Abstract
Despite growing recognition of drug and alcohol (D&A) use as a public health concern, carers from South Asian and Muslim (SAM) communities in the UK remain largely invisible. This article explores how stigma, emotional pressures and faith-based prohibitions shape SAM carers’ experiences of supporting individuals with problematic D&A use, with a culturally informed approach. A qualitative study recruited eight carers, two practitioners and two community ambassadors in two UK regions during July 2023–January 2024. Carers supported individuals whose substance use they identified as problematic, describing patterns consistent with the classification of mental and behavioural disorders in the tenth version of the International Classification of Diseases, though formal verification was not obtained, as this would have excluded ‘hidden carers’. Recognising that SAM frameworks define any use as problematic (lower thresholds than clinical criteria), we used reflexive, community-led sampling. Semi-structured interviews with participatory research group members identified three themes: faith, stigma and silence; social and psychological impacts on SAM families; and religious and cultural barriers to addressing D&A use. Most carers rely on informal networks for support due to a lack of awareness of mainstream services and religious institutions not equipped to address their needs relating to problematic D&A use. Definitional mismatches between cultural (any use is problematic) and clinical frameworks (specific diagnostic criteria) obscure recognition of escalating D&A problems, leaving carers distressed and services inaccessible. This study, led by a SAM community member, gives voice to hidden carers’ experiences and identifies their unique challenges through methodological innovation. Our findings advocate for co-produced, culturally sensitive services that bridge definitional gaps and position SAM carer support within a social justice agenda addressing cultural responsiveness and structural inequities.
| Original language | English |
|---|---|
| Pages (from-to) | 1-21 |
| Number of pages | 21 |
| Journal | Global Discourse |
| Early online date | 12 Jan 2026 |
| DOIs | |
| Publication status | E-pub ahead of print - 12 Jan 2026 |
Keywords
- stigma
- carers
- minority ethnic group
- religious identity
- substance use
- izzat
- cultural-clinical mismatch
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