What Pastors Need to Know about Addiction.

Derrick’s wife, Julie, calls you late on a Wednesday afternoon to tell you that Derrick has lost yet another job. Since losing the job on Monday morning, Derrick has been drinking both at home and with his unhelpful friends.

Julie suspects that he may be using Methamphetamine, too. His behavior has been more erratic and he has hardly slept in the last 24 hours.

As you try to counsel Julie, it may be helpful to understand what retired Harvard professor of psychiatry, Dr. Lance Dodes, calls the two types of addiction.

Why is it helpful for pastors to understand Dr. Dodes’ two types of addiction?

Having an accurate definition of addiction can help pastors focus on the gospel and avoid giving bad or even dangerous advice and counsel.

It can also help a pastor refer to the appropriate expert when needed.

What are the two types of addiction?

Dr. Lance Dodes makes an extremely important distinction between purely physical addiction and psychological addiction.

Dodes Defines Physical Addiction as a Purely Medical Problem.

Physical addiction is the response of the body to repeated administration of a drug that can be abused. To describe this type of addiction, Dr. Dodes’ uses terms like,

Tolerance: needing more of the same substance to obtain the desired effect.

Dependence: the body’s need for the substance to maintain homeostasis.

Homeostasis: a state of balance in the body. For example, the central nervous system’s ability to remain relatively neutral in regard to anxiety and depression.

Are there people who are only physically addicted?

One of Dr. Dodes’ most persuasive arguments in favor of the concept of physical addiction comes from the world of medicine. He argues that many people develop a physical addiction to opioids while recovering from surgery—yet very few of these people demonstrate the kinds of self-destructive and compulsive behaviors associated with a Substance Use Disorder.

Instead, they taper off the pain medication relatively quickly and resume everyday life.

Dodes Defines Psychological Addiction as a Compulsion.

According to Dr. Dodes, psychological addiction happens when a person habitually uses a substance to solve a problem.

Psychological addiction is characterized by intrusive thoughts about the substance and compulsions to use the substance—even when there is substantial evidence that using the substance will be harmful.

Where there is psychological addiction there is often physical addiction, as well. For example, a person using alcohol to manage rage and helplessness may have compulsions to use despite experiencing negative consequences from using. At the same time, they may also experience symptoms of life-threatening physical withdrawal when attempting to quit or cut down.

To get a better picture of psychological addiction, imagine that a woman’s husband invites friends from work to the house for dinner without advanced warning. The woman feels anger or helplessness but doesn’t know how to address the issue with her husband. She may find that drinking or using valium is a way to handle her negative feelings.

Over time, the woman may come to rely on drinking or valium to manage many different types of difficult or uncomfortable situations. The urge to use a substance can become a well-worn behavioral pathway—a compulsion to use.

Why is this distinction important to Pastors?

The distinction is important for a pastor to understand for three reasons.

The risk of ignoring the physical aspects of addiction.

Physical addiction is a medical issue.

Going cold turkey can be painful, medically risky and even deadly.

A first-step for many with an addiction should be to meet with a health care provider. An honest conversation with a family doctor can get the ball rolling regarding medical care for a person with a physical addiction.

Another option is a detox facility. Detox facilitates are often found at psychiatric hospitals. A google search of your area should help you find an appropriate detox center.

For anyone who is physically addicted, problems of anxiety, insomnia, and other issues may also emerge in the months after a person quits using the substance. Again, a medical professional can address these issues.

By ignoring the physical aspects of addiction, pastors may fail to recommend life-saving medical support for detox. They may also overly spiritualize physiological symptoms such as cravings or intrusive thoughts about drug use. This would be the equivalent of Jesus failing to heal the cripple or leper.

Physical symptoms need medical treatment, not spiritual help.

The helpful pastor will refer a person to a medical doctor and/or an addiction specialist.

CLICK HERE for a helpful resource on alcohol problems and getting medical help.

The risk of ignoring the psychological aspects of addiction.

Today, many secular experts ignore the psychological aspects of addiction and focus exclusively on the neurobiology of addiction. Some of these leaders have proposed that a pill or even brain surgery will eventually cure addiction.

Their view of addiction is reductionistic and ignores the psychological pain caused by addiction.

A spiral of shame and guilt can materialize, causing a person to reach for a substance to alleviate their negative feelings. Not surprisingly, the additional substance use only contributes to shame and guilt. This blog post helps explain why people feel so bad after drinking. It applies to other substances, as well.

Psychological experts are adept at helping clients identify behavioral patterns and the motivations that drive those patterns. They can also help clients make behavioral changes.

CLICK HERE for a comprehensive list of helpful resources regarding addiction, including resources on when and how to obtain psychological help.

The risk of not addressing spiritual concerns.

Many spiritual concerns accompany addiction. Questions of guilt, acceptance, forgiveness, and identity can all arise.

CLICK HERE to see a short video discussing how churches can help with addict’s spiritual concerns

Pastors can offer something no other professional can: the gospel.

Pastors, chaplains, and other Christians can share the mercy and forgiveness of God. They can share Christ’s compassion for hurting people. They can share the good news about redemption and eternal life.

They can reassure and console people in ways that medicine and psychology never can.

The gospel message can also serve to motivate a new, more God-pleasing lifestyle. Flowing from gratitude, relationships can be healed, health can be restored, and careers can be resurrected. The gospel can cause the demoralized to regain a sense of purpose and mission.

So, pastors have an important role in the recovery of a person who is addicted to a substance.

Conclusion

You don’t have to be a medical doctor or a psychologist.

By understanding the two types of addiction, you can focus on the spiritual and pastoral needs of those you serve. You can also help direct addicts and their families to appropriate services.