Alcoholism in Israel: Investigating addiction, dependency

It was a realization such as this that helped Rachel (not her real name) change her life. For some time she had been involved in a relationship in which her partner drank heavily.

“At first I told myself that he didn’t really have a problem, and I justified his drinking, thinking that he’s had a hard day at work and deserves the extra drink.

“But when my partner would leave on a five-minute errand and return drunk five hours later, it was I who became violent. My emotions would swing from depression to aggression – and I was the non-drinker.”

To many, Rachel’s heartbreaking situation may well sound extraordinary, but it is by no means the only story of its kind within the Jewish community in Israel. The wildly held view that there are no Jewish alcoholics is nourished by alcoholism often being included in general addiction statistics. There is also the intense denial that takes place in the community itself.

The closer knit a particular community is – such as haredi Orthodox groups – the greater the shame that is felt, and the more likely it is that every attempt will be made to deal with the problem within the family. This invariably proves to be a fruitless exercise.

As Rachel’s story illustrates, it is not only the drinker who needs help. For every alcohol-dependent person, there are at least seven or eight close relatives, including children, who suffer emotional and psychological stress. Typical problems are violence, fear, unstructured and unregulated home life, lack of the ability to love, and a loss of self-confidence.

When I asked Rachel why she remained in this relationship, she replied: ”I lost my self-esteem and had no self-respect. I thought that I was guilty and didn’t deserve better.”

The organization that has arguably continuous contact with serious alcohol addicts is Alcoholics Anonymous. Their activists or members – as attendees of AA meetings call themselves – are usually recovered alcoholics themselves. To help understand how one becomes an alcohol addict, I met with former alcoholic and longtime activist Rebecca.

Once an alcoholic takes that first drink, it sets up a craving in the body, so that if I were to take one drink I would want another. I’d have no control over it once I start. I’ve been a member of AA for 32 years, and for all that time I have not taken a drink. I believe that there is a genetic component. If one or both parents are alcoholics, that person has a genetic predisposition to also become an alcoholic. There is also the social-environmental factor – if one grows up in a home where there is a lot of drinking, they learn that behavior. But for a true alcoholic there has to be what we call an allergy, a physical compulsion. One drink will set off this loss of control. Many alcoholics wake up and resolve not to drink, but then go to bed drunk.

The main causes are stress or trauma to reach for the bottle and then the allergy sets in. The effects of the COVID lockdown tipped the scale for some non-alcoholics, causing some to get addicted.

There are many excuses why people drink, but they are not reasons. I believe – and our book, The Big Book of Alcoholics Anonymous, states very clearly – that the cause of our alcoholism is a separation from God. I feel inside of me a black hole, being separate from God, and I aim to fill that hole. Liquor is called spirit, and there is something spiritual about it: You take a few drinks and feel good, closer to people, closer to God without intending it. There is an allergy of the body, a mental obsession to get that next drink.

No, people of any religion, or none, are welcome and feel comfortable. It’s a spiritual program, and there is a difference between religion and spirituality: we say that religion is for people who are afraid to go to hell, spirituality is for people who have been to hell and don’t want to go back. Most members will get a sponsor who was an alcoholic and can guide them through these steps on an individual basis. When I joined, I said: “I don’t believe in God.” “You don’t have to believe in God – just talk to Him,” was the reply. At first, I thought that was crazy, then I tried and said: ”I don’t believe that You are there, but if You are, please help me.”

I must carry the message to other alcoholics. Before I joined AA I was depressed and felt that my life was meaningless. Now I am a very happy person with children, grandchildren and love. As a result of my difficult childhood, I am able to help other people and that gives meaning to my life. By searching for AA Israel, one reaches our website with all the information in several languages showing meetings all over Israel as well as the multilingual 24-hour hotline, (072) 393-2500.

THE SOCIAL ILL of alcoholism impacts on our society and the economy. I am thinking of the loss of work hours and the general inefficiency of the addict. As this is a health issue, I approached the Health Ministry, where I was met by Dr. Paola Roska, who heads the department concerned with addiction.

During the last years we found that the most used psychoactive substance is alcohol, even more than cannabis. It’s an important part of our work. Unfortunately, in Israel there is only one registered medication that is helping addicts not to crave alcohol and also reduces the pleasure from drinking alcohol. This substance has been introduced into the subsidized health basket during the past year. So there is some progress in this field. There are other medications available in the world, and we have to work on getting those registered in Israel.

One of our tasks is to collect and analyze data. For instance, recording the numbers who come to emergency rooms when they are drunk. We are introducing a new protocol of treatment from all over the world that should work here. We also attend relevant committee meetings and boards in the Knesset and do interdisciplinary work with other ministries that are involved, such as the Education Ministry, the police and social services.

Because Israel was always thought of as having low alcohol consumption, we have underdiagnozed the problem. But since the Russian immigration, alcohol has become a major problem, especially for young people. Ten years ago, it was thought to be 4% of the population, but recent research done with Hadassah medical school shows that 7% of the population has alcohol problems; not necessarily as alcoholics, but for instance binge drinking, that is, taking four or five drinks on the same drinking occasion now characterizes the drinking problem in Israel, and that brings about negative effects.

Yes, the secular part of the population is drinking overtly. Everybody knows that you drink, but among the religious, it is more like a hidden condition that one doesn’t talk about.

We have residential detox centers, where during a stay of between 21 and 30 days we administer the physical detoxification process. That has to be followed up by the referral agency to help work on the psychosocial determinants of the addiction supervised by the Labor, Social Affairs and Social Services Ministry.

Even after completing a detox course, it is very difficult to abstain from alcohol, because the triggers are everywhere. At a bar mitzvah or wedding, alcohol is served. Once it was thought that in treatment, the only way is to stop drinking completely, but during the last 15 years, a harm-reduction approach has emerged. It is thought that by programs like motivational interviewing, one can impress on the addicts the danger to which they expose themselves and so increase their motivation to change their behavior and will to reduce drinking.

We believe that as a first step, harm reduction will more successfully convince people to begin treatment, rather than immediate complete abstention.

Sometimes but they are more prone to become victims of aggression by men, because they don’t detect the dangers around them when they are drunk resulting in sexual assault or abuse.

It’s true that those who drink most in Israel are the young, even under 18. We are promoting legal intervention to sell bottles of alcohol after certain hours and not to drink in public places. But if you forbid that, they will make drinking parties in houses. During the corona period there was an increase in alcohol drinking. There were even virtual drinking sessions, so it is questionable whether prohibition will help.

The Education Ministry has various prevention programs for schools dealing with addiction of drugs or alcohol, but it is not compulsory and at the discretion of the school director to decide which, or if any, programs to include. So not all students receive the same information.

Other government agencies that are involved with alcohol abuse are the social services, which are concerned with the emotional or even physical effects of an alcoholic on his or her larger family circle and particularly on children.

Operating at the sharp end is the police, who deal daily with the dangerous effects on the larger society of the abuse of alcohol, such as drunk driving, domestic violence and sexual abuse. ■