Fentanyl-laced heroin pills. (DEA)
NEW JERSEY (FOX5NY.COM) - Esti Cohen was only 14 when she first started using drugs.
It started, she said, because of bullying.
In the Orthodox Jewish community of Lakewood, New Jersey, where Cohen grew up, she said it wasn't difficult to get her hands on pills.
"I went out and asked my friends, 'Do you know any meds that can help with my anxiety?'" she said. "And they were like, 'Here, try it.'"
Cohen comes from a strict religious upbringing. When she was 16, her parents gave her an ultimatum. "They told me, 'You could get clean, we will help you, or you can get out,' and I told them I wasn't ready, so they were like, 'OK you can go.'"
It took another two years and seeing a close friend's mother overdose on opioids before Cohen decided she needed to get help.
"Knowing that my family could find me dead in my room did not sit well with me, it put something in my heart that just dropped, and I was like, 'I need to get help,'" she said.
What her family found was Behavioral Crossroads Recovery in Turnersville, New Jersey, which bills itself as the only in-patient "kosher rehab" in the Northeast.
"We cater to the needs of the religious community, the Jewish religious community," said Deena Lefkovitz, the clinical supervisor at Behavioral Crossroads. "We have Jewish clinicians on staff, we have a rabbi on staff, and we're kosher so we understand the needs of the community."
In addition to serving kosher, home-cooked meals, men and women are housed separately and the program makes special accommodations for anyone who wants to observe Shabbat.
Rabbi Avi Richler, head of religious services at the center, said a common misconception in the Orthodox Jewish community is that going to rehab means compromising one's religious beliefs. He wants to dispel that misconception. He also said that talking about addiction is stigmatized.
"It's kept under wraps in the Jewish community, specifically in the Orthodox community," he said. "We have a concept, for better or worse, that the community hides the fact, is afraid to talk about addiction."
Whether or not people in this community want to talk about addiction, it is a serious issue. Fox 5 first highlighted the toll opioids are taking on the Orthodox Jewish community in 2017.
Richler said the problem remains at crisis level.
"The definition of a crisis is something getting worse, not better, and all we've seen is it getting worse and worse, more and more deaths," he said. "So until we can reverse the trend where the numbers are shrinking, we're going to remain in a crisis in our community."
Acknowledging the problem is the first step, finding help is the next, and sometimes stigma even surrounds that.
"The door to mental health opened up a few years ago in the Jewish community and I would say with addiction, we're still dealing with a window," Lefkovitz said. "The window is open, people are willing to hear, but they're still keeping it very quiet."
Lefkovitz said about 90 percent of current clients at Behavioral Crossroads Recovery come from an Orthodox background and can sometimes be sheltered from the outside world.
She said the thought is: "'It's bad enough my kid is doing drugs, it's bad enough my spouse is doing drugs, now I'm exposing them to all elements of the world.' So we try to curb that environment as much as we can and give them an environment that they're used to, that they're comfortable with."
But addiction experts said that a kosher rehab is not necessarily more effective than other programs and can also be very costly. Behavioral Crossroads is "out of network." Lefkovitz said some insurance companies will make exceptions because the center is one of the very few places to make kosher accommodations.
Richler said his goal is to get help to the growing number of people struggling with addiction, whether it is at Behavioral Crossroads or at another facility.
"I'm not here from a business angle, I'm here because I genuinely want to help people get better," he said. "We're talking about human lives and every life is worth saving. He who saves one life, it's like he saves an entire universe."
Substance Abuse and Mental Health Services Administration
National helpline 800-662-HELP (4357)