Amudim Awareness Event May 1,2017 Dr. Akiva Perlman Part 4 of 5

[Applause] what' you Sayce yourself all right I'm going to introduce myself thank you T my name is AKA Pearlman um thank you I believe that was my brother s um it's a real honor to be here I'm Brisa rashash Shiva and everyone in this room because everyone's taking a great deal of time to be here right before I got to speak I asked what the number was where were we at today and I think for those who follow amudim and they have an email that goes out to people every time we have a an unfortunate loss in our community he lets us know because he cares about the entire nation he lets us know where we're holding he shared a number that I don't want to share tonight not because I'm afraid to say it it's a number that I had one in my mind since January and it's certainly Beyond double what I thought it was but I know that when we say numbers however important they are I feel like we might we might just miss out on the individual we might miss out that that person when we lump them together with over a hundred other individuals we might forget that that one person is a mother that one person is a brother or a father or a talet or a student that one person is a universe that has a whole group of people that missed that individual so I don't want to share that number only because I don't want to lose sight of the power of that one person it's not easy to stand here not because I have stage fright which I clearly do but for other reasons because I know people in this room I know individuals they're familiar to me because I've seen them I've worked with some of them I work with some of their parents and I want to represent them in a way that's accurate I want to tell their story in a way that we could understand and hopefully use that information to change as a community because we need to we're no longer in a position where we could sit back and relax and say everything is okay we're losing our brothers and sisters we're losing people we're losing universes and worlds and in order to change you first need to State the facts you need to State the truth and then from there you move on and you say okay where do we go but we start with where are we today so I would hope I hope that I could represent the individuals the families that are suffering with this problem in a way that all of us could learn from and ultimately grow from today we're in a crisis in the past 10 years for those who've been looking at the data the rates of overdose in America have nearly doubled or shall I say they've nearly tripled they've more than doubled the rates of Overdose when it comes to opioids which are painkillers has has increased 300% and when it comes to heroin it's around 600% so we're not dealing with and these are Big terms like heroin but we're not dealing with every once in a while we hear a story and it used to be we we did hear stories but no one ever called it what it really was people passed away but it was a heart attack or something else but today we're calling it we're giving it a name and we're saying people are struggling with drug addiction and with plenty other addictions and we're losing lives as a as a result of it where did this come from just a very brief history around 20 years ago there was a change in the perspective when it comes to dealing with the treatment of pain and doctors changed their attitudes towards giving out opioids and started saying that if people are in pain we need to treat them in any way possible so instead of refraining or restraining from giving out medications to treat pain they started giving them out by the Dozen they writing scripts enough for every adult in this country to have access to a bottle of pills in their in their bathroom if they were struggling from anything a toothache whatever it might be and that's what they continued to do for a while and over time it stopped working the government realized the doctors realized that these drugs were simply too addictive and too dangerous to have around people's homes and before I go further I just want to say there are many homes that have pills just lying around and most people just forget about them but you should know the addicts do not forget about them they know this fact really really well I have someone that I worked with recently told me he cleared out his uncle's home his aunt's home his Rey's home because he knew that people are just not paying attention they just have these bottles lying around so if we could learn one thing it's be careful and it might not be your child at this age and it might not be your child at another age but it could could be that they'll develop into that person later or it could be that they have a friend that might just so happen to come to your house so drugs were everywhere these painkillers were everywhere until we caught up to the reality that they were hurting people people were dying they were getting hooked on them they couldn't get off the government got involved and they said we have to make it harder for people to gain access to drugs and they put a stop to it they started tracking who was taking it so people couldn't shop anymore and that created an additional problem which was what do you do with the people who are already addicted there are lots of people who were taking them for years and they didn't know how to stop taking them aside from their body being addicted to it em emotionally they were addicted to it spiritually they were addicted to it so then they turn to the streets and on the streets you have a very similar drug those who may not know opioids and heroin work the same way as other painkillers they work in in a very similar fashion and people turn to the streets and that's why we started seeing this increase in overdose so while numbers and the predicament may be important today we're not talking about numbers tonight we're talking about change what could we do about this and for one we're stating the facts we have a problem and we have a very big problem because people are doing these things and we can't call it what it is because there's a lot of Shame connected to it but today we're standing here and we're saying and everyone in this room is creating a great deal of change I'm going to be sharing a bunch of stories and please know that I'm going to obviously change the information of those stories to protect the identity of the people I work with but there's one story I want to share that is not about the people I work with but it's about my friend I have a friend who I grew up with who several months ago passed away and he passed away as a result of his addiction to drugs I don't know which of you have been to a funeral that is related to drugs but they tend to be very very very sad anytime you lose anybody it's a tragedy but often when it's related to such a tragedy there's so much shame involved that people don't even want to have a levia in a proper fashion often it's held beside the grave and where this one took place we're standing there a group of his close friends and family and a few people that knew him growing up and we cried and we spoke about his life and it was actually there was a part of it that we finally we started talking about him again we stopped talking about his suffering and what he's been through and how we could help him we started talking about the person some of us smiled to just remembering what he was like who he was as an individual but there were lots of questions there were tears that were shed but there was one question that was not asked and I remember coming home and speaking to my wife about it and saying why no one ever asked the question why and how no one asked how did this happen or why did this happen to this man and the reason I believe is because we all knew everyone there that night knew why and knew how cuz we all grew up with him we all saw him go through a family of divorce which was very challenging and traumatic for him we all saw him struggle academically we saw him struggle With Friends making them retaining them we saw him struggle finding a sh we saw him struggle in his marriage we saw him struggle being a parent so we saw his life of suffering so no one asked why we cried and why really didn't matter at the time but for tonight it gives us some sense and maybe a clue into what addiction is for those closest to an addict those in this room who are either experienced addiction or who know someone who's experienced addiction they don't ask why because they know because they're so familiar with the suffering so in order to understand who becomes an addict and ultimately how to treat them let's work backwards and this was addressed a little bit before but let's ask the question of who enters into treatment who ultimately goes and gets help let's look at the data of that and I want to I want to point out three studies the three studies that have really dominated the addiction field and have just shed some light onto who as to who addicts are and who are the people who ultimately end up seeking help probably the most important study was the study done was what we call the ace study the adverse childhood experience study as a very simple study but they studied it over and over again over a span of many many years and the results were always the same they took a list of 10 adverse experiences experiences that could create pain for anybody going through a challenging experience going through a divorce struggling academically having a parent who's an addict and so on and so on and they attributed to each of these adverse experiences a single point and what they said is that if people have experienced x amount of points they are much more likely to have an addiction later on in their life not only an addiction but they're much more likely to suffer from a great many maladies in their life so what we find is when we Look Backwards that 2third of people who are in treatment for addiction have a a a score of four and above 2/3 that's quite to me in my mind that's an overwhelming majority of individuals and it shed some light it tells us a story and what it starts saying is people who are in treatment for addiction are people who have had adverse experiences in their childhood the second study are the studies related to PTSD and its comorbidity rates with addiction if you look at virtually every study with PTSD which is post-traumatic stress disorder virtually every study points to the fact that people who have had trauma in their life also experience addiction they share similar pathologies and they share similar life experiences the other one is a study put out by the Harvard center of the developing child which really looks to explore childhood experiences and I'm going to quote from one of their studies that came out it says this early childhood stress leads to adaptations in behavior and comfort seeking patterns when we talk about adaptations and behavior and comfort-seeking patterns what that means is that people who've experienced stress need to find another way to live in this world they need to find another way to find to experience Comfort people so to sum up these these these primary studies people who become addicts are those who've experienced a great deal of pain and I know this is a big statement to make and I've worked with addicts for the past for my entire career I have never met an addict who has not lived a life filled with pain never I've never met an addict who's had a comfortable experience I've never met an addict who had a part of their life that they wouldn't willingly trade in for another these are are people who have suffered a great deal when you look at the the statistics on people who are in treatment centers nationally you can't find a study that doesn't have a number lower than 60% but most of them are between 60 and 80% that speak about individuals in treatment for addiction have a history of trauma I I wanted to ask this question to my colleagues in the Jewish Community I had the opportunity to work in a program called the living room which is is a center for um people in our our brothers and sisters from all our communities who have who are in recovery from addiction and I reached out to a friend of mine manak panski who's a director and I said what are the percentages of the people in the program today that have a history of abuse or trauma and he did not give me a number lower than 80% and by the way as the Russ Shiva mentioned before the women the girls who were in that program had higher rates than men but not a number lower than 80% I going ask my brother who runs our place as well his numbers are very similar and my wife who works for Rabbi wallerstein School for Girls at risk numbers are the same I have never ever heard from anyone in this profession a number lower than 50% so hopefully this begins to shed some light some light on who addicts are and where they come from and what is their lived experience so if you take that and you try tried to pair it with addiction what we find out is that the addiction to the addict is more about the solution than the problem now I know that sounds very challenging but let's try to make sense of it one of the most common statements you will find in the recovery world when people are in treatment when they're sharing their story they're sharing their story with a group of other addicts to give each other strength and hope one of the common things you will you will hear as they're recounting their childhood is I always felt different and uncomfortable my childhood was filled with discomfort until I had my first drug and that made me feel feel normal so as was recounted before people having their first drink for a regular person it's an experience I had a first drink it was fun maybe I went overboard and got too drunk and got sick but they forget about it they move on for the addict getting drunk or getting high for the first time represents a form of comfort it represents a relief from the life that they live live which is filled with pain one of the first cases actually that I was in ohal when I had this case not sure if you'll remember but at the time it was a young man from our community who was homeless and he came to O because o was the only organization that would treat him my supervisor at the time said we should charge this man to participate in treatment because he should have some form of ownership and I said how do we charge a homeless man to come the treatment and he said just a quarter and I remember this man who was on the streets at the time when I started seeing him he'd give just a quarter when he came into therapy at that front desk on the fourth floor and he entered into treatment and he was raised in conditions I don't want to talk about tonight they were horrific anyone in this room raised in such conditions I can't imagine what your life would what our lives would look like I don't know how I would survive the way this man did and he said something to me as I was first entering to the this profession I'll never forget so much so that I said to him could you please repeat that because I want to write it down I don't want to forget what you said and I wrote it down and I'll share with you today he wrote about his first experience with drugs he said the first time I used heroin I felt as though the world was hugging me I felt comfortable for the first time in my life when we think of heroin we think of it as a drug that could kill us and it does that's the drug that does kill many people but here was a person that experienced this drug and said I finally felt hugged I finally felt comfortable like I could live and the pain was relieved for just that moment Gabor mate who's a leading expert in the field of addiction made a statement in one of his books and he said it's impossible to understand addiction without first asking what relief the addict finds in the drug or The Addictive Behavior we can't understand addiction until we understand understand it's relieving quality and you only experience relief if there's something that you need to experience relief from for most of us taking a drug or drinking it's a way to escape it's not a form of relief where as if you could breathe for the first time but if you've had a life of suffering and pain you take a drug it provides you with a sense of relief so let's try to create a new definition of what addiction is addiction is many things but at its core addiction is a failed attempt at pain relief because it never works as we'll see in a bit it's an attempt to relieve yourself of pain yet it never works but at least initially provides you with some form of relief now most of us are given this for free most of us are given love and support and containment for free by our parents by our teachers by our rabim they hold us they hug us they let us know that the world is safe and okay addicts do not you notice if you go to the rooms what we call the rooms of recovery the 12 12-step programs there's a lot of hugging that takes place at the end of most meetings people hold hands and recite the Serenity Prayer when people meet each other after seeing after not seeing each other for a day or two they're hugging one another and I once asked an older man who I was working with I said why do you hug so much and he said I'm making up for lost time I need to hug because that's what makes me feel okay and I never had it so I hug and the other people in the room receive that and give it back as well so what is addiction how does it work as was mentioned before there's obviously progression of use where you start and it starts generally casual and then slowly especially for those who are very attracted to it it becomes habitual fairly clearly fairly quickly that is of the the landmark of addiction there are unsuccessful efforts to stop most addicts by the time they make their way into an office for treatment depends how old they are some of them have been suffering for 20 plus years trying to stop over and over and over again every single morning imagine we'll talk maybe a little later about a client of mine who literally every single week buys a new device to utilize his drug and I asked him why are you buying a new device every week he said CU at the end of the week I throw it out and I say I'm going to go into shabas without anything and no drug paraphernalia I'm going to start over and I'm going to get clean but then what happens again Sunday Monday hits he's trying he's struggling he's trying to get better and what he do he finds himself back in that same place again but imagine a world of 20 plus or even five plus years of unsuccessful efforts to stop something that is really harming you increase problems in one's life addiction creates problems and these are the three main aspects of addiction progression of use unsuccessful efforts and increase problems where it hurts but those are just symptoms the story of addiction is I'm just going to read this I had a client said to me a few weeks ago and I've been working with him for nearly a year now and he's been suffering for an addiction for 15 plus years and he's not clean today today he's out there using trying to get clean and I'm not his first therapist trying to help him get clean I'm probably his 10th and he looked at me the other day and he's shared his life with me a great deal and he said I don't think you understand what it's like to wake up each morning hating yourself I said you're right I I I don't I don't think I could really understand that I believe you I'm listening to you I hear you I don't think I could really understand what that means to wake up that way and why does he feel that way cuz it's been 15 years of struggle it's been 15 years of battle and those 15 years of hiding of lying of being lonely of struggling with relationships and the relationships that he does have it's a relationship where he only shares what he feel he can because he can't really be genuine it's hard to be genuine when you feel broken it's a lot easier to share yourself with another person when you feel whole he's stagnant professionally he's fragile he has marriage problems he has insecurity with raising his children and he's lost spiritually he's having a hard time finding himself and finding Hashem in this world addiction is a prison addiction destroys lives destroys people destroys families it takes children away from their parents takes parents away from their children it's a prison and it doesn't work we speak about how it's supposed to be something that relieves pain but after a very short while it stops working it may start with experimentation which leads to habitual use but ultimately leads to a cycle once engaged in that cycle you completely forget why you're there in the first place and that's what everyone's been referring to when we say a person gets stuck where gets lost and we use terms like no free will they're caught into a disease they're lost and they have no way out I had my first exposure to real real addiction when I first met with a guy who was smoking marijuana and for those who know about marijuana it's of the lower forms of drugs on the spectrum of drugs there are drugs that are much more potent and much more harmful than marijuana and that's not a suggestion to try it but it's certainly not the worst and I was working with this man who at the time when I started seeing him his marriage broke up because he couldn't stop there was an ultimatum at a certain point and as was mentioned before sometimes need to be really firm there was an ultimatum and he couldn't stop so his marriage broke up and then there was an ultimatum that he would lose his custody of his child and he couldn't stop and he lost custody of his child and then there was an ultimatum that he would lose visitation rights and he still couldn't stop and I remember asking my supervisor it's just marijuana what's going on and he said keii you're missing the point of addiction doesn't matter what the drug is the cycle is what's important he's caught in a world where he doesn't know how to escape he's trying to but he just doesn't know a way out and it doesn't matter what he's taking once you're engaged in this cycle it becomes a self-perpetuating one where the pain that you have fuels the behavior and the addiction and the addiction ultimately fuels the pain I was working with a man once who's doing really well now by the way there was a point where he came into my office and this was his first day he said I haven't looked at myself in the mirror for 5 years because I was afraid of what I was going to see and today I looked in the mirror I built up the courage to look myself in the face and see what I was and what I'd become and he said I didn't like what I saw and that's why I came into your office today but what he was sharing with me was that he forgot he said I was angry I remember I used to be angry I was angry at the world I was angry at yish kite I was angry at my parents and he goes when I looked myself in the mirror after 5 years I I forgot what I was angry about at that point I was just lost but now this man has received treatment he's okay he's married he has a beautiful marriage he has children he lives amongst us he's doing really well which leads us really to treatment we can't go into the minutia tonight I know I'm running out of time we can't talk about the specifics of treatment but I think it's important to talk about what what treatment is concerned about what addiction treatment would ultimately like to accomplish with the people that enter into it number one it's about stopping the behavior there's no way that you're ever going to get to a place where you could uncover any form of pain so long as you're using drugs and so long as you're engaged in any form of addictive behavior I had a client used to come into my office and say after every meeting we have I want to go out and use drugs because it's too painful to tolerate it and my answer to him was well don't that's you that's your life your life sometimes there's pain in your life but at least you're not running from it you're living in it and we'll help you find a way to survive through that pain we'll get through it a step at a time don't have to be so afraid of that pain but you need to know that for addiction to work work The Addictive Behavior needs to stop ultimately you get to exploring the pain and finding alternate ways to live in this world we try to find additional people new people to surround ourselves with new places to visit and try to distance ourselves from the things that ultimately harm us but ultimately you want to live a life that's acceptable to you you want to live a life that you could feel okay waking up in the morning and breae brething and and comfortable with the decisions that you make and the choices that you choose to live with one of the things that I've become familiar with hearing but never really surp but always surprises me but I at this point I'm not so surprised because I hear it all the time people in recovery often make the statement I'm grateful for my addiction and you'd think how could you be grateful for your addiction it caused so much suffering to you to everyone else in your life to to your marriage to your children to your family to your parents how could you be grateful for your addiction and the answer is always the same because ultimately my addiction brought me to recovery and Recovery taught me how to live it taught me how to tolerate myself how to tolerate my life how to feel okay in my own skin now that's not a suggestion for anyone here to become an addict but for those people who have been through it they're learning how to live and you can't imagine what that's like to see an adult to see someone who's lived a long time ReDiscover life in a way that is satisfactory and comfortable and people get better I asked my brother wanani who runs Hour plays I said could you give me a characteristic that you see of the people this the adolescence that you work with who are the ones that make it and who are the ones that don't and his answer has always been consistent and I've seen this throughout and also the other professionals I've spoken to have seen it the same way that the individuals who have support who have family who have love as was mentioned before who have that unconditional feeling from the people around them are those that are most likely to make it you have programs like the living room you have programs like o and amudim and all the other organizations connected today like relief and I'd ask the people in this room I know cuz I'm familiar with a bunch of you I'm asking all the addicts and all the families with addicts to look around look around tonight look at the people in our community who have chosen to be here to say that we could accept this we could deal with it we could take a step at a time and we could get better just know that there's a way out and I know that addiction is the darkest place that a person could live in you live in a crevice you live in a cave but look around and say Here's a group of people that are willing to allow me to come out and allow me to express some of that suffering and pain and allow me to exist there are programs out there that could help you every program could help you in a different capacity and you have a whole different sword of then come out of the darkness and all I could say it's going to be hard the journey is a very painful one and it's a slow one and there are many setbacks but I could promise you a life that is a lot more comfortable and it's filled with a lot more light than the one you're living in today I wanted just review the study was mentioned before rap Park Dr Bruce Alexander challenged one of the basic Notions that we had about addiction addiction in the 60s where all the studies were done on the physiological effects of drugs on the brain they basically took rats stuck them in a cage and were able to prove that those rats would take the drug to the point where it would kill them Bruce Alexander and his team decided to create a park rat Park and in that Park what he was able to show is that rats and we supped supped to learn the lesson for people as well who are in a community where there's love and there's connection and there's what to lose if you become an addict people are much less likely to become addicts in the first place but I think even more so for people who are in a community they're much more likely to get help the more we become a community that's willing to accept that this problem exists and look it in the face and tolerate it the more the people who are suffering could come forward we need to learn from rap Park it's my final words for tonight tonight we acknowledge in a very open forum and a beautiful Forum that we have a problem our brothers our sisters our mothers our fathers our children our students are dying some of them are dying physically but for those who are not dying physically there's a whole many more who are dying spiritually emotionally they're suffering and today today we acknowledge that we also acknowledge that we need to help them and we have places that that do help the organizations that we're dealing with that are that are here that are here tonight have collected millions of dollars to help people who are suffering with these issues and they're here to help and they need more by the way they need more money because there's always there's always a greater need know that there are people to help sorry huh yes know that there are people that are here to help and I just want to give us all AB Braha that Hashem should guide us through these challenging times and we may see the end of all the suffering in our time as quickly as possible tonight I want to we have a special guest who was not on the list but I am so honored to introduce I don't know this man personally at least I don't believe I do but I feel like I know him because I know the people who suffer like like this who have I feel so honored that they've shared their lives with me and I've journeyed along with them through the process of recovery he's a man who has enough courage to stand here tonight and share his story with us i' please like to introduce [Applause] [Music] [Applause] iiki and