As we drove through the mountains, my mom hummed nervously, maybe excitedly, to the sounds coming from James Taylor’s guitar while she gripped the steering wheel. I glanced out at those stiff white peaks from the passenger seat. They looked like the meringue we used to make with my grandmother at Christmas every year. I felt anxious, and I fiddled with the lining of my sweatshirt. My dad and stepmom drove separately in the car ahead of us. We followed them along those winding mountain roads for what felt like forever. We parked and exited the car, stretching our legs and our arms from the drive.

It was family day at rehab. We had not seen my brother—their son—in over a month. He was there detoxing and recovering from his addiction to heroin. This was his first time in rehab, but it would not be his last. Watching my brother’s experience of addiction and observing its impact on my family have forced me to confront challenging questions, both as the sibling of someone who has walked the hard path of addiction and as a Christian and theologian who has chosen to consider the intersection of theology and addiction.

Whenever I tell someone that my work in theological ethics focuses on addiction, I invariably get one of two responses. Some people ask with surprise how theology relates to addiction, and others tell me stories about how they or those they love struggle with addiction. Their stories are always difficult to hear—parents recount burying their children who accidentally overdosed, spouses describe leaving their partners because their relationships became unsustainable under the weight of excessive substance use, friends and relatives question whether their tough-love approaches will help or permanently damage their loved ones. It seems as though everyone knows someone that addiction affects, and statistics increasingly demonstrate this: overdose is now the leading cause of injury-related death in the United States, outpacing deaths caused by car crashes and firearms.1

As a theologian, I wonder how the Christian tradition can inform what it means to care for others who are suffering from addiction. Bill Wilson and Bob Smith probably wondered the same when they founded Alcoholics Anonymous (AA), the first of many twelve-step programs to blend spirituality with recovery. Often, these twelve-step programs take place in church basements, where coffee and cigarettes perfume the air.

It is good for churches to provide these spaces. Programs like AA help people, especially those who find its philosophy personally enriching. Even as the exact success rate of AA is notoriously difficult to measure, with some estimates as low as 5 to 10 percent and others as high as 31 to 35 percent, it is valuable that the program can work for some people or at least offer a sense of community and a place where people are able to tell their stories.2 Indeed, twelve-step programs existed for people when risky substance use was otherwise neglected by medicine and psychiatry, and they still offer a necessary refuge from the stigma that people dealing with addiction so often encounter.3 All of this is commendable.

Nevertheless, I am somewhat ambivalent about these programs. Researchers and social commentators have observed that the twelve steps unify powerlessness and personal responsibility, potentially blurring the lines between moralism and biological determinism. That is to say, twelve-step programs use medical language to categorize addiction as a biological disease while simultaneously suggesting that overcoming addiction requires turning one’s life over to a “Power greater than ourselves” and making a “moral inventory”—admitting to God, self, and another person “the exact nature of our wrongs” while asking God to remove these “shortcomings” and “defects of character.”4 In so doing, these programs often convey the contradictory message that although people are powerless over their pathologies, they are personally responsible for overcoming them.

Yet this moralistic focus on the role of personal sinfulness often fails to account for ruptured relationships between self, God, and others and therefore diminishes our sense of the theological reality of sin. Indeed, sin and suffering are often causally linked in both theological circles and the popular imagination. The belief that our suffering is God’s punishment in retribution for our sinfulness is pervasive. Focusing on addiction as an individual sin plays into this narrative and exacerbates feelings of stigma and shame, which then only drive people further into their addictions. Furthermore, this messaging ignores the social forces that power the addiction crisis.

These flaws have pushed me to consider whether Christian churches have more to offer those struggling with addiction than empty church halls and complimentary coffee. Looking at addiction through the lens of social sin may be a more productive approach in confronting the crisis, as the framework of social sin helps to disclose the political and ideological barriers that further addiction, stigma, and shame.

Alistair McFadyen helpfully reminds us that the language of sin must always be primarily theological; that is, it must express something about our relationship with God. He laments that “where the terminology of sin remains in public use, it tends either to be trivialised or deployed as an emotive device for passing judgment and attaching blame” rather than used as a way to understand how personal and social forces alienate us from God.5 McFadyen’s work is particularly helpful for a theological analysis of addiction because he offers two important reflections on sin: first, the language of sin is inherently theological—it speaks to our relationship to God and should not be used merely as a synonym for culpability—and second, social sin can profoundly affect an individual’s relationship to self, others, and God. In instances of addiction, social sin includes the stigmatization and marginalization that inhibit many people from receiving care. With McFadyen’s analysis in mind, it is important to consider the ways in which churches can help individuals who face the effects of such social sin.

For people of faith, God’s love, mercy, and grace are mediated through the church. In the incarnation, God communicates this love to all of creation. It is a love that is capacious and fecund. Paradoxically, God’s love is both universal and preferential. God shows special concern for the poor and the marginalized. In the Gospels, Jesus teaches us what the kingdom of God is like through his telling of the parables, and in those parables we learn that God is always a God of surprises. At the center of the Christian faith is a man who healed the sick; practiced tableside fellowship with sinners, tax collectors, and sex workers; and took on all of our suffering in order to transform it.

Jesus provides us with a double love command: to love our neighbors as ourselves and to love God with all of our heart, mind, and soul. By combining these commandments, Jesus teaches that these two things are the same. To love one’s neighbor is to love God. Thus, responding to God’s self-communication is a profoundly social task. Christopher Vogt contextualizes this claim for a contemporary audience by examining the “radically inclusive” biblical category of “neighbor,” which he notes includes all of those who are socially marginalized.6 Vogt maintains that Christians should “recognize the addict as neighbor” and respond to the ostracism, social marginalization, and stigmatization often experienced by people suffering from addiction. Christians can help people living with addictions by working toward reintegration and reconciliation through the practice of hospitality and works of mercy. In the ministry of Jesus, healing involves both the restoration of bodies and the restoration of relationships. Healing requires bringing those on the margins into the fold. It is no coincidence that Thomas Aquinas spoke of grace as healing.7

Churches should articulate a preferential option for people suffering from addiction. The language of a preferential option for the poor was originally articulated and developed by liberation theologians, and it is an important principle of Catholic social teaching today. A preferential option puts the needs of the most marginalized above all other concerns and emphasizes God’s partiality for those who suffer. People living with addictions comprise a large portion of the people who are pushed to the margins of society, where they often experience stigmatization, abandonment, and rejection. Church institutions can help to enact this preferential option by offering mercy, hope, forgiveness, and grace to those suffering from addiction.

But what does this mean when put into practice? A preferential option for persons with addiction requires more of churches than the generosity of space for twelve-step meetings. The donation of such spaces is but a single and relatively small dimension of the holistic treatment required by those struggling with addiction. Although individual churches cannot provide medical care, they are able to care for the overall health of people living with addictions. Priests and pastors can help to destigmatize addiction by mentioning it in their sermons. Churchgoers can organize advocacy programs and training programs for the administration of naloxone, which can be lifesaving in the event of an opioid overdose.

Another option for congregations is to offer pastoral support to people suffering from addiction and to the friends, family, and loved ones who often experience caregiving to be a burden or anxiety. Christians could volunteer on rotating schedules to help these individuals with childcare or making food for their families. Churches could also have information about addiction on hand to distribute to anyone who might need it. The Archdiocese of Boston, for example, now offers such addiction recovery and pastoral services through workshops, educational assistance, recovery support groups, and meetings that incorporate prayer and awareness for those suffering from addiction and their loved ones.8

Finally, and perhaps most importantly, churchgoers can accompany those who are struggling with addiction. Accompanying those who suffer is one way of imitating God who never abandons us and who is always nearer to us than we are to ourselves. Accompaniment can take many different forms, but it requires walking alongside those who are anguished and in need of healing. James Keenan describes mercy as the “the willingness to enter into the chaos of another.”9 Christians are invited to practice mercy and to accompany those who have addictions. Beyond what churches are doing with twelve-step groups, entering into the chaos of those affected by addiction entails accompanying persons with addictions into the messy ambiguities of their lives. It requires making ourselves vulnerable to those who are vulnerable to us. The scriptural imperatives to love are not abstract sentimentality. The life, death, and resurrection of Jesus show how radical, unconditional love manifests itself in a world broken by sin. God’s scandalous and ever-surprising love for all of creation calls upon the Christian community to go and do likewise. The mercy we must practice by accompanying people with addictions demands that we engage in the difficult work of loving those who suffer deeply and allow ourselves to be moved by them.

It’s been almost ten years since we first made that drive out to the mountains. My brother is currently doing well, though he is constantly reminded that his story could have ended much differently, much sooner. He has since moved out west, where that crisp mountain air is ubiquitous. Instead of looking out at the mountains from a rehab facility, he hikes them regularly. I am happy that things turned out so much better for him, but I know there are so many people who continue to suffer. The pervasiveness of addiction demands a more robust response to the problem. Christian communities are particularly well equipped to support, educate, and accompany people with addiction and their loved ones. To imitate God, Christians are called to mediate mercy and grace to the most marginalized.

  1. See Rose A. Rudd, Noah Aleshire, Jon E. Zibbell, and R. Matthew Gladden, “Increases in Drug and Opioid Overdose Deaths—United States, 2000–2014,” Morbidity and Mortality Weekly Report 64 (January 1, 2016): 1378–82,
  2. Keith Humphreys, “Here’s Proof that Alcoholics Anonymous is Just as Effective as Professional Psychotherapies,” Washington Post, June 9, 2014,; Lance Dodes, “With Sobering Science, Doctor Debunks 12-Step Recovery,” interview by Arun Rath, NPR, March 23, 2014,; “Is There an AA Success Rate?” Hazelden Betty Ford Foundation, July 24, 2016,
  3. Jessica Gregg, “Doctors Should Pause Before Dismissing the ‘12 Steps’ Approach to Addiction,” Washington Post, March 18, 2016,
  4. “The Twelve Steps,” Al-Anon Family Groups, 1996,
  5. Alistair McFadyen, Bound to Sin: Abuse, Holocaust and the Christian Doctrine of Sin (New York, NY: Cambridge University Press: 2000), 11.
  6. Vogt, “Recognizing the Addict as Neighbour: Christian Hospitality and the Establishment of Safe Injection Facilities in Canada,” Theoforum 35, no. 3 (2004): 323.
  7. See Aquinas, Summa Theologica 2.109.3.
  8. See Archdiocesan Addiction Recovery Pastoral Support Services,
  9. James Keenan, “The Scandal of Mercy Excludes No One,” Thinking Faith, December 4, 2015,