so many constructions around us We ourselves our bodies but without the the water of life without the spirit the spirituality we're dead we feel pain we don't feel good and a lot of people who are afflicted by addiction are acutely sensitive to this feeling they're very deeply Sensitive and connected to a pain they walk around with a pain these are broken hearted people like I said So they are sort of like our vital signs for our community if we have a community with a lot of addiction We're not doing so good in terms of the spiritual spiritual life for the spirituality We can be very good with the prayers. We can be very good with the activities and I think it's amazing what we how much we have conserved and how We are very We are very Amazing as a Muslim community in this country and I would say even around the world too. We still have the five prayers We still have maintained our traditions But I think what I'm seeing in the communities and and I'm not just talking about our communities I mean, I'm talking about the American community as well is there is a spirit. There is a pain and there is It is diseased spiritually So what should you not do when you're faced with addiction? So I'm gonna I'm gonna move along now Examine areas in your life for enabling. So what is enabling and I'm a healthy relationship dynamic that actually perpetuates a problem And what is that? That's the act of helping Helping that despite good intention Can actually support the disease now, what does that look like it means giving financial support paying someone's bills repairing the items that they broke Lying for the person making excuses for the person it can also be bailing them out of jail in severe cases In other words, it's doing for others what they have the capacity to do for themselves And that's what it looks like. It's it's really it has the emotional weight of carrying an elephant up a hill Removing the natural consequences of someone's behavior This can be very painful Some of us it can be very hard, especially if your loved one could become homeless It's not easy. I'm just I'm pointing this out what this can look like So what can you do? besides the enabling to look out for to possibly To to possibly I don't know how people sit like that the whole time So besides the enabling that That may need to be taken a look at it's also Being willing to venture out of your isolation. So addiction I'm saying mental illness too because these are all things that are very hard to deal with It's very hard to control That we can get isolated we can get our own in our own bubble. We don't have a lot of friends Because we're ashamed And we isolate ourselves and I would say that Just in general as a society where we isolate much much more of course than we ever have before and it's getting worse So with communities with families that are dealing with somebody who has a An addiction problem, it's going to be really important to get out of that isolation It's not healthy to be in it. Like I said, it's contagious. You may not be using the substance, but you may Start adopting the behaviors that we see so venture out of the isolation start engaging in healthy relationships Take care of yourself and your own needs first if you have been getting the person You're ready to go to try to go to the doctor for the last year, but you have not also gone to the doctor Please go to the doctor. Please start taking medicines if you need to take medicines start exercising if you need to exercise Eat so if you're not eating at all eat take care of You know look at your children I've heard of people who are so fixated on their husbands that they barely were able to take care of their children I know it's really hard You know as a woman Because we I've heard a lot of women share their stories about having the husband who's an alcoholic and You know, you can bear the brunt of a lot and if it's a situation that is unsafe I would recommend I would prioritize getting out of the unsafe relationship first The last is to consider seeing a specialist addiction medicine specialist or Or clinic and Looking into attending mutual support groups, so I know we had some at the mosque here Al-Anon groups are like I said also good as well I'm more I'm leaning more towards those because you don't need to depend on the same person being there You can go to a meeting anywhere at any time Sometime there's meetings all around the world. So those those can be really good opportunities to hear other people's stories and And get a different perspective Let's see. I said a lot of this here Is there hope this is the last the last the last slide of the presentation So I feel like this is this is a question a lot of people walking around having that might be a question people here have Through seeing this like I said This very very difficult situation having a loved one going through a substance use Disorder or addiction. It's extremely painful But we can if we want to I mean we can approach it in different ways we can be patient through it and You know pray and Continue to do what we're doing or we can look at it as a learning experience is what is it that I need to see here Is there something that I can do with this? that's that's more of my preference and Through this we have the opportunity to purify the self Experience a full reliance on God and respect for the autonomy of creation and Thereby becoming the best of human beings that was intended by our creation the vice-gerence as the Quran talks about Experiencing iman and ihsan, you know according to the the famous hadith Developing a healthy and healing presence And living a more fulfilling life But the idea that I love is that by your presence you can bring healing I mean that's to me is such a beautiful thing and I've always sought that and one of the ways to to reach or strive One of the ways to Reach or strive for these one of the ways to reach or strive for these levels is to Dig deeper into these types of Situations that we're going through and the difficulties that we're going through and I will say to answer this question Yes, there is hope. There is hope Do not give up Please be patient. I know some people I Know some people who are going through this either addiction or our loved one are feeling suicidal And I want to say that there's nothing wrong with with Feeling that but I would say be patient and that there is hope and There's people who are thinking of you and who are supporting you They're out there. You just may not have met them yet And I hope that you can Through this presentation see that there are steps that there are steps in their opportunities So I end will with will you take the next step? And I am Available to answer questions. This is the summary slide addiction is a pervasive disease affecting the mind body and spirit The effects can extend to family members friends the community and throughout generations So it does travel through generations It can serve as an indicator of the health of the community Family members can become just as sick as the person with the addiction in their attempts to cure or control the disease The person themselves did not cause their disease nor did anyone else and that the path to recovery contains a great opportunity and gift So that's it for my presentation Well, like I'm sorry. Oh craving craving. Okay That's a good question. So the the question was With damage to is the damage to the frontal part of the brain Permanent and also if I could differentiate again the craving from the Other parts of the addiction so That's a great question the Intoxic so those the three phases like I said again is the intoxication part of the brain that involves the brainstem So that's a little hard to point to but it's sort of the back of the brain and then there is the withdrawal or the negative phase which is more of the The inner part of the brain. It's kind of in the center and then These are not like localized. I mean, it's not fixed, you know The brain is a is a very complicated piece of circuitry So this is just based on medical science and studies. Then there's the frontal part of the brain that That is the decision making part of our brains is the higher part of ourselves that's involved with rationale insight Judgment discipline self-control Some people even without addiction have damage to their frontal brains and that can show up as they're impulsive They can Be kind of seen as reckless not having not being motivated There's been clinical cases of that So is there I There are So I did how do I say this there is documentation Where they did do images of people's frontal lobe Before recovery and then out a couple years after recovery and then comparing it to a normal person and recovery of the part that part of the brain does appear It can heal I Don't I always An open mind so I never tell people like things are damaged beyond control that there's no hope There's no miracle that you know, there's been Miracles I mean there have been people who have Low levels of cirrhosis forming then they stopped alcohol and then the body is able to heal itself I've heard of those types of things. So I think that anything is possible and I would say that um Your brain is not the same that's what I would say In some cases it can sort of be like a little bit of a PTSD of your brain That's why if you introduce the substance again, it doesn't matter if it's 10 years later 20 years later 30 years later People will be going back to using levels that they were when they were addicted There's no it's like starting out low. No, it's you're you go straight back The body doesn't forget. So I would say you're not the same but I said I would also say that there's there is hope for Recovery the body to heal yourself, especially if you take good care of yourself you eat your exercise You know you try not to have too many resentments and in your life and and take good care of yourself So my come Thank you for the presentation. I just I found it. It's fascinating cycle. So you spoke about this unfortunate most futile and frustrating attempt to If you ever found me over sticky recovery and they don't see that they have a problem or they haven't hit bottom so to speak How do you balance that when they don't want to? To seek treatment with the prophetic injunction to plant seedings When you even if you see the hour and also to keep the difficult ties of kinship When it's just so much easier to just cut off, especially when the love one doesn't realize They have an addiction as a problem Yeah Okay good so There's just I can I can say so much to that. So I'm trying to distill my words planting seeds is such a great phrase and It's it's a it's a very subtle action. It's different from why won't you do this? I mean we a lot of us have our our metaphorical hands around the person's neck or we're on them on their case Do this do this do this So planting seeds is different and that would be two things first If you find yourself telling somebody something more than three times Something to do or recommendation or suggestion you are being controlling as the first one The second is the best way to plant seeds is to attract rather than promote and I would say this is in with regards to our own lives our own Religion as well is that we you know the crew the Quran spends a lot of time talking about How to attract rather than to promote Because promoting controlling that that can be so destructive and It can be actually very abusive and When you start to learn a different way of affecting people and You see how successful it is and how you can still feel good about doing it that is That is how you know that you are on the right track that you're on the right path and that would be you know not only taking care of yourself physically and emotionally but also Amplifying yourself spiritually And when the person sees that you are Detached from their disease and that you are happy, you know, you're well, I should say serene content You are you have a life, you know, you're not just staying at home You know depressed and no, you know, you don't have any friends. You don't have any activities You're just involved in your family's affairs the whole time. That's not having a life Having a life being involved in the community. It's so important to be involved with other people And taking care of yourself and having things that you enjoy when they see that they Actually gets them to start with me at themselves and I'm not just saying this, you know, based on like a personal experience or Because I read it like I have actually spent time and This is this is talked about this is this is well-known, you know hundreds of people meet Around the the world to talk about their experiences and doing this is once you start doing that you not only You know feel good about yourself and you fulfilled feel fulfilled But it can also get the other person to like I said start thinking about themselves and maybe wanting that too So that is how I would say is the best way to plant seeds Yes Okay What's on like I'm sorry I'm dealing with a lot of stuff too Like I was supposed to go to a talk and you're like, okay, you're talking about me aren't you? So I'm a little bit loopy and I I'm trying to learn to not apologize for myself I don't mind to say my age. I'm 40 years old my daughter of immigrants. I've lived in the state all my life I still don't know how to figure stuff out one of the biggest. I think drugs That's affected me was lack of empathy in this world in the home in the school in the workplace I Struggled with even my higher education and that's another thing that we get shamed about it's not just about about Substances if you struggle in any way You're made to feel like crap And even when I tried to get help in this county, I got here four years ago five years ago and I was in Being in Bay Area trying to get mental health help has become nightmare even here even before COVID If you're not supposedly like you know You know off the rails so to speak or I Pushed to the edge, you know, I guess what I'm trying to say is like one of the person I like to listen to I don't know if you've heard of him But a lot of what you're saying kind of relates. You know dr. Gabor Mati Who you know has worked with people with addiction? His Austrian I think I know that I've read his book. Yeah, I would love to meet him. I was like I feel like You know, I was that have you heard of a CRT houses Or CRT facilities I don't even know about that option till I had to go to the hospital and say I'm not leaving till someone sends me somewhere They sent me to John George, which you know, are you here about psychiatric facilities being scary? I'm sorry. Well, I guess it's sort of relating if if well You know, okay I've been trying to get back into a CRT house myself because I feel like actually even even the places that have 30-day or 60-day programs Would be good for me, but they don't have that for people that aren't supposed to on substances But it's true. They say I've heard the same part of the brain might light up Even with emotional stress that people go drug addictions. So I think you're making you made a really good point, which is that we don't have very good support for mental health I Would say The some states are better than others, but it's not very good and I'm really glad that you're talking about it because in some Muslim communities. Well, I wouldn't even say some and a lot They're not talking about it I was really surprised when I came here when people were talking about addiction and mental health I thought this is great because you have to shine light on it in order for it to to be healed there is a Lot of darkness, you know with mental health and with addiction a lot of like I said pain a lot of broken hearts and so when you are Talking and connecting to the community and showing up That's amazing, and that's the first step You're allowing light to come into those cracks and sometimes darkness will find its way to sometimes you'll get disappointed on top of it And there's nothing more painful than that, you know when you have salt rubbed into a wound so I'm sorry that well, I don't even want to say I'm sorry I I'm always sad to hear that and You're not alone for sure and I Just wish and that this is why when I give these talks I encourage people to go out of their houses and to go out of their bubbles and talk to talk to each other To go out of the screens, you know with their symmetry in their boxes and where everything is in the proper place and see that life is not um Life is not like a whole square hole where you fit a block in that there are all different types of people We're all as different as a fingerprint. We're all unique We all process our experiences differently. We all react to things differently respond in different ways And if we could have a little more compassion a little more tolerance to other people's eccentricities and also honesty into their truth, you know, we can we can Start to treat more and we can start to get somewhere And I feel like there's hope here because like I said people are talking about it and there are people with me who you know have been affected and We're working very hard to try to get the conversations to open up and to get people to Pay attention and to direct their priorities and their funding to this and if it doesn't happen, it's coming. I mean, this is This this is an epidemic it's an epidemic so so you're not alone Thank you for for sharing that Just a couple of questions Based on your experience Why people don't give up? the addiction Like one of the example would be somebody's in depression, right? They start taking medication, but they don't In the long term, they don't give up on it. They continue to take it and The second question would be this marijuana is getting legalized like most of the streets How it will affect the community in the long term. Oh, well, that's a good question. Okay. I got to write it down marijuana and then the first thing that you said was How to get people Why do people not give up their drugs? Yeah, based on based on your experience. I mean you may have seen it More than anyone else in this room. What's the reason behind this? It may be genetic also, right? It may be something happened in their life and because of that they're continuing to take Yeah, well, you gave the example of depression medication and I would say Depression medication is the treatment for their depression. So they should take it But I think what you're referring to is the self-medicating. Is that what you're referring to with drug use? No, not self-medication, but I have seen people who are in depression Oh, they will never get out of it like even this Medication also right people started, but it's difficult for them to get away from it Even though they can So that kind of thing. Okay getting out of depression Yeah, so you've made the connection between mental illness and addiction The first one I feel like that was a That's kind of a different thing Why people don't get out of depression despite taking medication? in some cases people have severe depression and You know one medication may not do it some people need to be on multiple medications sometimes It's in a depression. That's kind of a side effect of something else. So for example with schizophrenia, they can People with schizophrenia can sometimes develop a depression after the schizophrenia and severe situations Or there may be a mix effect and so That's that's one thing that I think of is people with co-occurring disorders of course also if you're using Substances, it's going to make your depression worse as well If you're not taking good care of yourself if you don't have good social support, it's hard to get out of depression I think the important point with this is that Medicine isn't and thank you that was a really great question because you brought up a very important point that I'm about to make which is that Medication is not the only answer medication should always be part of the solution. It's It's another drug. So, you know All medicines all substances are substances their drugs and so it has a chemical effect But it's not going to go anywhere and until You You bring the spirit and the emotions in as well And if you have a person who is really distressed who has never learned to form healthy relationships They can't make friends and so what happens when you can't make friends, you know when you can't trust anybody Then you're living like your whole life in solitary confinement. So it doesn't matter how much chemical you take if you're not happy How are you going to get better? How are you gonna heal? So that's why I'm I'm a big proponent of Meetings, you know going to the 12-step meetings Because I feel like that that gets you out. It gets you with other people and it gets you an opportunity to look at yourself Along with others in a very gentle way, you know bonding with other people and those meetings actually help you to form healthy relationships I you know therapy is another one, but therapy is also one-on-one And I think if not meetings, you know support groups getting yourself out there Is important now when I say that when I talk to people with severe addiction or even mental illnesses I can't just say get out get yourself out there because they're going to be around other people and there's they still don't know how to Form healthy relationships. That's why support groups are the way to go Why does a person not give up their drug or alcohol? That's what I tried to address with this presentation That's not an easy question to you answer Some of that has a lot to do with these characteristics so And then also, let me see right here to contributors. So In some cases the person may be self-medicating They may have had a severe trauma or severe abuse or neglect Everyone has different There are a few different reasons for why people feel, you know, the need to use some people say the substance becomes their best friend Some people just feel better taking it. That's all that they say. Some people don't even have a feeling. They'll just say I just do it's just a compulsion. So I Don't and then also the other thing is with the spiritual Some people say that well in some cases it may be Kind of replacing the the sense of spirituality. So if so the people who will use a lot they They can get away with not even thinking about in some case, you know spirituality or religion They may be the most unreligious people. They may have a total problem with God. Don't believe in God at all and so the substance You know can provide can fill something or distract them from something And that's why when they stop using the substance they feel this emptiness And that's why I talked about the spiritual deficit So it's it's kind of hard to to to pinpoint. I can't give a reason, you know Without talking to someone else. So what I have done is gone to a meetings and the NA meetings And I listened to what they say and I listened to the patients to and the the bottom line is that it really doesn't matter Why they use? What matters is is what what can I get them on to instead and I try to get people on to that your life can be much more enjoyable and much more fulfilling Much more fun actually without drugs without alcohol and this is how so with the marijuana The effects of the legalization so It is it is being used a lot more frequently that marijuana that it has been in You know previous decades and the marijuana has also gotten a lot stronger. So I Think they say it's about like four to ten times stronger than it was in the past We have synthetic marijuana entering the market This type of marijuana causes symptoms that are similar to PCP, which is like agitation tremor high blood pressure high heart rate hallucinations Psychosis these are patients who are coming into the ER with these symptoms a lot of young people. Unfortunately, you're coming in with these symptoms It's already having its effects. I've dealt with people who have and one of my mentors at UCLA Ran a adolescent rehab and he said that we see psychosis all the time from marijuana. So It's going to take a while like it always does for people to sit down and say, okay, this amount is harmful This is what happens. This is this is the result of it To answer your question. It's already showing up and It's not being broadcasted because unfortunately Like it is with the drugs and pharmaceuticals that they're competing interests and there are people who are making money So I try to as much as I can educate people that the marijuana is no longer Safe as it once was and especially if you're using heavy You're using heavily which would be more than once a week and you're using Just marijuana on the market now is just so much stronger. So if you're using synthetic substances, it's It's deaf. It's definitely much more harmful We are very blessed that Dr. Arianna is not part of our community Takes care of us. Masha'Allah and many people know that before We had a substance abuse support group here and the substance abuse We had a substance abuse support group here and that kind of stopped working Because of COVID but now we have the we have some expertise here. So we're gonna be restarting that inshallah So just keep that in mind as I go ahead. I know there's still some questions in the room But I think we're a few minutes away from so her and so can you stay around for a little bit? Yeah, okay. Okay. Okay. Dr. Rene could stay around for a little bit shot. So just a coffee sound like them