Jewish Family Service Houston is keenly aware that addiction and substance misuse exist in our community across the lifespan. We are highly sensitive to the stigma and judgment surrounding care-seeking by users as well as by family and friends and we are here to support your emotional and treatment needs through confidential consultation, counseling, coaching and referrals. We are not in denial that we Jews, like other faith-based communities, are facing the costly and tragic consequences of opioid addiction and we are poised to increase psycho-education and treatment throughout our community.
Do not suffer in silence or watch your friends or loved one’s struggle with substance misuse in silence. We are here to support you emotionally and to help educate our community about the reality of substance misuse and addiction.
JFS hosts Al-Anon each Wednesday night at 6:45 PM and the office is closed so confidentiality is upheld.
Jews and Substance Misuse
Awareness of addictions in the Jewish community is becoming increasingly prevalent, and yet, a gap exists in the literature regarding addictions in this community. Knowledge about the prevalence of addictions within Jewish communities is limited; some believe that Jews cannot be affected by addictions. To address this gap, a pilot study was conducted to gather preliminary evidence relating to addictions and substance use in the Jewish community. Results indicate that a significant portion of the Jewish community knows someone affected by an addiction and that over 20% have a family history of addiction. Future research needs are discussed.
The prevalence of alcohol and substance use in the Jewish community remains uncertain, possibly due to the existence of some denial of addictive behaviors in this community. Israeli evidence documenting the lifetime prevalence of drug use in Israel is 13%. Yet, to date, it appears that a large portion of the North American Jewish community views alcoholism as an illness, has a strong fear of alcoholics, and blames individuals with addictions for their condition. One possible conclusion is that Jewish people believe that members of the Jewish community simply do not become alcoholics, so they are convinced that they are not exposed to people with addictions. Therefore, they lack the ambition to seek education on the topic and become naive to the reality of the prevalence of addictions in the Jewish community. The myth existent across Jewish communities is that Jews cannot have addictions. “Over the years, this long legacy of denial among Jews has resulted in unnecessary pain, heartache, and a great deal of alienation from Judaism by those suffering from addiction. It has also served to prevent some suffering Jews from seeking or accepting appropriate help”.
The refusal of Jewish alcoholics is also shown when a large number of Jewish people claim that they do not know any heavy drinkers. These views contribute to an active denial stage in Jewish addicts. The belief that Jews do not become alcoholics results in leaders of the community failing to address the problem and discourages health professionals to conclude the diagnosis of an addiction of a Jewish person. While these views may have changed on a societal level, empirical
evidence on this topic remains limited, resulting in outdated reflections of addictions in Jewish populations which may not accurately represent the current reality. For instance, Jewish Alcoholics, Chemically Dependent Persons, and Significant Others, commonly known as JACS, is a self-help program for Jews and loved ones coping with addictive behaviors. JACS groups are located throughout Canada, the United States, Australia, Brazil, and Israel and are indicative of the existence of addictions in Jewish communities internationally.
Alcohol and Substance Use in the Jewish Community: A Pilot Study, Journal of Addiction
Learning about Addiction
Addiction is defined as a chronic, relapsing disorder characterized by compulsive drug seeking, continued use despite harmful consequences, and long-lasting changes in the brain. It is considered both a complex brain disorder and a mental illness. Addiction is the most severe form of a full spectrum of substance use disorders, and is a medical illness caused by repeated misuse of a substance or substances.
Why study drug use and addiction?
Use of and addiction to alcohol, nicotine, and illicit drugs cost the Nation more than $740 billion a year related to healthcare, crime, and lost productivity.1,2 In 2016, drug overdoses killed over 63,000 people in America, while 88,000 died from excessive alcohol use. Tobacco is linked to an estimated 480,000 deaths per year. (Hereafter, unless otherwise specified, drugs refers to all of these substances.)
How are substance use disorders categorized?
The latest Diagnostics and Statistical Manual (DSM-5) describes a problematic pattern of use of an intoxicating substance leading to clinically significant impairment or distress with 10 or 11 diagnostic criteria (depending on the substance) occurring within a 12-month period. Those who have two or three criteria are considered to have a “mild” disorder, four or five is considered “moderate,” and six or more symptoms, “severe.” The diagnostic criteria are as follows:
- The substance is often taken in larger amounts or over a longer period than was intended.
- There is a persistent desire or unsuccessful effort to cut down or control use of the substance.
- A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects.
- Craving, or a strong desire or urge to use the substance, occurs.
- Recurrent use of the substance results in a failure to fulfill major role obligations at work, school, or home.
- Use of the substance continues despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of its use.
- Important social, occupational, or recreational activities are given up or reduced because of use of the substance.
- Use of the substance is recurrent in situations in which it is physically hazardous.
- Use of the substance is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance.
- Tolerance, as defined by either of the following:
- A need for markedly increased amounts of the substance to achieve intoxication or desired effect
- A markedly diminished effect with continued use of the same amount of the substance.
- Withdrawal, as manifested by either of the following:
- The characteristic withdrawal syndrome for that substance (as specified in the DSM-5 for each substance).
- The use of a substance (or a closely related substance) to relieve or avoid withdrawal symptoms.
How does NIDA use the terms drug use, misuse, and addiction?
Drug use refers to any scope of use of illegal drugs: heroin use, cocaine use, tobacco use. Drug misuse is used to distinguish improper or unhealthy use from use of a medication as prescribed or alcohol in moderation. These include the repeated use of drugs to produce pleasure, alleviate stress, and/or alter or avoid reality. It also includes using prescription drugs in ways other than prescribed or using someone else’s prescription. Addiction refers to substance use disorders at the severe end of the spectrum and is characterized by a person’s inability to control the impulse to use drugs even when there are negative consequences. These behavioral changes are also accompanied by changes in brain function, especially in the brain’s natural inhibition and reward centers. NIDA’s use of the term addiction corresponds roughly to the DSM definition of substance use disorder. The DSM does not use the term addiction.
How are substance use disorders categorized?
NIDA uses the term misuse, as it is roughly equivalent to the term abuse. Substance abuse is a diagnostic term that is increasingly avoided by professionals because it can be shaming and adds to the stigma that often keeps people from asking for help. Substance misuse suggests use that can cause harm to the user or their friends or family.
What is the difference between physical dependence, tolerance, and addiction?
Physical dependence can occur with the regular (daily or almost daily) use of any substance, legal or illegal, even when taken as prescribed. It occurs because the body naturally adapts to regular exposure to a substance (e.g., caffeine or a prescription drug). When that substance is taken away, (even if originally prescribed by a doctor) symptoms can emerge while the body re-adjusts to the loss of the substance. Physical dependence can lead to craving the drug to relieve the withdrawal symptoms. Tolerance is the need to take higher doses of a drug to get the same effect. It often accompanies dependence, and it can be difficult to distinguish the two. Addiction is a chronic disorder characterized by drug seeking and use that is compulsive, despite negative consequences.
How do drugs work in the brain to produce pleasure?
Nearly all addictive drugs directly or indirectly target the brain’s reward system by flooding the circuit with dopamine. Dopamine is a neurotransmitter present in regions of the brain that regulate movement, emotion, cognition, motivation, and reinforcement of rewarding behaviors. When activated at normal levels, this system rewards our natural behaviors. Overstimulating the system with drugs, however, produces effects which strongly reinforce the behavior of drug use, teaching the person to repeat it.
Is drug use or misuse a voluntary behavior?
The initial decision to take drugs is generally voluntary. However, with continued use, a person’s ability to exert self-control can become seriously impaired. Brain imaging studies from people addicted to drugs show physical changes in areas of the brain that are critical for judgment, decision-making, learning, memory, and behavior control. Scientists believe that these changes alter the way the brain works and may help explain the compulsive and destructive behaviors of a person who becomes addicted.
Can addiction be treated successfully?
Yes. Addiction is a treatable, chronic disorder that can be managed successfully. Research shows that combining behavioral therapy with medications, if available, is the best way to ensure success for most patients. The combination of medications and behavioral interventions to treat a substance use disorder is known as medication-assisted treatment. Treatment approaches must be tailored to address each patient’s drug use patterns and drug-related medical, psychiatric, environmental, and social problems.
Does relapse to drug use mean treatment has failed?
No. The chronic nature of addiction means that relapsing to drug use is not only possible but also likely. Relapse rates are similar to those for other well-characterized chronic medical illnesses such as hypertension and asthma, which also have both physiological and behavioral components. Relapse is the return to drug use after an attempt to stop. Treatment of chronic diseases involves changing deeply imbedded behaviors. Lapses back to drug use indicate that treatment needs to be reinstated or adjusted, or that alternate treatment is needed. No single treatment is right for everyone, and treatment providers must choose an optimal treatment plan in consultation with the individual patient and should consider the patient’s unique history and circumstance.
How many people die from drug use?
The CDC reports that in 2016, the rate of overdose deaths was more than three times the rate in 1999. The pattern of drugs involved in drug overdose deaths has changed in recent years. The rate of drug overdose deaths involving synthetic opioids other than methadone doubled from 3.1 per 100,000 in 2015 to 6.2 in 2016, with about half of all overdose deaths being related to the synthetic opioid fentanyl, which is cheap to get and added to a variety of illicit drugs. For more information about drug overdose rates, please go to cdc.gov/drugoverdose/data.