‘Set limits. Be able to say no’
Questions for Lew Abrams
Recently, West Orange resident Lew Abrams — an expert in Jewish addiction with private practices in Montville and New York City, a member of Ahawas Achim B’nai Jacob & David, and the leader of that congregation’s new addiction awareness group — sat down for a lengthy Q and A with NJJN, offering insight into everything from who is at risk to how to prevent abuse. (His answers, below, are edited and condensed.)
Abrams has been in the field of addiction and substance abuse since 1980. He has specifically focused on Jewish addicts since he began getting calls from religious Jews seeking him out for advice. In 2002 he started running the Yatzkan Center Residential Program in Mount Vernon, NY. He went into private practice in 2007; clients come to him from, among other areas, Passaic, Teaneck, Monsey, NY, and the five towns, on Long Island. He has lived in West Orange since 2002.
NJJN: What are you seeing in the Jewish community in terms of addiction? Are there differences between liberal and Orthodox denominations?
Lew Abrams: There has been an increasing awareness of the problem of addiction in Jewish communities over the last decade or so, with more treatment options and more programs catering to the needs of observant Jews, with kosher food and the like. The challenge continues with regard to stigma in all Jewish communities, but this is more so in more religious communities. People feel uptight about addressing the problem because in a close-knit community, they worry about what others will think. This is particularly problematic in ultra-Orthodox communities, where it could affect the marriageability of relatives.
But for everyone, the problem is out there, pervading all subcultures of Judaism, especially with the sexualization and glamorization of alcohol. It’s often around some kind of Jewish event that adolescents, especially Orthodox kids, are exposed for the first time to alcohol — a bar mitzva, a wedding, a kiddush, a holiday like Purim or Simhat Torah. Alcohol is the “gateway” to substance abuse. It’s the most abused substance, although we also see tremendous difficulty with opiates and marijuana and, among teens, with prescription drugs like Vicodin, OxyContin, and Percoset as well as Adderall and Concerta.
NJJN: Who is most at risk in the local Jewish community?
Abrams: Many people who drink will not have a problem. But a certain percentage do have problems, and there are four variables involved in triggering addiction: genetic predisposition to addiction, mental health, peer pressure and experimentation, and spirituality. Depending on the person and the specific situation, it is really a combination of these.
NJJN: What do you mean by spirituality?
Abrams: This is often an overlooked piece. People are often empty inside. Even if they are materially successful, they can be spiritually lost. And being religious is not necessarily being spiritual; they can have something to do with each other but they do not necessarily have to. Spirituality is a tremendous part of the recovery process. It’s really about behavior. If you are lying and deceitful and living double lives, you really need to work on your character deficits, and this requires a spiritual practice. Sometimes it’s religion but it can also be something like meditation. It’s about behaving spiritually and having faith in a power greater than ourselves. If you don’t change your behavior, the chances of staying substance-free are minimal. When the changes transcend simply not drinking or abusing drugs, then you will start to feel better and you will want to communicate with people outside yourself.
NJJN: Are there reliable statistics on Jewish addiction?
Abrams: I wouldn’t hang my hat on any studies. They are all very anecdotal. But I do stand by the generalization that about one of every 10 people who drinks has a problem with alcohol.
You also have to distinguish between substance addictions and process addictions. Substances involve anything you put into your body, like a liquid, a pill, something to smoke, something ingested. A process addiction is about behavior: gambling, computer games, sexual addiction. Food is a hybrid and can be very tricky, because the best treatment plan is usually abstention. But you cannot abstain from eating. Sex can fall into this category as well, since most people do not want to give up sex altogether.
NJJN: How can families, especially parents, engaged in the Jewish community prevent addiction?
Abrams: Learn as much as you can. Learn the signs and symptoms. One thing kids know is when their parents don’t know what they are talking about. There’s an amazing wealth of information on the Internet. Be well-versed if you want credibility.
Don’t isolate yourself from other parents. Set up a group of parents as a network. Take risks. If your kid wants to go to a concert, and you’re not so sure, ask other parents if their kids are going.
Be a role model. Kids are more interested in what you do than in what you say. Adolescents watch us like hawks. If kids see their parents drink irresponsibly on a Saturday at shul or at kiddush or at a wedding, a bar mitzva, or shalom zahor, or on Shabbos, you are sending a tremendous mixed message.
People deal with this issue in different ways. Some people stop having wine on Shabbos when their kids are adolescents. Others believe drinking responsibly offers a better role model. Either choice has pros and cons. But the most important thing is to talk with kids about what you’re doing. Make it a teachable moment.
Spend time with your kids. The more time you spend eating and talking, the less you and they will be afraid to bring things up. But don’t be naggy or preachy. Car rides are a good time because you have a captive audience.
Set limits. Be able to say no.
NJJN: What signs can parents look for if they are worried?
Abrams: In the early stages, it’s often difficult to tell. High school kids can look good. They can be doing lots of extracurricular activities, having healthy peer relationships, and be achieving high academic marks. The kid may have developed some relationship with a substance or process involving habitual use, but it may not be every day, and the process may be slow.
In the middle stages, the problems begin to emerge. People start to lose things, including self-respect and self-esteem. Relationships may start to fall apart. Look at school and academics: Is there a sudden drop in grades? Is the student dropping extracurriculars? Is he showing disrespect or defiance toward teachers? Is he present in class but inattentive, with frequent visits to the nurse?
Look at the family dynamic: Are you seeing a change in attitudes about rules? Is he withdrawing from family functions? Isolating himself? Is he breaking curfew? Are you seeing erratic behavior with food? Are there strange telephone calls? Is your kid secretive about the peer group? Has the peer group suddenly changed?
Also look for physical symptoms, like sudden weight change, or the smell of alcohol and marijuana, or defensiveness.
And in the religious sphere, are they losing interest in attending shul? Are they uncomfortable talking about religion?
Only about 2 percent will reach an end stage where they will lose everything. Here we are talking about the skid row bum. But this only happens to a very small percentage of addicts. For the rest, looks can be very deceptive.
Also, be aware about which kind of kid you have: the ‘just say no’ kid who won’t have any problem; the one who is just experimenting, trying out drinking out of peer pressure or curiosity; or the one who is starting to have problems. And remember that some of the signs mimic adolescence and can be hard to sort out at first.
In the end, I can’t guarantee the prevention of abuse, but you can always make a change for the better.
NJJN: What should someone do if they are addicted or suspect someone in their family is?
Abrams: Seek help. And remember this is a disease. The person did not set out to have this disease.