The Sunday Baltimore Sun (December 1) ran a front-page article on progress made toward enacting recreational marijuana legalization in Maryland for adults. (Medical marijuana was legalized in 2014.) The article begins by acknowledging that the likelihood of legalizing recreational marijuana use for adults “is growing dim for 2020,” with the bipartisan work group still in “investigative mode.” The article goes on to explain that state lawmakers are looking into a variety of issues: 1) setting tax rates, 2) identifying marijuana-influenced driving, and 3) expunging old convictions (presumably of cannabis possession).

These are no doubt important issues, though it is interesting that nowhere on this list is the concern that marijuana legalization will increase marijuana-related problems. As we have noted before [see www.wherewhatwhen.com/authors/view/michael-kidorf] marijuana is not a benign drug. While occasional marijuana use poses only minor risks, chronic marijuana use is associated with a number of well-documented health concerns. Among these concerns are the development of cannabis use disorder, cognitive and memory difficulties, psychological and physical problems, diminished educational and employment achievements, and more motor vehicle accidents. Teenagers and adults with ADHD, psychiatric conditions, or a history of trauma are particularly vulnerable to experiencing these problems.

The national focus on the opioid crisis unfortunately obscures the fact that the use of cigarettes is the leading preventable cause of mortality, accounting for about 480,000 deaths annually, and about 30 percent of all cancer deaths. Despite an over-50-year-long government campaign against cigarettes, smoking continues to hold many people in its addictive grip as well as draw new victims. Indeed, It is particularly worrisome to watch adolescents smoke either traditional (combustible) cigarettes or JUULs, knowing that smoking early in life is not only a strong predictor of smoking as an adult, but also greatly increases the likelihood of using other drugs. Adults who continue to smoke cigarettes will likely face a host of medical complications and increase the risk of transmitting the smoking habit to their children.

We frequently hear that America is experiencing an opioid crisis, an opioid epidemic, or even a public health emergency. These terms generally refer to the sharp increase in opioid-related overdose deaths over the past five years. As most people know, opioids are a class of analgesic drugs that provide pain relief and euphoria. These drugs include commonly prescribed painkillers (Codeine, Percocet, Vicodin), heroin, and synthetic variations (Fentanyl). Last year, about 70,000 Americans died from a drug overdose, and about two thirds of these cases involved the use of opioids (often mixed with other drugs or alcohol). The rate of opioid-related overdose deaths in 2017 was six times higher than what was observed in 1999. In Maryland, about 2,000 deaths over the past year were attributed to opioids.

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.

As we have discussed previously in this series, teenage drinking is quite common. The most recent scientific survey across public and private high schools shows that about a quarter of eighth graders report drinking. Among high school seniors, well over half are drinking, with 43% endorsing that they were drunk at least once. Middle school and high school students report easy access to alcohol, and tend to dismiss possible harms associated with drinking.

This is the second in a series of articles presented by Chayeinu, a new Baltimore organization dedicated to providing education and guidance to our community to address many facets of substance use disorder. We want to alert readers of WWW that as part of this objective, we have invited Dr. David Pelcovitz to speak to our community about substance use on January 9, 2019, at the Park Heights JCC. Dr. Pelcovitz is the Gwendolyn and Joseph Straus Chair in Psychology and Jewish Education at the Azrieli Graduate School of Jewish Education and Administration at Yeshiva University. We hope you can make it.

Predicting which of our children will develop substance use disorder requires some understanding about risk factors that often precede problematic use of alcohol or drugs. Risk factors increase the likelihood that a child will develop a substance use disorder. Before getting into the details, it is important not to panic. Most children with one risk factor never have a problem, and many children who ultimately develop an addiction do not possess traditional risk factors. However, what seems clear is that as the number of risk factors begins to accumulate, so does the likelihood of problematic substance use. This article will focus on vulnerabilities that lie within the child as the most critical risk factors for addiction.

It has become obvious, especially in recent years, that many people in the United States enjoy drinking alcohol and taking other drugs. The alcohol industry makes billions of dollars in sales annually. Tons of heroin and cocaine flow into the United States. Millions of prescriptions for opioids and benzodiazepines are filled annually, fueling overdose rates that are much higher in the United States than in other countries. Corporations and politicians work overtime to increase legal access to marijuana. The Juul e-cigarette company, which claims to market to adults, creates nicotine pods with the flavor of peaches, grapes, and berries. Substance use is big business.

One impact of all of this drug consumption is that many people develop a substance use disorder. (We tend to use the technical term “substance use disorder” instead of words like “alcoholic” or “addict” that convey a more pejorative meaning.) We hope that this article will be the first in a series of articles discussing substance use disorder and its treatment. This type of community education is an important part of the mission of Chayainu, a new community organization founded by Dr. Aviva Weisbord, Mrs. Esti Ziffer, and Larry Ziffer. Our aim is to help rabbis, schools, parents, and teenagers address the multiple challenges of preventing, identifying, and treating substance use disorder. We have met with the Vaad HaRabbanim, which strongly supports our efforts. We have also met with local schools and hope to work closely with other organizations that have led the way in addressing the impact of substance use disorder inside and outside of our community. There will soon be announcements about a series of parent education and awareness sessions that will feature useful information and strategies for educating our children and promoting wellness in our schools, shuls, and families.