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).