The Disease Concept of Alcoholism

What about the “disease concept” of alcoholism and drug addiction?

A. Rationale for using the term “disease”   – A simple definition of “disease” is any “unhealthy condition.”   Addiction has a well-established and recognizable set of “symptoms” with characteristic behaviors and similar effects upon every person who suffers from it.   Also, reliable scientific studies have established that many individuals have an inherited predisposition to alcoholism and other drug dependencies.   For secular researchers, who do not acknowledge the spiritual roots of addiction, using the terms “disease,” or “illness” is a logical approach to defining and understanding this condition.

The American Medical Association defines alcoholism as …

.. a primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterized by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences,  and distortions in thinking, most notably denial. Each of these symptoms may be  continuous or periodic. *

B. What the Bible says While this all may be true, we must reject an extreme application of the “medical model.”   Through it, some would imply that the individual didn’t have a choice in the matter and was somehow not responsible for the choices that led to his condition of addiction.   Because real repentance is essential to re-establishing a relationship with God, it is dangerous to accept any approach that removes from an individual personal responsibility for his own actions.

The process leading to full-blown addiction starts with the sin of drunkenness — which is a moral choice even for those with a family history of alcoholism.   As Christians we must be careful not to use an extreme definition of the term “genetically predisposed.”   This concept simply refers to the condition of some individuals who, because of an inherited bio-physical make-up, have bodies that process addictive substances in a manner that causes them to progress more rapidly toward compulsive use and chronic addiction.   While there are many physical, emotional, and social contributors that lead to addiction, the Bible is quite clear about the fact that choosing habitual sin eventually results in slavery or bondage for those with a genetic predisposition.

Being “genetically predisposed” to alcoholism refers, basically, to those individuals whose biological make-up causes them to progress more rapidly in the physiological aspects of the addictive process.   The Bible is quite clear about the fact that choosing habitual sin eventually results in slavery or bondage.   Actually, the Bible says the sin of “drunkenness” prohibits those who practice it from entrance into the Kingdom of God (Galatians 5:19-21)

C. Scriptural terminology The Greek word “bondage” (douleia) is a very appropriate Biblical term that sums up the condition of addiction to alcohol and drugs.   It is used extensively in scripture portions like Romans 6, and translated “servants to” and “slaves of.”   This term carries with it the connotation of a condition that, while it may have begun through personal choices, results in a state that supersedes the free will.   Just as the slave in Bible times could not break free of his state of bondage, which may have resulted from indebtedness due to his own choices, so is the addict bound in a condition that he will not escape on his own power.

D. Don’t minimize the problem! This bondage has dramatic and lasting effects on people who suffer from it.   Life-consuming sin has an impact on the total person.   As Christian counselors, we know that God’s power is able to deliver individuals from the compulsion to drink, and to set them free from the emotional, psychological, social, spiritual, and physical consequences of an alcoholic lifestyle.   Yet, we must never forget that enslavement to drugs or alcohol goes far beyond a simple habit.

After an addict is saved and stops using mood-altering chemicals, he must work through a special set of problems that are the “fall-out” or on-going consequences of the addicted lifestyle upon the individual and his primary relationships.   Usually, without the proper help, the addict will either fall back into use of alcohol and drugs or will transfer his addiction to some other compulsive behavior.   Thoughtfully combining insights from the secular research into these dynamics with scriptural principles can equip us to effectively help addicts and their families.

*   Journal of the American Medical Association, 1992


Originally published in RESCUE Magazine, the journal of the AGRM, Fall 1995

Updated   July 17, 2012

Guide to Effective Rescue Mission Recovery Programs

This resource was originally published by the Association of Gospel Rescue Missions in 1993 and then updated in 2001.

While out-of-print, I continue to receive requests for the information. So, I have decided to place most of it on this web site. It was originally packaged as a set of twelve recorded workshops with nearly 200 pages of supporting materials. These audio lectures and handouts make up a large portion of the City Vision College course, Managing Residential Recovery Programs.

These talks were given to rescue mission workers at various AGRM training events. However, the principles I shared are appropriate for anyone involved with helping alcoholics and drug addicts and their family members. I share many special insights learned from working for many years with homeless addicts, especially in residential recovery program settings.

The link to the PDF file below allows you to download the printed portion of the guide. It has the handouts that were used with most of the recorded lectures plus the Supporting Information from the Table of Contents and from Section B.   The PDF file has active links to the recordings which are stored online. So, if you save it to your PC, you can simply click on title and listen to the workshops as long as you are connected to the Internet.

Guide to Effective Rescue Mission Recovery Programs (download PDF File)

Table of Contents

  1. About the Speaker
  2. Introduction
  3. Registration

Section A – The CDs

Introduction to the CDs

  1. Spiritual Foundations for Recovery
  2. Understanding Chemical Dependency
  3. Defining Goals for Rescue Mission Recovery Programs
  4. Overcoming Denial
  5. Wounded Warriors
  6. Helping Addicts to Develop the ‘Life Themes’ Essential for Recovery
  7. Three Phases of Recovery at the Rescue Mission
  8. Using Written Client Recovery Plans
Section B – Supporting Information

  1. Answers to the Most Frequently Asked Questions About Addiction and Rescue Mission Recovery Programs
  2. Effective Support Groups
  3. Michigan Alcohol Screening Test
  4. Topical Index of Bible Verses for People in Recovery
  5. Suggested Resources

Section C – 2001 Update

  1. First Things First: Foundations of Addiction Recovery for Homeless Addicts
  2. Is It Easy to Change at Your Mission?
  3. Life After the Mission
  4. What Does Success Look Like?


 ©1993, 2001 – Association of Gospel Rescue Missions. All rights reserved. Reproduction of any part of this book or the accompanying audios is limited to the users own use only. No part my be used in any commercial products without written permission from the publisher.

Is Every Drunkard an Alcoholic?

You say a person who is not a “drunkard” in the spiritual sense can be still an alcoholic “therapeutically.” How can that be?

At first that may appear to be a confusing statement.   In Christian circles, the terms “drunk” and “alcoholic” are too often used interchangeably.     When dealing with alcoholics, too often believers focus almost entirely on whether or not the addict is actively using his or her “drug of choice” (which can be alcohol).   With this thinking, it’s easy for them to say “She’s doing better,” when their alcoholic is not on a drinking binge.   But what’s probably happening is that the person is simply between binges and most likely nothing has really changed.   She is still on the downward spiral of addiction that will inevitably lead to more chaos, pain and most likely death or incarceration.

A.   What the Bible Says – According to the Bible, anyone who becomes intoxicated on a regular basis is a “drunkard.”   Galatians 5:19-21 labels drunkenness as a sin, a real moral choice that will keep the offender from inheriting the Kingdom of God.   We must not confuse our terminology.   Alcoholics and addicts who are actively using their “drug of choice” are definitely “drunkards.”   But so are “social drinkers” who become regularly intoxicated.   While these foks may not be caught up in a web of compulsive alcohol or drug use, they are still engaged in an activity with serious moral and spiritual implications.

The Apostle Peter wrote, “Be of sober spirit, be on the alert. Your adversary, the devil, prowls about like a roaring lion, seeking someone to devour” (1 Peter 5:8, NASB).

We have enough difficulty discerning Satan’s activities when we have a clear mind. But if our spiritual sensitivity is clouded by intoxicants, we are more open to his deception and control. We need to take Paul’s exhortation to heart: “Do not get drunk on wine, which leads to debauchery. Instead, be filled with the Spirit” (Ephesians 5:18, NIV).

B.   The Physiology of Addiction — Repeated drunkenness is where addiction begins. Medical science has shown that long-term use of alcohol and drugs results in changes in the human body that do not disappear upon an alcoholic’s salvation.   As a matter of fact, this physical aspect of the disease of alcoholism will remain with the recovering addict until he is glorified and receives his new body from the Lord.   (1 Cor. 15:42-44)

The loss of control that occurs when the addicted individual begins drinking is a primary symptom of alcoholism.   It is not just a psychological problem; it has a physiological basis, as well.   This is why people who become established in a life of recovery must be mindful of the fact that they will always be “sensitized” to alcohol and drugs. For them, total abstinence is a must.   Any use of alcohol can “activate” the chemical mechanisms of addiction leading to compulsive drinking and behavior.

I’ve been asked, “Then why doesn’t God heal that too?”   Why would He?   The only benefit would be enabling people to go back to drinking in moderation.   There is actually a pretty good change that such a person will end up back into full-blown alcoholism!   If he never drinks again, this physical aspect of the illness will have no other actual effect on a recovering individual life or Christian walk

C.   The Battle with “The Flesh”   – The Bible is pretty clear on the fact that, while we are made new in our spirits and souls, the human body in which we live remains a part of this world.   We often see the term “flesh” used.   Even in Romans 7, Paul talks about the dichotomy Christians live with because we are spiritual beings still living in a fallen body.   For recovering addicts this means that, while he is a “new creation” in Christ, he must manage to live in a body that still has the mechanisms of addiction in place.   Furthermore, this fallen body still has a fallen brain, which is a physical organ – separate from the new mind God has given me.   This organ of my body still has a lymbic system that is programmed to respond to all sorts of stimuli in a sometimes twisted manner that is not that different than when he was in active addiction.

D.   Abstinence vs. Recovery — I would never say that remaining abstinent is not a good thing.     But, stopping active use is no guarantee that the addict’s life will automatically improve.   Actually, for most, the early days of recovery can be filled with withdrawal symptoms, sleeplessness, confusion, reemerging negative emotions, and so forth.   I’ve actually known people who were a lot more pleasant to be around while they were drinking than when they were not.   Stopping the use of alcohol and drugs is a whole lot easier that learning to live life without them.

  E.   Therapeutic Considerations — Besides the purely physiological issues, recovering individuals need help to overcome another set of consequences from alcoholism and drug addiction; those that reside in their minds and emotions.   There are attitudes, temptations, feelings, and patterns of thought that are unique to the addict.   Real joy and victory in life can only come through a definite process of discipleship, which is another way of looking a Christian recovery.     He must “transformed by the renewing of his mind” (Romans 12:2) and must learn to “walk in the Spirit that he might not fulfill the desires of the flesh.” (Galatians 5:16).

So, it is important to keep these issues in mind as we reach out to those who struggle with addiction.   There is deliverance but it is important to live circumspectly.   For recovering people, remembering where they came from is one sure way to keep on the path to where they need to go.