Ambitious Research Plan to Help Solve the Opioid Crisis

From the blog of Dr. Lora Volkow, National Institute on Drug Abuse Posted June 12, 2018

NIDA Banner Science of Abuse and Addiction

In spring 2018 Congress added an additional $500 million to the NIH budget to invest in the search for solutions to the opioid crisis. The Helping to End Addiction Long-term (HEAL) initiative is being kicked off June 12th with the announcement of several bold projects across NIH focusing on two main areas: improving opioid addiction treatments and enhancing pain management to prevent addiction and overdose. The funding NIDA is receiving will go toward the goal of addressing addiction in new ways, and creating better delivery systems for addictions counseling for those in need.

NIH will be developing new addiction treatments and overdose-reversal tools. Three medications are currently FDA-approved to treat opioid addiction. Lofexidine—a drug initially developed to treat high blood pressure—has just been approved to treat physical symptoms of opioid withdrawal. Narcan (naloxone) is available in injectable and intranasal formulations to reverse overdose. Regardless, more options are needed. One area of need involves new formulations of existing drugs, such as longer-acting formulations of opioid agonists and longer-acting naloxone formulations more suitable for reversing fentanyl overdoses. Compounds are also needed that target different receptor systems or immunotherapies for treating symptoms of withdrawal and craving in addition to the progression of opioid use disorders.

Much research already points to the benefits of increasing the availability of treatment options for Opioid Use Disorder (“OUD”), especially among populations currently embroiled in the justice system. Justice Community Opioid Innovation Network is working to create a network of researchers who can rapidly conduct studies aimed at improving access to high-quality, evidence-based addiction treatment in justice settings. It will involve implementing a national survey of addiction treatment delivery services in local and state justice systems; studying the effectiveness and adoption of medications, interventions, and technologies in those settings; and finding ways to use existing data sources as well as developing new research methods to ensure that interventions have the maximum impact.

The National Drug Abuse Treatment Clinical Trials Network (“CTN”) facilitates collaboration between NIDA, research scientists at universities, and a myriad of treatment providers in the community, with the aim of developing, testing, and implementing addiction treatments. As part of the HEAL initiative, the CTN Opioid Research Enhancement Project will greatly expand the CTN’s capacity to conduct trials by adding new sites and new investigators. The funds will also enable the expansion of existing studies and facilitate developing and implementing new studies to improve identification of opioid misuse and OUD. Further, it will enhance engagement and retention of patients in treatment in a variety of general medical settings, including primary care, emergency departments, ob/gyn, and pediatrics.

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A great tragedy of the opioid crisis is that there are a number of effective tools not being deployed effectively in communities in need. Only a fraction of people with OUD receive any treatment, and of those less than half receive medications that are universally acknowledged to be the standard of care. Moreover, patients often receive medications for too short a duration. As part of its HEAL efforts, NIDA will launch a multi-site implementation research study called the HEALing Communities Study in partnership with the Substance Abuse and Mental Health Services Administration (SAMHSA). The HEALing Communities Study will support research in up to three communities highly affected by the opioid crisis, which should help evaluate how the implementation of an integrated set of evidence-based interventions within healthcare, behavioral health, justice systems, and community organizations can work to decrease opioid overdoses and prevent and treat OUD. Lessons learned from this study will yield best practices that can then be applied to other communities across the nation.

The HEAL Initiative is a tremendous opportunity to focus taxpayer dollars effectively where they are needed the most: in applying science to find solutions to the worst drug crisis our country has ever seen.

Find Help Near You

The following website can help you find substance abuse or other mental health services in your area: www.samhsa.gov/Treatment. If you are in an emergency situation, people at this toll-free, 24-hour hotline can help you get through this difficult time: 1-800-273-TALK. Or click on: www.suicidepreventionlifeline.org. We also have step by step guides on what to do to help yourself, a friend or a family member on our Treatment page.

Apologetics: Defending the Faith Today (Part Four)

“But sanctify the LORD God in your hearts, and always be ready to give a defense to everyone who asks you a reason for the hope that is in you, with meekness and fear” (1 Peter 3:15, NASB).

Born Again

What is Conversion?

The word conversion when used in a cultural sense typically means buying into acceptance of a religious dogma or belief system. The fundamental biblical meaning of conversion is “to turn” toward God. The key question always is Am I born again? Exactly when did I get converted? It is typical for new believers to assume conversion is an instantaneous event. Someone gave me a suggestion when they learned I was addressing conversion in my series on apologetics. They said, “Read all four Gospels and try to determine when Peter was converted. Was it when he was following Jesus? When he realized Jesus was the Messiah? When he was sent out to preach and heal? When Jesus forgave him for denying him?” Apparently, it’s just not that clear-cut.

Of course conversion is not simply a shift in our relationship with God. Justification is required before conversion can occur. Romans 1:17 reminds us that the righteousness of God is revealed from faith to faith. It is written, “The just shall live by faith.” Conversion, however, is a much larger reality in which our restored relationship with God begins to touch and change every area of our lives. Justification is not something visible. It is purely a work of the heart. The New Testament speaks of conversion as metanoia, which is literally a change of mind, but is not merely altering your opinion about God. Instead, it is a redirection of your fundamental outlook—what we might call mind-set or worldview. Because it involves a change in affection and will, the very core of self, it is not simply a matter of opinion.

The Bible tells us, “You must be born again” (John 3:7, NIV). Colossians 1:13 states, “For He has rescued us from the dominion of darkness and brought us into the kingdom of the Son He loves” (NIV).  Christian theology speaks of regeneration, which is the fundamental work of the Holy Spirit in the life of the repentant sinner. This “in or out” language finally appears also in the terminology of contemporary sociology of conversion. But the complexity of this phraseology—of conversion, yes, but also of alteration, transference, renewal, affiliation, adhesion, and other terms for religious moves one might make—points to biblical and theological counterparts indicating there is more to conversion than just “getting it.”

What Are We Converted From and Transformed To?

The apostle Peter taught that one needs to “repent therefore and be converted, that your sins may be blotted out, so that times of refreshing may come from the presence of the Lord” (Acts 3:19, NKJV). Many believe conversion is just accepting Jesus into your heart or professing Jesus with your mouth. It is true that many today are testifying to religious experiences in which they met true reality. At first glance, the Christian sounds like everyone else because he is also claiming to have experienced ultimate truth. The unbeliever or casual observer needs more than a mere testimony of subjective experience as a criterion to judge who, if anyone, is right.

Christian conversion is linked inextricably to the person of Jesus Christ. It is rooted in fact, not wishful thinking. Of course, this statement is at the very heart of apologetics. Jesus demonstrated that He had the credentials to be called the Son of God. He challenged men and women to put their faith in Him. Jesus said, “I am come that they might have life, and that they might have it more abundantly” (John 10:10). When a person puts his faith in Jesus Christ, he enters into a personal relationship with God Almighty, which leads to changes taking place in his life.

It is not a matter of self-improvement or cultural conditioning. Besides the fact that Christian conversion is based upon something objective—the resurrection of Christ—there is also a universality of Christian conversion. Since the date of his death and resurrection, people from every conceivable background, culture, philosophy, and intellectual stance have been converted by the person of Jesus Christ. Some of the vilest individuals who ever walked the face of the Earth have become some of the most remarkable saints after trusting Jesus Christ. This must be considered. Because of the diversity of the people, it cannot be explained away by simple cultural conditioning. Christian experience is universal regardless of culture.

Concluding Remarks

God looks on the heart, the attitude, the intent. As long as one, in his heart, has a real desire to walk in God’s will—is deeply sorrowful for past sins and repents when he commits the occasional sin—and seeks to overcome sin and make God’s way his way, he will be forgiven. But if, following conversion, he is diligent in his Christian life, his occasional sinning will become less and less. He will make solid progress, maturing, overcoming, growing spiritually and in righteous godly character.

The experience of a new Christian —not just knowledge but experience—of who he is and what has happened to him, is profoundly determined by what he knows about the miracle of conversion. That knowledge is based upon Scripture. God ordained that the miracle of the Christian life be powered by his sovereign grace in the soul, but guided and shaped by His Word in the Bible. It important to note that God does not give the joys of conversion through the conversion alone. The fullness of conversion takes place when the new life within intersects with the old word from without.

On a final note, to “convert” is to repent or “turn away from” one thing and toward something new. When one becomes a Christian, he is given the power to essentially do a 180 and go an entirely different way. Conversion is based solely on faith or belief. Christianity is not a religion; rather, it is a relationship with Christ. Christianity is God offering salvation to anyone who believes and trusts the sacrifice of Jesus on the cross. Conversion is accepting the gift that God offers and beginning a personal relationship with Jesus Christ that results in the forgiveness of sins and eternity in heaven after death.

 

Opioids

Opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as Fentanyl, and pain relievers available by prescription such as codeine, oxycodone, Vicodin, morphine, and others.

opiate painkillers

All opioids are chemically related and interact with opioid receptors on nerve cells in the brain and on the spinal column. Opioid pain relievers are generally safe when taken for a short time and as prescribed by a doctor, but because they produce euphoria in addition to pain relief, they can be misused (taken in a different way or in a larger quantity than prescribed, or taken without a doctor’s prescription). Regular use—even as prescribed by a doctor—can lead to dependence and, when misused, opioid pain relievers can lead to addiction, overdose, and death. 

An opioid overdose can be reversed with the drug naloxone (Narcan) when given right away. Improvements have been seen in some regions of the country in the form of decreasing availability of prescription opioid pain relievers and decreasing misuse among the Nation’s teens. However, since 2007, overdose deaths related to heroin have been increasing. Fortunately, effective medications exist to treat opioid use disorders including methadone, Buprenex and Vivitrol. 

A National Institute of Drug Abuse (NIDA) study found that once treatment is initiated, both a Buprenex/Vivitrol combination and an extended-release Vivitrol formulation are similarly effective in treating opioid addiction. However, Vivitrol requires full detoxification, so initiating treatment among active users is difficult. These medications help many people recover from opioid addiction.

What are Prescription Opioids?

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Opioids are a class of drugs naturally found in the opium poppy plant. Some prescription opioids are made from the plant directly, and others are made by scientists in labs using the same chemical structure. Opioids are often used as medicines because they contain chemicals that relax the body and can relieve pain. Prescription opioids are used mostly to treat moderate to severe pain, though some opioids can be used to treat coughing and diarrhea. Opioids can also make people feel very relaxed and high, which is why they are sometimes used for non-medical reasons. This can be dangerous because opioids can be highly addictive. Overdoses and death are common. Heroin is one of the world’s most dangerous opioids, and is never used as a medicine in the United States.

How Do People Misuse Opioids?

Prescription opioids used for pain relief are generally safe when taken for a short time and as directed by a doctor, but they can be misused. People misuse prescription opioids by:

  • taking the medicine in a way or dose other than prescribed
  • taking someone else’s prescription medicine
  • taking the medicine for the effect it causes—getting high

How Do Prescription Opioids Affect the Brain?

Opioids bind to and activate opioid receptors on cells located in many areas of the brain, spinal cord, and other organs in the body, especially those involved in feelings of pain and pleasure. When opioids attach to these receptors, they block pain signals sent from the brain to the body and release large amounts of dopamine throughout the body. This release can strongly reinforce the act of taking the drug, making the user want to repeat the experience.

Opioid misuse can cause slowed breathing, which can cause hypoxia, a condition that results when too little oxygen reaches the brain. Hypoxia can have short- and long-term psychological and neurological effects, including coma, permanent brain damage, or death. Researchers are also investigating the long-term effects of opioid addiction on the brain, including whether damage can be reversed.

What are Other Health Effects of Opioid Medications?

Older adults are at higher risk of accidental misuse or abuse because they typically have multiple prescriptions and chronic diseases, increasing the risk of drug-drug and drug-disease interactions, as well as a slowed metabolism that affects the breakdown of drugs. Sharing drug injection equipment and having impaired judgment from drug use can increase the risk of contracting infectious diseases such as HIV.

Prescription Opioids and Heroin

Prescription opioids and heroin are chemically similar and can produce a similar high. Heroin is typically cheaper and easier to get than prescription opioids, so some people switch to using heroin instead. Nearly 80 percent of Americans using heroin (including those in treatment) reported misusing prescription opioids prior to using heroin. However, while prescription opioid misuse is a risk factor for starting heroin use, only a small fraction of people who misuse pain relievers switch to heroin. This suggests that prescription opioid misuse is just one factor leading to heroin use.

The Numbers

More than 64,000 Americans died from drug overdoses in 2016, including illicit drugs and prescription opioids. This number has nearly doubled over the past ten years. 2015 was the worst year for drug overdoses in U.S. history. Then 2016 came along. In that year alone, drug overdoses killed more people than the entire Vietnam War did.

A chart of US drug overdoses going back to 1999.

The Opioid Epidemic Explained

This latest drug epidemic is not solely about illegal drugs. It began, in fact, with a legal drug. Back in the 1990s, doctors were persuaded to treat pain as a serious medical issue. There’s a good reason for that: About 100 million U. S. adults suffer from chronic pain, according to a report from the Institute of Medicine.

Chronic Pain The Silent Condition

Pharmaceutical companies took advantage of this concern. Through a big marketing campaign they got doctors to prescribe products like OxyContin and Percocet in droves — even though the evidence for opioids treating long-term non-cancer related chronic pain is very weak despite their effectiveness for severe short-term, acute pain—while the evidence that opioids cause harm in the long term is very strong. So painkillers inundated society, landing in the hands of not just patients but also teens rummaging through their parents’ medicine cabinets, other family members and friends of patients, and the black market.

As a result, opioid overdose deaths trended up — sometimes involving opioids alone, other times involving drugs like alcohol and benzodiazepines (Xanax, Ativan, Valium) typically prescribed to relieve anxiety. By 2015, opioid overdose deaths totaled more than 33,000 — close to two-thirds of all drug overdose deaths. The numbers have grown exponentially over the past three years.

What Can We Do?

Seeing the rise in opioid misuse and deaths, officials have cracked down on prescription painkillers. Law enforcement, for instance, now threaten doctors with incarceration and loss of their medical licenses if they prescribed the drugs unscrupulously. Ideally, doctors should still be able to get painkillers to patients who truly need them — after, for example, evaluating whether the patient has a history of drug addiction. But doctors, who weren’t conducting even such basic checks, are now being instructed to give more thought to their prescriptions.

Yet many people who lost access to painkillers are still addicted. So some who could no longer obtain prescribed painkillers turned to cheaper, more potent opioids bought off the street, such as heroin and Fentanyl. Not all painkiller users went this direction, and not all opioid users started with painkillers. But statistics suggest many did. A 2014 study in JAMA Psychiatry found many painkiller users were moving on to heroin, and a 2015 analysis by the Centers for Disease Control and Prevention (CDC) found that people who are addicted to prescription painkillers are 40 times more likely to be addicted to heroin.

So other types of opioid overdoses, excluding painkillers, also rose. That doesn’t mean cracking down on painkillers was a mistake. It appears to have slowed the rise in painkiller deaths, and it may have prevented doctors from prescribing the drugs to new generations of people with drug use disorders. But the likely solution is to get opioid users into treatment. According to a 2016 report by the Surgeon General of the United States, just 10 percent of Americans with a drug use disorder obtain specialty treatment. The report found that the low rate was largely explained by a shortage of treatment options. Given the exorbitant cost of health care in America today, that is simply unacceptable. Federal and state officials have pushed for more treatment funding, including medication-assisted treatment like methadone and Buprenex.

Source: National Institute on Drug Abuse; National Institutes of Health; U. S. Department of Health and Human Services.

The Peacemaker (Part 3)

The Peacemaker: A Biblical Perspective on Resolving Personal Conflicts and Letting Go of Resentment.

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The goal of a peacemaker is to magnify the marvelous undeserved forgiveness that God has given to us through Christ and to inspire people to imitate such forgiveness to others. Jesus told us in the Sermon on the Mount, “Blessed are the peacemakers, for they will be called children of God” (Matthew 5:9). As Christians, it is very important that we understand this verse correctly. Note we’re admonished to be peacemakers not peacekeepers. It would be a drastic error to misquote the Words of Jesus. Although it might sound like mere semantics, Christ urges that we make peace rather than keep the peace. The Gospel and peacemaking are interdependent. The Gospel is the very catalyst for peace. As believers, we are incapable of promoting real peace in the flesh. It requires the power of the Holy Spirit.

Peacemakers strive to make peace and attempt to reconcile things and people that are at odds with one another. Peacekeepers, on the other hand, strive to keep peace at all costs. Proverbs 10:10 says, “People who wink at wrong cause trouble, but a bold reproof promotes peace” (NTL). Peacekeepers, by not acknowledging wrongdoings in an effort to make peace, are actually winking at them. We must be about peacemaking as believers. My church contains in its bylaws language about peacemaking being part of our mission.

Speak the Truth in Love

Peacemaking does not—indeed, cannot—happen by accident. It is a purposeful act. In fact, peacemaking is a higher priority than worship. Of course, love is the underlying commandment. John 13:34-35 says, “A new commandment I give you: Love one another. As I have loved you, so must you love one another. By this everyone will know that you’re my disciples, if you love one another” (NIV). People should be able to catch a glimpse of the Father when they look at us.

Ephesians 4:15 says, “Instead, speaking the truth in love, we will grow to become in every respect the mature body of Him who is the head, that is Christ.” Words play a key role in almost every conflict. When used properly, words promote understanding and encourage agreement. When misused, they usually aggravate conflicts and drive people further apart. If your words seem to do more harm than good when you try to resolve a disagreement, don’t give up. With God’s help you can improve your ability to communicate constructively.

Bring Hope Through the Gospel

When someone has disappointed or offended us, our human reaction is to come at them with the law, lecturing them about what they have done wrong and what they should do now to make things right. This approach generally makes people defensive and reluctant to admit their wrongs, which makes a conflict worse. The Lord is graciously working to teach us a better way to approach others about their failures. Instead of coming at them from a position of legalism, we need to bring them the Gospel. In other words, rather than dwelling on what people should do or have failed to do, we must focus primarily on what God has done and is doing for them in Christ. This is commanded throughout Scripture.

When Jesus confronted the Samaritan woman, instead of hammering away at her sinful lifestyle (as many pastors sadly do today), He spent most of His time engaging her in a conversation about salvation, eternal life, true worship, and the coming of the Messiah (see John 4:7-26). The woman responded eagerly to this Gospel-focused approach, let down her defenses, and put her trust in Christ. Although Jesus changed this focus when rebuking hard-hearted Pharisees, His typical approach to bringing people to repentance was to bring them the Good News of God’s forgiveness (see Luke 19:1-10; John 8:10-11).

The apostle Paul had a similar approach, even when he had to deal with serious sin. In his first letter the Corinthians, he had to address divisions, immorality, lawsuits, food sacrificed to idols, and the misuse of the Lord’s Supper and spiritual gifts. But before addressing these terrible sins, Paul’s gracious greeting held out hope for forgiveness and change by reminding the Corinthians of what God had already done for them through Christ. What a marvelous way to set the stage for repentance and change. Paul always kept Jesus in the center of his instruction and admonishment by first providing the believers a detailed description of God’s redemptive plan. When Paul finally got around to addressing errors in the congregation, his readers were already standing on a foundation of hope and encouragement.

Paul took the same approach with the Philippians and Colossians, who also needed correction and instruction. He begins his letters to these two churches by drawing attention to what God has done in each of them. As he continued, he frequently referred to the Gospel as he moved from issue to issue. For example, look at what Paul writes in Colossians 3:12: “Therefore, as God’s chosen people, holy and dearly loved, clothe yourselves with compassion, kindness, humility, gentleness and patience.” Before admonishing these believers, Paul reminds them of who they are in Christ.

Be Quick to Listen

Another element of effective communication is to listen carefully to what others are actually saying. Knowing this is not in our human nature, James gave this warning: “My dear brothers and sisters, take note of this: Everyone should be quick to listen, slow to speak, and slow to become angry, because human anger does not produce the righteousness that God desires” (James 1:19-20, NIV). Good listening is particularly important for a peacemaker. It improves your ability to understand others, it shows that you realize you do not have all the answers, and it tells the other person that you value his or her thoughts and opinions. Even if you don’t agree with what others say or do, your willingness to listen demonstrates respect and shows that you are trying to comprehend their perspective. This typically helps create an atmosphere of mutual respect that will improve communication.

Waiting…

Waiting patiently while others talk is a key listening skill that is a must for all peacemakers. Without this skill, you will often fail to understand the root cause of a conflict, and you may complicate matters with inappropriate reactions. As Proverbs 18:13 tells us, “To answer before listening—that is folly and shame” (NIV). In other words, avoid jumping to premature conclusions about what others are thinking; give them time and hear them out. Discipline yourself not to interrupt others while they are speaking. Learn to be comfortable with silence and do not respond the moment there is a pause. Moreover, do not offer immediate solutions to every problem others bring to you.

Reflecting or “paraphrasing” is the process of summarizing the other person’s main points in your own words and sending them back in a constructive way. This is the very definition of active listening. Reflecting may deal with both the content of what the other person has said and the associated feelings. Reflecting does not require that you agree with what the other person says; it simply reveals whether you comprehend another person’s thoughts and feelings. Reflecting shows that you are paying attention and you are trying to understand or empathize with them. Besides, reflecting what others are saying can make them more willing to listen to what you want to say.

Engage Rather than Pronounce or Declare

One of the fastest ways to make people defensive is to abruptly announce what they have done wrong. If you launch into a direct and detailed description of their faults, they are likely to close their ears and launch a counterattack. It is wise to think carefully about how to open a conversation in a way that shows genuine concern for the other person and engages him in listening to your words without becoming defensive. If you are going to be candid—this is often doable when speaking to a close friend—you should first affirm your respect and friendship and then describe your concern in direct terms. If strong trust has not been built between you, however, or if the issue is likely to trigger defensiveness, you would be wise to broach your concern in an indirect way that engages the other person’s heart and mind without putting him instantly on guard.

Whatever approach you use, your goal should be to describe your concern in a way that captures others’ attention, appeals to their values, and gives hope that the issue can be resolved constructively. The more you engage another person’s heart and the less you declare his or her wrongs, the more likely he or she is to listen to you. Communicate clearly enough that you cannot be misunderstood. Many conflicts are caused or aggravating by misunderstandings. People may say things that are actually true or inappropriate, but because they did not choose their words carefully they leave room for others to misconstrue what they mean and take offense. Fewer factors can derail peacemaking than miscommunication.

Use the Bible Carefully

It is often helpful to refer to the Bible as a source of objective truth when you have a disagreement with another Christian. If this is not done with great care, however, it will alienate people rather than persuade them. Never quote the Bible to tear others down, but only to build them up in the Lord. Make sure to use Scripture passages for their intended purpose. Never pull a verse out of context and try to make it say something other than its clear meaning. It’s advisable to encourage others to read the passage from their own Bibles; then ask, “What do you think that means?” This typically yields far better results than imposing your interpretation on them.

It is also paramount that you know when to stop. If the other person appears to be getting irritated by your references to Scripture, it may be wise to back off and give him or her time to think about what you’ve presented to them.

Summary and Application

Effective confrontation is like a graceful dance from being supportive to assertive and back again. This dance may feel awkward at first for those who are just learning it, but perseverance pays off. With God’s help you can learn to speak the truth in love by saying only what will build others up, by listening responsibly to what others say, and by using principles of wisdom. As you practice these skills and make them a normal part of your everyday conversation, you will be well prepared to use them when conflict breaks out.  In developing the skills of loving confrontation, you can see for yourself that “the tongue of the wise brings healing.”

God bless and thanks for reading.

Join me next Monday when I wrap up this series on peacemaking. We’ll look at the importance of taking one or two others along when confronting others in the interest of peace. Matthew 18:16 says, “But if they will not listen, take one or two others along, so that every matter may be established by the testimony of two or three witnesses.

 

 

Just a Simple Soldier

He was getting old and paunchy and his hair was falling fast, 
and he sat around the Legion, telling stories of the past. 
Of a war that he had fought in and the deeds that he had done. 
In his exploits with his buddies; they were heroes, everyone. 
And ‘tho sometimes to his neighbors, his tales became a joke, 
all his buddies listened, for they knew whereof he spoke. 
But we’ll hear his tales no longer, for ol’ Bob has passed away, 
and the world’s a little poorer, for a soldier died today. 
He won’t be mourned by many, just his children and his wife. 
For he lived an ordinary, very quiet sort of life. 
He held a job and raised a family, quietly going on his way; 
and the world won’t note his passing; ‘tho a Soldier died today. 
lest we forget
When politicians leave this earth, their bodies lie in state. 
While thousands note their passing, and proclaim that they were great. 
Papers tell of their life stories, from the time that they were young, 
but the passing of a soldier, goes unnoticed, and unsung. 
Is the greatest contribution, to the welfare of our land, 
some jerk who breaks his promise, and cons his fellow man? 
Or the ordinary fellow, who in times of war and strife, 
goes off to serve his Country and offers up his life? 
The politician’s stipend and the style in which he lives, 
are sometimes disproportionate, to the service he gives. 
While the ordinary soldier, who offered up his all, 
is paid off with a medal and perhaps a pension, small. 
soldier kneeling cross rifle.png
It’s so easy to forget them, for it is so long ago, 
that our Bob’s and Jim’s and Johnny’s, went to battle, but we know. 
It was not the politicians, with their compromise and ploys, 
who won for us the freedom, that our Country now enjoys. 
Should you find yourself in danger, with your enemies at hand, 
would you really want some cop-out, with his ever waffling stand? 
Or would you want a Soldier, who has sworn to defend, 
his home, his kin, and Country, and would fight until the end? 
He was just a common Soldier and his ranks are growing thin. 
But his presence should remind us, we may need his like again. 
For when countries are in conflict, then we find the Soldier’s part, 
is to clean up all the troubles, that the politicians start. 
If we cannot do him honor, while he’s here to hear the praise, 
then at least let’s give him homage, at the ending of his days. 
Perhaps just a simple headline, in the paper that might say: 
“OUR COUNTRY IS IN MOURNING, FOR A SOLDIER DIED TODAY.”
©1985 A. Lawrence Vaincourt

 

The Peacemaker (Part 2)

The Peacemaker: A Biblical Perspective on Resolving Personal Conflicts and Letting Go of Resentment.

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Peacemakers are people to literally breathe grace. They draw continually on the goodness and power of Jesus Christ, and then bring His love, mercy, forgiveness, strength, and wisdom to the conflicts of daily life. God delights to breathe His grace through peacemakers and use them to dissipate anger, improve understanding, promote justice, and encourage repentance and reconciliation. Peacemakers help others let go of resentments.

Peace is essential to Christianity. There can be no doubt about it. God created this world with the intention that it be full of peace. But human sin derailed God’s intention. Brokenness now pervades that which God set in motion. Of course, God’s peace is inextricably related to forgiveness, salvation, redemption, and restoration. Luke 1:77-79 says, “…to give knowledge of salvation to His people in the forgiveness of their sins, through the tender mercy of our God, when the day shall dawn upon us from on high to give light to those who sit in darkness and in the shadow of death, to guide our feet into the way of peace” (RSV).

Matthew 5:9 says, “God blesses those who work for peace, for they will be called the children of God” (NLT). Our aim as Christians—indeed, as peacemakers—is to encourage others to break free from the habit of focusing on other people’s wrongs and to promote peace by focusing instead on their own contribution to the conflict. We must essentially develop a passion for peace. First, it is critical that we understand how powerful words are. Peacemaking begins with saying the right thing the right way. Everything is relationship. We are constantly presented throughout each day with numerous opportunities to promote peace.

4 important keys related to conflict resolution and promoting peace:

  1. Resist the natural reaction to blame others and focus on their wrongs and differences. People who to take a moral approach are particularly fond of directions. They stress justice and fairness, noting people typically “get what they deserve.” They concern themselves with tangible rewards and the fruits of their actions. This is a “reap what you sow” perspective. They believe emotions simply get in the way. Those who focus on morals concern themselves with top/down thinking and are dedicated to truth. Simply put, they are concerned primarily with right and wrong. This limited viewpoint, however, lends itself to taking things too literally. Moral-minded people often have difficulty understanding or dealing with emotions, and are frequently highly critical and judgmental. It’s all black-and-white, with no room for gray. Those who focus on relationship concern themselves with intimacy, mercy, grace, and empathy. Focus is on the heart rather than the mind. This can be risky, however, as emotions tend to lie to us and become “reality.” Too much emphasis on emotion risks God’s principles taking a back seat to what we “feel.”
  2. The blame game always makes conflict worse. The more “right” someone thinks they are, the more self-righteous they become. This causes the relationship—the very interaction itself—to be more difficult. When we think the other party is wrong, we are reluctant to offer concessions. Failure to see conflict with an open mind can lead to stalemate. When we’re open and honest, we are more likely to accept our share of the blame in a conflict. We need to resist the temptation to list the other person’s faults. Our approach must spring forth from a problem-solving mindset and not be about proving our point. Sometimes it is best to “drop it” in order to stop the blame game.
  3. Conflict can be altered by taking a soft approach over harsh language. Confrontation is a key element to conflict resolution, but there is a proper way to approach someone about his or her conduct. Proverbs 15:1 says, “A gentle answer turns away wrath, but a harsh word stirs up anger” (NIV). Peterson translates the verse this way in The Message: “A gentle response defuses anger, but a sharp tongue kindles a temper-fire.” This concept holds true in conflict resolution, witnessing, and apologetics. We will be more successful in persuading others of our position, of being certain they actually hear what we’re saying, and increasing the chance to make a friend rather than an enemy, when we take a gentle approach. Even when others have unloaded on us, a soft response can prevent (or at least hinder or limit) an escalation of the conflict.
  4. Genuine reconciliation and lasting change require a transformed heart. Taking a hard-line moral approach when confronting someone is often counterproductive. It is akin to saying, “Here it is. Do it or else.” Effective peacemaking is a matter of the heart with a degree of give-and-take. Colossians 3:13 tells us, “Bear with each other and forgive one another if any of you has a grievance against someone. Forgive as the Lord forgave you” (NIV). Christians are the most forgiven people in the world. Therefore, we should be the most forgiving people in the world. It is unfortunately never that simple. It can be extremely difficult to forgive others genuinely and completely. We cannot overlook the direct relationship between God’s forgiveness and our forgiveness. Biblical conflict resolution is built on the solid foundation of grace, unconditional love, and forgiveness.

Perhaps This is You?

It is impossible to completely and unconditionally forgive someone based upon our own strength, especially when they have hurt us deeply or betrayed our trust. We can try not to think about what they did or stuff our feelings and put on a happy face, but the feelings will still be lurking. Anger can fester for a long time, and often leads to resentment. Unless we undergo a change of heart—and are cleansed and set free by God—the hurt remains. The conflict goes unresolved. There is only one way to overcome this barrier, and that is to admit that you cannot forgive in our own strength.

Maybe you have prayed like this:

God, I cannot forgive him in my own strength. In fact, I do not want to forgive him at all, at least until he has suffered for what he did to me. He does not deserve to get off easy. Everything in me wants to hold it against him and keep a high wall between us so he can never heart me again. But Your Word warns me that unforgiveness will eat away at my soul and build a wall between You and me. More importantly, You have shown me that You made the supreme sacrifice, giving up Your own Son, in order to forgive me. Lord, please help me to want to forgive. Please change my heart and soften it so that I no longer want to hold this against him. Change me so that I can forgive and love him the way You have forgiven and loved me. God, please forgive me for my own unforgiveness.

Summary and Application

This is what reconciliation is all about. By thought, word, and deed, you can demonstrate forgiveness and rebuild relationships with people who have offended you. No matter how painful the office, with God’s help you can pay honor and glory to God by imitating His forgiveness and reconciliation for mankind that was demonstrated on the cross. By the grace of God, you can forgive as the Lord forgave you. This is of paramount importance in the scheme of peacemaking.

God bless.

Directions to My Muse

Undo the four screws
on the plastic back

of the transistor radio.
Lift off the square with care.

Let the tiny people blossom
in the cup of your palm.

Hold the music, its weight—
write what you see,

It isn’t about writing—
it’s about opening, knowing.

©2018 Sarah Dickenson Snyder

About the Poet. Sarah Dickenson Snyder has two poetry collections: The Human Contract and Notes from a Nomad. Recent work will appear or has been in The Comstock Review, Damfino Press, The Main Street Rag, Chautauqua Literary Magazine, RHINO, The Sewanee Review, Front Porch, and Whale Road Review.   https://sarahdickensonsnyder.com/

NIH Study Yields Important Insight Into Addiction and Pain

From the web blog of Dr. Lora Volkow, director of the National Institute of Drug Abuse dated May 6, 2018.

We are on the verge of a new era in medicine, one that truly treats the patient as an individual and as a participant in his or her own care. New data-gathering and analytic capabilities are enabling the kinds of massive, long-term studies needed to investigate genetic, environmental, and lifestyle factors that contribute to disease. Fine-grained insight into prevention and treatment is creating a truly precision, individualized form of medicine, the payoffs of which are already striking in such areas as cancer treatment.

Recently, the NIH Precision Medicine Initiative launched All of Us, a massive study set to gather data from a million Americans across all demographic, regional, and health/illness spectrums. It will use electronic health records to track the health and medical care received by participants for a decade or more, incorporating surveys, blood and urine samples, and even data from fitness trackers or other wearable devices. For the time being, recruitment is limited to those 18 or older, but future stages will include children as well. The data will be open-access for researchers—and of course, anonymous.

The All of Us study will benefit addiction science in many ways, such as yielding valuable data on the influence of substance use and substance use disorders on various medical conditions. Information on use of alcohol, tobacco, opioids, and perhaps other substances is liable to be captured in the electronic health records used for this study, and surveys will also capture lifestyle-related information including substance use and misuse. Gathering these records and survey data over time will provide important insight into how common forms of substance use impact treatment outcomes for a range of common diseases. It could yield valuable insights into genetic risk factors for substance use and substance use disorders as well as predictors of responsiveness to treatment using different medications. Links between substance use, substance use disorders, and other psychiatric problems such as depression and suicide can also be explored with such a large sample.

Factors affecting pain and its treatment are also directly relevant to addiction, especially in the context of the current opioid crisis. All of Us could provide valuable data on demographic variations in pain prescribing, telling us what groups (ethnic, age, and gender) are being prescribed opioids as opposed to other medications or non-pharmacological treatments. It will also tell researchers how these treatments affect patients’ lives. This data set will help answer questions about the role opioid treatments may play in the transition from acute to chronic pain, for instance, and what role opioid treatment plays in development of opioid use disorders or other substance use disorders. It will also help us understand what other factors, such as mental health or other co-morbidity, affects trajectories associated with pain.

Like the ABCD study currently underway to study adolescent brain development, the All of Us study is deliberately open-ended. It is understood that rapidly advancing technology will give us the ability not only to answer new questions but also ask questions that might not even occur to researchers currently. Consequently, All of Us is being designed to allow the ingenuity of the research community to explore how this dataset can be utilized and design new ways of making it address their specific research questions.

The Peacemaker (Part 1)

The Peacemaker: A Biblical Perspective on Resolving Personal Conflicts and Letting Go of Resentment.

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Peacemakers are people to literally breathe grace. They draw continually on the goodness and power of Jesus Christ, and then bring His love, mercy, forgiveness, strength, and wisdom to the conflicts of daily life. God delights to breathe His grace through peacemakers and use them to dissipate anger, improve understanding, promote justice, and encourage repentance and reconciliation. Peacemakers help others let go of resentments.

The “Four Gs” of conflict resolution:

  • Glorify God (1 Corinthians 10:31). Biblical peacemaking is motivated and guided by a deep desire to bring honor to God by revealing the reconciling love and power of Jesus Christ. As we draw on His grace, follow His example, and put His teachings into practice, we can find freedom from the impulsive, self-centered decisions that make conflict worse, and bring praise to God by displaying the power of the Gospel in our lives.
  • Get the log out of your eye (Matthew 7:5). Attacking others only invites counterattacks. This is why Jesus teaches us to face up to our own contributions to a conflict before we focus on what others have done. When we overlook others’ minor offenses and honestly admit our own faults, our opponents will often respond in kind. As tensions decrease, the way may be opened for sincere discussion, negotiation, and reconciliation.
  • Gently restore (Galatians 6:1). When others fail to see their contributions to a conflict, we sometimes need to graciously show them their fault. If they refuse to respond appropriately, Jesus calls us to involve respected friends, church leaders, or other objective individuals who can help encourage repentance and restore peace.
  • Go and be reconciled (Matthew 5:24). Finally, peacemaking involves a commitment to restoring damaged relationships and negotiating just agreements. When we forgive others as Jesus has forgiven us and seek solutions that satisfy others’ interests as well as our own, the debris of conflict is cleared away and the door is opened for genuine peace.

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Unfortunately, many believers and their churches have not yet developed the commitment and ability to respond to conflict in a Gospel-centered and biblical manner. This is often because they have succumbed to the relentless pressure our secular culture exerts on us to forsake the timeless truths of Scripture and adopt the relativism of our postmodern era. Although many Christians and their churches believe they have held on to God’s Word as their standard for life, their responses to conflict, among other things, show that they have in fact surrendered much ground to the world. Instead of resolving differences in a distinctively biblical fashion, they often react to conflict with the same avoidance, manipulation, and control that characterize the world. In effect, both individually and congregationally, they have given in to the world’s postmodern standard, which is “What feels good, sounds true, and seems beneficial to me?”

Pastor Mike Miller at my home church, Sunbury Bible Church, started a Spring series on peacemakers. He opened the series on April 22, 2018 stating, “Peace matters to God.” The Hebrew word shalom has a comprehensive meaning beyond being content or “at peace.” It also means harmony, wholeness, completeness, prosperity, welfare, and tranquility. It can further mean “to be safe in mind, body, or estate.” Shalom speaks of a completeness or fullness that encourages you to give back. Jesus is not talking about mediators or political negotiators in Matthew 5:9, but those who carry an inward sense of the fullness and safety that is only available through son-ship with God. As you make others peaceful and inwardly complete, that makes you a peacemaker.

3 Relationships Needed for Building Peace:

  1. With God (first). Peace must begin vertically, between us and God, before it can be shared horizontally, between others. Man has a broken relationship with God since the Fall in the Garden of Eden. This has left a God-shaped void—a hole in the soul—which we try to fill with anything and everything. It’s like an infinite abyss.
  2. With Others (second). This is what helps build horizontal connectedness in order that we might live in harmony as much as possible. Philippians 2:5 says, “In your relationships with one another, have the same mindset as Christ Jesus” (NIV).
  3. With yourself (ultimately). We simply cannot expect to have peace within if we are at odds with everyone around us. Jesus knew this when He said, “Blessed are the peacemakers, for they will be called the children of God” (NIV). Moreover, we cannot expect to be at peace with others if we are not at peace with God.

But at What Cost?

Genuine peace is a priority, but it is costly. We often have to give up something of ours to obtain or promote peace. Genuine peace is only found at the Cross. We’re part of God’s plan of redemption and restoration. Genuine peace has eternal consequences. Most conflicts also provide an opportunity to grow to be more like Jesus. As Paul urged in his letter to the Corinthians, “Follow my example, as I follow the example of Christ” (1 Cor. 11:1). Paul elaborated on this opportunity when he wrote to the Christians in Rome: “And we know that in all things God works for the good of those who love Him, who have been called according to His purpose. For those God foreknew, He also predestined to be conformed to the likeness of His Son, that He might be the firstborn among many brothers” (Romans 8:28-29, italics mine).

Jesus’ Reputation Depends on Unity

Unity is more than a key to internal peace. It is also an essential element of your Christian witness. When peace and unity characterize your relationships with other people, you show that you are God’s child and He is present and working in your life. The opposite is also true: When your life is filled with unresolved conflict and broken relationships, you will have little success in sharing the Good News about the saving work of Jesus on the Cross.

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One of the most emphatic statements on peace and unity in the Bible is found in Jesus’ prayer shortly before he was arrested and taken away to be crucified. After praying for Himself and for unity among His disciples (John 17:1-19), Jesus prayed for all who would someday believe in Him. These words apply directly to every Christian today:

My prayer is not for [My disciples] alone. I pray also for those who will believe in Me through their message, that all of them may be one, Father, just as you are in Me and I am in you. May they also be in Us so that the world many believe that You have sent Me. I have given them the glory that You gave Me, that they may be one as We are one: I in them and You in Me. May they be brought to complete unity to let the world know that You have sent Me and have loved them even as You have loved Me (John 17:20-23).

In Summary

The message given by Jesus and the apostles is resoundingly clear: Whether our conflicts involve minor irritations or major legal issues, God is eager to display His love and power through us as we strive to maintain peace and unity with those around us. Therefore, peacemaking is not an optional activity for a believer. If you have committed your life to Christ, He invites you to draw on His grace and commands you to seek peace with others. Token efforts will not satisfy this command; God wants you to strive earnestly, diligently, and continually to maintain harmonious relationships with those around you. Your dependence on Him and obedience to this call will show the power of the Gospel and enable you to enjoy the personal peace that God gives to those who faithfully follow Him.

Please join me next Monday for The Peacemaker (Part Two), when we will look at helping others to break free from the habit of focusing on other peoples’ wrongs and to promote peace by focusing instead on their own contribution to conflict.