Addictions: Sin and/or “Chronic Disease”

Greg Strand – November 28, 2016 2 Comments

How are we to understand addictions? Are we affected by genetics and upbringing (nature and nurture)? Are we morally responsible for them? How does this affect our understanding of sin and responsibility? How does this affect how the church views and responds to these matters in the lives of individuals?

The USA Today includes a pronouncement from the Surgeon General, Vivek Murthy, on this matter, who claims addictions are not an indication “of a character flaw or a moral failing . . . It’s a chronic disease of the brain that deserves the same compassion that any other chronic illness does, like diabetes or heart disease.” (Surgeon general: 1 in 7 in USA will face substance addiction).

The article begins in this way:

A federal report released Thursday calls for a shift in the way America addresses substance addictions, finding one in seven Americans will face such disorders. Only 10% of those addicted receive treatment, the study said.

“Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs and Health” marks the first report from a U.S. surgeon general dedicated to substance addiction, raising the profile of the widespread epidemic and advocating proven treatment options.

This is the heart of the pronouncement:

“We have to recognize (addiction) isn’t evidence of a character flaw or a moral failing,” Murthy said. “It’s a chronic disease of the brain that deserves the same compassion that any other chronic illness does, like diabetes or heart disease.” [Another article reports Murthy saying the following: “. . . not as a moral failing, but as a chronic illness that must be treated with skill, urgency and compassion. The way we address this crisis is a test for America.”]

Bryon Adinoff, an addiction psychiatrist at the University of Texas Southwestern Medical Center, said the report’s influence carries hope that how Americans see and understand addiction might change.

Genetics account for about half of a person’s likelihood of becoming addicted, Adinoff said, but viewing addiction first and foremost as an illness clashes with Americans’ up-by-your-bootstraps mentality.

“Our whole approach to substance abuse disorders is they’re illegal and you go to jail,” he said. “It’s the only illness for which you send people to jail, for long long periods of time.”

Ponder a series of questions as you think through how to respond to this claim biblically, theologically and pastorally:

  • How do you read, understand and respond to this claim?
  • What implications does this have for how we understand and respond to individuals with addictions?
  • Do you see a moral equivalency between alcohol and/or drug addiction and diabetes or heart disease?
  • Can some heart disease be caused by sin, e.g. overeating, so that ought to be addressed morally as well?
  • How do we distinguish between Christian and non-Christians in the realm of addictions, and how does this distinction affect your pastoral care and counseling, i.e., what difference does union with Christ make in the life of a believer as he/she engages in this battle?
  • How do we understand the implications of the struggles with ongoing sin and the empowering presence and transforming power of the Holy Spirit as we engage in the battle for holiness and purity, as we put off the sins of the flesh and put on the graces of Christ in the realm of addictions?
  • Has the church generally, or any one of us individually, approached those with addictions more judicially than compassionately?
  • In response to those addicted, how does one uphold the biblical truths of moral accountability and responsibility while simultaneously being loving and compassionate, and to do so pastorally?

Update: In a recent article in Christianity Today regarding addictions, “Just Say No to Shame,” Timothy King writes, “Framing addiction as chronic disease does not remove the moral choices involved but gives us a broader framework for understanding them.” When I served in pastoral ministry, this is one reason I encouraged individuals to address both medical (depression, addictions, etc.) and spiritual issues. It often was not an either/or response but a both/and approach. As the medical or addictive issues are addressed, the patterns and behaviors that accompanied those medical issues or addictions also need to be addressed. We are transformed by the renewing of our minds (Rom. 12:1-2).

Greg Strand

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Affectionately called “Walking Bible” by his youngest daughter, Greg Strand has a ministry history that goes back to 1982. Since that time, he has served in local church ministry in a variety of ministry capacities: youth pastor, associate pastor of adult ministries and senior pastor. He is currently the EFCA's Executive Director of Theology and Credentialing. Greg reads voraciously and never stops learning — a passion reflected in the overflowing bookshelves that spill from his library to multiple offices. And he could tell you about each of those books! His hunger for learning pales in contrast to his great love for God and for teaching the Word of God.

2 responses to Addictions: Sin and/or “Chronic Disease”

  1. Greg,

    This question has intrigued me throughout my medical career, during which time I specialized in anesthesiology and pain management. After an early retirement I pursued a degree in counseling psychology at TEDS. I wrote a thesis titled, “Using Scriptural Concept to Manage Patients with Psychophysiological Disorders.”
    From 60 to 90 percent of patients in a doctor’s office on a given day are there with conditions that are caused or aggravated by psychological factors. Many Christian physicians see most patient disorders as combinations of physical, emotional, and spiritual factors. We understand that symptoms such as pain are real, but that other things may be going on at the psychological and spiritual levels.
    I mostly disagree with the Surgeon General’s statement. Rather I see addictions as a more complex problem. Granted there are physical aspects present. Recent advances in radiology have enabled us to identify a pleasure center deep in the brain called the nucleus accumbens. When an addict consumes a drug, this brain center “lights up” when it is viewed by certain scanning techniques. Interestingly, the same center lights up when a person engages in addictive behavior. Such habits include over-eating, watching television excessively, gambling, sex, the Internet, and compulsive shopping or spending. Granted, genetics plays a role in some addicts.
    Let’s consider obesity, which happens to be associated with thirty diseases. Two-thirds of the American population is overweight. The cost to the country is 150 billion dollars annually, or almost 500 dollars a person. Certainly this is not solely a genetic problem. Interestingly, people who move to the U. S. from other countries tend to become overweight because of American cultural influences.
    So is obesity a genetically determined disease, a psychological (will power) problem, or the sin of gluttony? Perhaps it makes sense to call it a consequence of addictive behavior. Thus diabetes and heart disease are physical diseases, but obesity is often a contributing etiology.
    Our goal in treating chronic pain is not solely to remove a symptom, but to maximize function. Instead of relying on narcotic medication—which so often leads to addiction and other complications—we utilize physical therapy, psychological counseling, and other modalities. Depression is often present, and it should be treated.
    Addiction reminds us of Paul’s admonition, “And do not get drunk with wine, for that is debauchery, but be filled with the Spirit” (Eph. 5:18). A friend of mine wrote his PhD dissertation on this one verse a few years ago at TEDS. Of course the main thrust of the statement is not just avoiding drunkenness, but rather pursuing the protective umbrella of being filled with the Spirit. Programs such as AA similarly focus on positive approaches.
    The church should play a role in fighting addictions. In our addicted society we should stand out as beacons of light. We are commanded to be separate from the world. The late Dr. Gleason Archer was a friend of mine. When one of us said in a deacon board meeting on one occasion that Scripture condones drinking in moderation, Gleason said that we wouldn’t feel that way if we took Romans 14 seriously. I decided to read that chapter several times. Finally I was convinced that avoiding alcoholic beverages completely was the right choice for me. What jumped out from the text was one word: LOVE. If we love our families and communities, we should show them that we can enjoy life without consuming alcohol.
    Thus I think we can address addictions preventively by reminding people not to even start using an addictive substance. Genetics won’t even affect us if we make good choices to begin with.

    Warren E. Anderson

    • Thank you for your lengthy and helpful response, Warren. Through education, training and experience, the Lord has allowed you to have an insightful perspective on these matters.

      The recent Christianity Today journal contains a testimony from one who suffered from opioid addiction. He progressively became addicted to medicate his pain. After reading this I added the following to my blog post: Update: In a recent article in Christianity Today regarding addictions, “Just Say No to Shame,” Timothy King writes, “Framing addiction as chronic disease does not remove the moral choices involved but gives us a broader framework for understanding them.” When I served in pastoral ministry, this is one reason I encouraged individuals to address both medical (depression, addictions, etc.) and spiritual issues. It often was not an either/or response but a both/and approach. As the medical or addictive issues are addressed, the patterns and behaviors that accompanied those medical issues or addictions also need to be addressed. We are transformed by the renewing of our minds (Rom. 12:1-2).

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