A Broader View on Substance Use

I am sitting at my desk waiting for my first patient and scratching my head at the number of notifications I have received about a drug and substance use prevention program to be held in this community in the coming days. I believe that we need many such programs but I cannot fathom what the goal of this event is. Excuse my cynicism, but 30 years ago a medical colleague and I were asked to develop a program for third through eighth graders on personal safety which included a major segment on how to avoid using illicit substances. The program was government funded and designed for yeshiva students. Thirty years ago only one local yeshiva allowed the program. Many of the other school principals the program was offered to did not respond to the offer and those that did smugly stated that they either did not have a problem or whatever problem they had was being handled internally. Since then some shuls have banned hard liquor on their premises and, to their credit, some schools have had assemblies once a year to discuss substance use with their students.

None of the interventions have curtailed the explosive use of alcohol and drugs in our communities.

Twenty years ago, I presented a detailed overview on the topic of addiction to parents at a local school. We discussed warning signs where and how to get help if there was a particular concern or indication of a problem and how the local police might assist. The program was mandated by the secular studies principal of the school for all parents. Only about half of the parent body attended. Similarly, just three years ago I was asked to do another program for a different Yeshiva in another community. This program, cosponsored by local shuls drew only about 25 percent of the mandated parents. “It’s not that parents don’t care” one of the attendees told me, “It’s just that they have so much to do.” I have children, I would find the time to attend a school mandated event. I don’t understand the excuse.

Here, however, is the bigger issue. I have always maintained that the problem is not just the teenagers, or even the 11-year-olds who I have seen getting drunk. It is the parents and the communities.

Go to any wedding or bar mitzvah party and see how much liquor is consumed. Not just whiskey, but single malt, $100 a bottle variety. I have been to more than one wedding where, even before the wedding ceremony begins, many of the young guests were throwing up from too much alcohol.

Parents boast to their friends about sacramental wines they have found. The varietals flow like water at the Shabbat table.

Even more disturbing is the easy access children have to their parents medicines. How did the 12-year-old boy know which pill to take from his mother’s medicine chest, and crush and snort it for maximum effect? More importantly, why would he do it?

It is far too easy to blame the children who are bad influences and the media. We tend to seek out easy scapegoats. It is easier to place blame elsewhere than to look at ourselves. Children tend to mimic adults, particularly parents. If it is alright for a parent to get so drunk on Simchat Torah or Purim that they throw up on their lawn or that three or four bottles of wine are drained at every Shabbat meal the example becomes a standard to be followed. And yet, there is more.

Many teenagers can be attracted to substances because they want to belong to something. They may want to experiment because teens feel invincible. Or, they may not feel quite right and drugs allow them to feel better. In one recent situation an adolescent started using drugs because she told me “I feel more human when I use them.” After some assessment we found that she had a significant anxiety disorder with panic attacks. She told me that she had discussed her feelings with her parents many times. “They just said to get over it.” I asked the parents if that were true. They admitted, yes. Why? Because they were afraid that if this child had a diagnosed disorder it would impact the family and make it difficult to find a shidduch for all their children. They also admitted that they tended to have a drink of alcohol daily, two to three times daily. In another situation an 8-year-old child asked me why his parents always take pills or smoke. I have numerous examples. They all point to the need for parents to honestly address their own addictive tendencies.

There is another angle as well. The community leaders who tend to trivialize or, at best, minimize the problem give cover to drug users and alcoholism. AA and NA meetings are filled with people attempting to stay in recovery but very few of those meetings are ever held in a shul. You can find the meetings in community centers and churches but rarely in a Jewish place of worship. We can only confront the problem when we accept that it is a problem for us too.

I welcome the community’s attempt to begin finally addressing the issue of substance use. I just hope that the impact is broader, more wide ranging, more about all the issues and not about finger-pointing.