n this series of articles about addiction, sponsored by the organization Chayeinu, we have been discussing paths toward opioid addiction and opioid overdose. In the last article, I wrote about the problem of teenagers progressing from alcohol or marijuana use to opioids. Often, they start with prescribed opioid medications (found in the family medicine cabinet, perhaps) and transition to illegal drugs. This is the most common path to opioid addiction. In this article, we will consider an alternate path to opioid addiction that might occur as a result of opioids prescribed to treat pain.

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Opioid analgesics like oxycodone and hydrocodone, and to a lesser extent codeine and tramadol (a synthetic analgesic), are considered frontline treatments for moderate to severe pain, including some chronic pain conditions. It is interesting to consider that over any two-year period, about a third of all adults in this country receive an opioid prescription. Physicians in the United States seem to be more open to prescribing opioids than doctors from other countries.

These past few months, I have been writing a series of articles about substance abuse as a part of Chayeinu organization’s efforts to provide education and guidance to our community regarding substance use disorder. While we might wish it were otherwise, substance abuse is not a stranger to our community. The unfortunate fact is that there is a strong probability that our children will drink or use drugs before graduating high school. The numbers in the United States are persuasive and alarming. Before completing high school, 60 percent of teenagers report drinking alcohol, 40 percent report vaping nicotine, 40 percent report smoking marijuana, and 20 percent report smoking traditional cigarettes. About 15 percent report using illicit drugs other than marijuana. And these are only the kids who choose to talk about their substance use!

Electronic cigarettes, or e-cigarettes, are battery-operated smoking devices. These devices work by applying heat to a liquid-filled cartridge. The liquid, which is converted to an aerosol by the heat, contains nicotine. Inhalation of the aerosol is often called vaping. E-liquids come in a variety of flavors that turn out to be quite appealing to teenagers, like watermelon, cappuccino, and mango. While there are many different brands of e-cigarettes, the JUUL brand is by far the most popular, and the term “juuling” is now pretty much synonymous with vaping. E-cigarettes come in many sleek and user-friendly designs, most often resembling cigarettes, pens, or USB flash drives. An important aspect of these devices is that they mask unwanted tastes and smells commonly associated with smoking.

In this latest in the series of articles presented by Chayeinu, a new organization dedicated to providing education and guidance to our community regarding substance use disorder, I would like to talk about marijuana. Marijuana is the most commonly used illicit drug in the United States. In 2018, over a third of high school seniors reported using marijuana in the past month, with 6% using it daily. A substantial number of eighth graders are also using the drug. Marijuana remains quite popular among adults as well. Approximately 15 to 20% report using the drug each year, with higher rates of use in states that have legalized recreational or medical use of the drug. While we hope that these statistics are not as high in our Jewish community, we would be naïve to think that we are untouched.

What Is Marijuana?

Marijuana usually refers to the leaves that come from the cannabis plant. The main psychoactive compound in marijuana is THC, and it appears that levels of THC in marijuana are rising. Smoking THC-rich resins or extracts from cannabis, which are called by names like hash, wax, or shatter, is also increasing in popularity. There is incredible diversity among marijuana extracts, one more potent than the other. The point is that this is not the same marijuana smoked by Bill Clinton or Barack Obama.

Marijuana can be purchased relatively cheaply. In Maryland, where marijuana for recreational use remains illegal, marijuana is purchased on the street in different amounts. An ounce costs somewhere between $250 and $350, while a gram can be purchased for as little as $12 to $20. Synthetic forms of cannabis, such as K2 and Spice, which are considerably more powerful and unpredictable than marijuana – and are sometimes called “parole-weed” because they do not show up on routine urinalysis testing – seem to be somewhat less popular at this time.

They’re disruptive; they’re delightful. They’re enraging; they’re engaging. Children with ADHD can have a powerful impact on everyone around them.

Because these children have problems with self-regulation, they often have trouble accomplishing tasks and following directions. At school, children with ADHD (Attention-Deficit Hyperactivity Disorder) usually have problems focusing in the classroom and completing homework. Some have difficulty making and keeping friends. At home, their behavior can affect family harmony. As these issues accumulate, children with ADHD can feel terribly left out and alone. They often “self-medicate” deficits in neurotransmitter functioning by engaging in activities that provide immediate stimulation, which can

I wanted to share some of my feelings regarding the recent loss of Rabbi Yona Munk, a”h, who passed away this year on Hoshana Rabba. The genesis of my relationship with Rabbi Munk can be attributed to a shul announcement. A number of years ago during Shabbat davening at Shomrei Emunah, Rabbi Weinreb concluded his sermon by stating that “one of our own,” Rabbi Munk, had completed a sefer, which was now for sale at a local sefarim store. Rabbi Weinreb noted that the sefer, entitled Hegei Yona (Thoughts of Yona), was written in Hebrew and contained a number of creative insights on the parsha. This routine announcement, a transition to Mussaf for most of the kehila (congregation), opened a window for me to more serious and engaging learning.