Sarah Gad got hooked on opioids the same way many others do in this country — with a doctor’s prescription.
A devastating car accident resulted in broken bones and a fractured skull. It stripped Gad of her ability to walk and speak.
Gad’s physician prescribed Percocet and Oxycontin to lessen her pain. Before long, the third-year medical student was dependent on the drugs, even after she recovered from her injuries. When she could no longer get the drugs from her doctors, she began forging prescriptions, which landed her in jail.
Her family was stunned.
"My dad, he was very sympathetic, but my mom didn't understand that addiction was a disease. She thought it was something that I could just stop on my own,” said Gad, 32, whose parents moved from Egypt to Minnesota in the 1980s. “So, she just kept asking me, like, 'Why can't you just stop?’ like, ‘You're ruining your life.’”
Substance abuse is stigmatized in many communities. But Gad, who was raised in a traditional Muslim family, knew that drug use was especially frowned upon and viewed as sinful and taboo.
For many in Minnesota’s Muslim community, drug and alcohol addiction is often silent struggle, even as efforts are underway to discuss the condition openly.
Gad said her older sister had struggled with addiction a decade earlier — and she also kept it a secret from her family.
"Even in American culture, the disease of addiction is so heavily stigmatized,” she said. “So, culturally it was even more, I guess, shameful."
Shame and fear are two of the main reasons that keep many Muslims from talking about drug and alcohol use. Islam prohibits the use of any substance that alters the mood or mind, and some fear being judged and labeled as sinners.
And for women who wrestle with addiction, the stigma can be even worse. Some say they’re told by their families that if they talk about their problem, they’d be shunned or labeled as “damaged” and lacking marriage potential.
But a number of recent deaths in the Somali-American community are bringing the issue to the forefront. The deaths, which community members and addiction counselors suspect are the result of opioid overdoses, have led to an effort to normalize addiction treatment and provide culturally competent counseling.
Yussuf Shafie runs Alliance Wellness Center in Bloomington, which bills itself as a first-of-its-kind treatment facility in the Twin Cities aimed at helping East African clients recover from drug and alcohol addiction. Shafie opened the clinic in 2016 and added an additional inpatient component last year.
Shafie, a drug and alcohol counselor, says he went to four different funerals during the month of Ramadan this year. The deaths, he said, were caused by gun violence or drug overdoses.
“Our youth is struggling with this,” Shafie said. “We have to be honest and face these things and people are dying and the moms are wondering what’s going on.”
At least 331 people died from opioid overdoses in Minnesota last year, according to preliminary numbers from the state department of health. The number includes prescription opioids, as well as heroin and the synthetic manufactured fentanyl.
“Addiction has no face,” said Mohamed Hussein, who works at the inpatient program at the Alliance Wellness Center.
Hussein was born in Saudi Arabia and grew up in Kenya and Canada before moving to the United States. He’s been sober for one year and said he can relate to his clients and their desire to stake out an identity.
"I'm Somali, I'm Muslim, I'm African,” he said. “Just the setting that I was in, it was pretty hard for me to fit in. That emotional aspect, as well, was a pretty big leading factor in my substance abuse — just not being comfortable with myself and not really knowing myself."
Islamic treatment center
There is a shortage of treatment beds in general, but it's even more difficult for Muslims to find programs that incorporate religion and culture. For example, some Muslim families believe that drugs and alcohol are "jinn," or an evil spirit that has overcome the body. They may not understand that treatment is a lengthy process with various steps.
Imam Makram El-Amin, of Masjid An-Nur, a mosque in Minneapolis, says the Muslim community is starting to realize that prayer alone isn’t going to treat addicts.
“The messaging coming from leaders in many respects was just to be more faithful, to pray more, to just trust God, etc.,” he said. “And while all those things are true and I believe them, I also understand that this is a particular situation that needs professional intervention and care.”
El-Amin is opening his doors to a drug counselor who wants to open an outpatient treatment center at the mosque.
Tucked in the lower level of El-Amin's mosque is an office where Al-haqq Zayid is trying to open the Zulu Islamic Treatment Institute.
Zayid says he experienced discrimination when he went to treatment himself. Now he's hoping to offer space for other Muslims seeking help.
“They need a safe environment where they can worship without being intimidated,” he said.
Gad, the former medical student, has been sober since 2015. She went against family pressure to stay silent and detailed her story of addiction and overdose in a personal essay published in Marie Claire magazine. Gad is now a law student advocating for medication-assisted treatment.
At first, her mother was adamant that she not publish her experience for all to see and possibly judge. But an outpouring of support from her Muslim friends showed a level of compassion that has helped her family come around to discussing addiction openly.
“It was such a shame that I had been so reluctant to speak about this before because the compassion really was there,” Gad said.
Correction (Sept. 17, 2019): A previous version of the story incorrectly stated the total number of opioid deaths in Minnesota. The story has been updated.