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Drug Abuse in Our Community
by Dr. Benzion Twerski

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12/20/06

Drug Abuse in Our Community: Searching for the Roots

by Benzion Twerski, Ph.D.

The community is becoming increasingly aware of the problem of defiant and rebellious adolescents among whom drug abuse is a significant problem. This issue is a hot topic among our schools, and there are families that are suffering constant crisis. Some ask how such problems can be prevented, others look for a quick fix. Neither is simple. Our media has been addressing this issue lately. The actual descriptions of what is witnessed rival the ongoing problem outside the Jewish community. This is not only extremely painful, but it is also very complicated. No two teenagers are the same, no two families are the same, the antecedents are as diverse as the victims, and the forms of suffering are disparate as well. I intend to address the problem from several angles. In this series of articles, I do not give answers. I only ask questions. These questions should not provoke defensiveness, since there is no intent to attack or blame anyone. I will address several groups of individuals separately, and each article will target a defined group of people. I hope to open some eyes and minds, challenge and break through some denial, and elicit some constructive ideas. The goal is obvious - to save the souls of our hurting youngsters while preventing this problem from destroying our most precious asset - the next generation.

In this first installment, I direct some questions to the parents of the troubled teenager. (I arbitrarily choose adolescence to include the range of 13-24.) Here are my questions, followed by an explanation of each one.

1. Is there a history of addiction in the family?

The jury is still out on the genetic transmission of addictive diseases. The research suggests that children of the addicted (regardless to what) have a greater incidence of developing an addictive disorder (even not matching the parent’s addiction). Whether there are genetic factors or learned patterns can be debated. Regardless of the medium, what is transmitted is a predisposition, for which preventive measures can offer protection from developing the disease of addiction. Escaping from the stresses of life by engaging in mind altering behaviors, despite their self destructiveness, is nothing foreign even to the most orthodox.

If the affected predecessors have entered recovery for their problem, has this been conveyed to the adolescent? Has the teenager been involved in his/her recovery or therapy?

2. Does the teenager’s family suffer from any of many forms of dysfunction?

This question will make me many friends and many enemies. Non-intact families, including those with divorce, separation, death of a parent, or similar aberration from the traditional family unit appear well represented among the troubled adolescents. Under the best of circumstances, a single parent cannot fulfill the two parent needs of a teenager. A child with less support at home is highly vulnerable to the influences and pressures that dominate the streets and that have entered the most orthodox of neighborhoods. Even an intact family where conflict is a major dynamic will deflect the child’s search for support to environments outside the home.

3. What were the systems of discipline, boundaries, and rules regarding acceptable or unacceptable behavior?

Face it. Our lives are controlled by rules. These include governmental laws, societal norms, halacha, and Jewish values. Families of various subgroups in the orthodox community may have some minor variations of customs. Kids are easily subjected to conflicting messages, and are often alienated by overly strict limits, inconsistent application of rules, poor parental role models (parents not adhering to the same rules imposed on the child), or the lack of rules. Sometimes, communities and families may impose certain rules or values which are truly questionable, such as marriage criteria based on external and irrelevant issues, such as the nebulous standards of the “kollel boy”. Adolescents are highly sensitive to these utter failures of the system. Rebelliousness is almost appropriate, though without destructiveness to self or others this is impossible. Often, kids retreat to other venues in which they expect a more acceptable system of rules. The street may appear to offer that. However, while rules of the street are always followed and enforced, these change constantly and without predictability.

Parents often impose contingencies for reward and punishment. Problems are apt to occur if these are not upheld. How often do parents retreat into forgetting the reward or canceling the punishment in the name of scoring points with their child? How about the provision of luxuries such as beepers, cellular phones, cars, unsupervised vacations, televisions, VCR’s and expensive sound systems? How often do parents purchase or provide any of these because their friends have them?

Differential behavior among siblings is another, sometimes unavoidable pitfall. Favoritism has its Torah precedents, and the tendency to fall into this may be genetic if not just a human imperfection. This, too, may be perceived by the adolescent as an inconsistency of values and boundaries. Such frailties of the human race elicit the proverbial joke about the Convention of Children of perfect Parents with an attendance of only one person.

4. Has there been any neglect or abuse by one or both parents?

This topic is politically unpopular. I will be brief, since this deserves a presentation and article on its own. However, certain points deserve to be expressed.

$ The definition of abuse or neglect is not determined by the perception of the parent but by that of the child.

$ Abuse and neglect of children, including physical, emotional, and sexual, is more prevalent in the orthodox community than believed.

$ Parental denial of abuse and neglect is never a reliable indication that it has not occurred.

$ While a child could lie about such events, it is not likely that reports of such are fabricated.

$ The external presentation of a family is in no way informative about present or past neglect or abuse of children.

$ If past abuse or neglect has contributed to the rebelliousness of the child, blaming has little value, but therapy does.


5. How does the child relate to authority figures?

Rebelliousness is seldom limited to a single target. The teenager who is giving his/her parents a difficult time is doing so to others, as well. These include teachers and other school/yeshiva staff, law enforcement, and virtually anyone in positions of power. Drug using adolescents are also manipulative, and they tend to bargain for relaxed rules and for freedoms that are not appropriate. At the risk of erring towards safety, giving in to these bargains is generally destructive and results in loss of control to the parent, rebbe, or other authority figure.

One question asked by the child is, “How do my parents relate to authority figures?” Are Roshei yeshiva and rebbeim typically degraded or disrespected in home discussion? In all likelihood, such attitudes will be mimicked by children.

6. Do the parents abdicate responsibility?

When a child reports a problem to the parent, about the most destructive response possible is that someone else is in charge and that the child should go elsewhere to resolve it. In reality, certain issues fall in only one domain, whether that of the parents, rebbe or teacher, or anyone else. To reject the problem is to reject the child. When the child is in school, parental responsibility does not stop, nor vice versa. Some common instances where parents extricate themselves from the loop include difficulties getting along with faculty or peers, learning disorders, other academic difficulties, and participation in extracurricular activities. There are parents who will not examine a child’s report card or discuss it with the child.

A Note to Parents

In many cases, you can find some interesting antecedents that can help you see your role in your child’s problem. I beg you to understand that there are probably other factors, as well. You should see an accusatory finger or two, since you may have contributed to the problem. I exclude the word blame, since it focuses away from constructive intervention. I seek only to analyze the problem from all its angles so that effective treatment can be rendered. If a treatment professional or program recommends family therapy, it may be to help identify some roots of the problem as well as to generate a supportive home atmosphere. You should know that one of the most definitive factors that distinguish between those who engage well in recovery and those who don’t is the positive involvement of the family.


Drug Abuse in our Community: Where Do the Schools Fit?

By Benzion Twerski, Ph.D.

Children are raised by the community, not only the family. It is of historical accuracy as well as observed reality that the orthodox community relies strongly on the educational systems to raise their children to adulthood. Our yeshivas thus are major partners in child rearing, including the turbulent adolescent years. Common gossip places considerable blame on these educational systems for all sorts of shortcomings and alleged improprieties. As in the earlier article, I have little interest in fixing blame. I will ask questions, explain their relevance, and allow yeshivas and mechanchim to examine themselves and their collective conscience. As in the previous installment, I do not have the answers. Even when blame is appropriate, it does not solve the problem, and other forms of intervention are needed.

1. Do your students receive individual attention?

No school would openly admit to falling short in this. Yet, this is somewhere between prevalent and universal. Chinuch systems play to the masses as most other systems do. This accusation can yield many hours of heated debate, best left for another time and forum. The question is not “school policy” being focused away from individuals (even skeptics cannot believe that is the case). The question at hand is the individual student whose needs are not being met. Some students are loud enough to notify faculty that trouble is brewing. Most are not. Regression in academic performance is often neglected when “educational” issues do not seem to be involved. There are some truly exceptional educators, and there are many more who claim to be.

2. Does the school have access to professionals for evaluations or consultations and utilize these resources?

Not to minimize the role of the parents, but the school is more often the gatekeeper for children’s mental health. Many schools have existing programs to address non-standard academic aberrations, and there are several organizations with similar programs that cover many schools. For those that do not have affiliations or regular staff, there are multiple resources by way of individuals or agencies that are available. The observation of many is that these services are severely underutilized. Our “troubled teens” scene is a window of evidence. Many of these youngsters were known to have some school observed difficulties years ago. At least logic dictates that early intervention has preventive value.

One can theorize about the reasons for the underutilization of professional consultation. Among the suggested ideas are the following:


$ Consultation by another professional denotes the failure of the school to meet all academic needs of the child. One cannot blame schools for wanting to prevent such reputation for the school and its faculty and staff.

$ Torah institutions should function on Torah principles, not only as the scholarly material but also as the tool to solve other problems. Somewhere, the Torah has the answer to a student’s behavioral, psychiatric, or social difficulties. Seeking secular knowledge (whether from a Torah observant professional or anyone else) is considered blasphemous.

$ Most rebbeim are good teachers and are dedicated to their work. Their sincerity is reliable to insure that they will do whatever the child needs. Many people in chinuch may be excellent teachers but may be inept in fields outside their expertise. What qualifications do applicants for chinuch positions need to be hired in our schools? Does hiring and firing give secondary consideration to educational qualifications? How often do extraneous features determine hiring, such as fund raising ability and yichus? There are now several “rebbe-mechanech” training programs available.

3. Does the school establish a partnership with the parents?

This is directed to the parents as well as the schools. As in any partnership, certain roles and responsibilities can be designated as specific to one partner, but ultimate responsibility rests on each of them. The clearest division of responsibility is the time factor, namely the scheduled hours of the child being at home or in school, and even this is not absolute. The allegation often made is the mutual bi-directional buck passing between parents and schools, which constitutes not only a failure of the system, but it is a serious message of inconsistency of authority. Teenage rebelliousness in this atmosphere is to be expected.

4. Does education stop at dismissal time?

It is a grave error to believe that education (especially Torah chinuch) has solid time limits. There are usually expectations about homework completion, though time constraints are more relaxed than classroom work. What students do in their free time, whether vacations, watching television or movies, club or group membership, sports activities, or additional educational ventures are every bit the business of the mechanchim. It is as wrong for the parents to withhold this information from the schools or to undermine the schools’ policies on extracurricular activity as it is for the schools to fail to take an active interest in what their students do everywhere else.

5. Did academic excellence or external image replace midos?

This sounds like an accusation, and it sometimes is. This question seeks a reckoning on the ultimate goals of the educational institution. The rebellious or defiant adolescent actually puts the school to the test. The student who performs poorly can provoke efforts to intervene and offer help, or alternatively take action to rid the school of the problem. Common justifications include:


$ Our school is not equipped to offer the services the child needs.

$ The remainder of the students are at risk of being influenced or corrupted by this one defiant teenager.

$ The child needs to be punished for his/her misbehavior, and expulsion is the only measure that fits the crime.

Various permutations of these are easily realized. The speed at which expulsion occurs is another indicator that the school has an agenda other than the needs of the child.

A famous line is that children learn from what we do, not what we say. This has withstood the tests of time and theorists who sought to disagree. How many valuable lessons in midos and mussar have been forgone for the want to produce a scholar (talmid chochom) or have a grade achieve high scores on some academic competition? In the best of schools, this has happened. One cannot blame a school for seeking the positive image, which gratifies the administration, faculty, and the student body. It is harder to see the saving of a single neshomoh as the issue and mission of the educational institution, and that this is an issue of pikuach nefesh.

6. Does the school abdicate responsibility?

It is perfectly reasonable to avoid interfering in areas where another is in charge. If parents and educators could only feel like partners in the raising of healthy children, they could communicate on issues that fall within the others’ domain. When one feels the other should take charge, it could be through open discussion, not assumption that matters will rectify themselves. Many a school could become more proactive in addressing such challenges.

A Note to Educators

Your role in the development of the adolescent is more than significant. Adolescence is a stormy stage in which individuation or separation from the parent is a major dynamic. Peers (who could be positive or negative influences) and the street are ready to accept youngsters who are distancing themselves from their parents and families. As outsiders to that, you are in a unique position to monitor and observe activities and choices. You are also capable and responsible to guide these children in positive and constructive directions. Please avoid hearing the message of accusation and blame. Please accept the nudge to do a little more for the individual, troubled child whose needs are begging for your attention and care.


Drug Abuse in Our Community: Questions to the Leadership

By Benzion Twerski, Ph.D.

In this article, the questions posed are directed at the many organizations who direct policy and practice in the orthodox community. The very concept of community is interesting, since it consists of many diverse elements. The notion of organizations as directed by few powerful figures is also far from universal. Essentially then, this set of questions is directed at the public or at ourselves. It is not enjoyable to ask ourselves direct questions that can be perceived as accusations, though the disclaimer about the intention being other than finger pointing applies. The reader may detect a sense of ire, as I have been personally frustrated by the extent of denial and mocking rejection when discussing this now epidemic problem. Even as more openness has begun to develop and the issues have become topics of discussion, the absence of activity is costing neshamos and lives. The affected children and families feel this, and they are not consoled by the knowledge that meetings are held. The absence of resources is painful to those who work in the field, who struggle to offer professional services without the support of the educational institutions, rabbonim, social service agencies, etc., who are not aware of the brunt of the problem. This finger pointing does not allege indifference, but more likely ignorance. While my personal frustration may show through these paragraphs, I urge the reader to look past this, and focus on the problem that is attacking our children.

1. Why does denial of the problem continue when the reports of the problem are increasing at such a pace?

Since moving to Brooklyn, I have had exposure to an element of the orthodox community that has me appalled. I have dealt directly or indirectly with problems of addictions that were surprising to me. When I shared this perception with others, I received cold responses such as, “I know” or my statement was rejected with varying degrees of disgust. Even now, when I mention that I work with addictions, the usual response is, “It doesn’t happen among our community.”

Of course, one can create sensational rumors and watch them circulate with increasing acceptance as fact. This has happened here, as well. I refuse to repeat these. Those reports with a factual basis do not spread far, and they are embarrassing enough to remain a whisper that meets with little challenge. I will note only that there are known hangouts and events in the orthodox neighborhoods where drug use and trade are known activities. We have dealers at various levels of wholesale and retail. There are parties and homes where the parents are absent (for any of several reasons), where Shabbos is spent by gatherings of young people involved in inappropriate activities including drug/alcohol abuse. Often, the homes are trashed, but no one files charges for the vandalism, noise, or other illegal activity. These events are left to disappear into faded memories. There is an occasional drug bust in which several yeshiva bochurim may be arrested or discovered as drug involved. Little or no action at the community level is likely to follow such events, and intense efforts are made at keeping the matter quiet. The spreading of the rumor might provoke public lectures about loshon horah or chilul Hashem, but some straight public talk about the problem is usually avoided.

Addictions are the only conditions in which denial of the problem is an integral aspect of the disorder. This is true at many levels, and equally within the community that is ashamed to have such a problem in its midst. However, this denial obstructs intervention and actually sustains the problem.

2. Can the community support efforts to establish treatment programs?

This question cannot be answered authoritatively. My personal perception is that there is a growing recognition of the need for such facilities. Some very legitimate issues arise as the discussions are raised, and these deserve to be aired.

$ Will such programs espouse a Torah perspective and remain compatible with orthodox values?

$ Can treatment offer assurance of return to mainstream Torah education and lifestyle?

$ Should we develop treatment programs of our own, or can we utilize existing facilities?

$ What about the adolescent who refuses to enter treatment? Is there leverage or incentive to insure or improve compliance?

$ Can a facility be co-ed or are separate facilities needed for boys and girls?

Meanwhile, the accessibility of drugs and other vices continues to grow and questions like these are used to thwart efforts to intervene rather than being subjected to problem solving. Since little else is being done, one may wonder whether this inaction represents careful contemplation or plain resistance.

3. Do existing treatment facilities such as clinics and hospitals in orthodox neighborhoods offer services for addiction treatment?

All existing facilities and agencies who offer counseling have staff that are required to know the basics about alcohol and drug abuse which was part of their professional training. All have the responsibility to identify such issues in their clientele when they are detected, and appropriate intervention or referral must be made. All of these enterprises actually play a valuable role in identifying addictions, and many do adequate jobs of triage of these patients. Emergency rooms and the other medical and psychiatric departments of our regional medical centers have unique opportunities to insure that those who require acute and intensive interventions receive follow up referrals for treatment. My experience suggests that such triage is done well only some of the time, and I hurt for those who missed the chance for referral to treatment at the golden moment of crisis. After sometimes heroic rescue efforts following overdoses, accidents, or other intoxication related mishaps, patients are discharged to their families without consultation to addiction or other trained professionals. Case management to follow up these patients after discharge is infrequent. Some patients with primary diagnoses of substance abuse may be diverted to other hospitals with less than optimal regard for their condition. Perhaps, even offering a minimum of addiction services, such as inpatient detoxification is rejected as a public admission of the problem. I am frankly surprised that our hospitals and clinics are the last to know about the problem.


4. Have community based lectures and discussions led to action?

I level an accusing finger here with three fingers pointed back at myself. Having spoken publicly at lectures and conferences as well as writing in the media, I have participated in discussions that stalemated.

There are many fears and hesitations encountered. Here are some of the questions that led to “cold feet”.

$ Will anyone refer patients to a “Jewish rehab”? Would referents see such a facility as an automatic compromise on their confidentiality?

$ Can rabbinical endorsement be obtained?

$ Can adequate funding be obtained to facilitate the opening of such a program? Would existing recipients of charitable donations perceive this facility as competing for the same dollars?

$ Can such a facility be adequately staffed by orthodox professionals?

$ What kind of reimbursement/payment plans can be arranged to cover the services without bankrupting the families or the facility?

$ If the child referred to such a facility cannot be held there involuntarily, how will patients be retained in treatment?

5. Do the Jewish print media address this topic?

Only recently has there been a noticeable change. Just a few years ago, press releases on addiction in the orthodox community were routinely ignored. Events were either not covered or not reported. Brief mention was included in articles on other topics. I have watched the artful dodging of specific mention of substance abuse. While no individual publication has total control over public opinion, the avoidance of the topic has had only a few exceptions until fairly recently.

Some writing of my own and my colleagues in the Jewish media elicited negative reaction. We have been challenged with hanging dirty laundry in public and with causing a chilul Hashem. This is parallel to the problems of agunos and other injustices that are embarrassing to the community and swept under the rug, but nevertheless a painful part of reality. The growing exposure to the topic in recent articles in the Jewish Press and Jewish Action, as well as other publications is commendable.

6. Is political intervention utilized in a positive way?

Drug possession, dealing, and abuse are violations of the law. Failure to apprehend, arrest, and charge the perpetrators allows such behavior to continue. Interruption in this process has the same result.

Clarification of my position is needed. While drug abuse is a crime, it is also a symptom of a problem, for which professional intervention and rehabilitation are far more appropriate than courtrooms and jails. The leverage of the justice system is useful in retaining drug users in treatment. The occasional jail sentence can serve as a valuable lesson for all that crime does not pay and that drug abuse leads to negative consequences.

We hear few reports of arrests for drug related crimes. When these occur, the news is quickly hushed. This conspiracy of silence has some noble intentions. There is, of course, the chilul Hashem factor. Also to consider are the shame for the individuals, families, schools, and shidduchim prospects for other members of the family. There is also political intervention that diverts the individuals from court involvement by accepting responsibility to pursue further action through community resources. The law enforcement agencies have also avoided drug busts and arrests of orthodox youth out of fear of antagonizing the community. Is the price of unbridled drug use without negative consequences and the resulting loss of Jewish souls worth the sparing of the shame?

A Note to the Community

Once again, blame is useless and non-productive. The approaches that have been used thus far have neither stemmed the growing incidence of substance abuse among our youth no

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