I wanted to use this space to once again encourage parents to consider the benefits of early intervention for their kids who have started to drink or use other drugs. We already know that substances like nicotine, cannabis, and alcohol are used by too many adolescents in our community. We also know that some of these kids who begin to use drugs will develop a more serious problem that will become a disorder.

It is no small thing to have a substance use disorder, no matter what the drug. It is one of the worst things that can happen to a person (and a family). The diagnostic manual used by most health practitioners (DSM-V) describes 11 criteria for substance use disorder. These criteria include:

·         symptoms that fall into the categories of poor control of use (e.g., using more than intended)

·         risky use (e.g., driving under the influence)

·         impaired social functioning (e.g., neglect of schoolwork or other obligations)

·         physical dependence (e.g., tolerance or withdrawal)

*  *  *

I was alerted to a brief article entitled “Destigmatizing Drug Abuse Is a Dopey Idea.” The author, a senior fellow at the American Enterprise Institute (apparently a right-wing think tank), calls attention to recent trends in the substance abuse field to change the language of addiction in ways that minimize stigma. We now almost universally employ what is sometimes referred to as “people-centered language.” For instance, instead of using the term “addict” or “substance abuser,” which defines people solely by their disorder, we prefer to use the phrase “person with substance use disorder,” simply to acknowledge that he or she is still a person!

This article’s author thinks that all of this is nuts and perhaps wants to return to the good old days when we called a drunk a drunk and a junkie a junkie. While her argument is more than a little mean-spirited, it is not without some merit. The author cites, as one example, the trend to call men who hit their wives “intimate partner violence users” instead of “batterers” or “perpetrators.” (At least our field is consistent!) My worry is that modifying the language can unintentionally minimize the severity of the problem. We can’t lose sight of the fact that substance use disorder and domestic violence are extremely serious and often deadly problems.

We have previously discussed several risks associated with adolescent nicotine vaping and the use of nicotine pouches. These risks include acute and long-term pulmonary and cardiac complications, alteration of healthy neuro-cognitive development, and vulnerability to addiction. Nobody in their right mind would want these problems.

Yet what if there is an upside to teenage vaping?

What I am thinking about is that vaping (or other nicotine use) among teenagers might at times be a primitive way to express feelings of distress. In the old days, we might have called it “a cry for help.”

With Purim approaching, we thought it might be helpful to consider the importance of speaking with your children about drinking. It’s an unpleasant topic, one that we parents might want to avoid in the midst of busy preparations for this happy day. Unfortunately, it has become necessary, just as we teach children to buckle their seatbelts in the car and wear their helmets when they ride their bikes.

Our rabbis ask: “Why does the Torah begin with the letter “beyt”? If I would have asked this question of Mr. Sam Broder, a”h, the husband of Mrs. Leni Broder, a”h, he might have responded with something like: “That’s easy. The Torah begins with the letter “beyt” because the first word is Bereishit.” Or he might have said, “The Torah starts at the beginning, and beginning begins with a “beyt.”

Our rabbis offer a different approach. The Kli Yakar, in his Torah commentary, writes that the Torah begins with a “beyt” because the letter “beyt” is spelled “beyt,” “yud,” “taf,” forming the word bayit, or home. Perhaps what the Kli Yakar is teaching is that if you want to know a person’s Torah, take a look in his or her home.

Over the last few months, I have received many questions about psilocybin, also known as “magic mushrooms,” a drug that seems to be constantly in the news. It turns out that much of the current research on psilocybin is conducted by my colleagues at the Behavioral Pharmacology Research Unit at Johns Hopkins, led by an excellent researcher named Dr. Roland Griffiths. This group has already established a Center for Psychedelic and Consciousness Research.

What is psilocybin? Psilocybin is a hallucinogen or psychedelic drug. This means that it can alter a person’s mood, thoughts, and perceptions. Other examples of psychedelic drugs are LSD and mescaline. People who take psychedelics often report a profound mystical experience that transforms the way they think about their life and values. Psychedelic drugs are distinguished from what are called “dissociative” drugs like ketamine or PCP, which make people feel disconnected from their body or environment. The drug MDMA (known as “Ecstasy”) seems to have both psychedelic and dissociative properties.