Is Addiction a Disease? - Discovering the Underlying Roots of Disease

There is much speculation and debate over the etiology of addiction. The desire to understand addiction and find a remedy no doubt arises from the pain and heartache of those affected. Daily, families unravel and lives are destroyed. Fortunately, amidst all the speculation, God has graciously revealed the underlying roots of addiction. Without this proper understanding of the problem we will provide little more than symptomatic relief.

Disease or sin…or possibly both?

Much of the culture sees addiction as a disease. Many of the better treatment centers and better groups within Alcoholics Anonymous see alcoholism (a form of addiction) as a three-part disease with physical, mental and spiritual components. I say “better” because there is currently a movement away from the spiritual roots of addiction and a focus solely on the mental and physical aspects, as segments of the recovery culture are becoming more and more secularized.

Christians, out of a need to confront those who view addiction through the lens of the medical model, will often too quickly polarize in defense of the biblical position that addiction is rooted in sin. I think the debate is unnecessary and may cost us opportunities to listen closely and seek points of agreement, which may help in communicating a biblical interpretation of their observations.

To deny that there is at least the possibility of a physical disease component to addiction is to deny the biblical reality that sin affects the body (causing disease). It should in no way be a threat to our biblical understanding if it is one day proven that the body of an alcoholic reacts to alcohol differently than non-alcoholics. As a matter of practice I find it is most helpful to concede as much to the culture as possible in so far as it does not compromise a biblical worldview. 

At minimum, we can see that in some sense addiction is a disease. God’s word tells us:

The heart is deceitful above all things,

and desperately sick;

who can understand it? (Jeremiah 17:9)

God says we have a heart that is diseased with sin. This spiritual problem taints our ability to see rightly, which would seem to include understanding the problem. This, however, does not leave us without hope because there is One who understands all things and He has graciously given us His word. We must look to him to rightly understand the nature of addiction.

speaking redemptively to the culture

One of my great joys is to seek opportunities to speak redemptively into what our culture is saying. One of the disconnects in our churches today is the inability to connect the gospel to the reality of our everyday struggles. Groups like Alcoholics Anonymous gain the confidence of their followers because they do a fantastic job relating to their experience. In relating to the reality of their experience, alcoholics are relieved, thinking, “finally, someone understands me.”

Dr. William Silkworth was a well-known psychiatrist in the 1930’s who worked tirelessly with alcoholics and addicts. In what is known as The Doctors Opinion, which is found in the “Big Book”, Alcoholics Anonymous, Dr. Silkworth makes a number of observations in his study of alcoholics. In those observations he humbly admits his limitations in producing the “entire psychic change” that is necessary for one of his patients to find freedom from addiction. This leads him to speculate as to the nature of the problem. Because he cared enough to listen and understand their experiences, alcoholics tend to trust him.

In describing the insanity of alcoholic, Dr. Silkworth makes the statement that they cannot after a time differentiate the true from the false. They continue to buy off on symptomatic relief that alcohol provides for their restlessness, irritability and discontentedness.  This lack of peace is symptomatic of a deeper spiritual problem, known as the “spiritual malady” in Alcoholics Anonymous, which we understand as sin from a biblical perspective. The alcoholic is seeking a solution to a spiritual problem with a created thing…a bottle. You can’t fix a spiritual problem with a physical thing.

a biblical understanding

Oftentimes we believe that the bible is insufficient in understanding our everyday struggles, thinking that it does not speak to things like addiction. In Romans 1:24, 26, and 28 the bible describes the idea of being given over to something physically, mentally and spiritually. This leads to slavery, bondage or in other words, addiction.

The bible describes why this happens:

 because they exchanged the truth about God for a lie and worshiped and served the creature rather than the Creator, who is blessed forever! (Romans 1:25)

One of the key features of addiction is the loss of control. No one wakes up one day and says, “I want to be an addict” – that’s absurd. That was certainly not my case in my alcoholism or the other forms of addiction that I have experienced over my lifetime. No, the addict desperately wants to control that which he cannot imagine life without. 

The key word in this text is worshipped. We worship what is uppermost in our affections, what we love the most. We will sacrifice lesser loves to maintain relationship with the thing or person we love the most. God is saying we are given over to the created thing we love more than we love Him. Typically, that is the thing we turn to for our joy, comfort, peace and relief. This explains the variety of things we can become addicted to: chemicals, sex, shopping, religious practices, people, programs, etc. Whatever we give ourselves to will enslave us. It becomes our life, what we serve. It controls us. Though addiction may have physical and mental aspects to it, it is fundamentally a worship disorder. It is a heart disorder. We will no doubt substitute various forms of slavery until our heart finds rest in what it was created to worship…our Creator.

The Gospel Alone

The lack of rest comes from the marring of shalom through the fall of mankind in our separation from God. Jesus Christ alone is God’s prescribed remedy for the insanity that results from our spiritual malady. Any promise of finding true freedom from this malady (sin) other than Jesus is a false gospel (or message). This gospel message is not foundationally built on what steps we take to be reconciled to him but rather what steps he has taken to rescue us from sin. In love, Jesus entered our chaos, became like us to lead us out.  As this gospel of grace captivates our hearts, we are reborn - given new hearts - which reorders our worship and redirects our lives. It begins to align us with his created design.

The gospel not only gives us new hearts but the redemption of our bodies through the resurrection. In this physical resurrection we will not longer be diseased. What this means on this side of eternity is we may have to refrain from drinking alcohol, we may need to get medical attention in detoxing safely and it may be helpful to supplement through medications or natural supplements to help with physical symptoms. At times, God will even do physical miracles. But all of these interventions have limitations unless our primary spiritual problem is addressed and overcome and this can be done through the gospel alone.