By Andrew Adler
In December of 2015, the Leviathan Jewish Journal published an article titled “Jews & Booze” which posed the question: “What is the relationship between Jews and alcohol?”
The article cited a 1958 Time Magazine column called “Jews & Alcohol,” which itself referred to a Yale study recalling a 1929-31 statistic reporting that out of 100,000 patients being treated for alcoholism, a mere 0.5 percent were Jewish.
Modern scientific research identified a genetic mutation, present in up half of all Jews, that made drinking alcohol decidedly unpleasant. Less drinking, less alcoholism – at least among the affected subset of the population.
The “Jews don’t drink excessively” meme has persisted, some say.
“I will tell you that when I was in graduate school training, there was this assertion that Jews did not have problems such as alcoholism and substance abuse,” recalled David Finke, CEO of Jewish Family & Career Services.
“There is this whole theory behind it,” Finke continued, “about how because alcohol – wine in particular – is intertwined with religious rituals like Shabbos and Seders – that somehow inoculates the Jewish community from rates of substance abuse.” Alcohol becomes a benign accompaniment to food, not a binge-worthy element on its own.
Anecdotal narrative notwithstanding, there’s no denying that alcoholism and related substance abuse remain significant challenges in populations of all backgrounds. Indeed, Finke cited one New York State survey concluding that “more than 10 percent (of those surveyed) acknowledged substance abuse in their families – of which 90 percent said they wouldn’t seek services.”
It’s that second number – the 90 percent – that’s especially worrisome. “It’s a stigma issue,” Finke says. That shame would diminish “if we were willing to talk about it, so that’s part of why it’s important, particularly among my clients.”
There are any number of available recovery resources. Twelve-step programs like Alcoholics Anonymous and Narcotics Anonymous are ubiquitous (NA has birthed all manner of sub-programs – the blackboard in one facility listed meetings for “CMA” – Crystal-Meth Anonymous).
Just as traditional 12-step programs emphasize the value of sharing “experience, strength and hope,” similar collectives remind participants that they’re not alone in their efforts to heal. At JFCS, “we have a support group that gets going on Sunday evenings,” Finke says. Soon, informational flyers will be distributed to, among other places, area synagogues and the Trager Family JCC, offering access to a “peer-led recovery group.” Additionally, “we have therapists on staff who going to be available to work with family members.”
When talking about addiction and substance abuse, this last point is crucial. “I think it’s a family disease,” Finke says, though “you have to be cautious about that phrasing, because some people will (think) that the family causes the disease – but it is a disease that affects the entire family.
Therapy – valuable that is for many people – is not the only path toward recovery. Other modalities have proven successful where talk therapy by itself isn’t enough.
Medicinal detox has long been employed to treat addiction, especially alcoholism. Traditionally, the process is managed in a hospital setting – inpatient or outpatient, depending on individual circumstances.
But such requirements can be both expensive (if insurance doesn’t cover the cost) and inconvenient. One alternative is in-home detox, which offers the parallel benefits of privacy and the emotional security of familiar surroundings.
The nation’s leading in-home-detox provider is Aware Recovery Care, founded in 2011 in a joint venture with Yale University physicians. Headquartered in Wallingford, Conn., Aware Recovery now operates in more than 10 states, including Indiana and – since this past December – Kentucky.
“I’m not aware of any other organization that has attempted to scale our model into homes nationwide,” says company chief operating officer Martha Mather, a Louisvillian who previously headed U of L Health – Peace Hospital, the city’s largest in-patient psychiatric facility.
“It’s a pretty innovative approach to treatment,” she explains. “where we literally convert the home into the treatment center. We have a multi-disciplinary team that goes into the home to work with adults who are 18 years and older that have a primary substance-use issue.” Aware team members typically visit clients two to four times weekly during a year-long process, in which oral withdrawal medication is combined with support therapy.
“If there’s a need for a psychiatric evaluation the nurse practitioner can do that,” Mather says, and if appropriate “prescribe anti-anxiety or anti-depressant” medication. Other team members include a designated “certified recovery advisor” psychotherapist, “and a clinical coordinator who might be a social worker or a nurse.”
“This made sense to me,” Mather says, “for individuals that have childcare responsibilities and couldn’t leave their home for 20 to 30 days for a long-term (inpatient) program, or professionals where it would be a hardship to leave their places of employment for an extended period of time.”
A key component of the Aware teams are the “peer recovery coaches” – people who themselves have grappled with substance abuse. “I think about 80 percent of our staff overall are in recovery,” she says. “This is passion-driven work for our employees.”
The Aware system is far from perfect – half of the clients who begin treatment don’t complete it. Still, according to Mather, a 50 percent success rate is better than what many alternative strategies achieve.
Mather and Finke agree that no program will succeed unless a person, whether in the grip of alcohol, heroin, opioids, whatever — genuinely wants to recover.
“An individual absolutely has to be self-motivated,” Mather says. “Now, there are times where there’s a family that’s strongly encouraging it and maybe the client is, you know, sticking their tow in the water. Sometimes it works and sometimes it doesn’t. This is a hard illness to treat.”
Because casual drinking is accepted and often encouraged in social settings, alcohol – legal, inexpensive and available almost everywhere – is especially tough to counter. The pandemic, in which people were stuck at home, alone, for extended periods, brought its own set of challenges.
“Research is showing that the pandemic impacted mental-health factors,” Finke says, “so there are higher rates of anxiety, higher rates of depression, higher rates of substance abuse and higher rates of suicide. That’s not surprising when you think about what happened in the pandemic, which is that people had to isolate. We’re social beings, so isolation is never in our best interest.”
Unlike Aware’s age-18-and-up clients, JFCS serves younger teens as well as adults. Still, like their older counterparts, teenagers must want to get better. “If an adolescent doesn’t buy in to the need to do things differently,” Finke says, “it’s very difficult to drag them in and be successful. They have to see the benefit.”
It all comes back to reclaiming a degree of personal agency.
“You need to have a voice,” Finke says. “And that’s true of any client. If they feel like they have no say,” like a teen “who gets picked up at school, not told they’re going to see a therapist and then is dropped off at the therapist’s office – that’s not going to be very successful.”
Ultimately, breaking a multigenerational pattern of substance abuse may be the greatest challenge of all – whether or not a person happens to be Jewish.
“There’s a saying in psychology literature that we’re drawn to what’s familiar and familial,” Finke says. “So we learn to parent by the way we were parented. We learn to embrace life the way we saw the people closest to us embrace life. Now that may be healthy, and it may be unhealthy, but there are a lot of ways to mitigate it. That’s where intervention comes in.”
Indeed, “there are plenty of people who live successful, healthy lives without any of the side effects of depression or alcoholism or substance abuse,” Finke believes. “And by and large, those are people who’ve had some mitigating factor – whether its actual treatment to help them recognize patterns they need to change, or whether it’s a significant figure in their life who helped them to see things differently.”
For those suffering from addiction, there is help. Our partners at Jewish Family & Career Services offer peer-based alcohol and substance-abuse support and counseling, intervention and treatment services to the broader community to further recovery. JFCS can be reached at (502) 452-6341, and online at https://jfcslouisville.org
You can get more information about Aware Recovery Care’s in-home addiction treatment by going online at https://www.awarerecoverycare.com or by calling (502) 907.2290.