Barriers and Facilitators to Accessing Inpatient and Community Substance Use Treatment and Harm Reduction Services for People Who Use Drugs in Muslim Communities: A Systematic Narrative Review of Studies on Service Users and Providers Experiences

Background: In many countries people who use drugs (PWUD) find it difficult to access treatment services because of the social stigma and the negative attitude of the health professionals (Gilchrist et al., 2014). PWUD in Muslim communities face particular kinds of stigma where the culture is conservative (Arfken & Ahmed, 2016). American Muslims, for example, especially women with substance use problems tend to seek treatment in isolated facilities where they cannot be seen by others from their community (Arfken & Ahmed, 2016). This narrative review seeks to answer the following question: ‘What are the barriers and facilitators to accessing treatment services for PWUD in Muslim communities?’

Method: Seven databases have been searched using the different concepts of drug addiction, Islam and health services accessibility including quantitative, qualitative, and mixed methods studies conducted in a Muslim country or where data were presented separately for Muslim communities in other countries.

Results: Key themes included: Meta theme: Stigma. This included 2 themes: Theme 1: Psychosocial •Individual disposition •Privacy •Social support •Islam •Women who use drugs Theme 2: Organizational •Affordability •Services •Awareness •Staff •Drug use registration •Interaction with the police

Although the findings were similar to other studies in non-Muslim countries. Based on the theories of individualism vs collectivism the origin of these barriers and facilitators explain the difference.

Conclusion: This narrative review gives an insight to how barriers and facilitators to access drug treatment and harm reduction services are similar or different for PWUD in Muslim communities. It shows how stigma impacts psychosocial and organizational factors with the emphasis of how different the source of stigma in Muslim countries compared to non-Muslim countries.