addiction – Jewish Independent

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.

Jewish take on health issues

Attendees engaged with panelists, left to right, Drs. Eric Cadesky, Brian Bressler and Jennifer Melamed at a Kollel event Jan. 29. (photo from Kollel)

A small but passionate group gathered at the Ohel Ya’akov Community Kollel Jan. 29 to engage with Drs. Brian Bressler, Eric Cadesky and Jennifer Melamed on the topic of Canadian Health Care Challenges Through the Jewish Lens, which focused on the legalization of marijuana, the treatment of addiction, the practice of harm reduction, the opioid crisis and medical assistance in dying (MAiD).

Cadesky, who chaired and moderated the event, is a family doctor in Vancouver and president-elect of Doctors of B.C.; until last summer, he was also medical coordinator at the Louis Brier Home and Hospital, a position he held for some eight years. Bressler is a gastroenterologist at St. Paul’s Hospital and a clinical assistant professor in the University of British Columbia’s department of medicine, while Melamed is co-owner of the Alliance Clinic, an addiction services facility in Surrey.

Bressler framed the conversation in terms of what he called the four principles of medical ethics for a healthcare provider: autonomy, respecting a patient’s choice and their right to understand and consent to treatment; beneficence, doing or recommending everything that could benefit a patient; nonmaleficence, taking into account all known risks to a patient and doing no harm, or the least amount possible, if harm is unavoiadable; and justice, making treatments available to all patients.

“I wouldn’t distinguish between those principles and Jewish ethical principles,” said Bressler. “I think they’re entirely consistent.”

Within this framework, the doctors’ dialogue with the audience took place.

One exchange was sparked by Melamed’s criticism of harm reduction clinics. “This is the dilemma we face,” she said, “is addiction insanity? Should we respect the patient’s autonomy even if the addiction has impaired that autonomy and they are not truly free to make decisions for themselves anymore because of the effects of the addiction?”

She said, “I refuse to accept harm reduction as the end result, as the highest result for my patients.”

Arguing that there “is really no such thing as a safe injection,” she said she believes such clinics are doing more harm than good.”

An audience member countered that recovery might be a realistic goal for working and middle-class patients, who have seemingly more to recover for; but, for addicts living in extreme poverty, who have a history of trauma and/or mental illness, they may not have a realistic chance of recovery. “With harm reduction, we keep them away from crime and treat them like human beings.”

The Kollel’s Rabbi Avraham Feigelstock said that, from a Jewish point of view, the community has a responsibility to do everything in its power to help a person recover. However, the question of how harm reduction clinics could go beyond their current purpose and move towards recovery was not pursued.

Discussing opioid use, Bressler expressed both a cautionary approach, based on his own practice (Crohn’s patients are at particular risk for addiction), and the opinion that it is important to focus on addressing the sources of pain, not just pain itself.

Both Bressler and Melamed were negative about the legalization of marijuana and its use in a medical setting. They said there was some evidence that marijuana was effective for a very limited number of conditions – neuropathic pain and nausea were mentioned – but that the risks of marijuana, such as cognitive impairment and a link to developing psychosis, were well-evidenced.

Melamed expressed concern about what she thinks will be the massive costs of policing marijuana intoxication, among drivers or industrial workers, for example.

When one person raised the potential of increased teen use of the drug, Melamed said teens were already using and she didn’t fear an increase, though she was concerned about the potential for increased use among adults.

Another audience member suggested the Jewish community should protest marijuana’s legalization.

The doctors took a less defined stance towards medical assistance in dying. Both Bressler and Melamed said they had personal and professional experience with it but did not take a stand in favour or against it, instead highlighting issues to consider. Bressler acknowledged the right of Canadians to MAiD but also pointed out that the practice conflicts with Jewish law.

Feigelstock said the general principle in Judaism is to prolong life but not necessarily to prevent death. “According to Jewish law, generally speaking, you may choose not to do things to prolong the life of someone who is dying,” he explained, “and you may give medicines to relieve suffering, which have the side effect of possibly shortening life, but you do not do something that will directly kill the patient. Every case must be dealt with separately, however, case by case; one cannot make general statements about what to do.”

Matthew Gindin is a freelance journalist, writer and lecturer. He writes regularly for the Forward and All That Is Interesting, and has been published in Religion Dispatches, Situate Magazine, Tikkun and elsewhere. He can be found on Medium and Twitter.

Sukkah more than symbolic

As we celebrate Sukkot this week, we’ll be thinking about many things – notably, how lucky the vast majority of us are to have a solid roof over our heads. For most of us, the sukkah is but a symbol of our wandering in the desert all those years ago, a symbol to remind us to be humble, empathetic, grateful. However, for many living in Metro Vancouver, including members of our own community, homelessness is a reality.

Last week, we ran a good news story from Tikva Housing Society – residents were moving into the recently completed Storeys complex in Richmond. The Diamond Residences at the Storeys will house six singles (five of whom are seniors) and 12 families. Tikva Housing is also working with various partners on the development of 32 townhouses in Vancouver, and they anticipate accepting residency applications by early 2018. These new projects are in addition to Tikva’s Dany Guincher House, in Vancouver – which has 11 units for people with low-income, people with disabilities who are independent and families fleeing abuse – and the Esther Dayson Rent Subsidy Program.

There is a lot of which to be proud. However, there is much more to do. Last year, Tikva Housing reported a decrease in donations to its rent subsidy program of more than $15,000. As a result, the organization had to decrease the monthly subsidy it provided to singles, couples and families.

According to Tikva, more than 16% of Jewish Vancouver residents – more than 4,200 people – are low-income and at least 450 Jewish children under the age of 15 in Vancouver are “living in households that depend on income assistance.” Its 2015 report on housing in Metro Vancouver concluded a need for 1,827 affordable housing units in the Jewish community, including for “those under 65, low-income singles, couples and families.” Calling this “an unreachable goal,” the report nonetheless suggests some solutions, most of which the Jewish community is already pursuing, such as rent subsidies and partnering with other agencies to develop new projects.

Yet, the problem remains. And, of course, it is not a problem unique to the Jewish community. On Sept. 26, the final report on Metro Vancouver’s 2017 Homeless Count was released. On the night of March 7, more than 1,200 volunteers conducted surveys throughout the region, on the streets and at shelters, “to obtain a 24-hour snapshot” of the situation. The final report confirmed the preliminary results – 3,605 were homeless in the metro area.

While there were four percent fewer homeless youth in 2017 as compared to 2014, there were five percent more homeless 55 and older. Overall, there was a 30% increase in homeless since 2014, “and the highest number since 2002, when the first metro-wide count occurred.”

According to the report, “The three most cited barriers to finding housing were the high cost of rent (50%), a lack of income (49%) and the lack of availability of housing that suits their needs (30%).” More than 80% of respondents reported having “at least one health condition, including addiction, mental illness, physical disability or a medical condition/illness. More than half of the respondents (52%) have two or more health conditions.” More than 40% of respondents received income assistance, 28% a disability benefit; 22% were employed.

Following the local Walk for Reconciliation on Sept. 24, where some 50,000 people – including an organized Jewish contingent – gathered downtown to join in a “call to action,” it is sobering to learn that 34% of the respondents of the Homeless Count self-identified as indigenous/aboriginal. “Indigenous people continue to represent about one-third of the homeless population in the region,” states the report, noting that it’s the highest proportion found to date in a regional count and “constitutes a strong over-representation compared to the total population, where two percent identify as aboriginal as per the 2011 Census.”

In a statement of the obvious, Mike Clay, chair of the Metro Vancouver Housing Committee, said, “In order to stem growing homelessness, it is clear we need more affordable housing options.”

But additional solutions are also needed, given the systematic discrimination that still exists for First Nations people and the health conditions many of the homeless are facing – and not only the homeless. Just last week, the Independent ran an article on the impact of addiction in our community. Jewish Addiction Community Service (JACS) Vancouver estimates that as many as 5,000 Jews in our community need support, “whether grappling with their own addiction issues or the addiction of a loved one.”

The Homeless Count’s findings most likely underestimate the problem. The report references the “hidden” homeless, which includes people “who do not have a regular address of their own where they have security of tenure, and who may be staying temporarily in another household – often called ‘couch surfing.’” The Tikva Housing press release about the new tenants at Storeys noted, “One 83-year-old woman cried when she was told she would be moving into a studio unit, as she has not had a place to live for years and was sleeping on someone’s couch.”

Then there are the tens of thousands of people at risk of becoming homeless. Apparently, housing shouldn’t account for more than 30% of a person’s or family’s gross income, yet the Homeless Count report notes there were 56,000 Metro Vancouver households in 2006 that spent more than 50% of their income on shelter, and the number had increased to 62,355 by 2011. (More recent data weren’t available but, based on skyrocketing housing costs, we can guess that the number of households spending 50% or more of their income on shelter has also increased.)

There is much to contemplate as we gather in our sukkot this week. And, once the holidays are over, once we celebrate Simchat Torah, thankful for the Jewish texts and traditions that have shaped the moral compass of even the most secular of us in some way, there is a lot of work to be done.

Compassion needed

“… what the Lord doth require of thee: only to do justly, and to love mercy, and to walk humbly with thy God.” (Micah 6:8)

Despite its solemnity, Yom Kippur is my favourite of the Jewish holidays. The ritual of atonement, the accounting for our soul’s transgressions, humbles and connects us.

When we ask God for forgiveness, what are we asking for? Not for His acceptance, nor His condoning of our transgressions. What we are seeking is His compassion: the recognition that we are human and that, to be human, is to have both divine potential and to be inherently flawed. Atonement humbles us; His compassion restores our dignity.

As a physician specializing in addiction medicine, I see and support people who truly believe they are unworthy of this compassion. Many people believe that addiction is not something that affects Jewish people. I can attest that Jews are as susceptible to this neurological disease as any other group. From the Downtown Eastside SRO (single-room-occupancy) hotels, to the extravagant homes of Shaughnessy, substance dependence is having a deep impact on our community as a whole.

Our failure to acknowledge the addiction issues within our community has forced people with substance dependence into hiding and fostered ignorance over compassion. Isolating drug users can be deadly. We know that, statistically speaking, the majority of the lives lost throughout the overdose epidemic have been people who have used drugs alone in their homes.

Is it possible for us to consider extending the compassion, the dignity that we desire to receive on Yom Kippur, to people who are dependent on drugs?

For most of my patients, drug use began as a coping tool, a way to manage physical or mental pain. Haven’t we all resorted to coping strategies at some time, sometimes constructive, sometimes foolish?

What is your coping mechanism? When you don’t want to deal with a situation, do you binge on Netflix? Do you eat junk food, work too much, smoke? Fiddle with your phone, endlessly scrolling through social media? Do you sometimes misuse a prescription medication to help you manage your thoughts or worries?

Have you ever experienced shame around your coping mechanism? Do you find yourself shutting the phone off when your spouse walks in the room? Eating differently when others are around?

Imagine if your coping mechanism was not easily hidden. Imagine if, when you realized that it had become a problem and you tried to stop, you plummeted into severe anxiety and physical withdrawal – convulsing, vomiting, sweating, aching everywhere – but you couldn’t afford the days or weeks it would take to withdraw because you had a job to do, a family to care for. So, you spiraled deeper, always in search of a way to manage your pain. Until, eventually, it became impossible to hide.

Drug addicts are our vulnerability and suffering made visible. Or, as Rabbi Shais Taub said, “Addiction is but the human condition writ large.”

Last September marked the launch of Jewish Addiction Community Services (JACS) Vancouver, an organization created to provide members of our community with support around the effects of addiction. Rabbi Paul Steinberg spoke at the opening event. His words continue to resonate: “… I pray that we can tear down our walls of fear and provide a safe place to express our vulnerabilities, truly embracing teshuvah as a real agent of transformation. If our congregations cannot be a place for the depressed, the addicted, the junkie or the ex-con, then what claim are we making on our Judaism? What kind of temple have we really built?”

This Yom Kippur, let us acknowledge and have compassion for the addict in all of us. Let us welcome those with substance dependence into our congregations, and into our hearts and prayers. If you know someone with an addiction problem, let them know that you are grateful for the effort they are making, an effort that reflects a persistent theme in the history of the Jews – escaping enslavement and finding freedom. We all have something to learn from their struggles.

And let them know they are not alone. Tell them about JACS Vancouver. For more information, visit jacsvancouver.com, email [email protected] or call 778-882-2994.

Dr. Alana Hirsh is a Jewish Addiction Community Service (JACS) Vancouver volunteer and program committee member.

How best to treat addiction

The Feb. 22 panel discussion at Congregation Schara Tzedeck featured, left to right, moderator Dr. Auby Axler and panelists Rabbi Andrew Rosenblatt, Dr. Jenny Melamed, David Berner and Rebecca Denham. (photo by Zach Sagorin)

Approximately 5,000 Jews in the local Jewish community need support around addiction, according to Jewish Addiction Community Services Vancouver.

JACS offers various support programs for those battling addiction, and their families and friends, and organizes events for community education and awareness. On the evening of Feb. 22, at Congregation Schara Tzedeck, the agency partnered with Schara Tzedeck and the Jewish Federation of Greater Vancouver for a panel discussion on the fentanyl crisis and addiction in the Jewish community in general. Participating panelists were Rabbi Andrew Rosenblatt, addiction medical specialist Dr. Jenny Melamed, addiction therapist David Berner and director of services at JACS, Rebecca Denham; the moderator was Dr. Auby Axler.

“JACS Vancouver is a new agency trying to tackle a taboo and shame-filled topic that can ignite passionate responses and strong resistance,” explained Denham in an email. It is committed to supporting community needs relating to substance use, and values a diversity of perspectives on addiction treatment.

At the panel discussion, Rosenblatt spoke about some of the community concerns and the internal conflicts that some people experience when trying to determine the best approaches to addiction support.

Melamed, an addiction doctor who has been treating people with opioid addiction for 15 years, said, “People have been dying from heroin, people have been dying from all drugs…. There are many drugs out there that are as dangerous. Alcohol is one of the most dangerous drugs out there, 90% of the trauma seen in the [emergency room] after midnight is from alcohol. A heroin addict is a calm, sedated person who is nodding off in a corner, he’s not violent; he’s a danger to himself, and he’s not a danger to anybody else.”

She explained, “Addiction is a … disease situated in the primitive part of the brain…. The addiction goes and sits there and it says, ‘if you do not use me, you will die, you need me.’ This is where the team comes in…. We’ve got the ability to say, ‘I’m not going to listen to you anymore.’ But the power to overcome that is what is needed and it is strong and it requires meetings, it requires therapy, it requires a team, it really is a village to keep somebody sober in the long term.”

About 40 people attended the discussion and Melamed commented, “When you look at how big the Jewish community is and how small the attendance is here tonight … we live with our heads in the sand and we don’t realize how many of us have family members who are in addiction.

“We need to remove the stigma related to addiction. When we tried to get somebody in recovery to talk tonight, we couldn’t find anybody in the Jewish community who would come and stand up, because we put that big addiction sticker on people’s forehead. But we all know that it can happen to anybody. Yes, there is an enormous genetic component, a 40% genetic component when it comes to addiction, but there is trauma. Sexual abuse happens in any religion. Everything happens across the board.”

While the Downtown Eastside is often considered the centre of addiction and drug use, Melamed said this is not the reality. “The people on the DTES make up maybe one to five percent of the drug-using population. Seventy-five percent of people using drugs are what we call functional … nobody knows what is going on out there. If you can afford your heroin habit, then you’re OK until you overdose and it takes you over to the other side.”

Berner, founder and executive director of a residential treatment centre for drug addicts and alcoholics, has conducted almost 11,000 therapy groups.

“Addictions are coping mechanisms…. I’ve never met someone in addiction who hasn’t had a terrible upbringing, who hasn’t had severe trauma, serious trauma,” Berner said. “I’ve rarely met anyone who has addiction who hasn’t suffered physical or sexual abuse, or emotional-psychological abuse, or financial abuse.”

Berner posed the rhetorical question, “Can you change? No.” But, he said, “You can change the things you do, including picking up [drugs or alcohol].”

He said, “Every week I give a lecture, every Tuesday morning, and then do group therapy. One of the things I say week in and week out is, I don’t want to hear about your substance.”

Berner also commented on the government’s spending on addiction services in Vancouver.

“We’ve got harm reduction, that’s it!” he said. “And then prevention, treatment and the law are not only ignored officially … they are officially denigrated by the health department, by the ministry of health, and anyone that can make a decision.”

In response to an audience question – “How does the word recreational fit in with the level of risk that’s involved in drugs?” – Melamed responded, “I think you have to replace the word recreational now with Russian roulette because that’s the word we’re using. There is no safe use.”

“Even with marijuana?” asked another audience member.

Melamed said she knows, based on urine samples she has taken, that “some of the marijuana is laced with fentanyl.”

However, a man in the audience, identifying himself as a federal prosecutor who works with the police on narcotics, countered that assertion. “My understanding, after looking at various police files on where this has been reported, [is that] marijuana laced with fentanyl … is anecdotal. It is from people who have overdosed in a non-fatal manner and have reported it to hospital authorities, doctors, police officers, [saying] ‘all I used was marijuana,’ and this is to avoid, in my understanding, the stigma of being labeled a hard drug user…. There has been no actual seizure by police in B.C. of marijuana laced with fentanyl.”

However, the prosecutor added, “We see cocaine laced with fentanyl, we see a lot of heroin laced with fentanyl, we see methamphetamine laced with fentanyl.”

With Purim approaching, Rosenblatt noted, “Drinking on Purim happens a lot, especially in the Orthodox Jewish community, because there is a statement in the Talmud – a person is obligated to drink on Purim until they don’t know the difference between cursed be Haman, who is the villain of the story, and blessed by Mordechai, who is the hero.”

He said, “Maimonides says the way you should be happy on Purim is by spending most of your effort feeding the poor on Purim. Why? You would think that maybe Maimonides was democratic and would say something very nice like the poor deserve a holiday, too.… That’s not what Maimonides says at all. Maimonides says that there is no greater joy in the world than helping another person.”

“JACS was born out of a necessity and I think it is important to remind you that JACS is here to support you,” said Denham in wrapping up the event. “If a question doesn’t get answered tonight or if an issue gets triggered for you, reach out to us and we will support you just as the community has supported us. We wouldn’t be here today without the kind accepting spirit that runs deep throughout this community. From the support of the rabbinical leaders, professionals, individuals, family foundations, the support of the Federation … all of whom continue to strengthen JACS services … we are bringing this much-needed discussion away from shame and into a supportive light.”

To learn more about JACS Vancouver, Denham can be reached at [email protected].

Zach Sagorin is a Vancouver freelance writer.