Timothy McMahan King’s book Addiction Nation is both a personal memoir and an exploration of addiction. He brings an understanding of public policy, knowledge of advances in neuroscience, and his own religious faith to bear on this complicated and urgent topic. We were pleased to discuss the book with King last week.
How would you describe your own faith history and current affiliation?
I started off in an evangelical home. I was even homeschooled for a while. That culture certainly shaped my early life, and also introduced me to Jesus and taking Jesus seriously. And the more I learned about Jesus, the more I became concerned about people and issues that are on the margins. Over time, that shaped and formed me to the place where I am today of still loving parts of the tradition I grew up in, but also being drawn into contemplative spirituality and now the Episcopal church.
How did you become addicted to opioids?
My addiction started with an extended hospital stay. I had a minor case of pancreatitis at the age of 25. My doctors weren’t sure why so they kept doing some procedures and tests. One of those went wrong and that was when I developed acute necrotizing pancreatitis. I was put into the ICU, given a 50/50 shot about whether I would live or die, and pulled through after about two months in the hospital. I was sent home on heavy doses of opioid pain medication.
Being on those drugs for that long, I moved from a simple physical dependence to a compulsive usage and addiction. I didn’t know how to process that experience for a long time, because so many of the models and the stories and the narratives I had in my head about addiction were wrong ones. They were stories about how only immoral people get addicted. If you get addicted, you must have done something wrong. It was through this journey and the blessing of having medical staff who understood the scientific and medical parts of addiction that I was able to find recovery.
Why did you decide to call your book Addiction Nation?
Typically, people approach addiction as if there is an aberrant group of individuals who have done or participated in something wrong. The more I understood about addiction, the more it was clear that addiction isn’t an issue of certain people, it is something that we have facilitated with our entire culture and our public policy. Our nation itself has its own addictions. That might be to our criminal punishment system, a rampant capitalism without restraint, our culture of constant consumption.
All of these things contribute to a culture that facilitates addiction. We have to work against those streams that so often draw people in. I wanted this book to be an exploration, not so much of the individual issues at stake, but of these broader cultural implications for the levels of addiction and overdose we see today. What does that say about all of us, not just the people who are caught up in the midst of it?
Is drug use a sin?
No. And the Bible’s pretty clear. Jesus used (and even created) a drug, alcohol. There was a big debate in the early church, in particular the Council of Jerusalem. Is it inherently sinful to eat particular foods? The answer was no. Then you have Augustine, who was in the midst of a battle of whether evil is a specific substance. He argued “no,” and the church agreed. Everything God created is good. Everything God created has a role and a purpose. The things that we call sinful or evil are not those things that God created. Sin comes with our relationship to those things.
In the hospital, I was on the chemical equivalent of heroin. It was called Dilaudid. In fact, it’s often referred to as “hospital heroin.” It was not a sin for me to be on that. It was lifesaving. My doctors said that if they hadn’t been able to manage my pain, I might not have survived. These chemicals were a blessing.
But just because something is good in one situation doesn’t mean we shouldn’t also be cautious and that it doesn’t have dangers. This is where we need a better theology of understanding of our relationship to drugs, to be able to say simultaneously this can be a good in a person’s life under certain circumstances and also be a danger.
We know that water is essential for life and it also can be dangerous. We do this with other substances where we have a cultural and political historical bias against specific substances that too often means that our policy is not based on science or even a consistent ideological approach, but just cultural biases often rooted in racism and anti-immigrant sentiment.
You mentioned your evangelical upbringing. What would you say to evangelicals who oppose even the legalization of marijuana, which is obviously safer than the drugs that you were making good use of?
First, I would quote the Bible. Don’t call anything bad that God has created and called good. Second, Jesus was clear when asked about Sabbath laws. Jesus said, “God did not make man for the Sabbath, but the Sabbath for man.” There is a role for laws in our society. But laws always have the purpose of human flourishing, and that is where we need to ask, “Are our laws around marijuana adding to human flourishing or detracting from it?” Based on the amount of people who have been locked up for this substance, I think the answer is clear.
Third, I’d ask if they know their history. Do they know why marijuana was singled out as a drug to be criminalized? It didn’t have anything to do with science and how marijuana affects our brains. It didn’t have to do with research around the substance. It had everything to do with a racist campaign focused on Mexican and Latinx people. It was about stirring up fear about people who didn’t look like the European immigrants who were in this country. It was based in our fear of the other, not in an understanding of the proper role for that substance.
But, again, so many people of faith consider drug use a sin. Where does that concept fit into this discussion?
This is where I think we need better language. I think it is imprudent and unwise for an individual to use, say, cocaine recreationally and it might lead to behaviors and broken relationships we would call sin. But if that same individual were to try the traditional usage of chewing some leaves from the coca plant while hiking in the Andes mountains, that certainly wouldn’t be a sin.
When we look at the origins of the last major usage of coca products in Coca-Cola, I don’t think it was a sin to use that. But I do think we have a very high responsibility to talk about prudence and wisdom. I’m not a parent, but if I were, I would definitely warn my children about the potential dangers of addictive substances and want them to have the best knowledge on how to make those decisions. Any kind of drug use, whether nicotine and alcohol or cocaine and heroin, has even higher risks for those under the age of 25.
What we have today is misinformation for young people. That is what’s most dangerous. They get misinformation from people about a particular drug as an evil substance, and then the first time they’re exposed to it—they see their friends using it or they’re offered some and they don’t see the dangers that they heard about from the authorities—then they just don’t trust the authorities at all. They don’t trust their parents at all. And I think that has led to a higher problematic usage rate than if we simply had the honest conversations about the realities of drugs. It’s the lying to young people that makes them lose trust, and we need to be honest about it.
Is addiction a disease?
I think the disease model of understanding addiction has really helped us move forward in understanding the physical, the neurological, and the medical ways of dealing with and addressing addiction. This is hugely important in shaping the ways that we can address addiction as a public health crisis. At the same time, I think we need to understand that there are also limits to any model for understanding a complex phenomenon. This is where I always try to be careful with my phrasing.
It’s important for people to always know that they are a part of their own recovery. There are some studies that have indicated if a person believes that their addiction is a disease that they can’t do anything about, they are less likely to enter into recovery than if they think they’re a full participant. The disease model is important, but it’s also not the only way, the only lens we should look at addiction through.
Is there any sense in which personal drug use should be considered a crime?
Not the use itself. But, as with other drugs like nicotine and alcohol, that doesn’t mean there aren’t restrictions or responsibilities. If your usage endangers or puts others at risk, that could be considered illegal or criminal. But that is drug usage plus a behavior, not usage itself.
Would you decriminalize all drugs?
Yes. I didn’t start at this place when I first started researching. Once I started seeing all the papers and the studies out there that made the case for decriminalization I was amazed at the level of evidence for its effectiveness at saving lives and reducing crime. It isn’t a “soft on crime” position, it is just smart policy.
Would you legalize all drugs?
I would be much more careful about legalization and what that looks like. A lot of people who think about legalization see this kind of Wild West with the availability of dangerous substances. It is important that we always communicate that that is not the approach. But should we look at programs like heroin-assisted treatment in Switzerland? Absolutely. It was creating a highly restricted and controlled program and environment for legal access to heroin. It destroyed the country’s black market for the drug, plummeted the crime rate, reduced overdoses, and the majority of the people on the program to begin with are now in recovery. We need to follow the science and the evidence, not our biases.
The reality is most people are dying from drug use because they don’t know what’s in their drugs. They don’t know the dosage. All these drugs are being sold on the black market. These crimes are happening because it’s black market. One of the ways to undercut the black market is to make sure that if someone is in the throes of addiction to a substance, they have safe and legal access to that substance in order for us to be able to reduce harm and give that person the opportunity, time and time again, to make that choice to enter into recovery when they’re ready.
What role then does punishment have when it comes to drug use, both in our criminal justice system and in the home?
One of the things I believe as a Christian is that the most transformative power in the universe is not punishment but grace. And I don’t think that that’s just true, uniquely true, about someone in the Christian tradition. I believe that what Christ revealed is a deep truth about how the world works and how people change. The primary mode of helping people change, the path to the most sustainable change, is not the outside imposition of a specific behavior, but the cultivation of a vision for what is a good and full life.
I think that is true about our criminal justice system. Addiction is a self-harming behavior by its very definition. Increasing the level of harm through punishment doesn’t change that behavior. It’s completely nonsensical to think that is going to work.
In the home, I think it’s important for parents to be able to talk with their kids about these issues, to set boundaries that are age appropriate for their children. But you also need to ask whether your parenting is going to be driven solely by fear for your child, or by the belief that you are trying to cultivate your children to make wise decisions on their own.
If you use fear and punishment to control your children in the home, are you setting them up to make decisions for themselves, for the rest of their life, in a way that makes sense? And are you as a parent going to be able to be a trusted person? Will they know that even if they make a wrong decision, they can go to you for help not having to worry about whether they will get kicked out of the home or whether this will end your relationship?
I’m not saying that is easy for a parent to do. But I’m saying it’s a place that they need to lean into.
What should churches and individual clergy be doing given the reality that we live in, as you say, an Addiction Nation?
One thing churches can do is give people a language to talk about a topic that we are often silent about. Addiction thrives in silence and shame. As soon as it’s brought out into the open, people begin to feel that they have the opportunity to admit the struggles they might have in their own life or in the lives of their families and friends.
Another huge piece, and it’s related, is to reduce the stigma. If we’re able to talk honestly about addiction, this facilitates recovery. When people feel the community they’re a part of requires them to be perfect, they are not going to be honest about their struggles.
Churches should be on the front lines of making sure that “justice rolls down like a mighty water, and righteousness like an ever-flowing stream.” They should mobilize to end a War on Drugs that is antithetical to everything that Christ taught and everything that Christ demonstrated on the cross.
When politicians hear people talking about ending the War on Drugs, or decriminalizing drugs, or legalizing certain drugs, they picture a libertine society devoid of all morals. The truth is just the opposite. We’re advocating for it because we have a deep moral compass. We’re advocating to end the War on Drugs because we care about human flourishing. We care about the dignity of every human life. And that’s what motivates us.
Rev. Alexander E. Sharp, Executive Director
(This interview has been edited for length and clarity. -Ed)