Is it permissible to use medication that includes alcohol and pig products? If it is valid, for what cases can they be used?

Dear Brother / Sister,

“Spirit, beer etc. that are not made from grape wine cannot be drunk but it cannot be claimed that they prevent prayer when they are spread on the clothes or the body." (Hak Dini Kur’ân Dili, II/763.)

As it is understood from the quote above, the alcohol in perfumes and eau de cologne is not included among the alcohol types that are regarded as dirty by some imams of Hanafi madhhab; therefore, they do not prevent prayer when they are spread on the clothes or the body. They are regarded as dirty according to the other madhhabs like Shafii and Hanbali; therefore, it is necessary to wash the places where they were spread before performing a prayer.

* * *

The Messenger of Allah stated the following:

"Be treated. Allah did not create any illness without a cure. Allah did not create cures in the things that He rendered haram." (Abu Dawud, Tibb 11; Muwatta, Ayn 12)

A Companion called Tariq b. Suwayd asked the Prophet about hamr (wine). He prohibited it. Tariq said,

"But we use it as medication." The Prophet said,

"It is not medication (cure); it is trouble." (Muslim, Ashriba, 12)

According to what Bukhari narrates, Ibn Masud said,

"Allah did not create your medication in the things that He rendered haram." (Bukhari, Ashriba 15) The Messenger of Allah (pbuh) said,

"May Allah not give a person cure who seeks cure in wine!"

In the light of these hadiths, the majority of fiqh scholars concluded that one could not be treated by dirty and haram things including wine and pig products (under normal circumstances). What is meant by normal circumstances is when alternatives are found for medication that includes alcohol, pig products or other dirty substances or when they are not found, there is no vital risk for the patient.

However, when there is no medication to replace the medication that includes alcohol and pig products and if a Muslim specialist (doctor) says the patient will risk his life if he does not take this medication, almost all fiqh scholars accept that such medication can be taken in the minimum amount that is necessary.

The views of Hanafi maddhab regarding alcoholic drinks are various and detailed:

1. Hamr (Wine): It is obtained when wet grape juice is kept as raw, becomes tangy, is fermented and foam forms. This is regarded as sheer impurity. It is haram to use it for any purpose and sell unless it is transformed into vinegar. It cannot be used for things like disinfection, hair care, etc. It cannot be used after it is boiled if it is not transformed into another substance by chemical reaction (istihala). According to the relied view in the madhhab, it cannot be used for treatment, either. The decree does not change when the amount is little or much. 

2. Tila: It is the alcoholic drink that is obtained when wet grape juice is boiled until two-thirds or less of it evaporates and then becomes intoxicant. If it is boiled until less than two-thirds of it evaporates, it is called “baziq”; if it is boiled until half of it evaporates, it is called "muhassaf". These two are unanimously haram. If it is boiled until two-thirds of it evaporates, it is called "muthallath", which is the real “tila”. According to Imam Muhammad, it is haram; according to the others, it is halal. Fatwa is based on the view of Imam Muhammad. Therefore, “tila” is dirty like “hamr”.    

3. Sakar: It is the drink that is made from wet date juice as raw; it becomes tangy and foam forms.

4. Naqi: It is the juice that is obtained from raisin as raw; it boils and foam forms. The last two are haram but according to Sarakhsi, their impurity is light. Besides, all of the three except “hamr” are halal and clean unless they boil and become tangy. (For more detailed information regarding the issue, see Ibn Abidin, VI/448 ff.)

According to Hanafi maddhab, (Abu Hanifa and Abu Yusuf), the beverages except these four liquids are halal and clean; it is permissible to buy and sell them. Accordingly, spirit, eau de cologne and the types of alcohol that are produced through methods and substances other than the ones mentioned above and that are used as solvents in syrups and essences are clean; they can be bought and sold. 

However, an amount of them that can intoxicate is unanimously haram no matter what it is made from; and according to the majority of the fiqh scholars and the view of Imam Muhammad, on which fatwa is based in Hanafi madhhab, if a large amount of anything causes intoxication, a small amount of it is also haram and dirty; it is not permissible to buy and sell it. According to some fiqh scholars, intoxicants are haram but they are not dirty; they can be used in disinfection and externally. 

Therefore, Hanafi madhhab is a saver that can be applied especially for today by being “the middle way” regarding the issue. However, since we cannot ignore the view of the majority of the fiqh scholars and Imam Muhammad, it is necessary to regard the view of Abu Hanifa and Abu Yusuf cautiously and it can be used only in treatment and disinfection temporarily.

These views are valid for liquid beverages. The solid ones like henbane and opium are regarded as legitimate for medication; therefore, they can be used in treatment in amounts that will not intoxicate; it is permissible to sell them since they are clean. (see Ibn Abidin, VI/455.) (Allah knows the best.)

As for hamr (wine), which is unanimously agreed to be haram and dirty, being used in treatment, according to what is reported from a group of imams from Balkh, it depends. If it is certain that it will be useful, it is halal to use it. (Fatawa al-Hindiyya V/254-55; Qasani says the same thing; see 1/61.) For, it is permissible for man to eat a small amount of something haram so as not to die when there is nothing else to eat and for a person who to drink a small amount of alcohol so as not to be choked if he cannot find any halal drink. 

According to Imam Muhammad, the bones of the creatures except humans and pigs can be used in the production of medication in any case. According to some scholars, medication can be produced from the bones of the animals whose flesh is not permissible to eat if they are slaughtered in accordance with the rules of the religion of Islam and if the bones are dry.

Hamr (wine), which is unanimously agreed to be haram and dirty cannot be used in treatment unless there is a necessity; it cannot be used in brightening the hair, in gargling and in injections. (Ibn Abidin, VI / 449)

It is necessary to know the content of the medication that includes haram substances from pigs, etc. If they underwent a chemical reaction, it is not haram to use them since its impurity is removed. If it did not undergo any chemical reaction, it is haram to use it unless there is a necessity or according to some other scholars, unless it is stated by a reliable specialist that it is the definite cure and there is no alternative. 

In our fiqh books, the following phenomena are shown as examples to chemical reactions: pig being transformed into salt by remaining in a salt pan, manure being transformed into soil by remaining in soil, dried dung being transformed into ash by burning, the blood of musk deer being transformed into musk; dirty olive oil being transformed into soap. (see Tahtawi: see also Makhluf, 11/121, 140; Qadihan, IH/403; Ibn Qudama, Mughni, IH/605; Namankani, al-Fathurrahmani, 1/63; al-Khattab, al-Manhal, II/206 Zuhayli, al-Fiqhul-Islami...) However, Abu Yusuf does not regard chemical reaction as a reason for being clean. Nevertheless, fatwa is not based on his view.   

We think we have answered your question to a certain extent with the explanations above. However, it is clear how complex and sensitive the issue is. Therefore, those who take medication should search the issue consciously and those who prescribe medication should act very carefully about finding alternatives to the medication that contain haram substances and that have no alternatives and if there are, using the alternatives and synthetic ones.

We do not know how true it is and how appropriate it is in terms of medicine, but a scholar from Konya told us the following incident: a doctor told the my friend’s mother, who was suffering from a chest disease, to drink beer to heat her chest and that there was no alternative to it. When a Muslim doctor was informed about it, he said diluted pekmez (grape molasses) would be more beneficial than beer. Pekmez turned out to be better. 

(see Faruk BEŞER, Fetvalar, p.181-186)

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