By Yair Hoffman
Question: “Rabbi, I have ADHD, and there is absolutely no way that I can stay in shul on Yom Kippur without medication. Can I take my ADHD medication in order to stay in shul? It is no big deal if I don’t take it, but I would like to have a meaningful Yom Kippur.”
(Believe it or not, this question was posed to this author twice just after the Rosh Hashanah holiday.
Answer: This is an excellent question, and it would seem that there are two halachic issues here. There is the issue of consuming something on Yom Kippur and the second issue of taking medicine on a yom tov.
We will address the consumption issue first. There is a fascinating statement written by Rabbi Yosef ben Meir Teumim (1727–1792) in his sefer Pri Megadim. This Pri Megadim is quoted by the Mishnah Berurah (O.C. Siman 612:15) who states: When we have foods that are not ra’ui l’achilah, edible, there is a rabbinic prohibition to consume them at the outset. If they are less than a shiur, one should also be careful l’chatchilah.
We see then that it is less than a rabbinic prohibition, but a slightly lower level known as a “warning to be careful.”
Rav Moshe Feinstein, zt’l (in his Igros Moshe O.C. Vol. III #91), ruled that even a sick person who is not dangerously ill may take a pill on Yom Kippur. But perhaps the ADHD person is not halachically considered to even be categorized as someone who is sick. Would it be warranted to take a pill on a “warning to be careful” in order to be able to sit and concentrate on Yom Kippur?
And now the second topic: What about the additional prohibition of taking medicine on Shabbos or yom tov? We know that the rabbis forbade the consumption of medicine on account of the concern that one may come to grind other herbs to be used as medicine. Unless the person falls under certain categories of serious illness, there is a general prohibition of taking medicine. This applies not only to Shabbos but to yom tov as well.
The Shemiras Shabbos K’Hilchasah (34:19) rules that birth control pills are not forbidden to take on Shabbos on account of the rabbinic enactment to safeguard against grinding, because the prohibition applies only when someone is actually in physical pain or is particularly weak. ADHD meds would be likened to this case.
Davening on Yom Kippur in a proper state of mind would certainly be defined as a mitzvah. The Magen Avraham (O.C. end of Siman 619) states that one should negate a minhag of staying up all night on one’s feet on Yom Kippur night so that one would be in a better position to daven properly on Yom Kippur itself. It would seem to this author that it would outweigh something that is not at the level of a rabbinic prohibition and is just a “warning to be careful.” This is also the ruling of Rav Mordechai Gross from Eretz Yisrael (Naavas Mordechai Ma’aser K’safim Vol. III p.60). On the other hand, a caffeine pill would not be something that should be allowed to be taken under such circumstances. This is the ruling of Rav Felder from Lakewood in his Shiurei Halachah (p. 191).
There is, of course, another possibility that should only be done under the instruction of the person’s doctor. Sometimes an additional partial dose of such medication can be taken before Yom Kippur in a time-release covering. Once again, this should only be done under the medical advice of an expert doctor.
What About The Water?
But what if one cannot take a pill without swallowing it with water?
There is a solution (pun intended). A few years before his passing (before Yom Kippur of 5769), Rav Elyashiv, zt’l, ruled that a person could utilize a different option—consuming water that has a pagum (unnatural) taste that is not normally consumed because of its negative taste. The rationale for this ruling (based upon a Rema) is that such drinking does not constitute a normal form of drinking and is thus only forbidden by rabbinic ruling. The rabbis, however, never made such enactments for people who are dangerously ill.
What’s the recipe for such water? It should be distasteful enough that a normal person would not drink the water, yet not so distasteful as to cause the drinker to get sick or to violate the prohibition of bal teshaktzu—doing something disgusting.
One should always check with one’s doctor, but this author has experimented with various concoctions to create the pagum water. (Do not take the pagum water if your doctor does not advise it for you.) The recipe that best fits the bill, in this author’s opinion, is to mix a half-teaspoon of granulated onion powder and three shakes of salt into a room-temperature 16.9-oz. bottle of water. The onion powder should first be dissolved in a small amount of hot water before Yom Kippur if possible. This will keep it pagum but will help reduce possible stomach unrest later.
Experiments conducted by this author have revealed the following revelation: The colder the water, the more onion powder and salt one can tolerate.
The author can be reached at Yairhoffman2@gmail.com. Read more of Rabbi Hoffman’s articles at 5TJT.com.