Most church buildings host two kinds of activities: traditional worship in the sanctuary on Sunday mornings, and meetings of Alcoholics Anonymous (AA) in the church basement, usually on weeknights. The twain rarely meet. Drug use and addiction don’t merit prime-time attention.
There is something profoundly wrong with this picture. AA and other Twelve-Step meetings are, of course, confidential. But what we do and say in church should reflect the reality that addiction exists all around us. If those who suffer from addiction feel not only unwelcome but stigmatized, what is our faith really about?
That is why almost three years ago I was delighted to learn of a conference on faith and addiction to be held in Minneapolis. I attended that meeting and blogged about it. Since 2019, the small group of volunteers who created that first event have transformed themselves into the organization called the Center of Addiction and Faith (CAF).
Though it is still taking shape, CAF now has a board and executive director. Its website offers theological reflections on addiction, sample sermons, a bibliography of helpful and inspiring readings, podcasts and webinars from leading authors and practitioners, and a directory of 12-step recovery groups for lay and clergy. This new organization has the potential to transform the way the institutional church, and, indeed, all of us, understand and respond to addiction.
CAF is holding its third annual conference in person as well as remotely in Minneapolis on October 7-9. Workshop topics will include: how to bring the subject of addiction forward in a congregational setting, and harm reduction as a spiritual response to substance abuse. I will be leading a discussion on the role of churches in ending the War on Drugs. All sessions will be online.
Beyond these workshops, I see a second and possibly overriding reason why the conference is important. In bringing addiction out into the open, CAF may be key to accomplishing something that all of us hope for and few of us know how to do. I speak of revitalizing a progressive Christianity that is clearly in a downward spiral.
We normally think of addiction as manifested in those abusing substances or trapped in gambling or pornography. It is important to deal with these afflictions as they affect individuals.
But, at a more profound level, seeking to understand addiction is a way of coming to terms with what might be considered the human condition. It raises profound questions about personal freedom, how we change, and the sources of meaning in our lives. These are religious questions. Yet they are rarely answered in the traditional church.
Even as church attendance declines, we hear increasingly of those who say they are “spiritual but not religious.” They are the “new wine” that the Bible talks about when it says “new wine is put into fresh wineskins.” (Matt. 9:17) They reject the “old wineskin” of organized religion with its outdated theology and empty ritual.
In my experience, the religious figure today who comes closest to capturing what those who call themselves “spiritual but not religious” are reaching for is Richard Rohr, a Franciscan Father and founder of the Center for Action and Contemplation in Albuquerque, New Mexico. His spiritual insights have the potential to bring new vitality and meaning to a Christian church that must change to survive.
If you drop his name in casual conversation, you will be surprised how many people recognize it and smile. How many theologians recently have been the subject of articles in prominent national magazines such as the New Yorker and Harpers?
The language of addiction is central to Rohr’s theological perspective. In one of his books, Breathing Underwater: Spirituality and the Twelve Steps, he makes the case that in a profound sense, we are all addicts. In varying degrees, we pursue false gods. These, in turn, separate us from our “True Self” as the source and expression of authentic joy and meaning.
Although he will not be with us in person, Rohr’s message will be abundantly present throughout the CAF conference.
Rev. Alexander E. Sharp, Executive Director, Clergy for a New Drug Policy
As we witness the agony of our withdrawal from Afghanistan, most of us think that after 20 years there at least we are ending America’s longest war. But conventional wisdom would be wrong. The United States is still fighting a War on Drugs which Richard Nixon officially declared on June 17, 1971, over fifty years ago.
Both wars have been fueled by false assumptions. When the concepts that are used to justify a war prove misguided, it is reasonable to believe that our leaders, supported by the public, will change course. This is what has caused us to leave Afghanistan. The same thing can happen with the War on Drugs.
The false premises that have propped up the War on Drugs for over 50 years are clear. The first misguided assumption is that the best way to keep individuals from using, and too often abusing, drugs is to punish them.
Prohibition, which criminalizes drug use, does not work. As President Carter famously observed, it is a cure worse than the disease. If punishment were a meaningful deterrent, we would have won the Drug War long ago.
The second false assumption is that drug use, rather than the harm caused by drugs, should be the object of our concern and the metric by which we should define success. Our policy metric when it comes to drugs should be “harm,” not “abstinence.”
Tragically, it took the AIDS crisis beginning in the early 1980s even to conceive of this approach, so obvious when you think about it. As AIDS spread, it became clear that individuals using drugs were being infected by sharing contaminated needles, and that such infections could be minimized by making clean syringes available.
Like decriminalization, harm reduction enjoys growing public support. Clean needles are now available in 300 exchanges across the country, and the federal ban on such services has been lifted. Naloxone, an antidote which can quickly bring an individual back from drug overdose, is legal in 49 states and available over the counter; there are over 120 overdose prevention sites throughout the world, where individuals can safely test their drugs and use them under medical supervision. We will have such a site in the United States very soon.
Specifying the false premises of the War on Drugs helps us to understand what an end to that war would look like. We also now have proposed federal legislation that would get us there. On June 15, 50 years after Nixon declared his War on Drugs, representatives Bonnie Watson Coleman (D-NJ) and Cori Bush (D-MO), working with the advocacy group Drug Policy Alliance, introduced the Drug Policy Reform Act (DPRA).
This bill would decriminalize low-level possession of all drugs, treating such offenses like a traffic violation. It would shift drug regulatory authority from the Department of Justice to Health and Human Services “to emphasize that substance use is a health issue and not a criminal issue.” If passed, it would drive a stake through the heart of the War on Drugs.
How close are we to its passing? All the suffering notwithstanding, it was obviously easier to withdraw from Afghanistan than it will be to end the War on Drugs. The former was possible through Executive Action. Congressional approval is much harder.
This is especially the case since the War on Drugs has entrenched support among stakeholders in the current system such as prosecutorial offices and prisons, sweetened with federal funds, at virtually all levels of government. Further, lawmakers who support drug policy reform can be labeled by opponents as “soft on crime.”
For these and other reasons, developing a national constituency for the Drug Reform Policy Act will require the same kind of state-by-state trench warfare that has brought us to the cusp of national marijuana legalization. Oregon took the first step in February 2021 when it decriminalized low-level possession of all drugs in combination with access to 10 treatment centers across the state.
Executive leadership could make a big difference. Perhaps this is not so far-fetched. As a presidential candidate in 2020, Pete Buttigieg stated that he would “eliminate incarceration for drug possession, reduce sentences for other drug offenses and apply these reductions retroactively, and legalize marijuana and expunge past convictions.” These would be important first steps.
It has taken over 50 years for policies to emerge that respond to the potential dangers of drug abuse and addiction with healing and compassion rather than false assumptions about punishment and incarceration. It is time now to bring to an end what is, in fact, America’s longest war.
If asked to name the American thinkers of the past 150 years whom I most admire, I would place the great pragmatic philosopher William James at the very top of the list. Starting as a professor of physiology at Harvard in 1873, James virtually created psychology as an academic discipline. His Varieties of Religious Experience, published in 1890, endures as a religious classic.
William R. Miller, distinguished professor emeritus of psychology and psychiatry at the University of New Mexico, should be considered among James’ most worthy successors. While he may not have created an academic discipline, Miller did, along with colleague Stephen Rollnick, develop a new therapeutic technique – Motivational Interviewing (MI) – now used worldwide to treat individuals suffering from alcoholism and addiction and more broadly seeking personal change.
It is easy to forget that until about 40 years ago, many people believed a confrontational “boot-camp” approach was an effective treatment for alcoholism and other addictions, The concepts of MI have helped to expose this misguided view.
Miller’s experience in working with addicts also led him to explore with academic rigor the notion of sudden personal conversion. He is the first scholar since William James to do so. In his book Quantum Change, he documents what he finds to be the reality and surprising frequency of such experiences. He is now exploring the ways MI and such “change” experiences might be related.
I am delighted to introduce Dr. Miller to you here, for two reasons. First, Clergy for a New Drug Policy is devoted to ending the so-called War on Drugs. The tenets of Motivational Interviewing make clear why criminalization as the primary weapon in this war, as currently fought, is a tragic response to drug possession and addiction. More broadly, these same principles offer the potential for human change regardless of the arena.
Dr. Miller recently participated in a webinar broadcast by the Center of Addiction and Faith (CAF), a Minneapolis-based organization that engages clergy and churches in responding to addiction. A selection of Dr. Miller’s comments under key issues is provided below.
On the origins and key tenets of Motivational Interviewing:
Early in my education, I was on an internship in Milwaukee, Wisconsin working on an alcoholism unit. It was run by a psychologist who was compassionate and scientifically oriented, so I felt very at home. I knew nothing about alcoholism, really, but had been trained in Carl Rogers’ person-centered and behavioral approaches.
It was the patients who taught me about alcoholism. I began reading the literature on alcoholism from the 1970s, which said, “Alcoholics are pathological liars, completely in denial, out of touch with reality, and horribly difficult and defensive.” And I said, “Gee, those aren’t the same people I was talking to.”
This puzzle was the beginning of Motivational Interviewing. I realized that that picture of people being very difficult, defensive, and dishonest was a function of the way we were treating addiction at that time — in a very confrontational, authoritarian, shut-up-and-listen kind of way.
The spirit behind Motivational Interviewing is partnership rather than “I’m the expert and you’re only a recipient.” It’s two people talking to each other as peers. I have expertise, but so does my client. My client knows more about him- or herself than anybody else in the world. If we’re talking about a change in that person’s behavior, I need their expertise, as well as my own.
Rather than saying “I have what you need, and I’m going to give it to you,” the communication in Motivational Interviewing is more “You have what you need, and together we’re going to find it.”
A central principle is that it should be the person, the client, the patient, the student, who’s making the arguments for change and not me. If I’m arguing for change and they’re arguing against change, I’m in the wrong chair.
On the importance of “self-acceptance” in personal change:
Here was one of Carl Rogers’ interesting discoveries: that when you experience yourself as unacceptable, it’s very, very difficult to change. It’s paralyzing. And when you experience acceptance, profound acceptance — as you are — whether from a therapist, or a friend, or your family, or God, then it becomes possible to change. Now, I don’t know why we’re wired that way, but we seem to be.
On the role confrontation and punishment in response to addictions:
Punishment suppresses behavior. It doesn’t teach anything new. It doesn’t say, “This is the way to go, … this is the way forward.” I began a very different approach to working with addiction accidentally and [found] very different outcomes.
Human beings don’t generally take well to being told what’s wrong with them and what they should do. If you take a different, person-centered approach, you get a very different outcome. You find that you are working with a very different kind of person.
When we also looked at the literature on confrontation, it is completely negative. There’s not a single clinical trial of a confrontational approach that produced a positive outcome. It was the norm at that time. We thought that that’s what those people needed. But there never was any science to the notion that if you can just make people feel bad enough, they’ll change. And nor is that my faith.
On the debate over addiction as a disease or a choice:
It’s an old idea that people with substance use disorders just can’t enter into a therapeutic relationship. There never was any science to that. Quite to the contrary, person-centered approaches like Motivational Interviewing have a very, very good track record.
When we have this black-and-white way of thinking about things, there are only two possible outcomes, perfection or disaster. I’ve done outcome research for 40 years. Outcomes don’t look like that. They’re all over the map. It used to be alcohol dependence and alcohol abuse were different disorders. They’re not. It all lies along a continuum. Outcomes look the same way.
We know that with chronic illnesses, we don’t expect people with diabetes to never taste sugar again. We don’t expect people with hypertension to abstain totally from salt in all forms. The main thing is to be moving in the right direction.
What is meant by the disease model is that you are completely different, incapable of controlling what you are doing. For some people that’s helpful. Identifying with that is the way they stay sober, and that’s good. However, if you don’t remain perfect, it can be discouraging.
We have a study in which we found that an endorsement of the disease model actually increases the relapse rate. People were more likely to not just use, but use catastrophically, when they believe that if one drinks one is a drunk. For some people, that’s helpful. For others, it’s not. That’s human nature and there’s not one solution, one answer for everybody.
On the seemingly contradictory approaches to recovery (some evoking a “higher power,” others “personal agency”):
One of the wonderful things about addiction treatment is we have a terrific menu of different science-based approaches that can help people. There isn’t one approach you should always do.
One of those is the 12-step program. It’s very nicely scientifically documented. (Alcoholics Anonymous itself is harder to document, although there are a lot of studies of it.) But a 12-step facilitation treatment works on average just as well as cognitive behavior therapy or Motivational Interviewing on average. So, if one thing isn’t working, try something different.
For Bill Wilson (founder of Alcoholics Anonymous), who was a banker and at the top of his game, learning powerlessness might have been the key. But if you’re working with individuals who have experienced deep trauma, they might need to focus on methods that will draw out personal agency.
Feminist theology has questioned whether women in general need more powerlessness. Women for Sobriety and SMART Recovery and other kinds of approaches were developed as reasonable alternatives. Humility and ego busting and powerlessness doesn’t seem to be the path for them.
On how churches and other communities can respond to addiction:
First, make it a topic of conversation. So often there’s so much shame around this topic in the United States that you just don’t talk about it. You can change that norm in a church by preaching about it if you’re the pastor, by sharing stories in prayer time. Bring it out of the closet. In this country we have made it a shameful thing.
Albuquerque is an interesting example. The University of New Mexico Hospital operates the largest addiction treatment program in the state. But it’s not located at the University of New Mexico Hospital. It’s in a warehouse district out by the airport. Now, why is that? It’s because we don’t want “those people” around the hospital. Except guess what? They’re already there being treated for all kinds of other things.
That’s not right. We have science-based, perfectly reasonable treatment methods that are rather like what therapists are doing anyhow with other kinds of clients. And yet, we’ve somehow come to believe that this is somebody else’s work. We should mainstream it in churches, in healthcare, in psychology, in social work, in homeless services. It’s just a really common part of life and not one to be shunned.
On the importance of “small interventions:”
Most of the things in my career that were most important were unexpected. And I learned early that when you don’t find what you predicted, that’s when you should get interested, become curious, and follow that, believe your data and follow your data.
In 1983, I was thinking of Motivational Interviewing as a kind of priming the pump or getting people ready for what would be real treatment. The unexpected thing that popped up was that after a conversation in this way, people often began changing without additional help.
My training as a therapist had been “the longer you spend with me, the better you’ll get.” But I began to find that even after a relatively brief conversation, people seemed to turn a corner on what had been very longstanding destructive patterns. It didn’t make sense to me, but we kept pursuing it. That has held up over time.
If you look at the stories of healing and in writings about Jesus, they’re not long interactions. They are relatively brief encounters. He almost always touches the person, which is interesting. But these things are not long-term psychotherapy sessions. Something is happening that powerfully changes the person.
On the possibility of personal conversions:
Some people don’t know that the author of the hymn Amazing Grace was a slaver. His last trip was not the one on which he wrote Amazing Grace. He had a couple more exchanges. And so, it doesn’t necessarily happen all at once. It’s not always like Ebenezer Scrooge, where you’re totally transformed in the moment.
But sometimes people are. I wrote a book called Quantum Change. The last psychologist I could find who was interested in this was William James, for whom psychology and religion naturally fit together at the beginning of the 20th century.
He was fascinated by people who are suddenly transformed and tells some of their stories in Varieties of Religious Experience. I wondered, “Is that real? Does that actually happen in real life?” Well, the stories are found in biography and autobiography. We found that it was not difficult at all to find people who had had such “turning point” experiences in their lives. They hadn’t told anybody. They often didn’t talk about it, because the experiences sometimes sound pretty crazy.
I just went into the study asking, “Does this even exist? Is there such a thing as an experience that happens within a few minutes or hours that permanently changes the person, like a one-way door?” It is real and it’s common. (For more on this aspect of Dr. Miller’s work click here.)
On the relation of psychology and religion:
Psychology in the middle of the 20th century was phobic about religion. Psychology arose in the 19th century out of philosophy and religion. Those are the parents of the field. But somewhere in the middle of the century, psychology just drew back from that, almost like an adolescent rebellion, really, I think.
And when I was in graduate school, I was told, “If you have to believe that kind of thing, just keep it to yourself.” I wondered, “Why is that? That doesn’t make sense to me.” I kept my mouth mostly shut about my faith during the graduate training. But those worlds have always fit together for me. Toward the end of the 20th century, books began appearing on spirituality and psychology and religion and psychology as well in the journals of the American Psychological Association.
It was almost like we had passed the adolescent rebellion and begun to say, “You know, maybe my parents did know something.” Openness to spirituality and religion has really begun to take hold in psychology. But I think we had to get through that rebellion period.
These are only a few of the humane and enlightening insights from this interview with a gifted psychologist and man of faith. If you would like to hear the full interview as conducted by Timothy McMahon King, digital organizer and author of Addiction Nation, click here.
Rev. Alexander E. Sharp, Executive Director, Clergy for a New Drug Policy
P.S. The following two pieces provide a broader understanding of topics included in the above interview.
DO CHURCHES CARE ABOUT ADDICTION?
In the above interview, Dr. William Miller comments on the critical role churches and health care institutions can play in combating the stigma associated with substance abuse and other forms of addiction. The current issue of Reflections, the online magazine of the Yale Divinity School, includes a piece I have written on this theme, along with thoughts about the role of the church in public life. I include my article here. It is drawn from the webinar offered by the Center of Addiction and Faith in January, 2021.
WILLIAM R. MILLER SPEAKS AT THE UNIVERSITY OF CHICAGO
In 2014, Professor Miller was invited to give the Ruth Knee Lecture on Spirituality and Social Work at the University of Chicago School of Social Service Administration. The first half of his lecture focused on Motivational Interviewing, the second on the notions of personal conversion as addressed in his book Quantum Change. I bring this lecture to your attention here, especially for those who seek to know more about this second topic, and the relation between the two.
On election day, Oregon became the first state in this country in which individuals possessing small amounts of any drug are no longer treated as criminals. Instead, they are now being charged a small fine – a civil offense – and offered the opportunity for treatment. It’s called “decriminalization.”
Illinois has just filed legislation to “defelonize.” Unlike the Oregon legislation, it does not eliminate criminal penalties. But individuals can only be charged with a misdemeanor, not a felony. For people seeking to rebuild their lives after prison with a job, housing, and basic social benefits such as unemployment insurance or Medicaid insurance, this is critical. That is why the Illinois bill – HB 3447 – is titled “Reducing Barriers to Recovery.”
If the Illinois bill becomes law, it will become the 29th state to defelonize, a measure only one step away from what Oregon has done. Does this mean that Oregon was simply the first state in a national movement? Yes.
Is Illinois on the right path? One way to answer that question is to look at the best arguments against decriminalization and see if they hold up. Eight years ago, James Q. Wilson, professor of Criminology at UCLA, formerly of the University of Chicago and Harvard, opposed drug legalization in a debate with Ethan Nadelmann, founder and then head of the Drug Policy Alliance and formerly a professor of politics and public affairs at Princeton University. In taking this position, Wilson was, in effect, also opposing decriminalization. (Legalization means that both using and selling drugs are legal. Under decriminalization, selling remains illegal.)
Wilson was perhaps the most prominent conservative criminologist of his day. In 1982 he brought forward the “broken windows” theory of policing, which argues that strict enforcement of minor offenses prevents more serious crime. That theory, which was embraced by public officials notably in New York City, morphed into the “stop and frisk” policies that began in the 1990s.
In opposing the motion, Wilson argued that legalizing drugs “will increase [their use] by a factor of four, or five, or six.” Why did this matter? Because for him, drug use is inherently wrong.
Elsewhere he had written that “… it is immoral because it enslaves the mind and destroys the soul.” In the debate with Nadelmann, Wilson cited “…the lives of the people I have watched in the skid row areas of Los Angeles, hopeless victims of drug abuse, who live on the streets because they cannot live anywhere else.”
Wilson then argued that limiting the supply of drugs does not work. The only way to limit drug use is to reduce demand. And the only way to reduce demand is through some form of prohibition.
Here is Wilson’s argument in a nutshell: “If there are no penalties for the private possession, then it would be difficult to see how we could punish private transactions. If there is no punishment for what people consume, I don’t see how there can be a punishment for what people buy….drug consumption in this country will increase.”
Everything Wilson says starts with punishment. He even sees punishment as essential to treatment: “our treatment programs….work only when the person subject to them is constrained… Ethan’s policy of avoiding punishing people for anything they consume means the end of our effort to reduce the impact of psychoactive drugs and the end of most treatment programs.” (Yes, he actually said this. Listen to the debate.)
These statements about treatment are simply wrong. Many people, probably the large majority, seek treatment without being coerced. As a practical matter, Wilson ignores the fact that drug treatment is available for only about 10% of those who need it. Shouldn’t those voluntarily seeking treatment be given first claim? Finally, he fails to ask the extent to which treatment that is coerced actually helps.
Wilson acknowledges that many people who use drugs do not abuse them and do not harm others. Beyond this, he says nothing. He simply embraces them in his call for punishment. His failure to speak to this population is, by omission, itself an argument for decriminalization.
Finally, let us revisit Wilson’s take on Skid Row: “You see these absolutely destroyed human beings, and what they were destroyed by? Well, a lot of things usually, not one simple thing, but in most cases, they were destroyed by drugs.” Did Wilson, who died in 2012, know nothing about mental illness, trauma, joblessness, lack of housing? Of course he did. How then, could he have argued that our Skid Rows across this country would diminish significantly if it were not for drugs? His insistence on a false morality based on punishment blinds him to the complexities of human fragility.
Ethan Nadelmann won this debate. We can move forward toward decriminalization without reservation. The arguments against it simply do not hold up, even when advanced by as formidable an opponent as James Q. Wilson.
Rev. Alexander E. Sharp, Executive Director, Clergy for a New Drug Policy
Over the past several months, some ideas have come together for me concerning addiction, churches, the War on Drugs, punishment, and blame that had originally emerged as separate themes. Let me summarize:
Most mainline Christian churches act as though addiction does not exist despite the pain it brings all around them to those they seek to serve. They may host a 12-step group in the basement, but addiction is rarely the topic of sermons, educational programs, service and outreach, advocacy, or any other congregational activity.
With their silence, these same churches perpetuate the stigma that accompanies addiction.
Even though a majority of the public considers it a failure, the 50-year-old, War on Drugs fuels this stigma through its basic message that punishment in the form of criminal prosecution is the primary response to drug use and addiction.
There is ample evidence that punishment, including jail and prison, is fundamentally the wrong way to help people overcome addiction. It does not work.
We must hold people accountable for what people do when abusing substances. But we must not blame them. This is possible. It is what Jesus did.
As these themes have come into focus, I have been delighted to lend my support to a new organization which addresses most of these themes, and I am now eager to bring it to your attention. I first heard of the Center of Addiction and Faith 18 months ago and attended its second annual conference. I described this event for you here.
In a short time, CAF has come a long way. In 2019, an annual conference was the group’s only activity. The Rev. Ed Treat, a Minneapolis Lutheran pastor, had organized the first two conferences as a volunteer with modest back up help from church staff.
Attendance grew significantly in the second year with over 250 attendees representing 34 states and 12 denominations. Encouraged by this expression of interest and unfilled need, Ed took a big step six months ago: he resigned from his church after 25 years as pastor to work full-time in establishing the Center. Since that time, CAF has developed a website, named a board, gained its 501(c) 3 status, and launched a broad base of activities including podcasts, webinars and daily devotions.
I am committed to the work of the Center, and hope you will look closely at what it has to offer. It can educate us about addiction. It can help our churches learn how to welcome those struggling with addiction. It has material to help clergy respond to the needs of individuals in their congregations.
The possibilities for preachers are vast. Addiction brings illness and death. Jesus healed throughout his ministry. We can learn much about what He said and did by trying to understand addiction – psychologically, sociologically, physiologically, not to mention theologically.
Finally, I am hoping the Center will guide congregations in advocating for an end to punishment as society’s response to drug use.
Last week I had the opportunity to conduct a webinar for the Center – Addiction and Advocacy: The Role of the Church. Here are the video link and full written text. Let me close with one excerpt:
“Mark Osler, a lovely man, is a professor at St. Thomas School of Law in St. Paul, Minnesota, and a renowned expert and advocate on clemency and pardons for the wrongly convicted.
As someone who grew up in a church environment, he could cite at least a few familiar Biblical passages. They stayed with him.
For many years, Mark Osler was a federal prosecutor in Detroit. His job was to send those accused of dealing, or even just possessing, crack cocaine to prison, sometimes for life. Under the law, those dealing crack, usually African Americans, were 100 times more likely to be convicted than those, mostly whites, using powder cocaine.
One day Osler remembered Jesus saying to the pharisees who were about stone to death the woman caught in adultery, “Let him who is without sin cast the first stone.” “I realized,” he recalls, “I was the guy with the rock.”
Sincerely, Rev. Alexander E. Sharp, Executive Director, Clergy for a New Drug Policy