What is addiction? A Biblical Response
There are many philosophical views of addiction. The mainstream narrative surrounding addiction is that addiction is a brain disease. The Brain Disease Model of Addiction (BDMA) is a model developed as part of a campaign to reduce stigma (Heather, 2017). The BDMA was given notice and credibility after brain scans indicated neurobiological changes in brain chemistry after repeated drug use.
An increasingly complex BDMA was purported to lead not only to new treatment avenues for people with substance use disorders (SUDs), but also to a reduction of the stigma associated with SUDs, previously viewed as resulting from moral failure, not brain pathology.
The implied utility of the BDMA has yet to be thoroughly proven, for which little empirical support has been sought (Blithikioti, 2025). The NIH has published significant amounts of material suggesting that addiction is a brain disease, void of moral implications.
The problem with this is that removing moral implications removes a part of what it means to be human.
The NIH’s philosophical belief of what it means to be human is on full display in a booklet published in 2018 by the NIH says verbatim,
“In short, your brain is you-everything you think and feel, and who you are (National Institute on Drug Abuse, p. 14).”
To refer to James Sire’s worldview questions in his book, The Universe Next Door, when answering the question, “What does it mean to be human?” Sire says,
“To this we might answer: a highly complex machine, a sleeping god, a person made in the image of God, or a naked ape (Sire, 22).”
At best, the NIH’s statement would answer this question as either “A highly complex machine” or “a naked ape.”
However, the Bible declares humans are “made in the image of God (Gen. 2-3, ESV).” Christianity is far more honoring of human dignity and worth than secularists’ beliefs, who attempt to remove God from their understanding of humanity, reality, morality, and truth.
The BDMA (brain disease model of addiction) places emphasis on the neurobiological consequences of addiction, while dismissing the immaterial realities of the soul, the afterlife, and God. National secular thought leaders on addiction, such as the National Institute of Health, run the slogan, “Addiction is a brain disease, not a moral failure.”
The biblical worldview offers considerable flexibility and freedom in exploring empirical evidence, such as the workings of creation, the cosmos, and the human body— primarily because God has created it all, and it is fascinating to explore.
This is why a biblical worldview has no issue simply addressing the effects of drugs on the human brain (namely, the amygdala, prefrontal cortex, and basal ganglia). The issues here are not in science, neuroscience, or biology. The issue is the caveat, ‘…not a moral failure.’ Not only is the pathology of the effects on the brain cut exponentially short within the BDMA model, but the Biblical worldview cannot accept reducing human behavior and choices down to neurobiological impulses and the removal of moral responsibility.
Alan Leshner, then Director of NIDA (National Institute of Drug Abuse), asserts this in his BDMA manifesto,
“One major barrier (to closing the gap between scientific and public understanding) is the tremendous stigma attached to being a drug user or, worse, an addict. The most beneficent public view of drug addicts is as victims of their societal situation. However, the more common view is that drug addicts are weak or bad people, unwilling to lead moral lives and to control their behavior and gratifications. To the contrary, addiction is actually a chronic, relapsing illness, characterized by compulsive drug seeking and use.”
Leshner’s assertion that addiction is a brain disease and not a moral issue is positioned as a scientific proposition when, in fact, these are simply philosophical positions with serious philosophical and theological implications. One of the implications here is that humans are not morally responsible for their behavior, but are, in fact, victims. This contradicts the teachings of scripture. Another implication is that since people who are addicted are not morally responsible for their choices, then choice doesn’t really exist here.
If choice is removed from behavior and decisions, then the person doesn’t have agency, but is just a brain with neurobiological impulses making decisions for them, which can mean (1) they have no soul, but are just matter and biology, or (2) they are basically good people who do not need forgiveness for sins.
Even though Leshner positions his statements as sophisticated compassion, they are actually philosophical statements known as scientism.
Scientism is not science, but rather a way of interpreting data from a purely naturalistic perspective. Scientism adamantly refuses to acknowledge or consider immaterial realities, such as the soul, God, morality, and the human conscience. Scientism is the view that the hard sciences – like chemistry, biology, physics, and astronomy—provide the only genuine knowledge of reality and are vastly superior to what we can know from any other discipline, such as theology or philosophy.
J.P. Moreland says in his book Scientism and Secularism,
“…scientism is not science, but philosophy. Now we can go a step further and say that not only is scientism not science, it is not even a friend of science, but rather its enemy (Ibid, 55).”
Scientism is a worldview that derives from naturalism.
Think of naturalism as the idea that everything in the world happens because of natural things and natural laws, like gravity, biology, or chemistry, but not because of God or any supernatural forces. It means that when we want to understand why things are the way they are, we seek real, natural explanations that we can observe, test, and verify.
In simple terms, naturalism says: “Nature is all there is, and it works in ways we can figure out.”
Naturalism is a philosophical perspective on how to interpret reality and the world around us.
Naturalism assumes atheism.
Worldviews are, indeed, a matter of the heart and the mind. The biblical concept of the heart encompasses wisdom (Prov 2:10, ESV), emotion (Ex. 4:14, John 14:1, ESV), desire and will (1 Chron. 29:18, ESV), spirituality (Acts 8:21, ESV), and intellect (Rom. 1:21, ESV).
With that being said, how we interpret addiction is based on the worldview we are interpreting from. Worldviews inform some of life’s biggest questions: (1) What does it mean to be human? (2) What do I do with suffering? (3) Who is God? (4) What is the meaning of life? (5) What is truth?
The answer to these questions flows from the heart.
In biblical terms, the heart is the central defining element of the human person. It is from this heart that all one’s thoughts and actions proceed. Since we believe this, and since this is what the Bible teaches, then Christians understand addiction as much more than a neurobiological disease.
Is saying, “addiction is a disease, not a moral failure,” truly helpful? Or is it harmful?
“The moral model of addiction is now unpopular, and those who subscribe to the disease model would argue that it is not primarily a matter of moral culpability that one suffers from the disease of addiction (Cook, p. 20).”
First, let’s begin with this: addiction is complex because humans are complex.
As stated above, the Bible teaches that humans are created in the image of God, with a soul, free will, a brain, a mind, and a body. The Bible is also clear on its moral stance on addiction when addressing ‘drunkenness’ as a work of the flesh, which Paul instructs believers to put to death (Galatians 5:19-21, ESV). Drug abuse would fall into the category of drunkenness due to the nature of not having a sober mind.
For Augustine and Aquinas, drunkenness was understood primarily as failing to contribute to the ultimate good. For Augustine, it represented a failure to strive to please God alone. For Aquinas, it was an impairment of human beings' ability to fulfill the rational function for which they were created. With all that being said, the church has interpreted the fundamental sin of addiction and has historically viewed it as a moral dilemma up until the nineteenth century, when new medical conceptions of addiction changed (Cook, 2006).
Even though we recognize that there are sin implications, the Biblical worldview does not, or should not, only provide help for people struggling with addiction by identifying their sinful patterns.
Often, counselors in this industry bounce between a secular humanistic perspective, suggesting that humans are inherently good and that their poor behaviors are caused by biology, to a poorly handled, rigid religious response that does not acknowledge the body or the mind, but only focuses on the depravity of man when considering behavior and choice.
Both are unhelpful.
One reduces human behavior down to biology, removing the reality of the soul and choice, which is condescending to the Imago Dei; while the other produces a form of religiosity that is unloving and shame-inducing, often perpetuating the behavior.
A genuine biblical approach acknowledges the needs of the body and how it affects the mind; it cares for the pain that has been inflicted on the individual; and holds the individual morally accountable before God, with the Gospel as the source of relief. Biblical compassion, love, and charity should be demonstrated by addressing a person’s emotional, mental, and physical needs, as well as acknowledging the reality of sin and eternity.
Understanding addiction psychologically [the mind] with a biblical worldview:
There are various psychological reasons people choose to pick up a substance, such as trauma, faulty belief patterns, etc. Biblical compassion and the command to long-suffer with one another (Eph. 4:2, ESV) and carry each other’s burdens (Gal. 6:2, ESV) would require that the issues of trauma and faulty beliefs be carefully and gently addressed.
The psychological reality of addiction is that it is an avoidance disorder, a mechanism to escape the suffering of this world. Suffering comes in many forms: sins committed against us, sins we have committed, and the naturally fallen nature of this world, which includes illnesses, death, and disease.
Addiction is also a bonding disorder, characterized by the individual bonding to a substance rather than others and God. According to Genesis, chapters 1-3, humans are created to be in a relationship with God and others; however, in active addiction, individuals choose instead to be in a relationship with a substance. This is why, ultimately, addiction is a form of misguided worship, or idolatry.
Many sins are committed while intoxicated, such as stealing, sexual deviance, lying, etc., but the sin of addiction, at its foundational source, is having a relationship with a substance in a way someone should be having a relationship with God.
Since the biblical narrative teaches the complexity of humanity, the Christian worldview would adopt a ‘nature, nurture, choice’ approach, which acknowledges both neurobiological consequences and psychological reasons.
The biblical narrative also portrays individuals as capable and morally responsible, teaching the reality of the soul, the need for salvation, and the justice and mercy of God.
It is not helpful to not acknowledge sin and guilt.
There are many injuries that happen in active addiction, such as emotional injury, physical injury, as well as moral injury. Moral injury is a clinical term that is gaining more attention in the clinical field.
Moral injury (MI) was initially conceptualized in a study of those in the military suffering from PTSD. MI was defined as “Perpetuating, failing to prevent, or bearing witness to, or learning about acts that transgress deeply held moral beliefs and expectations (Grimel, 2018).” The clinical discovery of moral injury (MI) is further evidence of the reality of our God-given conscience and that God’s moral laws are written within each person.
The reality of the soul and conscience means that humans have God-given feelings of guilt when moral laws are broken, whether it is due to perpetuating sin, witnessing sin, or failing to stop sin.
The Bible has made it clear that we have all been given a conscience of the reality of the moral law, which is why no one will be without excuse (Romans 1:18-20, ESV).
Biblically, moral failures (using the verbiage of the National Institute of Health) will affect the conscience either by shame or guilt; and to never deal with this type of ‘injury’ is not caring for the entire person (the soul).
These feelings of guilt are given by God and are ultimately there to drive us to Christ for salvation, which is for our good: “For God has consigned all to disobedience, that he may have mercy on all (Romans 11:32, ESV).”
As outlined in the moral injury study, with the acknowledgment of their moral injury (biblically, we can call it ‘guilt’), and receiving spiritual forgiveness, the soldiers suffering with PTSD were able to have better outcomes.
The BDMA model asserts that reducing stigma is a way to remove the uncomfortable feelings of guilt. However, according to the Bible and psychological research, removing necessary guilt is harmful to the person for several reasons:
(1) it does not acknowledge the needs of the soul by not acknowledging moral injury (feelings of guilt from sins committed, seen, experienced),
(2) it ultimately removes the need for Christ and makes the Gospel pointless, and
(2) it can produce a victim mentality, narcissism, selfishness, and self-centeredness, which ultimately produce spiritual and relational isolation.
“The bad psychological material is not a sin, but a disease. It does not need to be repented of, but to be cured (Lewis, p. 91).”
“Spiritually, addiction is a deep-seated form of idolatry. The subjects of our addictions become our false gods. These are what we worship, what we attend to, and where we give our time and energy, instead of love. Addiction, then, displaces and supplants God's love as the source and object of our deepest true desire. It is, as one modern spiritual writer has called it, “a counterfeit of religious presence.” – Dr. Gerald May, Psychiatrist and Author of Addiction and Grace, p. 13
The Church should consider these narratives critically, recognize their influences, and weigh them against scripture, ultimately to be rejected. Many of the mega-narratives in the industry have not only proven that they do not align with a Biblical worldview but are exaggeratedly positioned as unquestioned truths within this industry.
There are also many experts in the fields of addiction science, neuroscience, biology, medicine, and philosophy who disagree with the BDMA’s assertions. However, naturalistic and secular worldviews dominate the natural sciences and humanities, so they either ignore Christian claims or attack them forthrightly (Groothuis, 277).
However, God's love persists, providing hope and a pathway toward redemption, enabling individuals to reclaim their lives and relationships in a way that honors their innate dignity as beings created in the image of God and being in right relationship with their Creator.