The tendency of our community to shower disgrace upon people who
have personal experience with the problems of substance abuse ensures that those who could
speak out must hide in secrecy and shame.
The Disease in Our Own Backyard
Alcohol and drug abuse is a disease. It is a fatal illness that begins with casual or experimental use of a chemical for its mind-altering effects. It rapidly becomes an addiction, which involves loss of control over the substance or behavior, and eventually leads to self- destructiveness. Most experts in addiction consider it a disease, thereby absolving the addict of responsibility for the addiction while leaving him totally responsible for his behavior. Misbehavior and infractions of the law deserve punishment and discipline. Illness deserves treatment.
The myth that Jews are immune to the diseases of addiction prevails, though it has been losing its credibility. The textbooks on substance abuse still cite outdated references that Jews drink more alcohol per capita than any other identified ethnic group, yet have a remarkably low rate of alcoholism. Current experience of addiction professionals does not support this contention. Drugs of abuse were once inaccessible to Orthodox Jews. Unfortunately, times have changed to our disadvantage.
There was once a small number of yeshivah students who left the fold
of mainstream Jewish education. We have since witnessed the growth of Torah institutions
focused on attending to the wayward, dropout, behavior problem students, many of whom have
already been introduced to lifestyles that were never encountered by the Orthodox
community. As lofty a goal as saving the wayward adolescents might be, it is also a huge
undertaking that meets with less success than intended. One of the chief enemies is drugs.
Academic discipline and the best of mechanchim are far too weak to counter addiction.
While we need to identify how this deterioration occurred, the rejection of these obvious facts deserves attention. I have spoken to many rabbonim and roshei yeshivah about suggestions to address the problem and have met with resistance. I have no thrill in treating Jewish addicts. I could utilize my skills and experience elsewhere. But I anguish for those whose existence is relegated to fantasy, whose cries for help are dismissed by our own leaders.
Is Marijuana Harmless?
Marijuana, often considered a "soft" drug, can be found in too many yeshivos today. As a long-acting drug which is relatively inexpensive, it is rarely seen as a parallel to "hard" drugs which are more physically addictive. Yet, it is highly destructive to a great many body and brain functions. Its academic consequences are devastating, and include poor concentration, impaired memory storage and retrieval, distractibility, and comprehension impairment. These are witnessed in falling grades and general disinterest. The retention in the body of THC, the active ingredient in marijuana, is quite long -- up to six weeks -- and the impairments continue to be wreaked while even trace levels remain in the system, long after the "high" has dissipated.
The bland attitude towards marijuana is compatible with the social acceptance of tobacco smoke. The scientific research is overwhelmingly conclusive that tobacco, in any form, is toxic, carcinogenic, and dangerous to several body systems. The studies on marijuana are similar, but the numbers must be multiplied by a factor of 25-30. The halachic ramifications of ingesting a dangerous chemical are obvious. I have no question about the impermissibility of tobacco or marijuana; but it is recognized poskim who must act upon this information and clarify the halachic details.
From my files...
Hard Drugs and Our Children
Intravenous (IV) drug abuse is rising again in popularity, having lost some of its appeal with the outbreak of AIDS. The picture of the "bummy"-looking drug user sitting in the back alley with a needle in his arm is not the prototype addict. Many drug users dress well, hold jobs, socialize, and give the appearance of managing well. Many -- particularly younger addicts -- rate the label of "functional addicts," having not met with terrible brain and body damage, yet. Some of these teens -- even our religious ones -- excuse their behavior by claiming to know adults who function well while "successfully controlling their addictions." This is equivalent to being "a little bit pregnant." Addiction is a progressive disease that only gets worse. It doesn't stagnate or improve on its own.
It is a fatal error to judge an addiction by the drug of choice, the route of ingestion, the dollar value or volume consumed, the frequency of use, or the degree of physical dependency. It should rather be seen in terms of the resulting dysfunction in all spheres (health, occupational or academic, financial, legal, social, family, mental, and spiritual). As it destroys the addict, it severely affects many others, including the immediate family, friends and co-workers. In the frum community, where family ties tend to be stronger, this impact is usually quite serious.
The Experience of the Addict
The alcoholic/addict submits to treatment after "hitting rock bottom." This connotes a state of affairs in which he/she can no longer tolerate the addiction and becomes willing to change. This event is often catastrophic, and may involve arrest, overdose, suicide attempts, major medical problems, job loss, financial ruin, family breakup, or other losses. The addict is generally unable to recognize the loss of control, especially because it crept up gradually. The disease of addiction is the only one known to science where the denial of its very existence is a hallmark symptom.
At this point, the loss of control is often obvious to others, though it may not be clear that addiction is the culprit. The classic sequence of events involves a phase when the addict becomes aware of a downward spiral of his/her life, but feels totally powerless to arrest it. Since denial of addiction is dominant, anybody and anything else is easily blamed. This tends to increase the suffering of family and other close ones. A long list of excuses to avoid change is common. Therapists are often amazed by the creative combination of genius and folly that generate the greatest excuses.
Eventually "rock bottom" hits. Some addicts declare their powerlessness and enter treatment willingly. Some are forced by circumstances, family, the courts, or employers to go for help. Others stick with their destructive illness to the bitter ends of homelessness, poverty, divorce, unemployment, incarceration, disease, or death. Halachically, an addict qualifies as a choleh sheyaish bo sakanah (a sufferer of a life-threatening illness) for whom violating Shabbos may sometimes be indicated.
Those who wish to help addicts need to remember that enabling them to continue their addiction is tantamount to assisting in their murder. We need to be alert, especially with regard to those asking us for money. Addicts have discovered that soliciting tzedakah is a successful technique to finance a drug habit. If a known addict comes to my door for tzedakah, stating that he has no food to eat, I offer food -- not money (which could finance the next purchase of drugs that could kill him/her). Yet the family abandoned by the addict often needs our help and support. The community should not forsake husbands, wives, or children victimized by the addict/alcoholic who is unable to provide for them.
From my files...
What Came Before the Addiction?
People do not normally take medications they don't need. If feeling "normal" somehow becomes intolerable, one seeks relief and will use medicine to help. Mind-altering drugs are invariably used to self-medicate, not to find pleasure (despite the pleasurable experience of the "high"). Identifying the perceived condition that the addict medicates is most challenging, and this is where skillful group or individual therapy is critical. Commonly found are a plethora of emotional consequences of abuse (verbal, physical, sexual) and neglect, various problems in adjustment related to educational and academic problems, and underlying psychiatric and psychological problems.
From my files...
Getting the addict into treatment involves another major hurdle. Where should one go? There are many rehabilitation centers across the country that offer residential or inpatient treatment for a specified time period, usually 28 days. Existing health insurance limits this time. Day hospital and outpatient services are also available.
One of the most frequently-asked questions is: Where can I find a
Jewish treatment facility in United States? The answer: You can't, and don't bother. I
believe an observant Jew should have religious needs respected and accommodated in
treatment. But our community has not accepted the disease enough to support such a
facility. We would probably not send our family members there, in order to protect our
The prevailing attitude in addiction treatment is that the disease is a manifestation of spiritual deficit. The 12-step approach (Alcoholics Anonymous, and other groups) refers amply to God as we understand Him and to a "Higher Power" (with virtually no reference to any specific religion). Reconnecting a recovering addict to a simple faith in God while allowing the pursuit of his own religious context is just what the addict needs to recover as a mentsch -- and then he can learn more about being an ehrlicher Yid.
We Can Still Save the Future --
If We Dare
I often ask an addict seeking therapy a simple question: Would you
be willing to report the names of the dealers who sold you drugs to the law enforcement
authorities? The addict's answer may well reflect his or her true level of motivation to
Dr. Benzion Twerski is the staff psychologist at Substance Abuse Services at Elizabeth General Medical Center in Elizabeth, New Jersey. He is on the professional advisory boards of JAADD (Jewish Association for Attention Deficit Disorder) and JACS (Jewish Alcoholics, Chemically dependent persons, and Significant others). He has written and published in a wide variety of lay and professional periodicals, and lectures on addictive disorders in the Jewish population.
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