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Addiction and Substance Abuse:
Role of the Rabbi
By: Rabbi Moshe Taub
Originally Published in AMI Magazine
Rabbis are not doctors; rabbis are not therapists. And yet, rabbis are asked to give their view on any number of highly specialized areas, and called upon to give advice to individuals struggling with problems in these matters. In this column, we have often spoken about the need for rabbis to acknowledge, and stay within, their province and field of expertise; just because something comes across one’s desk does not, eo ipso, make the owner of that desk the right man for the job. However, there is little doubt as to the importance of getting a Torah perspective on serious issues and problems; all the more so when it comes to existential ones such as addiction.
As noted in the sidebar, one of the main litmus tests of addiction is an individual’s ability to prioritize; sadly, many addicts place their need for whatever it is they are addicted to above their families and professional responsibilities. This often brings the family members (not the addict, who may be in denial) to seek out someone to talk to. A rabbi is a common choice, and can help guide them to the appropriate professionals. It is not, however, the addiction specialist’s job to discuss the Torah’s hashkafa during counseling sessions, and may even be inappropriate.
In fact, an important debate is taking place right now among leading poskim and mental health professionals. There are different schools of thought. One school insists that a frum therapist is obligated to rebuke his client and guide him in the right direction when the client is engaged in acts that are clearly forbidden. The other school of thought holds that this is not only contrary to professional standards, but counterproductive as well. Aside from the fear that rebuking the client would cause him to clam up and no longer view the therapist’s office as a “safe zone,” it could also severely curtail the professional’s ability to help others in the future.
A rabbi, as mentioned, is in the reverse position: he can and must share the Torah’s perspective on complex issues like addiction, yet he must simultaneously tread very carefully lest he venture outside his area of expertise.
What is the Torah perspective on addiction?
The Gemara in Pesachim (113a) tells us in the name of Rav Chiya that one should stay away from drugs, and the Rashbam gives two reasons: so as not to become addicted to the point of having to rob people for money, and because even the most therapeutic drug in the world may be good for one part of the body and harmful to another, as there is no such thing as a perfect drug.
An unnerving statement about addiction, considering its source, was written by Rav Dessler (Michtav Me’Eliyahu, Volume 1, page 79): “I intuit and it is intellectually certain to me, for example, that smoking cigarettes is bad for my health…nevertheless, I go ahead and (continue to) smoke. Why is this? Clearly an emotional attachment cannot be overridden by that which I know rationally.”
Once, while still in Gateshead, Rav Dessler (whose yahrtzeit is this month, the 25th of Teves) put up a sign on his office door stating that he had officially quit smoking. He explained that he was testing himself to see which temptation is greater: his desire to continue smoking, or his desire to be seen as a man of truth!
Being a former smoker myself I can relate to the following words of Rav Shach: “When I used to smoke I thought I could never understand a Tosefos without a cigarette; now that I quit I do not know how I ever managed to learn with a cigarette!”
Rav Hirsch was at one time so addicted to snuff that before retiring to bed one evening he caught himself placing his snuff box under his pillow in case he wanted a pinch in the middle of the night. Shocked at the power his habit had over him he quit that night, never to touch it again.
Back in 1973 Rav Moshe Feinstein was made aware that some frum teenagers were experimenting with marijuana. Aside from the very real issue of dina d’malchusa dina (which Rav Moshe, peculiarly, ignores, perhaps due to the correct assumption that it would eventually be legalized in many places) he writes in Igros Moshe Y.D., Volume III #35, no less than seven reasons for its prohibited status; this although marijuana may not even be an addictive substance. (This is a subject of ongoing debate. According to the National Institutes of Health, “Long-term marijuana use can lead to addiction; that is, people have difficulty controlling their drug use and cannot stop even though it interferes with many aspects of their lives. It is estimated that nine percent of people who use marijuana will become dependent on it.”)
All the more so would his reasons apply to harder drugs (his reasons range from kibbud av to kedoshim tih’yu to increasing one’s tayva, making this particular responsum very difficult to understand from a purely halachic standpoint; see Darchei Teshuvah Siman 116:109 and Shu”t Ksav Sofer Y.D. #77 regarding the difference between a psak halacha and a psak hashkafa). Rav Moshe ends this teshuva by imploring that we especially work to keep yeshiva students away from such vices.
What about alcohol?
Over the years many organizations have begun to crack down on alcohol abuse in religious settings, especially by young people on Purim (See Rambam Hilchos Yom Tov 6:21 for precedent for such bans and concerns). Many in our community have met this with a touch of cynicism, as they hold the mistaken belief that Yiddishkeit doesn’t subscribe to such a negative view of alcohol. While there are, indeed, many statements in the Torah and Chazal that refer to the positive aspects of alcohol, they pale in comparison to the number of statements against it. This is similar to the current medical view that in the right setting, small but regular alcohol consumption can be beneficial, yet it can also hold great potential for abuse. In Talmudic parlance, there is a difference between a shasuy (drinker) and a shikkar (one who is drunk); see Eruvin 64a.
So while the Gemara teaches (Eruvin 65) that “Wine was created so as to console mourners,” the Midrash in Bereishis Rabba (36:4) teaches that “[wine] caused exile and will continue [to do so] in future generations.” Similarly, “Wine gladdens the heart of man” (Tehillim 104), and “Do not drink, for its end is blood.” (Bamidbar Rabba) Summing the Torah view up neatly: “Eight things are harmful in abundance and beneficial in moderation…wine.” (Gittin 70a)
The Midrash Tanchuma (Shemini 11) relates the story of a son who slowly weaned his drunken father off his dependence on alcohol. When he felt it was safe to let his father out of the house they went for a walk, and came upon an old drinking buddy of his father’s. The friend was lying in his own filth in the road, laughing to himself. Hoping that his father would now see the loss of dignity associated with drunkenness, the son pointed him out to his father. However, the father ran over to his old friend and whispered into his ear, “Where did you find such good wine?”
Based on the above Tanchuma and Esther Rabba (5:1) the Gra interprets the verse in Mishlei (23:35), "They struck me and I did not become ill" as symbolic of an alcoholic who becomes oblivious to alcohol’s negative effects and even claims that his addiction is virtuous—a sort of Stockholm syndrome. (See Artscroll's Esther Rabba ad loc., footnote 28 and Insights A for further elaboration.)
For a wonderful treatment of this topic and on addiction in general, see Judaism and Psychology by Moshe HaLevi Spero, Ktav Publishing, Yeshiva University Press, 1980, pages 120-141.
While it has been argued that Orthodox Jews seem to have a lower rate of alcohol abuse in proportion to its drinkers than many other groups, if true, this is due to our being grounded in alcohol’s reality, not because of our denial of it (see American Sociological Review, 1980, Volume 45, “How Jews Avoid Alcohol Problems,” pages 647-664; Time Magazine “Jews and Alcohol,” March 17, 1958; The Daily Beast, “Pass the Manischewitz, Please,” August 2008; and The New Yorker, “Drinking Games,” by Malcolm Gladwell, February 2010.)
It states in Shir HaShirim (1:2), “For Your love is better than wine.” Wine can be wonderful, but it should not come between us and the love of our families and Hakadosh Baruch Hu.
[sidebar] A Short Definition of Addiction, from the American Society of Addiction Medicine
Addiction is a primary, chronic disease of brain reward, motivation, memory, and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social, and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.
Addiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.
A rabbi can and must share the Torah’s perspective on issues like addiction, yet he must simultaneously tread very carefully lest he venture outside his area of expertise.
Playing the bad guy
When Dovid HaMelech desired to explain why he was confident that he would have a share in the world to come he did not touch upon in his many battles waged and won on behalf of klal yisroel or his brilliant immortalized compositions, rather he chose to highlight the fact that he had to answer uncomfortable Halachik queries (see Berachos 4a for the exact quote and the example Dovid HaMelech used).
While I typically avoid sharing current issues that I must deal with, especially when real people are involved, as will soon become clear the following is an exception. Among other things the events you are about to read can serve as an example of an “uncomfortable” Haklachik issue.
In addition, as is the purpose of this column, I want to shine a light as to what goes on behind the scenes and in a rav’s head when descisons are being made that will impact a community.
Ever since I took over the Vaad of Buffalo I have maintained a record of never having to pull certification due to kashrus concerns. Make no mistake, if needed I would not blink, rather, the fact that I have never needed to pull certification is because, largely, I have the luxury of choosing who I go into business with and there are certain telltale warning signs that would indicate that I stay away.
An example: There was once an Indian restaurant that wanted to go under the vaad. This was not a bad idea for him or the Jewish community. Indian restaurants are, typically, vegetarian to start with, so that the changes one would need to make would not be prohibitive. As for the Jewish community, it is always better for a small town to have it so that its kosher restaurants appeal to and be supported by non jews and jews alike.
We made an appointment to meet in his restaurant at a specific date and time. Meeting in his facility was important so that I could see the inner workings of his operation and would then immediately be able to inform him as to what changes would be necessary before we could certify it.
I arrived at his restaurant. No one was there. No one. Not one cook, not one waitress, and not the owner. I was able to walk around the premises without fear. Not a good sign. I went through the kitchen, the ingredients, etc. waiting for someone to stop me. No dice.
When the Indian owner finally arrived it was an hour later and only after I had called him numerous times.
From the start of our conversation, he acted as though he was meeting with me as a favor. I reminded him that he had contacted us –and not the other way around – and that he was under no pressure to become a kosher restaurant.
Then it began: he started to tell me all about kosher; how his brother owned a kosher Indian restaurant in Manhattan and how he therefore did not really need me to tell him what Kosher was. This was, of course, laughable but not just for the obvious reasons. The fact was that this restaurant was not even truly vegetarian as advertized, as many of the ingredients I perused before his arrival had meat based products in them that he, unfamiliar with the food industry perhaps, was unaware of. It should be pointed out that vegetarians would likely be horrified if they better understood the food industry and simple facts like infestation in produce.
As the saying in the kosher industry goes “A salad can be a great source of protein”.
Back to my conversation with the Indian restaurant owner: all of the events leading up to what he was about to say next were bad signs: his lateness without calling first; his leaving his restaurant open with no one inside; his obduracy, etc., but the clincher was when he excitedly explained his kosher vision for this restaurant. “Look rabbi” he began in a thick accent “Here is what we can do for you” he so kindly offered. “You give us a kosher letter of certification which is easy to do because, anyway, we are already kosher, and in return I will give you and your family free dinner every time you come to my restaurant”.
I got up and left without saying another word.
The purpose of the above story is to illustrate a critical tenet in the world of kashrus: no matter how many mashgichim a facility has or how good those said mashgichim are at their job, if the owner of that facility –especially a restaurant – shows acute dishonesty or disregard or disrespect to kashrus or the idea of being told what to do there is no way to stop nefarious activity. Meaning, the first line of defense in the world of Kashrus supervision is a trustworthy proprietor, everything else that is to put into place is solely to prevent innocent error or other workers’ malice. There simply is no way to guarantee that cooks will not slip an ingredient from their pocket to the soup or fill an empty kosher-labeled box with a non-kosher replacement short of them having a boss who is on the side of Kashrus. And even then…
As I began the column Over the past several years I have been fortunate enough not to be put into a situation where I felt the BVK needs to be pulled. Sadly it appears "Kshem Shikibalti Schar Al HaDrisha Kach Ani Mekabel Schar Al HaPerisha"