Too many options, too little purpose

As the synthetic opioid crisis in America enters its second decade, many of us have grown numb to the grim statistics that chronicle its toll. Over the past 12 months, around 110,000 Americans have died of drug overdoses—nearly 300 per day—the vast majority triggered by synthetic opioids like fentanyl. One shocking recent story, however, put an exclamation point on this data: a 1-year-old child in New York City died after being exposed to fentanyl hidden under the sleeping mat at his daycare nursery. But the fentanyl epidemic is only one of many forms of addiction that seem to be destroying lives and communities throughout America. How should Christians make sense of this crisis?

We are often pulled in two directions when it comes to addiction. On the one hand, as Christians, we should be moved to compassion by the sight of anyone suffering in such bondage—a vivid picture of the bondage of sin that all of us experience. On the other hand, we may be keen to resist our culture’s tendency to portray addicts as one more category of helpless victims. In the face of the opioid crisis, much attention has focused—and rightly so—on the evils of pharmaceutical companies that grew rich off selling addictive drugs, but this may leave us wondering if we aren’t downplaying the personal responsibility of individuals who knowingly allow themselves to become enslaved to addictive substances. Is addiction a disease (the dominant category in public discourse today), or a choice?

If the former, it is best solved by medical experts with their treatments and techniques, with the addict reduced to little more than a patient on a gurney. If the latter, it requires confrontation, repentance, and the hard work of sanctification. The same analysis also applies if we widen our lens to society as a whole, rather than the individual addict: Is the opioid crisis a disease afflicting the country that demands a treatment by technocrats, or is it the symptom of a spiritual crisis that must be dealt with at the root?

For a powerful analysis that cuts through this false dichotomy, Christians could not do better than revisit a brilliant book from 2011 by Kent Dunnington, Addiction and Virtue. In it, Dunnington argues that the disease-versus-choice binary ignores the mediating category of habit that stood at the center of premodern moral philosophy and moral theology. When we do things by habit, we are still the agents of our actions, but often not consciously or purposefully so. Indeed, a habit can become so engrained that our rational mind wants to act differently, but cannot seem to manage it (as Paul famously described in Romans 7).

It may seem trivializing to frame something as powerfully enslaving as fentanyl addiction as merely a bad habit, but that is not the point. The point is that, as many addiction counselors know, it is rarely enough to treat the chemical and physiological aspects of the addiction; the addict must also break out of the mental and psychological grooves that drive him to the substance. And, contra the disease model, he does have some choice in the matter. As Dunnington writes, “addicted persons do indeed lack the resources necessary to exercise enduring control over their addictive behavior but nevertheless possess the resources to act indirectly in such ways as to eventually develop the habits needed to make such enduring control a reality.”

Dunnington argues, moreover, that it is a mistake to think of the addict as guilty of intemperance: the alcoholic is not someone who cannot control his love for the pleasure of alcohol, but someone who cannot stop drinking alcohol even though it gives him no pleasure. Chronicling the experiences of many addicts, he highlights the disconnect between sensory pleasure and the continuing pull of the addiction. What then is it that addicts seek? Here he proposes a profound insight, although one that would not have surprised our ancestors: addiction is the pursuit of a psychological or spiritual good, the response to a lack much deeper than the brain’s urge for chemical stimulants.

Many moderns, especially after the rise of digital media and the decline of public Christianity, find themselves inhabiting a world with too many options and too little purpose, a fragmented reality in which any number of goods and “experiences” are on offer but in which there is no connecting thread to make sense of them. “Modern persons,” writes Dunnington, “no longer know what to do because they know all too well how many things they could do.” Traditional cultures offered commitment as an antidote to such paralysis, providing a pathway of stable and consistent behavior, but our society has declared war on commitment. Therefore, “addictions have become substitutes for commitment in our culture … a release from a welter of responsibilities that lack a unifying rationale.” The addict, at least, has found a common thread to guide his actions, a groove to travel in, dark and deadly though it may be.

Confronted with an epidemic of addictions, we are tempted to respond by blaming China, cartels, or pharmaceutical companies, by highlighting the damage wrought on communities by de-industrialization. All of these are part of the problem, and must be vigorously addressed. But we will find ourselves playing whack-a-mole with addiction unless and until we can fill the gaping emptiness at the heart of contemporary culture.