View attachment 51225 In the last two years, the director of an Islamic funeral home in Sunset Park, Brooklyn, buried six young men. Heart attacks, some neighbors said, but the whispers and witnesses said something else: heroin. The families of the men would not discuss the causes of death.
“They tell us straight up, ‘Don’t say anything,’” said the funeral director’s son, Kareem Elmatbagi. Drug overdose is considered suicide, a sin in Islam, and therefore a source of shame for many in the Arab-American community.
Among Russian-speaking immigrants in South Brooklyn, where heroin use has raged for more than two decades, a study showed that some young addicts were pilfering pills from their grandparents, with whom they lived in multigenerational households. The country’s epidemic abuse of opioids — heroin, or prescription pills — is often seen as an affliction of white suburban and rural communities, but it has also spread to New York City’s immigrant neighborhoods. There is no city data that breaks down drug abuse by ethnicity, but anecdotal evidence suggests that it is emerging or even worsening where it already has a foothold.
Experts and those enmeshed in the fight against drugs see many possible explanations. Immigrant parents are often unfamiliar with the signs of drug abuse and may not know how to navigate the world of treatment and recovery. Immigrant families, steeped in traditions, can also have an especially strong culture of shame around addiction that discourages asking for help.
“No group has a monopoly over stigma,” said Dr. Gary Belkin, the executive deputy commissioner for mental hygiene at the city health department, who oversees the city’s addiction services. “But we need to appreciate the different ways it plays out.”
In Bay Ridge, there were about 19 overdoses from opioids the last two years within the Arab-American community, according to Mohamed Elnashar, the director of the Islamic Society of Bay Ridge. The drug epidemic, he said, “has hurt the whole community.” When Awad Elsayed Elmatbagi, the director of the Islamic International Funeral Services home in Sunset Park, Brooklyn, and his son prepared the bodies of overdose victims for burial, Kareem was speechless.
“These are kids I saw in the community,” Kareem Elmatbagi said. “And to see them on the tables back there — wow.”
Mohammad, 22, a recovering addict, did not go to any of the funerals. “I just couldn’t face their families,” he said recently, sitting in a Bay Ridge treatment center. “Most of them knew what I used to do with their sons.” Like the other recovering addicts interviewed, he asked to be identified only by his given name.
Mohammad’s addiction followed a familiar arc. He said he started taking prescription painkillers in high school because of knee surgery after a football injury. A couple of years later, he was in a car accident and injured his back. His doctor prescribed oxycodone. He was hooked. When the prescriptions ran out, he turned to street dealers. Eventually that became too expensive, so he switched to heroin, which was one-quarter of the cost. In October 2015 he entered a treatment program.
In Bay Ridge, many families have arrived within the past decade from Egypt, Lebanon and Yemen unprepared for the differences in American life; schools stop monitoring students once the last bell rings and parents are busy working.
“It’s the transformation of how you raise your kids back home and the whole village is taking care of your kids to here,” said Kathy Khatari, a neighborhood activist who is Muslim. “You’re in America; the only village taking care of your kids is the street.”
Ms. Khatari lobbied local Arab-American leaders for financial support and brought in Donna Mae DePola, the founder of the Resource Training & Counseling Center, a drug-treatment program, in Sunset Park, to open a satellite office in Bay Ridge. Of the 67 current Bay Ridge clients, 12 are of Middle Eastern heritage, Ms. DePola said.
Connie Pentony-Brown, the director of the Bay Ridge office, said she has noticed a distinct cultural difference in the reactions of families. “With our American patients, while family might be angry, family is supportive,” she said. “I think with the Middle Eastern community, the family wants them to get help, but I don’t think they know how to support them.”
Ms. DePola said the Arab-American Association in Bay Ridge asked her to speak to mothers to educate them on the signs of drug abuse. About 30 women attended.
“The mothers are very frustrated, there’s a lot of crying,” she said. “Taking advice is very difficult. They go back to the Quran. ‘Praying is great,’ I tell them, ‘We need just a tiny bit more than praying. We need treatment.’”
In the Midwood neighborhood of Brooklyn, the Dynamic Youth Community, an adolescent treatment program, has existed since 1970, but it was not until the late 1990s that it had its first Russian-speaking parents’ support group. “We needed it because suddenly we had all these people coming from one area,” said Karen Carlini, the associate director, who has been on the staff since 1974. Of the 161 young adults currently in treatment, about 25 percent are from families who emigrated from the former Soviet Union, she said. According to a June 2015 study of young adults in Brooklyn whose families had emigrated from the former Soviet Union, most of them began using “within a social setting with peers after school,” said Honoria Guarino, the principal investigator. Once primed, some swiped prescription drugs from an unsuspecting relative. The study was published in the Journal of Addictive Diseases.
Dr. Guarino found the Russians were often well-educated, had close relationships with their families, and financial support — all factors that tend to inoculate young people against addiction. Dr. Belkin, of the city’s health department, spoke of the “healthy immigrant effect” — the notion that people who decide to uproot themselves for life in a new country are psychologically sturdy and motivated to remain healthy. But that theory may not apply to their children, he said.
Anastasia Teper, 33, a researcher on the study and a recovering addict who had come from Russia as a teenager, said that immigrant young adults are under stress to assimilate, which can lead to experimentation.
“You have this huge conflict of the traditional values clashing with the so-called American values and this Russian stubborn temperament,” Ms. Teper said. But there was also a taboo against even speaking about drug use, which got in the way of treating it, the researchers said. “Once you are a drug user, you are disowned,” Ms. Teper said. “It’s like you’ve killed someone, you’ve prostituted yourself. It’s worse than being a drunk.”
In order to break the silence, a Russian radio station last year broadcast weekly interviews with young addicts in recovery, parents and advocates. Sasha, 25, who came to United States from Ukraine with her family 20 years ago, was addicted to pills, making her unusual among Russian addicts, who tended to inject heroin. Her path to addiction started when she was teased for not knowing English, and the pressure her parents put on her to succeed at school. s a teenager, she grew depressed over the apparent suicide of a boyfriend; she was hospitalized, and doctors prescribed drugs such as Klonopin and Xanax. She started buying drugs on the street and even got a job in a pharmacy, fueling her addiction.
One day, Sasha’s mother, Helen Berg (they have different last names), saw an advertisement for Dynamic Youth Community in a Russian newspaper she rarely read. “It was a sign from God,” Ms. Berg said. “But I thought, ‘No way do they take girls, this is only for boys.’” Sasha arrived at Dynamic at age 21, weighing 80 pounds. After living in the center’s residential treatment program in upstate New York, she moved to all-day treatment in Brooklyn that became semiweekly. Later, she worked for the center; now she is taking pre-med classes.
“If a kid comes here for an interview,” Sasha said, “mom and dad have this internal discussion: ‘What is grandma going to think? What is Aunt Tatiana going to think?’”
Russian parents lack education about drugs, said Natalie, a mother with two sons who have battled addiction. After coming to the United States, she got divorced, worked and went back to school.
“American parents are close to the problem,” she said. “We know about alcohol. Drugs, they are like the moon for me.” Like most other mothers interviewed, Natalie asked to be identified only by her given name.
Naïveté and desperation drove some mothers to spend thousands of dollars on so-called interventionists for a quick fix. I was losing him, he had overdosed once,” said another mother, Raschel, about her son. A friend told her about a rabbi who supposedly specialized in mystical healing. She said the rabbi insisted on spiritually cleaning her home. At the end, the rabbi’s associate asked for $1,800. Raschel recalled her son’s incredulous reaction: “Mom, are you high?”
These Russian-speaking mothers blamed themselves, what they saw as lax oversight in American schools and doctors who overprescribed pills for their children. As their children have fought to become clean, the guilt lingers.
“My parents left everything behind to come here for a better life for me to become a drug addict,” said Roman, 25, who emigrated from Ukraine as a child. “So much suffering has been done, that’s something I struggle with. I have apologized.”
By Liz Robbins - The NY Times/July 21, 2016
Photos: 1-Sam Hodgson, the NY Times; 2-Sam Hodgson, Alex Wroblewski, Joshua Bright, all NY Times photographers
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