ADDICTION: Sin or Sickness?

1. What the Bible says:

Noah Genesis 9:21
Lot Genesis 19:32
Isaac Genesis 27:25
Nabal 1 Samuel 25:36
Uriah 2 Samuel 11:13
Amnon 2 Samuel 13:28
Elah 1 Kings 16:9
Ben-Hadad 1 Kings 20:16
Ahasuerus Ester 1:10-11
Leaders of Israel Isaiah 56:12
King of Israel Hosea 7:5
People of the Nations Joel 3:3
Bad stewards Luke 12:45
Christians 1 Corinthians 11:21

The Effects of too much alcohol PROVERBS 23:20-35

2. What is a Disease?

Psychological illness: Any mental or psychological condition (In the areas of perception, emotions, thinking, volition or behaviour) that would:-

1. Impair productivity (work or education roles)
2. Impair relations with others
3. Impair physiological functioning
4. Markedly impairs self-contentment driving the individual to seek professional help.

A classification (nosological) history of the term:

DSM I(1952): Addiction and Alcoholism put under Personality Disorder, Psychopathic Personality Disturbance;

DSM II(1968): The term is replaced by "drug dependence" incompletely separated from personality disorder;

DSM III(1985) and DSM IV (1994):
The term Substance Abuse is introduced.
The independent category established.

ICD Classification followed a parallel route but ICD 10 (1992) is almost similar to DSM IV.

Although the terms Substance dependence and Substance Abuse are the more "officially" scientific terms, addiction is still maintained as a term in a number of scientific and official organizations, journals and publications.

3. Addiction as disease: Primary or Secondary?

Addiction as Primary Disease (not caused by anything else)

AA, NA, 12 Steps, The Minnesota Model....etc.
E.M. Jellinek. 1960:- The Disease concept of Alcoholism.

Addiction causes depression, anxiety, antisocial behaviour and psychotic symptoms.

Addiction as Secondary Disease

A manifestation of a psychodynamic disturbance
An attempt at self medicating depression, anxiety, personality problems or psychosis
Learning of faulty ways of thinking and behaviour
A personality disorder
A manifestation of a family pathology.

The popular disease concept:

Genetics: Twins and adoption..
Alcohol and nicotine studies provide strong evidence; other substances are not sufficiently studied.

The Naive Disease Concept

You treat me: If I have a disease, you're the Doctor, treat me!
Depreciation (you are a sick person),
Stigmatisation living in the past: once an addict always an addict.

Balanced

May be I (the addict) am not responsible but I can and must do something now. In many diseases the patient has to change his life style if he wants to improve or recover e.g. hypertension, angina, allergies, asthma...etc.
Adapt and live with it.
Continuous vigilance and watchfulness.

It is interesting that those who advocate the disease concept most vigorously advocate spiritually, reliance on God and spiritual growth with the same vigour.

4. What is Sin?

1. Popular (Non-Christian) sense; Something you do that: is hurting others: is bad and you can stop doing it if you choose.
2. Christian sense
Missing the mark. Hamartia
Lack of godliness. Asebia Rom 1:18 A state of mankind (Heredity is not the accurate theological term) Rom.5:12
Egocentricity living for oneself and relying on one's own resources-selfishness and Pride.
Living for oneself and relying on one's resources to achieve happiness. Out of this all kinds of "sins" proceed.

5. Addiction as Sin

Naive (popular)

1. No help is needed. If they choose to they will stop it. They just need to pull themselves together.
2. They brought it on themselves why should we help them.
3. If they repent instantaneous deliverance will take place.
4. I am better than an addict or normal people are better than addicts.

Balanced

1. Sin is not overcome without grace. Grace is normally mediated through people and relationships, the 'normal' sinner needs our help as much as a sinner who happens to be an addict too. Proclaiming God's grace is a demanding commission.
2. Discipleship and a daily walk with the Lord is essential to have the personality transformed. It took Jesus one second to heal the blind man but three years to change the way 12 people used to think and act (and these were "normal people" .
3. Egocentricity became part of our being ( the old man, the flesh, the sinful nature) instant experiences are would not overcome this unless they are part of a continuous process.
4. I ("normal" people, ex-addicts...etc) am not better than an addict. I am a sinner as she/he is. Normal people are not better than addicts.

Addiction as Sin: The particular picture.

Pre-occupation with one's favourite sin.
Compulsion (slavery of will) is more evident.
False facade.
Drastic consequences are more evident.
Egocentricity manifested in: deceit, sexual looseness, theft, pride.. etc. T
he unity in Satan's Kingdom is most evident.

"Some men's sins are clearly evident, preceding them to judgement, but those of some men follow later" 1 Tim 5:24

6. Proposed formulation : Addiction as both Sin and disease;

Sin can be manifested in :

Substance abuse
Substance dependence
Other addictive behaviours
The religious unsaved sinner
The successful well adjusted mature citizen sinner
The successful psychopath
Anti-social problems
The normal mature individual
The normal immature individual

Disease (Primary, secondary or both);

Through genetic, psycho-dynamic, social learning socio-economic, and other factors help in determining the ways sin is manifested;

Some people appear to vulnerable to some forms of sin this is the disease concept.

The disease can make discipleship (spiritual growth) more difficult. Yet makes the need of it more evident. Treating the disease without treating sin is possible, but sin will manifest itself in another way.

Our task is to deal with both.

Treatment programmes

12 steps programmes great success related to the spiritual/faith element.

Therapeutic communities, and existential approaches dealing with emptiness and despair. Breaking the extreme social and human isolation.

Even cognitive approaches speak of lifestyle change, and commend "religious belief" as helpful.

7. Addiction Affects:

The addict's health (physical, mental, spiritual)

Relationships and family (breakdown)

Society (Crime, Health, Social fabric)

The Church