Why the definitions matter:
With sobriety comes clarity. When leaving the fog of addiction we find that the haze that shrouded our judgement is gone and that there is hope. Where before everything seemed somewhat shrouded, or sometimes even completely blacked out by the hopelessness of addiction – the unceasing cycle of withdrawal, craving and the next high – we find that now we can look back on the time spent in active addiction and learn quite a bit about ourselves. At least that is my experience. So much so that under the lens of introspection, examining what was before, a lot of things suddenly make sense.
For example, in my own life, before I even tried any kind of mind altering substance there was a certain impulsiveness to my decisions.
Depression in my early teens, left untreated, would also become a ticking time bomb later in life when I found myself in the ‘real world.’
In my personal testimony of how I got clean and sober, I explain how up until this day I cannot remember what went through my mind when I took my first line. I cannot blame any person or situation for my decision to pick up, and even though throughout this reading I might make reference to certain behavioral patterns or traumatic experiences, etc., these are just facets of a greater whole.
Definitions of addiction, or more properly, substance use disorder, have changed over the years. The view has shifted from it being a purely moral and ethical decision, towards it being a chronic disease.
The original term, addiction, is derived from the Latin addicere – “to adore or surrender oneself to a master.”
And this has been misinterpreted especially by the church.
I remember trying to get clean a year prior to my first fellowship meeting.
I went to two pastoral counselors who in my opinion were not very cut out for the job of addiction counseling, even though they had helped one or two addicts before.
It was made clear to me that I was transgressing against God, that I had to repent of my sin and turn to Jesus – and in the long run their sessions with me only led to deep seated guilt and relapse. Their heart was in the right place, but they were not equipped for the process and did not achieve much.
A friend of mine attended a fellowship group during his first few months of sobriety which was completely faith based and without therapeutic value.
The addicts were assembled in a room, and the families gathered in another. Once seated they were told that they were sinners, that they had to repent and this was followed by a verbal beating from the family members who were instructed to practice ‘tough love’. Apparently it was quite brutal and the experience comes up quite often in conversation.
These kinds of counseling methods do more harm than good. No one berates a diabetic for being sick, and no one goes up to a cancer patient and tells them to repent.
Addiction, according to current definitions, is a very real, often life threatening chronic illness and needs to be treated as such.
I believe that God heals. His Word makes it clear that He has paid for our restoration and healing – but I also believe in divine healing through wisdom imparted to professionals – where men and women are the hands and feet of God.
I’ve seen miracles. I’ve seen and even experienced physical healing through prayer, but I’ve also come to understand that sometimes God is in the process.
My addiction wasn’t just spiritual.
It was not some demonic force that plagued me and had to be driven out. It was my own brokenness, a brokenness that had been hidden in my heart since a very young age, that was seeking reprieve. I wasn’t doing drugs or drinking because the devil told me to do it. I wasn’t an addict because of some generational curse. It was very much a mental infirmity – one which, through the proper course of treatment, has gone into remission.
My hope is that in sharing this with the church we can move away from outdated models of thinking, outdated and frankly stupid ways of helping and move towards a way of reaching out to our fellows – the captives Christ promised to set free – and bring them back into the fold.
I did not choose to be an addict, but I did choose to get better. I chose recovery over addiction and continue to do so day after day.
My hope is that the love of Christ will shape our understanding, and that I might be able to share some knowledge with you that will empower you to help someone struggling with drugs and/or alcohol. That you will become equipped to assist broken families in finding hope and healing. That you might be ready and willing, armed with the necessary know-how to perhaps actually save a life.
And it starts with understanding what addiction is.
Below are some of the models we use to understand addiction. It might seem like a lot of information, especially when we start researching and delving into each one. My purpose here is just to show you the broader picture. And God will do the rest.
Definitions of Addiction
The Moral Model: Dating back to the 19th century, this model explores addiction as a moral failure of character. The idea is that individuals have free will and therefore is absolutely responsible for their decisions and behavior.
The Spirituality Model has close parallels with this (in my humble opinion) outdated way of thinking about substance use disorder. The spirituality approach believes that addiction is a spiritual malady and therefore is caused by a lack of connection to a Higher Power. The early Oxford Groups which would later influence the Twelve Step programs that we have today, believed that it could fix the problem of addiction by developing in clients a morality aligned with God. The Twelve Steps having evolved from this line of thinking, in parallel with earlier versions of the Disease/Medical model, seek to address this malady by encouraging a relationship with a Higher Power/God. Although this way of thinking seems outdated, and although I do not agree with the idea that addiction is solely the consequence of moral failure, it has played a big role in my own personal recovery. It has allowed me to confront certain defects of character, address certain ways of thinking and learn the value of mercy, compassion and forgiveness as well as asking for forgiveness.
The Self Medication Model: In the 1960’s psychoanalysts started exploring the idea that people often start using mind altering substances as a way of coping with hardship, mental illness and other problems present in their lives. It should me made clear that this model should be used in conjunction rather than competition with other ways of approaching addiction. (See Khantzian, E. J. (1997). The self-medication hypothesis of substance use disorders: A reconsideration and recent applications. Harvard Review of Psychiatry, 4, 231–244.)
Medical/Disease Model: The Disease/Medical model, first proposed in 1810 but only officially recognized in 1945 by the American Medical Association and thereafter accepted by the World Health Organization, proposes that addiction is a relapsing brain disorder and not a mental disorder or moral failure. It is defined as a severely harmful and potentially fatal illness which might go into remission with the proper treatment and care, but for which there is no known cure. A great documentary on this model is Pleasure Unwoven and it is my suggestion that anyone struggling with addiction, or who has a loved one struggling with addiction, find and watch it for some insight into what addiction is and what it is not.
Although the Impulse-Control Disorder model is a generally new way of approaching and trying to understand the problem of addiction, I would categorize it with the medical/disease model.
The basic premise of the Impulse-Control Disorder model is that there is a neurobiological or genetic defect that makes an individual unable to control and regulate impulsive behaviors. Under the wrong conditions such individuals will put themselves at risk, engaging in self-destructive behaviors such as pyromania or substance abuse.
Over the course of the last three decades there have been leaps and strides in medical science which have discover certain Genetic Predispositions in some individuals to alcohol, tobacco and other substances of abuse. Studies in the field of epidemiology have hypothesized that 40-60% for an individuals potential for addiction to opiates, alcohol or cocaine might be genetic.
More and more genetic researchers are starting to believe that different classes of substances might be connected with genetic preferences.
Along with this pre-existing preference the Bio-Medical model, proposed in the 90’s, supposes that the repeated use of mind altering substances over time physically changes brain structure and function and that these changes and the effects thereof might persist long after the individual has stopped using the substance. (Leshner, 2001).
Besides Medical and Spiritual models, we also look at possible social roots of addiction.
For example, Social Learning and Erroneous Thought Patterns.
“Social learning theorist Albert Bandura (1977, 1986) indicates four stages of social learning: (1) Attention—The individual makes a conscious cognitive choice to observe the desired behavior; (2) Memory—The individual recalls what he has observed from the modeling; (3) Imitation—The individual repeats the actions that she has observed; and (4) Motivation—The individual client must have some internal motivation for wanting to carry out the modeled behavior.” (The Addiction Counselors Desk Reference).
We see that a cognitive choice is involved in the first, where as the second concerning thought patterns, could be the result of social learning, or might have its roots in something else entirely – for example a lack of education or even mental illness.
These two approaches, in my opinion, can be considered branches of Biopsychosocial model. This model is based on the idea that addiction vulnerability – your chances of becoming an addict – is affected by the complex interactions between your physical and psychological states as well as social dynamics, or the way we interact with the world and the world interacts with us.
In my experience all of these models give us insight into the problem of substance use disorder as well as other addictions, however, I do believe that they should all be studied and used together – parallel and not in competition with one another.
The disease of addiction is not always an easy situation to understand. It is complex, and definitely more so than just a simple decision that someone takes, and although the solution is often simple – the road of recovery starts with one single step – actually understanding your client or yourself is not as easy as it might appear.
Humans are beautifully complicated, and because of this the task of actually helping our brothers and sisters – especially in the field of pastoral counseling – is sometimes a daunting task – but there is hope.
I have seen God use our knowledge and turn it into wisdom. I pray that as we seek to understand, as we read and contemplate and pray, God will lead and guide us towards comprehension and compassion.
The solution to the problem and disease of addiction is simple – and it starts with what Jesus taught us. Love your neighbour as He has loved us.
Love like Jesus loved, and this love will be a lamp unto our feet, will lead us on.
If you or a loved one is struggling with addiction – please reach out: 065 370 3806.
