addiction

COVID’s impacts on mental health

(image from bastamanography)

Purim 2020, which took place in early March, brought with it added significance. For some, it represented the last time they gathered in a Jewish setting in person, outside the home. For others, it was the first “live” service to be canceled as a result of SARS-CoV-2. In the days that ensued, lives changed as the perils of the coronavirus became apparent. School, work and religious services all moved online; personal contact with friends and family became exceedingly limited; travel, for most people, ceased.

Among the societal issues compounded by the pandemic have been increased isolation, drug dependence, and food and job insecurity. Underlying these problems has been COVID-19’s effect on mental health, including within the local Jewish community. As a result, numerous groups have stepped up their efforts to help the most vulnerable, and all those who have been impacted by the pandemic. During the past weeks, as the first anniversary of COVID-19 came and went, the Jewish Independent spoke with several people at the forefront of handling the Greater Vancouver Jewish community’s response.

At Jewish Family Services (jfsvancouver.ca), efforts to tackle mental health issues have widened, as more people have been seeking the agency’s support. Early on, JFS opened a crisis line that runs seven days a week, from 9 a.m. to 9 p.m. (604-588-5719 or [email protected], with the promise to respond within 24 hours).

“People are struggling, without a concrete end to the restrictions, and so demand for emotional support and learning different coping skills has surged. Our crisis line is always there for people who need immediate help and, for many community members, this is the easy way to connect with a counselor. If someone wants to remain anonymous, that is absolutely an option, we do not require a caller to identify themselves,” JFS chief executive officer Tanja Demajo told the Independent.

From its launch at the start of the pandemic to August 2020, the JFS Community Crisis Line received 955 calls, serving 494 individuals. Case workers spent 2,052 hours on the line. Additionally, 166 individuals accessed free programs offered by the JFS mental health and wellness team via telehealth and video conference – a 40% increase compared to pre-COVID times.

“Many are struggling with the added role of being a caregiver in the pandemic context, as well as dealing with their own emotions, so our workshops and support groups provide a community where people are able to vent, talk and support one another. We also connect people with friendly callers. These services have been a lifeline for many of our clients,” Demajo said.

A report released by the JFS client advisory committee last summer highlighted many ongoing concerns. One alarming quote from a client cited in the report reads, “COVID-19 has been depressing and frightening for me. My anxiety has been through the roof and I’ve had an increased number of panic attacks and migraines. My chronic health conditions have increased in severity and I have new ones. My nightmares and terrors have also increased.”

Prior to the pandemic, some JFS clients were already battling with mental health issues, often severe, which have been aggravated by the need to now cope with unaccustomed fears and anxieties. Some people, according to JFS, have refused to go outside, whether it be to the grocery store or outside for a walk. This problem is often felt by seniors, who, like everyone, need exercise and who confront serious health conditions such as heart disease, diabetes and high blood pressure.

Many housebound JFS clients depended on family and friends visiting for social and emotional connection before COVID hit and have been feeling deeply alone since the pandemic began. Irritability and anger are rising. Senior clients who were used to spending significant time with their grandchildren are missing them desperately. “I miss hugging my grandchildren,” is a common refrain.

Since mid-May of last year, there have been weekly depression and anxiety support group meetings with JFS’s mental health outreach therapist, Kevin Campbell. Run on Zoom, the 90-minute sessions teach coping skills and allow a safe place to talk and share. The group focuses on cognitive behavioural therapy and mindfulness techniques. JFS also has an active seniors caregivers support group led by Lily Shalev.

Not all COVID-19 developments in connection to mental health are grim, JFS notes. Due to technological developments, some of those experiencing isolation are able to access telehealth, work from home, get home deliveries and view a variety of educational and cultural offerings online, including many synagogue activities.

Jewish Addiction Community Services Vancouver (jacsvancouver.com), an organization that helps community members navigate the troubles of various substance abuse issues, has held one-on-one meetings on Zoom ever since COVID started.

“Clients seem to like this kind of individual counseling better, as it allows for greater intimacy, even though it is on Zoom,” said Shelley Karrel, manager of counseling and community education at JACS. “What people liked most about the group meeting was the getting together physically.”

To help those who would prefer to meet in person, Karrel has arranged for one-on-one socially distant coffee meetings. “What JACS has done is to make ourselves more available to someone when they want to talk, and to be able to schedule a meeting fairly quickly. As a registered clinical counselor, I am able to offer clients tools and exercises for managing their symptoms and for exploring the root causes when the issues of anxiety and depression are evident. Some of my clients are finding AA meetings helpful online. And, like with our clients, some are not using that medium for the same reason – it’s not personal enough.”

For ongoing support, JACS has a monthly email that lists many resources for people, if they want to reach out for specific help. JACS is also beginning a new program, Sustaining Recovery, that offers additional support in the form of a structured plan to help someone develop goals and be able to keep track of their progress. This plan, JACS finds, is very useful in creating accountability and support.

Inclusion services at the Jewish Community Centre of Greater Vancouver (jccgv.com/inclusion) continues to provide a number of targeted social and recreational programs intended to engage, educate and provide meaningful lifelong learning opportunities, as well as engage individuals with diverse needs. The programs are rooted in Jewish values and the principles of social connection, community building and belonging.

“Social isolation is a prevalent issue for individuals with diverse abilities [and] this reality was exacerbated by the COVID-19 shutdown,” explained Leamore Cohen, coordinator of inclusion services. “These communities have been particularly impacted by the loneliness, uncertainty and economic hardships caused by the global pandemic, leaving these individuals at higher risk for numerous health challenges. The work we do in the inclusion services department creates the needed awareness of the individuals we support. But, now more than ever, community members are looking to us for routine and engagement at a time when they are most vulnerable.”

As people have settled into life with COVID-19, “these individuals continue to be shut in and vulnerable to mental health challenges,” she added. “In response, we offer a hybrid of virtual and in-person programming throughout the week that is both accessible and safe. In-person programs adhere to best COVID practices, and our virtual offerings allow for those who are unable to attend in person to access programming and community virtually.”

The Bagel Social Club, for example, met weekly in pre-COVID times as a means to increase avenues for integration, self-reliance and wellness. The program has shifted to weekly social clubs over Zoom and a weekly Relax and Just Breathe class, which includes gentle stretching, breathing exercises and visualizations.

As the lockdown took effect last year, Jewish Federation of Greater Vancouver (jewishvancouver.com) began convening multiple stakeholder groups to determine the pandemic’s impact on many aspects of Jewish communal life. A common thread during these discussions involved concerns about the impacts of increased social isolation on seniors, families and youth. Federation also hosted several webinars on mental health for community members, related to the impacts of COVID-19.

“Through this work, we were able to identify a number of key initiatives that we could support both financially and organizationally,” said Shelley Rivkin, vice-president of global and local engagement at Federation. “These include over $170,000 in emergency funds to Jewish Family Services, part of which was used to support the emergency care line; funds for Jewish Seniors Alliance to expand their peer support program; and the organization of several webinars with community psychologists directed toward young adults, families and teens.

“The Jewish Community Foundation, Federation’s endowment program, has also supported a number of projects to enable community agencies to undertake mental health initiatives,” she added. “Support for mental health issues for both agency employees and leaders was also identified as a priority for the community recovery task force when they launched their first grant round. It will continue to be highlighted as we move into the next grant round.”

Last December, youth workers voiced concern about the mental well-being of youth and young adults. Consequently, Federation hosted a roundtable with key leaders to ascertain how community members in this age range are faring, especially when faced with so many disappointments and cancellations over the past year. Based on these conversations and others, Federation will be collaborating with these agencies to develop a community mental health strategy for children and youth.

Sam Margolis has written for the Globe and Mail, the National Post, UPI and MSNBC.

Judaism and addiction

When we think of Pesach, the theme that emerges is: “We were slaves of Pharaoh in Egypt, but the Lord brought us out of Egypt with a mighty hand.” As slaves, we endured years of torture and hardship, with no choice but to obey the edicts of the Pharaoh. In essence, we were powerless. Those addicted to either drugs, alcohol or a behaviour (think gaming, gambling) are slaves as well. They are chained to a disease that has control over their lives – their brain has been kidnapped into thinking “this is what I need to live, to survive.” They no longer have freedom. Often, the notion that they can break free is beyond what they can envision.

When the Jews left Egypt, their days in the desert were a struggle. Some wondered why they left what they knew for the unknown. Yet, here they were. With manna for food, a cloud for protection, they wandered for 40 years: a long, hard journey to learn how to live with their new-found freedom.

When someone initially breaks the chains of addiction, the struggles they face are no less daunting. There is fear, a sense of loss; a feeling of, will this work? Can I be successful? Will I be better off? In essence, they can feel like they are in a desert.

To assist individuals in the precarious time of new-found freedom, JACS Vancouver has launched the Sustaining Recovery program: a wrap-around service that supports clients with individual counseling, assessment and program planning.

Working with our client, we together build and implement a personalized set of supports and tools that focus on where they are in their journey, and what specific supports they need. When the opportunity arises, we help them focus on identifying the forces, triggers and/or messages that are beneath the surface of their addiction. They learn how to make different choices, where to go for help and how to recognize that life is better, health is possible.

The path to freedom, as our ancestors found out, was not easy – nor is it for those wanting to sustain recovery from addiction. With personal willingness and commitment, and solid and constant support, success and a purposeful life is within reach.

Shelley Karrel is a registered clinical counselor, and is manager of counseling and community education at JACS Vancouver. For more information about JACS, contact [email protected].

Making safe, inclusive space

Clockwise from the top left: Tanja Demajo, Shelley Karrel, Amanda Haymond Malul and Rabbi Yechiel Baitelman participate in a JACS Vancouver panel discussion Oct. 15.

“When someone comes through the door and says, ‘I’m an addict. I’m a recovering addict,’ do they feel judged or do they feel accepted? Do they feel that we are putting them in a box, giving them a label?” asked Rabbi Yechiel Baitelman in a recent community discussion. “We have to identify the illness, there’s no question about that. But, is that the only way to view a human being? I think to respect every human being for their humanity, that’s what people are really craving – respect and love.”

Baitelman, director of Chabad Richmond, was one of three panelists on the topic Building Safe and Inclusive Spaces for Those Affected by Addiction and Mental Illness. He was joined by Tanja Demajo, chief executive officer of Jewish Family Services (JFS), and Amanda Haymond Malul, a community member in recovery, in the Oct. 15 event presented by Jewish Addiction Community Services (JACS) Vancouver. JACS Vancouver’s Shelley Karrel moderated the conversation.

Haymond Malul would like to see more community discussions on addiction and people being taught acceptance. She spoke of the need to “have support from the religious leaders of the community, from every single agency in the community, to start talking about it – make it acceptable, educate.” (See jewishindependent.ca/help-repair-the-world.)

And we need to ensure that what we are teaching is in line with our actions, said Demajo. “If we talk to children about acceptance, but we don’t actually practise that, that’s creating double standards where we talk about certain things, but that’s not what people experience,” she said. This could be damaging, she said, to people who “really need that support and want to trust.”

We must see each member of the community as a human being, said Baitelman. Love is important, but, he said, “Love is on my terms, respect is on your terms. If I love you, it’s more a reflection of who I am. But, if I respect you, it’s more of a reflection of how I see you, what you are about – and I think that’s really important. Respect the humanity. If you can love them, that’s even greater. But respect is more fundamental.”

When Karrel asked panelists for tangible ways in which people could be more accepting and inclusive, with love and respect, Demajo said agencies are overwhelmed with the number of people needing support. She said it is up to each of us to connect on a personal level with others, accepting that it will take time for them to trust us enough to share.

“You have to build a relationship, and a relationship is not built overnight,” said Demajo. “I had a client who I often think of, a person who spent a number of years [in the] Downtown Eastside being homeless, not having pretty much anything in his life…. He would come to see me … and we would speak about books, because he was a huge reader and I love reading. It took him six months until he really started talking about things that were going on in his life and what he actually needed, and we started working from there. Now, he has a regular life. He has a home. He brought his family back. He is working. So, things are in a place that he wanted … a number of years ago. Recovery is a process of being vulnerable and, so, if social services don’t have the time to invest in people, I think we are setting ourselves up for a really huge failure.”

All panelists agreed that having a drop-in centre with people who understand is absolutely essential and that, while professional support would be ideal, it is not essential. To be kind, respectful and loving, you do not need to be a professional, they said.

While there are recovery clubs in the general community, Haymond Malul said it would be great if there were also one in the Jewish community – “having a safe place for people to come and be able to drop in, and know that this is the Hillel House of Recovery,” she said.

However, having a community place might inhibit some people from coming out, due to fear of being exposed, warned Demajo. “The other piece is that I do feel that what Amanda has done tonight, speaking of her own experience and being in the community, and [talking about] some of the things that were helpful for her, is important to start with; having those opportunities to open up the conversation – not just for me, in a professional role, but from a personal place – because that is where the relationship happens. I do believe that is the core of whatever we come up with – the core is the relationship.”

Each of us is deserving of respect, regardless of our achievements, successes, failures or addictions, stressed Baitelman. “The fact that you were created by G-d makes you worthy of the highest form of respect and no judgment,” he said.

“Why would I not be involved with somebody who’s in recovery?” asked the rabbi. “After all, these people are accountable. They’re working on character development and are improving certain areas of their lives that they have the courage to acknowledge need to be corrected. They’re actively making amends with people around them. They are working on a conscious relationship with G-d rather than on other forms of success that society often judges success by. This is really an achievement.

“How many of us would like to change even one iota of our character, and people in recovery have changed more than one iota. They have made an incredible change, which is so admirable and should command respect. I think that’s part of the attitude that should be helpful in the broader community, and how we act with people, and the stigma.”

Karrel closed the discussion by giving a brief synopsis of JACS and its services. “We are working to diminish the stigma of addiction,” she told the Independent after the event. “Let’s keep this conversation going so we all feel we belong in our community.”

Rebeca Kuropatwa is a Winnipeg freelance writer.

Help repair the world

I am flipping through one of my social media outlets, as I lie on my bed, cuddling my 7-month-old baby to sleep. A picture catches my eye. Garbage strewn in front of a restaurant. I look closer, puzzled as to why someone would post a picture of garbage. Then I see. Discarded needles littered amongst the garbage. I read the accompanying message. The poster says that we need to relocate addicts to a secured facility in the north. Provide them with drugs and food and medical care, but we need to get them off of our streets.

I scroll through the comments. I cringe as I read them. I see posts such as, “These people,” “Get them off of our streets,” “Decided to act against societal norms,” “Until they wish to act like proper citizens,” “Undesirables” and so much worse.

The poster is Jewish. Many of the people commenting are Jewish.

My mouth drops open. I take a sharp breath and feel a pain deep inside of me. My heart hurts. I want to cry. My hands shake. It takes all the strength I have not to respond. I am hurt and angry. I shake my head in pain.

I am a recovering alcoholic and drug addict. I haven’t had a drink or a drug in a little over 20 years.

Yes, I am one of those undesirables. So is my husband. My mother and some of my best, most cherished friends.

I was 25 years old when I found recovery. I am one of the lucky ones. I never lived on the street. I didn’t do needles. I didn’t have to experience that kind of bottom, but what being in recovery has taught me is that I am no different than those who live on the streets, than those who inject themselves with needles. Because I am an addict. Once I use, I can’t stop.

The American Psychiatric Association classifies addiction as a complex brain disease that is manifested by compulsive substance use despite harmful consequence. I have a brain disease. I will drink and drug even though it causes harm to me and those close to me. Once I use, I don’t care about anything else. I have a disease that I have to live with and battle for the rest of my life. It is painful. It is a struggle. Some days are easier than others, but the fact of the matter is, I have to live with a disease that can return at any moment. Like a person in remission from cancer.

Does the Jewish community not want me or my children because I am an addict? Am I less of a worthy Jew because of my disease? What about my children? Even as I write this, my heart is beating fast, my breathing is shaky. I think of v’ahavta l’reacha kamocha. I think of how we, as Jews, are commanded to love the stranger who dwells among us, to have one law for the stranger and the citizen, to never embarrass our fellow human beings in public, and to guard our tongues and speak no evil.

Where is the love of humankind when we classify human beings as undesirables? Where is the humanity in suggesting that we take human beings and put them into remote locations, away from civilization? Is this starting to sound familiar? Perhaps like the Shoah? When Hitler classified us Jews as undesirables? Did those Jews have a choice as to whether or not they were classified as Jews even?

I have a disease. I did not choose to be an addict. I did not know, when I drank my first drink and smoked my first joint that I would end up addicted. I was a kid. I did what almost every other teenager did. I experimented. None of my friends from high school are addicts. I am. I got it.

Addicts come from all walks of life. They are your teachers, your lawyers, your doctors, heads of companies, celebrities. They are also those living on the street and leaving their dirty needles behind. Addiction doesn’t discriminate based on your ethnicity, your socioeconomic status or your religion, yet we, as a community, want to believe that addiction doesn’t happen among our tribe. I can tell you that it does. I can also tell you that there are many Jewish addicts and their families who are afraid to come forward precisely because they are afraid that they will be looked down upon and judged as morally impaired. As undesirables.

This, to me, is morally reprehensible. We, as a community, need to act with love. Let’s help repair the world that we live in so that we can love and support all people, even when they are sick with a disease that we don’t understand. It is our duty as Jews. V’ahavta l’reacha kamocha and tikkun olam. Love your fellow as yourself and help repair what is broken.

Amanda Haymond Malul is a JACS (Jewish Addiction Community Service) Vancouver supporter.

Talking helps reduce stigma

Left to right: Peggy Allen, Shelley Karrel, Shelley Rivkin, Jordan Bowman and Howard Harowitz. (photo from JACS Vancouver)

The capacity for transformation and healing was front and centre at the event Optimism and Hope: Erasing Stigma of Mental Illness, Addiction and Homelessness.

Co-sponsored by Jewish Family Services (JFS), Tikva Housing and Jewish Addiction Community Services (JACS) Vancouver, the panel discussion on Feb. 26 was held at Temple Sholom. It featured Shelley Rivkin of the Jewish Federation of Greater Vancouver, Abbotsford entrepreneur and volunteer Peggy Allen, and Jordan Bowman of Last Door treatment and recovery centre in New Westminster.

Temple Sholom’s Rabbi Dan Moskovitz welcomed those gathered by talking about the Aleinu prayer, which, he said, asks us “to go out into the world and do what we’re praying for. And so, if I can make a request of all of us, myself included, it’s to go out from this room and to do and to share what we’ve learned and what we’ve heard tonight with our families and with our broader circle. That’s our shlichut, that’s our sacred mission, beyond just coming here today to get what we need for ourselves.”

JACS Vancouver board chair Howard Harowitz briefly described the missions of each of the event sponsors before introducing the night’s speakers, beginning with Rivkin, who shared the stories of a few community members who have been impacted by the risk of homelessness. She prefaced her remarks by saying homelessness is not limited to people living on the street or who live in shelters. Rather, the growing concern in our community is “relative homelessness, the lack of suitable, consistent and predictable housing,” she said.

She also noted that “it is not a natural equation that addiction, mental health and homelessness are faced by all people” in need. “Each person has to be approached individually and uniquely,” she said, then listed six sources of support in our community: JFS, Tikva Housing, Yaffa Housing, JACS, the Kehila Society of Richmond and the community’s synagogues.

Originally from Regina, Sask., Allen has lived in Abbotsford for a long time. She lives in an area where homeless people have gathered since the Salvation Army moved into the neighbourhood in 2004. A wife and the mother of two children, the situation was very difficult initially. She shared stories of her young granddaughter witnessing people having sex and shooting up, and of being chased out of her home by a crack addict.

“I was quite a happy person and then the homeless moved in and I changed forever,” she said. “I got angrier and angrier and angrier and I ended up making, in 15 years, I made 463 calls to the police. And they came every time and did nothing, because what are they going to do?”

Allen said she became very depressed. Then, she was invited to a meeting at city hall about the homeless. She challenged attendees to come and see the extent of the problem for themselves, and two women from Fraser Health took her up on it. Over coffee, Allen shared with them her concerns and, despite her self-described antagonism to them, they invited her to speak at a meeting of the Drug War Survivors, a peer-based user group that participates in the development of harm-reduction policies, among other things.

Reluctantly, she agreed. Expecting an audience of maybe 10 drug addicts, “there were 110 of them,” she said. “I look around and I open my mouth and I just let it all out. I don’t know what happened, it was a miracle, really. I talked about my father and I talked about him beating my mother so desperately,” waking Allen’s sister, who was told to return to bed by their mother, and did. “That’s what we were raised with,” said Allen. “I had never spoken about it, and I just let it all out,” including how she was kicked out of a school in her teens for selling drugs.

After her remarks, audience members lined up, but she didn’t know why, so she started to leave. “As I’m walking out, the first guy comes up and hugs me. They were all standing there to hug me,” she said, holding back tears.

One of the men recognized Allen from secondary school. He shared with her that he was raised with such anger that he went down the path of drugs, whereas she – who his family warned him about as a teen, since she sold drugs – did not. He said to Allen, “I see now that I, too, can change my life.”

This interaction, she said, changed her life. “I went home, and I was walking up the driveway to get the mail and this crazy lady that lived on the street and was a huge drug addict and was nasty and did not like me, she came running up my driveway swearing and yelling at me with this other guy. I was so emotional, I went running at her, I don’t know what I was going to do, and I stopped. I changed my mind. I turned around and I went home. And my life changed. Everything on our street is still happening and nothing has changed much there, except me.”

Allen started giving to the homeless. She joined the city’s Business Engagement Ambassador Project, which works to build relationships between Abbotsford residents, business owners, homeless and others to strengthen the sense of community. “What I do is I speak all over the place and raise money to help them help themselves,” she said of those who are homeless.

The project is a year-and-half old and she described it as a success. One aspect in particular that is working, she said, is that the program pays homeless people to clean up area businesses and parks.

The last speaker, Bowman, now 22 years old, has been clean for just over four years. He is a youth program support worker at Last Door, the centre at which he was set on the path of recovery.

Bowman said he had a good upbringing, went to Jewish summer camp and day schools, was into sports, has lots of friends and has a great family. Having lost his mother to cancer when he was 10, he said, “That was obviously tough, but by no means do I point my finger at that and say, ‘that’s when I started using drugs.’”

He described his life as normal, living with his dad and brother. There were no indications, he said, that he would become an addict. Addiction does not discriminate, he said, and people need to know that. His family, he said, were completely surprised to find out about his drug use and were “unversed in the topic of addiction.” Luckily, he had a cousin who works as a drug and alcohol counselor and “she saved the day” when it came to him seeking help.

At age 14, Bowman started to experiment with marijuana. He couldn’t say exactly why he started using harder drugs, but perhaps he had just gotten in with the wrong crowd. He described the process as progressive. “It went from using once in awhile to using every day, to doing whatever it takes,” he said.

“I’m not going to get too much into the things I did to get to get high every day but it definitely involved a lot of stealing from the people very close to me. It didn’t matter if you would love me, if you would hate me, if you were older, if you were younger, if I had the chance, I would try and rip you off if I was with you, and that was the reality of my life.”

From age 16 to 18, he was using opiates every day, while still going to school, while still trying to cover up that he was an addict. “I wanted help, but I didn’t,” he said. “I wanted help because I knew in my mind that I could be a better person than I’m being right now but, in the other part of my mind, I was scared and I wanted to keep getting high.”

The breaking point came when he stole a significant amount of money from his brother. From that day, when his brother reacted with love rather than anger – Dec. 22, 2015 – the efforts at recovery began, with the help of his father, brother, cousin and others. There were a few false starts, a couple of detox and treatment centres, before he landed at Last Door in mid-January 2016. He has not used drugs since.

Waiting times and the cost of treatment were among the topics discussed in the question-and-answer period. Giuseppe Ganci, director of community development for Last Door Recovery Society, was in the audience. He explained some of the different levels of care, ranging from assisted living residences, for which there are minimal guidelines, to treatment centres, which will have psychiatrists and other professionals on site. The definitions of the levels differ between regions in the province, he said, making the system hard for people to understand and, therefore, access.

“The problem is,” he said, “you always hear there are not enough beds in British Columbia. That’s actually a myth. There are so many beds. Last Door runs probably at 80% capacity every day [and has] for years. We have about 100 beds and only 35 of them are funded [by government]; the rest, there’s no funding for them, so it’s a shortage of funding for treatment, it’s not a shortage of beds.” This means that people who can afford it are able to get treatment within 24 hours, rather than join the queue of six to eight weeks or longer, he said.

After a couple more questions, Harowitz wrapped up the event. Addiction is not a choice, he stressed, citing JACS speaker Steve Whiteside. “It’s not a weakness of character, it’s not anything other than any other kind of disease that people have,” he said, challenging the audience “to keep the conversation going.”

Addiction a risk for all

Left to right: Lisa, Jacob and Richard Hillman. (photo from Lisa Hillman)

“I had a fairly demanding and public position in the health system. I was president of our hospital foundation, had a very large board of about 25 people and a staff of about a dozen people. We were raising a lot of money to build a new hospital campus at the time, and so I was very public and very out and about. And, my fear was, as sick as it is to say today, that, if somebody would find out that my son had a drug problem, what would that say about me? What kind of mother could I be? What kind of person was I if I had a son who was using illicit drugs?” Lisa Hillman, author of Secret No More: A True Story of Hope for Parents with an Addicted Child, told the Independent.

“That was my feeling at the time,” she said. “I was not at all prepared to have addiction in my household. I was both ashamed and terrified at the same time.”

Hillman and her now-sober son, Jacob, shared their story at a Jewish Child and Family Service (JCFS) event at Congregation Shaarey Zedek in Winnipeg late last year.

Lisa and Richard raised their family in Annapolis, Md. Jacob was in high school when they found out he was using drugs. With almost 40 years of experience in the healthcare industry and being the healthcare decision-maker for the family, Lisa was determined to help Jacob overcome his addiction, while also keeping it a secret.

Like many others, however, she learned the hard way, after a couple of years, that this was not something she could fix. Although she held out hope that Jacob’s use of drugs was just a normal coming-of-age rite of passage, like trying cigarettes or alcohol, and that he would return to being the high-achieving person she knew him to be, that is not what happened.

“At first, we had him evaluated,” said Hillman. “I asked him if he would see a psychologist. He said ‘yes.’ He had bi-weekly meetings with a psychologist. At one point, my son gave me permission to talk to him – Jacob asked me, ‘If he tells you I’m alright, will you get off my back?’ And, I said, ‘sure.’

“This was when he was still in his senior year of high school. I visited with the psychologist, who said to me, ‘I told your son to smoke a little less.’”

Jacob was arrested during a holiday week after graduation, and the situation became more serious. As the family worked to get Jacob help, he resisted it, as addicts often do.

“The question I always get is, ‘How do you get them to accept treatment if they don’t want it?’” said Hillman. “I wish I had an answer for that. What we did with our son is finally say to him, ‘Jacob, you have a choice. You can continue to use, but you can’t live under our roof, or Dad and I will pay for inpatient treatment.’ Fortunately, he accepted inpatient treatment.

“Keep in mind, I’m very blessed,” she added. “I had some insurance and other resources. We were able to afford to send him someplace, which I know a lot of families can’t afford to do. I’m very, very lucky.”

The Hillmans found a place in Maryland, because Jacob did not want to leave the state. The place seemed to be very lovely and spiritual. They were hopeful he would get better there. But, after 12 days, the Hillmans visited their son and Lisa knew he had been using. Sure enough, the next day, Jacob’s counselor asked them to come pick Jacob up, that Jacob could no longer stay there.

“We brought him home to Annapolis,” Lisa Hillman said. “He entered the addiction treatment centre inpatient [program] that is part of my health system, where I was then and am still today, on the board. So, my drive for anonymity in this situation was about to crumble. The counselor my son was seeing said to me, ‘You have to tell somebody at work.’ So, I told my boss, the CEO of the hospital, and he was very empathetic and extremely understanding.”

Jacob went in for two weeks, after which the counselors suggested the Hillmans allow him to go to Florida for continued treatment, where he could live in a sober living house and continue to get outpatient treatment.

“The day he left, the counselor said to me, ‘Your son is going to have his program. What are you going to do for yourself?’” said Hillman. “My immediate reaction was that the counselor must have had 10 hits too many, because I didn’t have an addiction. I wasn’t the sick one, my son was the sick one. And yet, I realized I was crying all the time, I was obsessed with where he was and I couldn’t go to sleep at night until I knew he was home.

“I was isolated, I was depressed,” she said. “I wasn’t sharing anything with family and friends. So, I tried Al-Anon. And, from my very first time, I realized I’d [found] a home. These people understood me and were going through the same thing. I wasn’t alone anymore. I had people around me who got it and who were going through the same thing. Meanwhile, my son was in Florida and was getting better.”

Midway through that first year, Jacob had a minor relapse and told his parents about it over the phone. In that conversation, his mother said to him, “Jacob, we love you. Thank you for being honest and telling us. Please take care of yourself. You’re the only one who can.’ And Jacob replied, “Mom, thank you. That’s exactly what I needed to hear.”

Hillman recalled, “Pre-Al-Anon, I would have been on the phone screaming at him, angry. Fast-forward another six months, and he has another much more serious situation. We were told, ‘Your son needs detox.’ He was using heroin IV, a horrible scenario. So, we were asked to pay for a third inpatient treatment centre.

“I remember clearly asking the counselor, ‘How many times do we have to pay for this?’ And he said, ‘Tell your son that this is the last time.’ So, we did and, at the time, we did mean it, really. This was the last time we’d pay for him to have inpatient treatment.”

Although Hillman cannot say for sure that this ultimatum is what did it, Jacob stayed there for 100 days. After that, he moved, got a job and stayed for six months in a sober house. He kept the job for several years and eventually moved into an apartment. He has been active in AA ever since and has been clean for almost eight years.

Hillman has continued going to Al-Anon. She asked her husband to come with her and try it out at least once. They went to a different meeting than she had been going to. “We walked into the room and there were two couples who we know really well,” she said. “Both of them had children with similar problems and we had no idea. We’ve been going to that same meeting now for almost nine years, every Thursday night.

“That first meeting was a huge relief,” she said. “I couldn’t speak at the first meeting. I couldn’t open my mouth, with lips quivering as I cried. They let me cry. Other people at that meeting cried. And I heard a phrase that night, that I think really guided me: ‘Detach with love’ – meaning you have permission to detach from your loved one’s problems, that you’re not responsible for them, that you can’t fix their problems, but that you still love them.”

Hillman realized, over time, that Jacob would have to find his own way and that she couldn’t enable him by sending money or paying for things for him. “But, we never stopped loving him the whole way, the whole time,” she said.

As she healed, Hillman felt the desire to write a book about her experiences. She asked her son for permission to publish it.

“The reason for writing it was, I knew there were other families in hiding and ashamed, and that shame and fear just makes it worse,” she said. “It makes it worse for you if you love someone in addiction, and it doesn’t help the person with addiction. The whole purpose in writing this was to help particularly other moms and dads and sisters and brothers and boyfriends and aunts and uncles and grandfathers who I knew were sort of in hiding and had secrets and weren’t sharing – giving them hope that they can do it, too.

“Don’t hide,” she stressed. “Find professional help for yourself. My message is not to those with addiction, it’s to those who love people with addiction. My son says, ‘Mom, remind people that this is your story. Not mine.’

“If you have somebody in your life that is using or drinking, please go get help for yourself,” she said. “If one person in the family can get healthy and understand addiction, boundaries, and how to take care of themselves, then it will affect the rest of the family.

“That’s what happened in our family. I got stronger, my husband got stronger. Jacob saw that we were trying to understand him, that we were trying to get ourselves right again. He was getting better and we had a common language.”

Hillman said, “I think people who recover from an addiction and somehow live every day clean and healthy, year after year after year, to me, they are the most amazing, profound people. My son has become just an astonishingly profound young man and I’m very, very proud of him.

“I think that Judaism hasn’t helped us here today,” she added. “I think it’s getting better, but, looking back on it, part of my shame was that this doesn’t happen to Jews. We’re smart, educated, driven, are achievers, we don’t have addiction – but that’s not true.”

The Nov. 25 event with the Hillmans was sponsored by the JCFS and Gray Academy of Jewish Education. Panelists included an addictions physician, a therapist and an Addictions Foundation of Manitoba consultant on youth.

“Recovery is individual. There is no single treatment that works for everyone. There is no easy fix, like there is no single cause. It’s a combination of factors,” said Ivy Kopstein of the JCFS. “As a community, we need to end stigma and judgment, and replace it with compassion and understanding so we have no need for secrets anymore.”

Rebeca Kuropatwa is a Winnipeg freelance writer.

Drugs and teens

When we hear the word addiction, it often conjures up negative images or stereotypes. We might think someone has made poor choices, is down and out, or weak-willed; we might think that it’s a problem confined to the Downtown Eastside. Rarely do we think of the word disease or think of addiction as a mental health issue.

Jewish Addiction Community Services (JACS) is committed to providing opportunities for the community to learn together and, on April 4, JACS and the Jewish Community Centre of Greater Vancouver youth department are presenting a community forum called The Fentanyl Crisis: How It Affects Our Teens. This free event, geared to parents, teens and youth workers, is designed to help build awareness of illicit drugs, specifically fentanyl, and to teach how these drugs affect the teenage brain, and how to talk to teens about drugs.

According to a B.C. Coroners Services report, which was published last month, 86% of fatal illicit drug overdoses in 2018 occurred inside (i.e. not on the street) – 58% in private residences. The majority of these deaths were men between the ages of 19 and 59.

While the problem of addiction in British Columbia is well known, what is less well known or acknowledged is how our Jewish community is affected. In fact, denial that the problem exists is more the reality. Rabbi Shais Taub, a specialist in addiction and spirituality, who visited Metro Vancouver in 2012, said one in 10 people are touched by addiction – whether directly or through a close family member. It makes sense that those statistics are similar in our community.

Compare the reaction of when you hear about a friend who has recently been diagnosed with cancer, or another debilitating disease. While we may not know how to help, when a loved one is affected with a life-altering illness, we are usually motivated to offer assistance, whether it is making meals, visiting or giving money to a cause. In sharp contrast, addiction tends to push us away and we tend to blame the person who has a substance use disorder, instead of wanting to rally around and help them.

Why does a family feel shame and the need to shield others from knowing their loved one is affected by the disease of addiction? Why does the person themselves feel the need to hide? Clearly, the answers are complex. In a recent visit to an emergency department, a patient pleaded with a nurse that “no one in my community must know I am here.” That person was a member of our Jewish community. Not only are people struggling with an illness, but they often can’t reach out for help or don’t know where to turn.

We must and can work to reduce the stigma of addiction so that both families and people with addiction are supported. It begins with awareness of resources and education, with fostering a culture of being less judgmental, of being curious and open, and being willing to talk about how someone may have found themselves suffering from addiction. We also need to remind ourselves of the Jewish values of teshuvah (repentance), tikkun olam (repair of the world), community and chesed (loving kindness). People knowing that there are resources available, when they are ready, is key to recovery.

The April 4 community forum includes panelists Dr. Alana Hirsh, a physician working in the Downtown Eastside; Lee Gangbar, a registered nurse who works both at St. Paul’s Hospital’s emergency department and as an outreach healthcare nurse; and Anne Andrew, a parenting coach and author. To attend the forum, RSVP at eventbrite.ca (Fentanyl Crisis). For more information on the program or JACS, email [email protected].

Shelley Karrel is the manager of counseling and community education with JACS. She has her master’s in clinical counseling, is a registered clinical counselor and also has a private counseling practice. She can be reached at [email protected].

Effects of crystal meth

Winnipeg Mayor Brian Bowman speaks at the Nov. 22 forum Wide Awake. According to Ivy Kopstein of Jewish Child and Family Service of Winnipeg, he “is advocating to all levels of government for resources to deal with this health crisis.” (photo by Nik Rave)

“It is a significant issue in both Winnipeg and Vancouver,” Dr. Ruth Simkin told the Independent. “In Vancouver, it has been overshadowed by the opioid crisis, but is a significant problem there, too. It is seen in the Winnipeg Jewish community. I don’t have stats on its prevalence in this particular group, but it is likely similar to other populations.”

Simkin is a family physician working at a community health clinic in Winnipeg and part-time with the addictions unit/addictions consult service at the Health Sciences Centre (HSC) and Rapid Access Addictions Medicine (RAAM). The JI recently interviewed her about addiction; in particular, to methamphetamine, in light of a Nov. 22 forum in Winnipeg on the topic.

Wide Awake – An Eye-Opening Look at Methamphetamine in Winnipeg was held at the Asper Jewish Community Campus. It was co-presented by Jewish Child and Family Service (JCFS) of Winnipeg, Gray Academy of Jewish Education and the Rady Jewish Community Centre.

Amphetamines were developed in the late 1900s and used commercially from about 1930 for various reasons, including nasal congestion and to keep soldiers awake. Because of their adverse effects and addictive properties, however, their use became legally restricted in the 1970s.

Methamphetamine (crystal meth) belongs to the amphetamine class of drugs – stimulants that speed up the body’s central nervous system. Although not legally available in Canada, crystal meth has been used recreationally for a very long time.

“The initial effects of methamphetamine on the user are a sense of well-being or euphoria, increased energy and alertness, increased confidence and little need for food or sleep,” said Simkin. “Unwanted potential side effects include racing heart, dry mouth, nausea and vomiting, anxiety and restlessness. It can also produce paranoia, delusions and aggressive and violent behaviour.”

“Methamphetamine comes as a powder that can be used by ingesting, snorting, smoking or injecting,” explained Dr. Erin Knight, medical director of the HSC’s addictions program, who was a Wide Awake panelist. “It also comes in a crystal form (crystal meth). It is produced in illegal labs with fairly inexpensive and sometimes toxic ingredients. It may be made with ingredients from antifreeze, batteries and cleaning fluid.”

It is estimated that one percent of students in Manitoba from grades 7 to 12 have tried methamphetamine over the last year. It is easily accessible and inexpensive. Its price has dropped significantly in the last few years, from approximately $30 per gram to $10 per gram.

In her work at the HSC, it is common for Simkin to see patients who use meth, usually along with other drugs.

“It is a growing problem,” said Simkin about the use of the drug. “It is very accessible, cheap, has a prolonged effect on the user – six to eight hours if injected and 10 to 12 hours if smoked – and it is very reinforcing (addictive).

“As well, its effects are more unpredictable than other drugs. The number of users has doubled over the last few years. And, we’re also seeing a shift from individuals smoking meth to them injecting meth.”

According to Sheri Fandrey of the Addictions Foundation of Manitoba – who also was a Wide Awake panelist – drug mixing increases the potential for challenging behaviours and the possibility of a serious overdose. That meth is bought and sold in an unregulated market increases the risk that it may contain adulterants and contaminants that can cause further harm.

“There is no specific treatment in terms of medication,” said Simkin regarding addiction to meth. “There is some evidence for the use of motivational interviewing (MI) and rewards-based treatment.”

A recent Winnipeg Regional Health Authority (WRHA) report stated that, in the 2014-2015 fiscal year, 682 people who sought treatment at the Addictions Foundation had used meth over the prior 12 months. A year later, that number had increased to 1,198. Meth was no longer being reported to be an occasional drug, and women were using more than in the past.

“As far as we know, meth use crosses all lines: rural/urban, high/low income and male/female,” said Simkin. “However, as with other substances, there are higher risk groups. These higher risk groups are students, low-income, rural, homeless, disenfranchised groups and people with co-occurring mental health disorders.”

Last year’s theme for Addictions Awareness Week, chosen by the Canadian Centre for Substance Use and Addiction, was “All Walks of Life.” Substance use issues and addiction do not discriminate by age, gender, class or religion.

Simkin said this is a complex and difficult issue, but suggested that having education programs in schools would be helpful, as are forums such as Wide Awake.

As a community, Simkin said there are several things that can be done to improve the situation:

1. Reduce the stigma around substance use in general, so people who need help aren’t afraid to seek it.

2. In terms of government, increase funding for detox beds and addiction treatment, including harm-reduction services.

3. Work on other determinants of health, like poverty, housing and education, as well as mental health, to try to prevent addiction in the first place.

photo - Ivy Kopstein, coordinator of the substance use and addictions program at Jewish Child and Family Service of Winnipeg, answers a question from CityTV at the forum Wide Awake — Ivy Kopstein, coordinator of the substance use and addictions program at Jewish Child and Family Service of Winnipeg, answers a question from CityTV at the forum Wide Awake. *(photo by Nik Rave)*

Another resource now available in Winnipeg are the RAAM clinics that have been instituted recently by the WRHA to provide low-barrier access to resources for individuals needing help with substances abuse issues, including crystal meth.

“The City of Winnipeg and law enforcement are responding to the crisis on the streets and have included public education programs in all areas of the city,” said Ivy Kopstein, coordinator of the substance use and addictions program at JCFS Winnipeg. “Our mayor is advocating to all levels of government for resources to deal with this health crisis.”

“Emergency Medical Services (EMS) has now been given the authority to give meth users the antipsychotic drug Olanzapine,” Simkin offered by way of an example.

When a loved one has a substance abuse issue, it impacts the whole family, she said. Family members may feel stressed and anxious and it’s important for them to also seek support.

In British Columbia, the B.C. Centre on Substance Use (bccsu.ca) “is a provincially networked organization with a mandate to develop, help implement and evaluate evidence-based approaches to substance use and addiction.” Other resources include Crystal Meth Anonymous (crystalmeth.org), which is similar to Alcoholics Anonymous and lists a meeting place on Hornby Street in Vancouver, and Jewish Addiction Community Services (778-882-2994 or [email protected]).

Rebeca Kuropatwa is a Winnipeg freelance writer.

Wilderness helps youth heal

BaMidbar students hike in all weather conditions, learning to live and care for themselves in outdoor environments. (photo from BaMidbar)

When she was 15 years old, now-camp director Jory Hanselman had some family members who were struggling with mental illness and addiction. At the same time, a couple of close friends passed away in pretty quick succession. Hanselman was struggling to cope, until her parents sent her to a wilderness therapy program.

“It was an extremely transformative experience for me,” Hanselman told the Independent. “I was there over Passover and so, while the program I was at was not in the least bit Jewish, my identity as a Jew was really central to what I experienced and got from it.

“I really connected it to the narrative, and thinking about finding my freedom from narrow places and overcoming obstacles I’ve faced in life. So, I looked into how I could become more involved in wilderness programs.”

In college, Hanselman spent summers at Ramah in the Rockies and saw firsthand the beautiful integration of Jewish learning via meaningful, outdoor-based experiences. And, when Ramah in the Rockies started exploring the idea of opening a Jewish wilderness therapy program, their director reached out to Hanselman, knowing that she had been working in the field. Hanselman was asked to provide input on how to build a therapy program.

“They decided they would move forward and officially create BaMidbar and so I came on board at that time, in September 2016, to help move the program from a space of ideas to implementation and actuality,” she said.

One great thing about its location – literally, in the wilderness – is that it’s only an hour-and-a-half drive from Denver, Colo. However, said Hanselman, “To give you a perspective, we are an hour drive from cell service in any direction.”

The therapy retreat is for Jews from 18 to 28 years old who are struggling with mild to moderate social and behavioural challenges, including depression, general anxiety, social anxiety and more. The young adults in the program have reached the tipping point where the issues are getting in the way of their being able to fully engage with the people and things around them in life.

“We also see lots of folks who have co-occurring substance abuse disorders, who are also using substances in addition to working through challenges associated with other mental health challenges,” said Hanselman.

photo - Staff member Cliff Stockton teaches primitive fire building skills to students at BaMidbar — Staff member Cliff Stockton teaches primitive fire building skills to students at BaMidbar. *(photo from BaMidbar)*

“The idea of wilderness therapy (WT) is using wilderness- and adventure-based experiences as the vehicle for therapy, to grow. So, we joke a lot in the WT industry that it’s not about doing therapy in the wilderness, it’s about doing wilderness-based therapy. It’s not just going out and meeting with a clinician in a wilderness-based setting; it’s really using that experiential environment as a vehicle for working through different therapeutic concepts.”

The BaMidbar program involves the whole family. While students work with an individual therapist, their family is having weekly phone meetings with the therapist who, in turn, also works with the field staff to implement a treatment plan.

“So, our students are learning how to, for example, build a fire with friction, and they use this opportunity to build primitive skills to challenge themselves,” said Hanselman. “They learn what tools they need to work through and understand what they’re capable of.

“Wilderness-based experiences are used as metaphors and storytelling to support our students in connecting what is happening in the wilderness environment to life outside the program.”

The small-group environment at the camp is used as a way to help campers learn and rebuild communication skills and other tools.

“We provide feedback and strong support for them, as they determine how to have healthy emotional responses to different stressful situations, or anger management strategies, and things like that,” said Hanselman.

While there are many WT camps, BaMidbar is possibly the only one that uses a Jewish lens and framework in everything they do, including using the Jewish calendar as an opportunity to look at topics that are thematically relevant to campers.

“To give an example, for Passover last year, every day we had a theme we focused on that tied to the Passover narrative, as well as our student therapeutic journey,” said Hanselman. “Day One, we focused on our narrow place. Day Two, we talked about the story of Nachshon Ben Aminadav … jumping into the unknown and what it might look like to take a leap of faith and know that you need to change your situation, even if you don’t know what the future holds. Day Three, we looked at manna in the desert and talked about what sustains you physically, metaphorically, spiritually. Day Four, we talked about receiving the Torah on Mount Sinai and did a summit hike, talking about our personal value systems, what we live by, things like that.”

With BaMidbar being a kosher camp, Shabbat is a break from the routine, which, in this case, is wilderness. On Shabbat, they spend time in a cabin, while still studying texts through the lens of how they are relevant to one’s life. This is the perfect time, said Hanselman, to talk about family. For instance, “because, throughout Genesis, that revolves around challenging family dynamics…. I always joke that Abraham was the first wilderness therapy participant. He leaves everything he’s familiar with and goes off into the wilderness on this journey of self-discovery. So, we do a lot of programming around Shabbat.”

photo - BaMidbar’s program is rooted in Jewish ritual. Here the BaMidbar community celebrates Havdalah — BaMidbar’s program is rooted in Jewish ritual. Here the BaMidbar community celebrates Havdalah. *(photo from BaMidbar)*

BaMidbar (which means “in the desert” in Hebrew) is non-denominational and the organizers are dedicated to meeting every student where they are in their unique journey, recognizing and honouring that it can be very different for each individual.

“We are very dedicated to making sure that students understand that our goal is to explore meaning, values and purpose through a Jewish lens – not to tell them how to live Jewishly or what that ideal Jewish life might look like,” said Hanselman. “That’s not our goal. Our goal is to look at the wisdom Jewish tradition provides and to support students for whole health wellness.”

Participants can expect 10 to 12 weeks in the wilderness (Shabbat in a two-room cabin). Groups are small, with a current maximum of eight individuals, and the program runs year-round.

In winter, said Hanselman, “We fully outfit our students, so they receive all their gear from us. We make sure they have what they need to be safe and warm in a wilderness environment. We have a lot of staff practices around safety and support in that winter environment, and then we have tents that have wood stoves in them when it gets below a certain temperature.”

The camp fee is around $3,500 US per week. A nonprofit, the BaMidbar program offers scholarships and works with every family, regardless of their financial situation. Currently, about 75% of students receive scholarships provided mainly by private donors and foundations.

While BaMidbar has received many inquiries from Canadian families, they have not had any Canadian participants. “But, we can work with them – from Canada, or Israel, or other countries,” said Hanselman. “We just haven’t yet.”

For more information, visit bamidbartherapy.org.

Rebeca Kuropatwa is a Winnipeg freelance writer.

Dealing with addiction

Dr. Jenny Melamed (photo from Jenny Melamed)

“I’ve been in addiction medicine for at least 15 to 20 years now. I spend my time with people in addiction and recovery; that is all the work that I do. I believe in recovery and I believe in remission for the disease of addiction,” Dr. Jenny Melamed told the Independent.

Melamed, who now lives in Vancouver, was born and raised in Johannesburg, South Africa. She moved to Canada with her husband in 1987 – first to rural Saskatchewan, then to Vancouver. Her work with addiction began with a friend’s suggestion to try some work at a methadone clinic. She immediately was drawn to help people in this way and became certified in addiction medicine in the United States, then in Canada and internationally.

“I’ve got lots of initials behind my name,” said Melamed. “I’ve spent most of my time in addiction talking, doing person-to-person counseling. I don’t wear a stethoscope.”

According to Melamed, physicians were among the first abusers of prescription drugs. “It was thought that treating pain with opioids would not be addictive,” she said.

“Opioids are narcotics that act on opioid receptors to produce morphine-like effects, so we were prescribing it and, now, there are so many opioids out there. And we’re having these pill parties, where kids are taking pills from their parents’ cupboards – going to these parties where they’re putting them into these big bowls and they don’t even know what they are taking out. We’re looking at 13- or 14-year-olds that are trying these drugs. They’re finding it young.

“There’s not that much OxyContin available anymore,” she added, “as people are now scared of it.”

Melamed said there is no way to know for sure if a person will become addicted or not. Kids often take more than one possible addictive drug at these kinds of parties, she said, so they will likely not even know which one(s) affected them and what the specific effects were.

“For some people who take their first drink or take their first opioid, they will say that ‘the minute I used X, I felt calm for the first time,’” she said. “For some, it starts immediately. For others, it starts as weekend use at parties. Then, they start to use a little more during the week, and then they start realizing that, when they try to stop, they can’t. They’re actually dependent on this drug and are going through withdrawal. They can’t move away from it.”

Melamed said, “Addiction is a disease of escape. They’re using it to help them cope. I said to a young girl yesterday, ‘Why do you use?’ She said, ‘Sometimes, I just don’t want to feel.’ And that’s what it is. They learn from an early age, and the addiction part of the brain takes over and says, ‘I will help you through this.’

“We all live in a society where there’s a lot of stress and many of us, especially young people that have not developed coping mechanisms, turn to different modes of escape, as they are the easiest thing to do.

“The important thing to remember is that, when you come down from whatever high you used, you still have the stress, if not even worse, as now you’ve got to pay for your drugs. You may have blacked out or overdosed … but, in the spur of the moment, addiction is such an instant gratification that you don’t even think of it. You just think about self-medicating.”

Recovering addicts learn that there is no such thing as a cure from addiction. Addiction may go into remission in the same way that type 2 diabetes can go into remission, said Melamed. If one changes their diet and loses weight, etc., they may not have to use insulin anymore, but, if they gain weight back, change their diet or lifestyle, the diabetes will flare up again.

“So, you get the person who is out with buddies and somebody says, ‘You want to try this heroin?’ not knowing there’s fentanyl in there,” she said. “And they die, because the brain tells them that they can try it just once. And they actually believe that they can go back to being a social user, or a social drinker.

“They don’t understand that this is a chronic disease that is with them for the rest of their life. And, you know, when you say to a 15-year-old, ‘you’re not going to be able to use or drink for the rest of your life,’ it’s a very difficult concept and very scary … and that’s why the AA [Alcoholics Anonymous] concept of one day at a time is really important.”

While only about eight to 11% of people who use a substance become addicted to it, no one knows which substance will entrap them. But, one thing is for certain – it can affect any of us and the problem affects us all.

“I think the first thing we have to understand is that it doesn’t matter what religion we are, what our economic status is – everybody has a risk of addiction,” said Melamed. “We have some very wealthy families in the city who have lost kids to addiction. We have to move it out of the stigma.

“You have the concept of, ‘Oh, he’s a functional alcoholic, just drinks at lunchtime.’ And, we accept that. But, we shouldn’t accept that in any form. And, we also shouldn’t stigmatize it in any form. We need to talk to our children about it and be on top of it.

“In some ways, as a Jewish population, we feel like we’re a little different and protected,” she continued. “We’re not. The conversation has to happen at home. When I gave a talk here, at the Schara Tzedek, about addiction, the room was empty. We believe our kids would never do it.”

There are things you can do at home, in addition to talking with your kids about addiction. Any prescription drugs that are not being used should be returned to a pharmacy for proper disposal, and any medications that are being used on a regular basis should be locked up.

“You also should take a look at why you are using these medications,” she said. “Even as adults, our drug use is inappropriate.”

Melamed said one of the best ways to keep an eye on your kids is by making your home a welcoming space where they and their friends are happy to hang out. That way, they are comfortable being around you and you see what is going on.

“You need to know where your children are, who their friends are and what they are doing,” she said. “And, you cannot assume that, just because they are from the same socioeconomic status, that everybody’s good. It’s really important to know parents, their friends and to know what’s going on.”

Melamed is open to hearing from educators, schools, community groups and others who would like her to come and speak on addiction and its treatment.

Rebeca Kuropatwa is a Winnipeg freelance writer.