Kuwaiti critics find 12-step cure for addiction goes too far

Opponents argue that western-style programmes and support groups for treating drug addiction are inappropriate for the region.

KUWAIT CITY // Every week in a candlelit room rented from one of Kuwait's few churches, about 20 men and women gather in a circle to share their darkest thoughts, a western form of treatment for drug addiction that some Kuwaitis believe is alien to the region. "I tried everything to quit: praying, travelling, getting back with my girlfriend, hospitals, changing the drug, but I always kept coming back to heroin," said one of the addicts, 25, after the session concluded with a round of handshakes and hugging. "Meetings are the right way to quit.

"We don't bring a doctor and put him in here. We help each other: this is the solution. We all have the same problem, so we pray [for] ourselves and we help ourselves," the Egyptian, who was raised in Kuwait, said. The group consists of young and old Kuwaitis, other Arabs and westerners. They believe they can express thoughts of suicide, anger or emptiness with each other without fearing the rejection that might come from people with less experience of drugs. By venting their emotions and listening to each other's stories, the addicts hope to remain clean. The meeting is one of about 50,000 that are held across the world by Narcotics Anonymous (NA) every week.

But for some people in Kuwait, the western model of treating drug addiction with a spiritual - not necessarily Islamic - 12-step programme and meetings with addicts who could be strangers is not consistent with the country's religious and familial traditions. Abdul Hamid al Bilali, the chairman of Bashayer al Khair, a local society promoting a more home-grown Islamic solution to addiction, summed up his organisation's approach when he said in a promotional video: "We have to make them reach an ecstasy stronger than drugs, and this is the ecstasy of faith."

Patients who sign up for the organisation's programme memorise the Quran and are encouraged to feel penitence and visit Mecca. Although Mr al Bilali is a member of the Islamist political group, the Muslim Brotherhood, the society says the two organisations are not connected and its funding comes from other charities and the public. Bashayer al Khair allows patients to protect their identities with the option of private rather than group counselling. Women - who make up between 10 per cent and 15 per cent of the patients - are treated separately.

"Because Kuwait is a small society, anonymity is not an option," said one of the volunteers at the charity who called himself Abu Saad, a 57-year-old former addict who used to travel to Goa and Kathmandu to binge on heroin. "You have to establish a programme to suit your environment; you can't have a copy of Narcotics Anonymous." Abu Saad said his sons are reaching the age when they will marry, and if he is known as an addict in the local community, they will struggle to find brides. He said group sessions with strangers are not necessary either because the Gulf's strong family networks provide addicts with a forum in which to share their thoughts.

Bashayer al Khair claims to have philosophical differences with NA's method for treating addiction. "They say, 'Don't feel remorse and don't feel guilty,' but we believe taking drugs was your choice and it is you who harmed your loved ones," he said. "It's a positive remorse that pushes you away from the addiction and encourages you not to go back." Abu Saad said the society has helped 1,300 addicts "reach the safe side" since it began its work in 1992. Many patients joined the programme through an early release scheme from prison and the society is now in talks with the government to open a new centre for about 120 prisoners who sign up every year. A society volunteer, who called himself Abu Fahid, 36, was sent to jail for five years in 2003 after police discovered him unconscious in his car after injecting heroin. He was recruited by Bashayer al Khair in prison, and now he tours the country's schools to educate pupils about the dangers of drugs.

Abu Fahid said, unlike NA, the society's programme encourages patients to mix with volunteers who are recovered alongside others who have never taken drugs. He said the association with respected people "makes people trust us more". Most addicts in Kuwait currently undergo treatment at a government-run addiction hospital that opened a new facility in 2005. The consultant psychiatrist who heads the self-admission unit, Mamodh el Gamal, said the hospital treated 1,336 inpatients last year and 2,875 outpatients. He said 359 of the inpatients were sent by the court and the rest signed up voluntarily; 84 per cent of those treated were Kuwaitis. He said most of the addicts abused multiple substances and the most popular are heroin, alcohol, amphetamines and hashish.

The centre uses the 12-step programme favoured in the West and groups representing Narcotics Anonymous and Alcoholics Anonymous meet there regularly. Volunteers from Bashayer al Khair also assist, but they are not given free rein to implement their theories. Whether western or Islamic-based treatments are best for addicts in the Gulf, a clinical psychologist at the hospital, Khaled Essa, said the region's strong family traditions can both help and inhibit recovery.

"The patient must face all the consequences of his addiction," and this can happen quicker in western countries, Mr Essa said. "Here, the patient might not reach his threshold of pain because families cover for him with financial support, legal support and acceptance, and this enables addictive behaviour. "But once the patient begins to commit to the programme, the social support network of the families may help the patients to be reintegrated once again into the community," he said.