Understanding Addictions

Addiction involves craving something intensely, loss of control over its use, and continuing involvement with it, despite adverse consequences. Addiction changes the brain, first by subverting the way it registers pleasure and then by corrupting other normal drives such as learning and motivation. Although breaking an addiction is tough, it can be done.

According to the American Psychiatric Association, “addiction is a complex condition, a brain disease that is manifested by compulsive substance use despite harmful consequence. People with addiction (severe substance use disorder) have an intense focus on using a certain substance(s), such as alcohol or drugs, to the point that it takes over their life. They keep using alcohol or a drug even when they know it will cause problems. Yet a number of effective treatments are available and people can recover from addiction and lead normal, productive lives.”


The Diagnostic Manual for Mental Disorders (DSM-5) lists criteria for identifying substance use disorders based on decades of research and clinical knowledge. In order to be diagnosed with this disorder, a person must exhibit at least two or more of the following 11 symptoms within a 12-month period:

  • Loss of control over drug/alcohol use
  • Investing large amounts of time obtaining substances
  • Cravings
  • Continued use in spite of relationship conflicts
  • Risk-taking, such as using while driving
  • Continued use in the face of developing health problems
  • Increasing tolerance levels
  • Loss of interest in activities once enjoyed
  • Withdrawal episodes
  • Failed attempts to stop using
  • Failing to meet obligations (work, home, school)

Mild alcohol/drug use is characterized by a person meeting 2-3 or these symptoms; moderate use is meeting 4-5 symptoms, and severe use is by 6 symptoms or more. Substances for which a person can establish a substance use disorder include:

  • Alcohol
  • Cannabis
  • Phencyclidine
  • Other Hallucinogen
  • Inhalants
  • Opioids
  • Sedatives, hypnotic, or anxiolytic
  • Stimulants (including amphetamine or cocaine)
  • Tobacco

What causes addiction?

The word “addiction” is derived from a Latin term for “enslaved by” or “bound to.” Anyone who has struggled to overcome an addiction—or has tried to help someone else to do so—understands why.

Addiction exerts a long and powerful influence on the brain that manifests in three distinct ways:

  • craving for the object of addiction,
  • loss of control over its use, and
  • continuing involvement with it despite adverse consequences.

For many years, experts believed that only alcohol and powerful drugs could cause addiction. Neuroimaging technologies and more recent research, however, have shown that certain pleasurable activities, such as gambling, shopping, and sex can also co-opt the brain.

Although the DSM describes multiple addictions, each tied to a specific substance or activity, consensus is emerging that these may represent multiple expressions of a common underlying brain process.

New insights into a common problem

Nobody starts out intending to develop an addiction, but many people get caught in its snare. Consider the latest government statistics:

  • Nearly 23 million Americans—almost one in 10—are addicted to alcohol or other drugs.
  • More than two-thirds of people with addiction abuse alcohol.
  • The top three drugs causing addiction are marijuana, opioid (narcotic) pain relievers, and cocaine.

In the 1930s, when researchers first began to investigate what caused addictive behavior, they believed that people who developed addictions were somehow morally flawed or lacking in willpower. Overcoming addiction, they thought, involved punishing miscreants or, alternately, encouraging them to muster the will to break a habit.

The scientific consensus has changed since then. Today we recognize addiction as a chronic disease that changes both brain structure and function. Just as cardiovascular disease damages the heart and diabetes impairs the pancreas, addiction hijacks the brain. This happens as the brain goes through a series of changes, beginning with recognition of pleasure and ending with a drive toward compulsive behavior.

Adapted from and other sources.



Chayeinu’s mission and programming are based on the conviction that talking and teaching about addictions, bringing the conversation into the open, is necessary if we are to address this problem. For too long, much of our community has been in a state of denial for some very understandable reasons:

  • There is a popular stereotype that Jews don’t have problems with alcoholism because we use alcohol for sacramental purposes.
  • There is the problem of stigma. Addiction is seen to be a reflection on the whole family, and people have preferred to try and cover up these problems rather than have them be addressed in the open.
  • There is consideration for “shidduchim.” People worry that having one family member who is known to suffer from addiction will impact on the chances of finding suitable marriage partners for their children or other family members.
  • Addictions are viewed as being associated with “bad people,” “bad behavior” or “moral failure” rather than being seen as health problems that require appropriate medical and mental health treatments.

Chayeinu’s education agenda is focused on addressing addictions as part of an overall wellness approach, with emphasis on assisting people who are struggling with addiction to get the help they need. We believe that nobody chooses to become or to be an addict. Our community and our institutions need to address these issues with compassion and find new ways to emphasize wellness as part of our educational curricula.


Chayeinu works closely with other agencies and organizations that provide such direct services or referrals to professionals with appropriate training and expertise. We do not provide any direct medical or counseling services. As we continue our education, awareness and advocacy work, we hope that the list of cooperating organizations and entities will grow. Existing partners include:

Narcan Training

Chayeinu has established relationships with local leaders who can bring Narcan training into our schools and shuls.

NARCAN® (naloxone HCl) Nasal Spray is the first and only FDA-approved nasal form of naloxone for the emergency treatment of a known or suspected opioid overdose.

NARCAN® Nasal Spray counteracts the life-threatening effects of an opioid overdose. Since most accidental overdoses occur in a home setting, it was developed for first responders, as well as family, friends, and caregivers—with no medical training required.

  • Narcan is designed to be easy to use without medical training (but should be administered in accordance with the instructions for use that accompany dosages).
  • Narcan is available from local pharmacists, without a doctor’s prescription
  • Narcan is covered by most major insurance plans

NARCAN® Nasal Spray is not a substitute for emergency medical care. Always get help immediately, even if the person wakes up, because he/she may relapse into respiratory depression. The use of NARCAN® may result in symptoms of acute opioid withdrawal. Results may vary.


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Addiction awareness and prevention in the Jewish community is our mission.