Is the Disease Model Concerning Addictions Accurate?


Substance abuse is ubiquitous. Addictions are no respecter of persons. They affect the rich as well as the poor. As a pastor of a small rural church in Jones County, MS, my heart is torn for those who are struggling with drugs or alcohol, as well as for families who have members who are struggling with a particular addiction.

Personally, I have have been extremely encouraged by those who have blazed a trail in the world of addictions, especially in the realm of biblical counseling. The Bible has much to say concerning addictions (drunkenness). But most people are not familiar with what the Bible says. Rather than trusting in God’s sovereign work in the life of the addict, most people turn to secular approaches to addiction – the disease model.

What is the difference between these two philosophies of addiction? Is it wrong to choose a more worldly model over the biblical model? My own research has left me feeling discouraged with secular models of addiction. I am certainly not upset with any friends or family members who counsel using these models. However, at the end of the day, I find the disease model to be unhelpful and inaccurate concerning the world of addictions. There are, at least, five reasons why the disease model of addictions is inaccurate.

1. Addiction is not a disease.

Of course, I realize the controversial nature of this statement. Most people in the medical world believe that having an addiction is a disease. But, we must stay true to God’s Word and biblical convictions. An addiction is not a disease, but an idolatrous enslavement of the heart. Sometimes, addicts want to play the victim. Do not let this form of emotional manipulation fool you.

When a tornado comes and destroys a person’s house, it would be foolish for us to tell them that their house was destroyed as a result of their sin. This homeless person is a victim of nature’s cruel violence. But an addict is not a victim of nature’s cruel violence. Rather, an addict made the choice to use recreational drugs, or get drunk, or to view pornography. Over a period of time, the seeking of pleasure/or self-punishment becomes a habit. The continuous habit becomes an addiction. In their minds, addicts believe that they cannot live without their addiction and become enslaved to sin.

2. The Disease Model offers no hope.

In his book that encourages the church to be counselors, Jay Adams writes, “…personal helplessness, hopelessness, and irresponsibility are the natural results of the Medical Model. If a person’s problems in living are basically problems of disease and sickness rather than problems of behavior, he has no hope unless there is medicine or therapy which can be applied to his case. Since there is no medical cure for people in such trouble, they move from despair to deeper despair.”[1] To my knowledge, there is no medicine that treats or cures any kind of addiction. Therefore, do we really want to believe the medical model? Do we want to believe that an addiction is a medical problem?

The Apostle Paul says, “See to it that no one takes you captive by philosophy and empty deceit, according to human tradition, according to the elemental spirits of the world, and not according to Christ” (Col. 2:8). My fear is that the world, including Christians, have been duped by the “philosophy” of the day. There is no hope for the addict when we tell them that they are suffering from a disease as if it was cancer, diabetes, or congestive heart failure. As biblical counselor, Mark Shaw, notes, “Jesus did not die on the cross for a disease. Jesus died on the cross for our sins. When you call an addiction sin, there is an answer for the sin problem: forgiveness. When you call addiction ‘disease,’ there is no answer, because the addict is not to blame for his ‘disease.’”[2]

3. The church has the message of hope.

Do not believe the lie that we must refer, those who come to us for help, to “trained professionals.” The church is not inadequate to help those suffering from addictions. If you feel like you are not equipped, but do want to help, then I encourage you to get some training.

God has commanded the church to help, serve, and minister to those who are suffering from the consequences of their sin. Therefore, what is the solution to being chemically dependent upon a debilitating substance? First, seek medical help from a trusted physician to help with the detox, and seek spiritual help from the Great Physician. Second, seek medical advice in order to come off of the substance physically. Third, seek the grace of God and become obedient to His Will in order to come off of the substance spiritually. Shaw says, “By remaining obedient to Him, you will avoid developing insatiable and powerful cravings for your drug of choice. Obedience will enable you to avoid problems of cravings, dependence, and tolerance. Your biggest problem is not your appetites for alcohol, drugs, sex, sleep, or food. It is your sinful heart attitudes that indicate you prefer satisfying temporary pleasures with drugs and alcohol rather than fulfilling them with a thriving relationship with an eternal God. Excessive satisfaction of temporary appetites leads to sinful ways of acting, thinking, and speaking along with tolerance, cravings, and dependence upon the drug. In this sense, your flesh and its lusts and desires are your primary problem and your own worst enemy. God’s grace will empower you to overcome your addictive tendencies of your heart. His grace is your primary solution!”[3]

4. The Biblical Model works!

The medical model does not accurately portray a biblical understanding of addiction. Again, this is incredibly controversial in our culture. Even though my understanding of addiction may seem controversial, I believe it to be thoroughly biblical. Not only is it biblical, I have seen it work first-hand. God has done an amazing work in the lives of men and women where I serve as a pastor. But, what if I’m wrong? What if the medical model is correct? Then nothing is really lost except that I may have offended some of you and a few of you may not agree with me. If I’m wrong, the worst thing about this whole lesson is that the Bible is wrong. And if the Bible is wrong about addictions, then there is a possibility that it could be wrong about other issues as well.

What if I am wrong? What if the medical model is correct? Then nothing is really lost except that I may have offended some of you and a few of you may not agree with me. If I am wrong, then the Bible is wrong. I don’t think that we want to believe that the Bible is wrong. So, if I am right, then here is the solution for any life-dominating sin – Jesus Christ. If Jesus can change the heart of a murderer like the Apostle Paul, then He can change the heart of an addict. I have witnessed addicts go from a substance to a Savior because of Christ. There is no hope found in a worldly man-centered approach to understanding addiction. The only hope for an addict is to place their faith and trust in Jesus Christ, giving up the substance, and being transformed by the Savior.

In conlcusion, seek to rid yourself from this destructive lifestyle and tell someone immediately! There are three key ingredients for every successful recovery: Jesus, accountability, and YOU!! The first two ingredients are a given. First, if you place your faith and trust in Jesus, He will transform your life. Second, you can always find an accountability partner that will help you walk through this difficult process. Ask a trusted godly friend, or pastor. The third key ingredient in YOU! YOU have to be willing to trust Christ as your personal Lord and Savior. YOU have to be willing to be held accountable for your actions. YOU have to be willing to change your behavior. YOU have to be “sick and tired” of being sick and tired.

If you are struggling with a life-dominating sin, such as an addiction, then seek the Savior Jesus Christ. Ask Him to radically change your life (and mean it)! Find someone and tell them your decision. As the Bible says, “Today is the day of salvation” (2 Cor. 6:2)

[1] Shaw, Divine Intervention, 59.

[2] Jay Adams, Competent to Counsel (Grand Rapids: Zondervan Publishing, 1970), 7.

[3] Shaw, The Heart of Addiction, 75.