Substance Abuse and Dependence

“No temptation has overtaken you except what is common to mankind.
And God is faithful;he will not let you be tempted beyond what you can bear.
But when you are tempted, he will also provide a way out so that you can endure it.”
1 Corinthians 10:13

What Is Drug or Alcohol Abuse or Dependence?

There are many terms that are used interchangeably to define the overuse and misuse of substances like illegal and prescription drugs and alcohol. Because the term “addiction” is targeted by many with questions about biology, genetics, etc., the terms dependence and abuse are more commonly used. Still, to understand what dependence and abuse mean, let’s tease those out a bit more.

Dependence upon a substance (including any of those listed above), would be defined as a state in which the individual uses the drug so frequently and consistently to the point where it becomes difficult for the person to imagine, or experience, getting along without use of the drug. Abuse, on the other hand, applies to situations in which drug use either causes problems or increases the likelihood of problems. It’s important to keep in mind that someone can be dependent upon or abuse substances that are legal, such as stimulants like Adderall, pain medications like Xanax, or even over-the-counter medications like Benadryl. It is not the legality of a substance that makes it possible to depend upon it or misuse it; instead, it is the purpose for which one uses it, the frequency of its use, and the effects of its use that lead professionals to use these terms.

Keeping this in mind, then, we will use the term abuse throughout this article to describe an unhealthy use of substances in one’s daily life.

Why Would Someone Abuse Drugs or Alcohol?

There is a complex interplay of circumstances and relationships that factor into drug-taking behavior. It is important to consider how a person who is abusing drugs feels in relation to parents, friends and acquaintances, to the community, and to events that occur in his or her life. The college years have unique challenges and stressors that can contribute to drug/alcohol abuse. Oftentimes, the motivation for drug and alcohol abuse may come from any or all of the following reasons:

  • a desire to forget;
  • an attempt to cure self-consciousness and timidity;
  • to avoid pain;
  • to fill holes in one’s self-image;
  • to manage emotions;
  • to fit in with others;
  • to prove to oneself that he can do what he wants (and no one can tell him what to do); or
  • to keep loneliness at bay.

Is Substance Abuse a Physiological or Spiritual Problem?

When counseling from a biblical perspective, it is important to look at a person’s thought patterns and the resulting behaviors. An essential task also involves examining the perspective he or she has regarding the interaction of these behaviors and patterns with the scriptures and with his or her relationship with Christ. Much of the secular world views addiction as a disease that is best viewed from a physiological perspective. However, more and more, Christian theologians point to the essential view of examining recovery through a spiritual lens. Our theology indeed makes a difference toward our ability to recover and experience healing from substance abuse. “Addictions are ultimately a disorder of worship. Will we worship ourselves and our own desires or will we worship the true God?” The suffering person must ask himself, “Who is my master, God or my desires? Do I desire God above all else?” (Welch, 2001, p 23). In short, substance abuse represents reliance upon something other than Jesus Christ in meeting one’s needs and providing the strength to navigate the daily challenges of life.

That is not to say that this spiritual problem is also not physiological. Indeed, there are many real physical problems associated with substance abuse. Thus, the answer to the question, Is this a physiological or spiritual problem is, “It’s both.”

Is Drug and Alcohol Abuse an Incurable Disease?

It must be said that the disease model which places such strong emphasis on the physical aspect of addictions is not without merit. However, possible physiological tendencies do not mean that self-control is impossible or that personal responsibility is diminished. They simply mean that some people must be more vigilant in situations where that sin can be easily provoked. And although as Paul says in Romans 7 that we do the very thing we do not wish to do (over and over again), the sin we practice, though we feel powerless to change, teaches us to believe lies.

So can our unique biological design make us predisposed to substance abuse or dependence? Most researchers agree that we can be genetically predisposed toward addictive-type thoughts and behavior patterns. However, a biblical view would contend that, although this influence may be very real, there is a great difference between influence and the viewpoint that biological make-up determines one’s behavior. Influence does not mean self-control is not possible, or that we can throw personal responsibility out the window. It more accurately suggests that we are all predisposed to certain sins over others, and we need to guard ourselves against situations that may more easily lend themselves toward falling to temptation and sin. We must avoid triggers when possible, and be prepared with a battle plan of how to handle our response to triggers that are unavoidable, or that come out of nowhere to blindside us.

In her classic Praying God’s Word, Beth Moore what looks like a seemingly incurable affliction in our lives is rather a stronghold pretending to be bigger and more powerful than God. 2 Peter 2:2-3 states, “Grace and peace be multiplied to you in the knowledge of God and of Jesus our Lord, as His divine power has given to us all things that pertain to life and godliness, through the knowledge of Him…” So liberation for those who suffer from substance abuse comes through complete and absolute dependence on the person of Jesus Christ, apart from anything else that may deceitfully pretend to provide that peace and comfort we so desire.

That is not to say that treatment for a stronghold like this is not helpful, needed, or wise for those struggling with substance abuse. On the contrary, complete and absolute dependence on the person of Jesus Christ is often the very thing that leads us to ask for help from those safe people with training and experience who can walk with someone struggling with these issues. Thus, it is often essential to one’s healing that he or she surrender to the Lord and find help in a therapeutic relationship.

How Do I Know If My loved One Has a Problem?

Problems associated with substance abuse include changes, vocational difficulties, academic struggles, social and family dysfunction, and physical concerns. It is often hard for someone to admit that he or she has a problem due to the shame and fear of judgment associated with substance abuse. He may choose to think he is a social drinker, or she may prefer to think she abuses her prescription medication for ADHD only when she is stressed and needs to be productive before final exams. This is called denial, which occurs when a person refuses to admit, or even consider, that he or she might have a problem with drugs or alcohol.

Sometimes people are able to keep their substance abuse a secret, but often at least some changes are noticed by those closest to them.

Some physical changes associated with substance abuse include*:

  • Bloodshot eyes
  • Changes in appetite or sleep
  • Weight changes
  • Unusual smell on one’s breath, clothes, or in one’s room
  • Tremors
  • Slurred speech
  • Poor coordination

Behavioral signs of substance abuse include*:

  • Attendance or performance in work or classes change
  • Unexplained financial problems or requests for money
  • Secret or suspicious behavior
  • Changes in friends, hangouts, or hobbies
  • Frequently fighting with others

Finally, psychological signs of substance abuse include*:

  • Neglecting responsibilities in one or more areas of life
  • Legal problems
  • Relationship problems
  • Personality changes
  • Lack of motivation or lethargy/”spacing out”
  • Sudden mood swings
  • Fearfulness, anxiety, or paranoia with no apparent cause
  • Life revolves around substance use
  • Activities previously enjoyed have been abandoned

(Items marked with * were adapted from

What Can I Do?

If you know or suspect that someone is abusing substances, it is important to proceed with empathy, honesty, and respect. Remember that someone abusing a substance is ashamed or feels guilt about the abuse, which may lead to defensiveness or outright denial. He or she will not feel loved or supported by your judgment, frustration, or criticism.

We would first encourage you to pray about what to say, seeking the Lord’s counsel on your word and the timing of that conversation. Talking to your loved one is a powerful way of showing love for him or her. Those who are aware of the substance abuse but either deny that a problem exists or lack the courage to confront the individual and assist him or her in seeking treatment and intervention becomes an enabler of the problem itself. Therefore, we encourage you to speak the truth in love since many who have abused a substance later felt appreciative that someone took the step to address the problem directly.

If you have prayed about talking to the individual and feel led to do so, the following tips may be helpful to you:

  • individual’s privacy.
  • Use “I” language instead of “you” language may make the conversation proceed more smoothly. For example, you might say, “I am concerned because I’ve noticed some changes in you, and I wanted to ask if anything had been troubling you or if you needed any help.”
  • Express why you are concerned. “I feel pain watching you suffer and struggle. I care about you and want to see you find happiness and live in freedom.”
  • Be specific, noting the actual changes you have observed. Now is not the time for being vague or walking on eggshells. If the person thinks no one has noticed, the abuse may continue.
  • Suggest that he or she finds help. “I think this is a problem that a counselor would be able to help you with. Would you be willing to make an appointment at Counseling Services or someplace off campus?”
  • Offer to help them get help. “I would be glad to be present if you talk to your parents/make a counseling appointment/etc.”
  • Remember that you cannot provide treatment. You are not your loved one’s savior, nor can you take on the burden of solving her problems while trying to surrender yours to the Lord.
  • Show concern without nagging. Feel free to follow up on how he or she is doing or how counseling is going, but be sure to show interest and care about other parts of his or her life, too.
  • Commit to praying for that person.

What Are the Options for Treatment?

The first step in seeking treatment for substance abuse is to make an appointment with a trained professional. Counseling Services has trained professionals with experience in treating substance abuse issues, and we use a biopsychosocial model. Simply put, we agree that there are multiple pathways, through biological, psychological, and social factors, that can contribute to substance abuse.

Whether or not someone would readily admit or feel certain that he or she has a problem with substance abuse, it would be wise to seek an assessment from a qualified professional. Our counselors can administer either a simple questionnaire that serves as an assessment tool to help someone determine if he or she has a problem or can offer a more thorough professional intervention that may involve ongoing counseling.

What Should I Know about the Treatment Process?

One important aspect of the counseling process includes having the suffering individual share as much as he or she can about family history. It is important for both the person and the counselor to have a more thorough understanding of the family dynamics. Through the counseling process, the counselor will work to help the client understand what factors have led to substance abuse. This is known as identifying triggers, which will assist someone in knowing what people, places, or things trigger temptation to abuse a substance. Additionally, we will work to help the client connect with other resources to help him or her find lasting freedom and support in maintaining sobriety.

Finally, some individuals who have admitted they have a problem with substance abuse seek help through Alcoholics Anonymous (AA) or Narcotics Anonymous programs (NA). We support these options, and we also endorse an alternative developed by the Christian community that is modeled after these groundbreaking twelve step programs. Celebrate Recovery offers hope and healing by helping individuals recognize the hurts, hang-ups and habits that have damaged their lives in one way or another. Through use of the scriptures, and particularly the Beatitudes, Celebrate Recovery not only helps people recover from past sins and hurts, but teaches them to make the choices that will assist them on their journey of becoming more Christ-like in character.


Addictions: A Banquet in the Grave; Finding Hope in the Power of the Gospel by Edward T. Welch (2001)

The biggest barriers to overcoming the grip of addiction are misplaced worship, and idolatry. Ed Welch contends this is due to a heart issue. This book is filled with many scriptures that can provide life application for one’s desire to be free from addiction. Welch shares how a biblical view toward sin, salvation, and sanctification must replace the addict’s cycle of sickness, recovery, and relapse.

Praying God’s Word: Breaking Free from Spiritual Strongholds (of relevant help will be pages 127-146) by Beth Moore (2000)

Beth Moore calls addiction a stronghold, defining a stronghold as something that pretends to be bigger and more powerful than our Lord. She exhorts those who battle addiction to focus upon three areas in their relationship with God: time, trust, and cooperation. As is the case with any of the strongholds she addresses in the book, Moore offers scripture prayers to help those struggling, to claim the power of the Word to equip them in their battle to break free.

Freedom from Addiction: Breaking the Bondage of Addiction and Finding Freedom in Christ by Neil T. Anderson (1996)

Neil Anderson addresses the cycle of addiction, and shares the amazing story of Mike and Julia Quarles. By describing Mike’s path to recovery, through realizing his identity in Christ, the author shows how one can apply principles that will lead the addicted person to see his or her identity in a new light.

Drugs, Behavior, and Modern Society by Charles Levinthal (2010)

This textbook is an excellent reference source. It is used for a course that is taught here at Cedarville. It goes into detail regarding five areas: Drugs in Society/Drugs in our Lives, Legally Restricted Drugs in our Society, Legal Drugs in our Society, Medicinal Drugs, and Treatment, Prevention and Education.

Web Resources

Celebrate Recovery

“Over 700,000 people have gone through the Celebrate Recovery program in more than 17,000 churches worldwide. Celebrate Recovery is a program designed to help those struggling with hurts, hang-ups, and habits by showing them the loving power of Jesus Christ through the recovery process.” - from Celebrate Recovery’s website

“Helpguide was launched in 1999, inspired by our belief that… access to unbiased, reliable information [gives] a sense of hope and direction. Since then, this website has grown from a small local project to an internationally recognized resource serving over 50 million people a year.” - from Helpguide’s website

National Council on Alcohol and Drug Dependence, Inc.

“NCADD Affiliates offer a range of services including help for individuals and family members. If you are concerned about your own alcohol or other drug use or that of someone you care about—a child or other relative, a friend or co-worker—please make the contact. You will be able to speak to someone who will listen, assess your needs and provide information about available services, costs and how to deal with another person’s alcohol and/or drug use. Help is just a call or visit away—Make the contact now!” - from NCADD’s website

National Council on Alcohol and Drug Dependence, Inc. - Alcohol Self-Assessment

This is a self-assessment of one’s alcohol use to be used as an initial step in determining if he or she has a problem that warrants therapeutic help.

National Council On Alcohol and Drug Dependence, Inc. - Drug Self-Assessment

This is a self-assessment of one’s drug use to be used as an initial step in determining if he or she has a problem that warrants therapeutic help.