September 24, 2018

Renowned lawyer Shapiro brings substance abuse awareness to Jewish community

Photo from Pexels

More than a decade later, renowned lawyer Robert Shapiro still can’t seem to get a distinctive ringing out of his head.

“The phone rang and rang and rang. It seemed to ring a little too long. It was a little too early,” Shapiro told a crowd on May 8. “Then we got the call that no parent would ever want to get.”

The October 2005 phone call was regarding Shapiro’s son Brent, a 25-year-old college undergrad who was contemplating law school. A recovering drug addict, Brent relapsed in the early hours of that morning at a party. He was buried just over a day later.

An overflow crowd of nearly 300 people, mostly observant Jews, at YULA Girls High School listened to Shapiro and other speakers during a program called “We Need to Talk About Prevention.”

The drug and mental health awareness event was organized by the Aleph Institute, a Florida-based Jewish nonprofit, which runs Project Tikvah — “tikvah” meaning “hope” in Hebrew — a program that advocates for alternative sentencing options and interventions for struggling Jewish youth and those in prison.

The Aleph Institute, which has offices in Los Angeles, was awarded a 2016 Cutting Edge Grant of $250,000 from the Jewish Community Foundation of Los Angeles for its Project Tikvah proposal. 

Robert Shapiro. Photo courtesy of Aleph Institute.

The event featured mental health professionals, heads of treatment centers and former addicts discussing the prevalence of substance abuse and mental health issues, particularly among youth in the city’s observant Jewish community. It was repeatedly mentioned by speakers that many in observant and Orthodox circles are hesitant to address substance abuse and mental health concerns for fear of judgment and stained reputations.

Aleph Institute Vice President Jimmy Delshad, a former Beverly Hills mayor, who is Iranian-American, told the Journal that he thinks the city’s Persian-Jewish community is “sweeping the issue under the ‘Persian rug.’ ”

Ari Stark, vice president of operations for Destinations, a company that operates teen treatment centers in California and Nevada, cited statistics to illustrate the seriousness of the issue. He said East Coast Orthodox communities have experienced 75 suicides in the past year, all attributable to either drug or alcohol abuse and mental health issues. Each case involved an individual under the age of 35, he said.

“We as a community are not immune,” he said. Stark added that in his work at his company’s teen treatment centers, he has dealt with students from most of the city’s yeshivas and elite Jewish day schools.

Josh Harvey, 32, grew up a Jewish day school poster boy in West Los Angeles. The product of an observant Jewish household, he attended Pressman Academy of Temple Beth Am, a Pico-Robertson-area day school. As a teen, he turned to substance abuse and began to sell drugs. He spent years in and out of treatment and jail.

Now, sporting stylish glasses and ornate tattoos on his arms, he’s four years clean and sober and working as an addiction counselor at a Los Angeles recovery center. Harvey applauded the efforts of the program organizers to raise awareness in the Jewish community.

“We need to know that even Jews can be addicts,” he said. “I can’t believe that the Jewish community would hold such an educational event. It’s so positive for our community to acknowledge that addiction exists and we need to treat it. We need to be aware of it. We need to make families aware of it. We need to make communities aware of it because this is a problem that isn’t going away.”

According to Leah Perl, Project Tikvah’s associate director, the aim of the event was to initiate a difficult, ongoing dialogue.

“Los Angeles is ready to start tearing down the stigma and shame associated with mental illness and drug addiction,” she said. “By ignoring it, we’re losing kids. This is happening within our own community. You can’t teach people everything in one event, but you can start the conversation.”

Dr. Ron Nagle, a Beverly Hills pediatrician, emphasized the need to monitor drug use in the home. He poured dozens of Tylenol pills into a tin cup, showing how many it might take to induce an overdose. He then took just two of them, meant to represent common prescription painkillers such as Oxycontin or Vicodin, and said, “That’s all it might take.”

Shapiro, well known as one of O.J. Simpson’s defense lawyers when the former football star faced murder charges, established in 2006 the Brent Shapiro Foundation, an organization dedicated to creating awareness about addiction diseases and finding ways to help halt their spread. He left the audience with one final plea for increased attention to what he repeatedly referred to as an epidemic.

“If there is a problem, don’t run away from it; face it head on and do the best you can to get the help you need,” he said. “And if there’s not a problem, do everything you can to prevent one.”

Can moderation join abstinence as an addiction therapy?

In 2001, as 25-year-old Adi Jaffe lay on the pavement in the intersection of Beverly Drive and Olympic Boulevard following a devastating motorcycle crash, his broken tibia and fibula were not his biggest problem. Rather, that would be the amount of cocaine he was carrying (and selling), which could easily have netted him 20 to 30 years in prison.

Unable to walk and in need of immediate medical attention, Jaffe was arrested on the spot. 

Thirteen years later, Jaffe is now executive director and co-founder of Alternatives Addiction Treatment, an outpatient rehab clinic focused on helping substance abusers, primarily alcoholics, who are losing — or have lost — control over their lives. 

Jaffe said in an interview in the center’s Beverly Hills office that he resisted entering a treatment program until his attorney informed him that if he did not admit to being a methamphetamine addict (which he was) and commit to a rehab program, he would face a long prison sentence. 

The Tel Aviv native entered a 12-step program while serving a one-year sentence at Los Angeles County Men’s Central Jail. After sobering up, Jaffe earned a doctorate in psychology from UCLA and is now a seasoned researcher and clinician, specializing in understanding how people fall into addiction. He’s also been successful at helping them recover.

One catch, though: While Jaffe himself went through a 12-step program — the consensus go-to treatment for overcoming addiction — and abstained for three years before slowly reincorporating alcohol into his life, he now believes that telling everyone with any dependence on alcohol that they must never drink again — a core tenet of the 12 steps — does more harm than good. 

Jaffe, along with clinical psychologist and recovered alcoholic Marc Kern, runs Alternatives, with treatment centers in Beverly Hills and Irvine. Their program operates on the notion that moderation, not abstinence, is often a preferable treatment option for alcoholics, or at least those in the early stages of dependence. For 40 years, the idea that people with drinking problems serious enough to need treatment would be able to learn to stop at just a few drinks has generated fierce debate and has failed to gain a foothold in the mainstream addiction recovery world. 

Today, Jaffe’s program, and a growing number of programs like it in the United States and Canada, is offering the option of a middle path, indicating a sea change may be developing, however slowly.

“Most people who struggle with drugs and alcohol are actually not those stereotypical addicts who need lifelong abstinence,” Jaffe said. “Most people don’t fall into that bucket; they just get dropped into it for lack of another bucket.”

The Alternatives program and other “controlled use” centers offer both a moderation and an abstinence track — the former, Jaffe believes and research indicates, is in fact more effective for alcoholics with severe dependence than abstinence tracks.

Jaffe likens the abstinence-only approach to a doctor advising a patient experiencing foot pain to amputate below the knee — the solution, he believes, may be an overreaction to the problem, and the all-or-nothing approach can scare away people who need treatment but aren’t willing to commit to forgoing alcohol for the rest of their lives.

“You really don’t want to go for the hardest, most restrictive version of treatment first,” Jaffe said. “Most diabetics don’t go to daily insulin right away.”

Jaffe and Kern opened Alternatives in 2013 and have so far graduated 29 people. According to Jaffe, of the clients still sending information to the center, 12 are now abstaining and eight to 10 are drinking in moderation.

In place of the 12-step model, which emphasizes an addict’s powerlessness over alcohol and the need for a God-based, spiritual element in recovery, Jaffe’s clients work on mindfulness training, neuro-feedback tests and other advanced science-based treatments that seek to change the habit-forming parts of an addict’s brain.

In their first week at the clinic, which Jaffe terms “boot camp,” clients have 32 hours of one-on-one time with Jaffe, Kern and their team of seven doctors, clinicians and mindfulness experts. The moderation track lasts six months and the abstinence track has both a two-month and six-month option — drinking with control, the co-founders believe, takes more work than not drinking at all. 

Following the initial week, treatments consist of 10 to 15 hours per week doing neurological feedback exercises, therapy sessions and group activities such as hikes, movies and beach visits.

A central social element of Western cultures and widely available in most countries, alcohol’s appeal is not far behind that of sex.So, Jaffe asks, why are alcohol addicts and sex addicts treated so differently? 

“Imagine for a second a treatment for people with sex issues that would dictate that they have to abstain for the rest of their life — nobody would ever go there,” Jaffe said. “But we do it to people with [alcohol] addiction all the time.”

A five-year study published in 2012 by Columbia University’s National Center on Addiction and Substance Abuse found that only about 10 percent of Americans older than 12 who have drug or alcohol addiction seek treatment. 

Modern research on the abstinence-only versus moderation debate dates back to a 1970s study of 20 patients at Patton State Hospital in San Bernardino, in which researchers Mark and Linda Sobell concluded that alcoholics who are taught controlled drinking techniques functioned better after two years than alcoholics taught to abstain. 

Although their study provoked a harsh response from researchers who believed in the 12-step model and accused the Sobells of publishing exaggerated or fraudulent claims, numerous recent studies have indicated a moderation approach can be more effective both in getting problem drinkers to enter into treatment and in keeping them from falling into a state of severe drinking. The Sobells currently run a recovery treatment center at Nova Southeastern University in Florida that bills itself as a “non-12-step alternative treatment.”

A 2006 study by the health research group Cochrane examined data from 40 years of worldwide alcohol treatment and found no evidence that “unequivocally demonstrated the effectiveness of” the 12-step approach in reducing dependence. A 2001-2002 epidemiological study by the National Institute on Alcohol Abuse and Alcoholism looked at 43,000 adult alcohol abusers in the United States and found that among the 35.9 percent of people considered “fully recovered” after one year, 18.2 percent were abstaining and 17.7 percent were “low-risk” (i.e. moderate) drinkers.

A major shift in how medical and treatment professionals view alcoholism is illustrated in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (known as the DSM-V), released in 2013, which paints alcohol addiction as a spectrum — people with some form of addiction can either be mildly, moderately or severely dependent, which is a more segmented view of alcoholism than had been accepted in previous editions of the DSM. “Historically it was like an on and off switch,” Kern said. “Either you were addicted or you were not addicted.”

Mark Sobell, in a telephone interview from Florida, said that most existing alcohol treatment programs are geared toward people with severe dependence, who, he said, typically want to abstain and not moderate. They are not created with an eye on those who, as the DSM-V puts it, have mild or moderate alcohol problems — which Sobell said constitutes the majority of people with any form of drinking disorder.

Moderation advocates often point to the reportedly low success rate of 12-step abstinence-focused programs (estimates range from 5 to 10 percent) as one reason programs like Jaffe’s should, at the very least, not be considered taboo. Wayne Skinner, a clinical director at Toronto’s Centre for Addiction and Mental Health (CAMH), indicated in a telephone interview that the uniform abstinence treatment in the United States does not comport with the reality of alcoholism as a “continuum.”

“The treatment ideology in America is very strongly oriented to, ‘If you’ve got a problem you’re an alcoholic, and if you’re an alcoholic you should be abstinent for the rest of your life,’ ” Skinner said, adding that this ideology isn’t particularly helpful given that “the batting average of the abstinent-only approach hasn’t been terrific.” Skinner’s center at CAMH will accept patients who cannot commit to abstinence, or even moderation, but are concerned enough with their own bad habits to seek out treatment.

“[Moderation advocates] are not against people being abstinent, they just want to introduce the idea that for some people it might be possible to moderate your drinking,” Skinner said. “People who have less severe problems often do well with a moderation approach.”

Skeptics of controlled drinking programs, which includes the majority of clinicians in addiction recovery, say that moderation is simply not possible when it comes to a true addict. 

Peter Nathan is a clinical psychologist with an extensive background in alcoholism treatment and research, who once, but no longer, believed that controlled drinking would provide a major breakthrough in alcoholism treatment. He said that, like many junior alcoholism researchers, he began his career doubting the efficacy of 12-step programs, a treatment method he has since embraced.

“At the end of the ’70s I pretty much had come to the conclusion that it was not responsible to continue to provide this kind of treatment, because the data did not suggest that chronic alcoholics were able to get better, were able to resume a pattern of responsible controlled drinking,” Nathan said in a telephone interview. “It’s amazing that it’s still around.”

Distinguishing between alcoholics and those who get “carried away now and again,” Constance Scharff, director of addiction research at the Cliffside Malibu treatment center, believes problem drinkers can benefit from moderation treatment. “You might be able to learn some skills to keep your drinking in check,” she said.

However, while Scharff, like Nathan, considers moderation treatment a “disservice” for people with severe dependence on alcohol, she also does not consider the 12 steps to be an effective treatment method, notwithstanding the valuable camaraderie and support that Alcoholics Anonymous provides. 

“Twelve-step programs, I say it publicly and I’m sorry I have to, that is not treatment — that is not rehab,” she said. “What would we say about a cancer treatment that only had a 10 percent success rate? We’d say that’s terrible.”

Cliffside Malibu’s treatment regimen, which is highly influenced by Scharff’s research, focuses on the structure of an addict’s brain, which, she said, more or less necessitates a lifetime of abstinence if they want to lead productive lives. She pointed to actor Philip Seymour Hoffman, who died last February from a heroin overdose. He had relapsed in 2012 after remaining clean for 23 years. 

“Philip Seymour Hoffman is a great example of that. He hadn’t been using for 23 years, but his brain structure and biochemistry said, ‘You know you’re using like you used to use 23 years ago,’ ” Scharff said. “When you go back into addiction, that old structure of addiction is still there, and it just wipes people out.”

At a point in the abstinence versus moderation debate, terminology becomes a key factor, with some, like Scharff, saying that a “true” alcoholic cannot control his or her drinking, implying that those with some level of dependence who can nevertheless moderate are not technically alcoholics.

“When you tell an alcoholic that they can moderate, you’re lying to them,” Scharff said. Another point Scharff added is that addicts sometimes think, usually mistakenly, that their addiction won’t transfer between substances and that if they abstain say, from meth, they can try to use something else in moderation.

Jaffe, who said that for the past eight years he has consumed alcohol moderately — an average of a few drinks per week — without issue, has had people tell him that he was either never “truly” a drug addict (in addition to once being an alcohol abuser) or that he will eventually relapse because of his decision not to abstain. 

“I don’t know how to answer that,” he said. “Maybe they are right, maybe they are wrong.”

Pesach without wine

How can we have Passover without wine? This is a question that is asked of me each year as Passover approaches. I always answer that the blessing is over the fruit of the vine and grape juice is perfectly acceptable. I then ask a different set of questions.

Passover is the celebration of our leaving Egypt. It is not a historical event. Yet too many of us consider the Passover seder as a recollection of an historical event. We need to go back to the intent and direction of our haggadah to see ourselves as if we, too, were brought out of Egypt. We have to ask ourselves, “What is the Egypt/Narrow Place I have to leave this year?” All of us have these, be they substances like drugs and alcohol, behaviors like eating disorders, compulsive gambling, etc. We also get stuck in the narrow places of despair, hopelessness, why bother, etc. And we can get stuck in the narrow places of comparing and competing with others, basing our self-worth on our net worth and/or seeking to feel good from outside validation, like lists, who we hang with, etc. 

These are the Egypts that wine could come to blur for us during Passover. I would suggest that everyone abstain from wine and drink grape juice instead this year. I am asking you all to make this an Alcohol-Free Seder so that every person will:

• Look inside themselves and see the narrow places that are keeping them stuck in old thoughts and behaviors.

• Tell the story of their enslavements to others at the seder, and ask for help in getting out and staying out of these narrow places. 

• Offer suggestions to others to help them out of their narrow places. 

• Write down on a piece of paper what the narrow place is, and make these your korban Pesach, your Pesach sacrifice, and burn them all together so that you release your need to run back to Egypt.

• Be present and see how we can work together to get out our comfortable slaveries.

• Make a commitment to be of service to others who are still enslaved and look for the similarities in others. 

In doing this, we will make the seder relevant and we will build stronger relationships through transparency and authenticity. 

It will allow all of us to break our addiction to perfection. We Jews have been telling our story for thousands of years; this year let us make it our story so next year we will be free

Rabbi Mark Borovitz is the senior rabbi and spiritual leader of the Beit T’Shuvah recovery program and Congregation Beit T’Shuvah.

Just Say No, Even on Purim

One is obligated to become intoxicated on Purim until one cannot distinguish between “cursed is Haman” and “blessed is Mordechai” (Talmud, Megillah 7b).

Purim is like the Jewish topsy-turvy day.

Unlike many Jewish holidays, which are marked by serious and meaningful customs like lighting the menorah or holding a seder, Purim’s main edict seems to be: have fun.

On the holiday that celebrates the downfall of the evil Haman and the saving of the Jewish people from destruction, adults and children alike dress up in costumes, put on satirical spiels and conclude the holiday by eating a festive meal — and getting drunk.

Now, concern over the rise in teenage alcoholism in the Orthodox community has led some rabbis and organizations to protest this last custom.

This year, the Orthodox Union (OU) and the National Council for Synagogue Youth (NCSY) have produced a brochure aimed specifically at teenagers to combat the issue of drinking on Purim.

The brochure is being distributed to some 10,000 OU synagogues and NCSY chapters throughout the country and can also be downloaded from the NCSY Web site (

The two-page pamphlet features cute diagrams printed in wine-colored text. It explodes the idea that you’re “supposed” to drink on Purim, and has catchy headlines that include “Breaking News: A nonalcoholic version of wine is now widely available! It’s called grape juice.”

“Purim in general is an amazing wonderful holiday but a lot of kids take it to excess,” said Rabbi Steven Burg, national director of NCSY. “It’s important to send a message in this brochure that this is not carte blanche. It’s not a Jewish frat party where it’s OK to get trashed in this 24-hour period.”

Burg said that Purim was chosen to launch the pamphlet because it’s a major holiday in the Orthodox community.

“Over the years drinking on the holiday has been taken to excess and I don’t even think we realize it,” he said.

But combating drinking on Purim is not the end goal of course; it’s putting an end to teenage alcoholism and all forms of substance abuse — a trend that’s on the rise, say those who work with teenagers.

Some current events have made the problem more pressing. In November 2004, 42 high school kids were arrested for drug and alcohol abuse at a party of a Livingston, N.J., yeshiva student. And, just last month, an Encino boy died from a drug overdose while in yeshiva in Israel, while four others were arrested there on drug dealing charges.

Many in the Orthodox community have recently demanded some institutionwide action against an often hidden problem among kids. And Purim — along with other religious events that encourage drinking — has also come under fire.

Last month, the OU called for an end to Kiddush Clubs — an ever-popular Shabbat morning custom where some synagogue congregants leave services during the haftarah reading for bite to eat and a drink or two.

Despite protests from congregants, some synagogues have taken action. Young Israel of Century City was among the first, sending out a letter to its members to say that a Kiddush Club “sets an inappropriate example for our children,” and citing a young man who said the beginning of his substance abuse began as a child with alcohol at his shul’s Kiddush Club every Shabbat morning.

Certainly, the rise in substance abuse among teens is not confined to the Orthodox community, but the OU’s new task force signifies that the religious community is taking notice.

The whole community is in denial, said Rabbi Mark Borowitz, the founder and director of Beit T’Shuvah, a Jewish rehabilitation house who himself is a recovering alcoholic.

“None of us have wanted to face this problem,” he said. “And the OU should really be commended for saying OK, we have this issue and we’re not just going to sit around and do nothing.'”

Borowitz says teenage alcoholism is on the rise across the board.

“Kids are looking for something to get out of themselves and that’s always problematic,” he said. “As things get worse in the world there’s more hopelessness and there’s more need to escape.”

Burg said that the community’s denial of the problem is melting — and that the OU’s new anti-drug task force will help. Under the banner of “Safe Homes, Safe Shuls, Safe Schools,” the new program will hold meetings, provide educational material and guest speakers throughout the country. In addition, NCSY has posted materials on its Web site discussing the dangers of drug and alcohol abuse. There is also a sign-up list for kids to publicly promise to avoid taking drugs and alcohol.

“We want our kids to have a clean, moral life,” Burg said. “And we need to bring a heightened awareness to parents to keep their eyes open. Teenagers are not adults. They still need love and a hug and understanding.”

Burg, who is hosting 150 teenagers this year at his house, will lead by example: this year he will only serve grape juice.