Let’s Go to Theology Class! Week Five

Summary of the fifth week of class in pursuit of my Master’s in Theology at Colorado Christian University. These five weeks covered the topic of Major Approaches to Theology

Written by Steven Barto, B.S. Psych.

How does the foundation of Scripture as the primary source for theology help to prioritize and structure the relationships between the various sub-disciplines of Christian theology? How might these all contribute to the unity of Christian theology, or is there one approach that might contribute most to its unity?

Friedrich Schleiermacher identifies three unique and equally important substrates of systematic theology: Historical Theology, Philosophical Theology, and Practical Theology. These must be interconnected relative to every mode or operation of the Christian faith itself for there to be a true “unity of faith.” This is the very beginning of the “community of believers.” Of course, foundation is key to everything.

Consider the parable of the wise and the foolish builder in Matthew 7:24-27. Jesus was nearing the end of His Sermon on the Mount. He had spoken just minutes before regarding fasting and prayer, storing treasures in heaven rather than on earth, and allowing God to provide for our needs without worry. He said if someone hears His words and puts them into practice, that person is like the wise man who builds on a foundation of rock. Such a foundation can withstand stormy weather. The man who hears His words, however, and does not heed them is like the foolish man who builds his house on a foundation of sand. Such a dwelling cannot withstand the storms.

For Christianity in general, that foundation must be the Word of God for it to have a positive, systematic impact on the body of believers. Indeed, such a comprehensive and systematic study is not necessary for the individual, nor for a small study group or congregation; rather, it is for the church at large—the entirety of the “faith.” Only then can it promote universal and coherent application. Christian Theology, specifically, is the collective embodiment of those branches of scientific knowledge and those rules of art required for consistent church government. Faith alone (sola fida) does not need an apparatus for the individual or the family unit. Faith in such an intimate setting is an individual matter. Relative to a systematic theological undertaking of the Christian faith, it must ultimately be laid solidly upon the foundation of Scripture alone (sola scriptura). There is, of course, However, no foundational building block for Philosophical and Practical Theology without a clear continuum of the idea of Christianity.

Historical Theology calls for sifting through and supplementing what others have determined in past teachings of the church. Christianity can never be a solely empirical or intellectual undertaking (simply collecting data). It should, however, involve viewing en masse (in its historical context) all teaching and comparing same ultimately to other churches of the faith. If “history” is missing from systematic theology, it is devoid of “corporate will” (which is determined over time and within the church at large). In this regard, unity is lost. Troeltsch asks whether history merely renders judgment of probability (based on what has happened before). Moreover, is it merely the application of analogy to a specific time? We know analogy brings many problems with it, even when applied to things that happen before our very eyes. Much can depend on our worldview, and can be further compromised by bias, deception, dislocation, formation of myth, misinterpretation, preconception, imposture, factiousness, and so on. Barth says dogmatics can help with this, but it is only appropriate for the “listening” church. In other words, for those who are already believers and are able to “hear” the Word of God and compare Scripture to what is being espoused. He adds that dogmatics provides the mechanism by which human reflection and action (and their fallibility) can be subjected to another reflection and action—that of God’s. God Himself speaks for Himself! He has spoken in the past, He speaks to us now, and He will speak to us in the future. Dogmatics is essentially a kind of “call to order” for the community of believers. It is the means by which unity can be established. Barth thinks of it as a call to the teaching church itself to hear—that is, to hear Christ. Dogmatics must never form doctrine. Instead, it is a tool for weighing the words of the teaching church against the Word of God.

Dogmatics is a reminder that over and above the content of all human speech and its possibility, what is said has plainly been said already, and will be said again, and only consistent with the Word of God. Subject matter should therefore be grounded in the Spirit and not in human intellect or interpretation. In other words, the church teaches, not the person. This is a great tool for checking consistency. Historical Theology is quite significant for analysis due to historical criticism and comparison. Biblical criticism itself is rooted in analyzing the ways by which all the rest of church history has been handed down to us. As Barth noted, there has always been the risk of “equivocal” proclamation when the Word of God comes from the mouths of various theologians and ministers, but the goal must be unequivocally pure doctrine! It all must be said in accordance with (and therefore be comprised solely of) the Word of God. It is advisable, also, to be wary that personal intellectual capacity, history, or life’s situations must never color the truth of the Scriptures. The church essentially makes (or owes) a promise that no matter the circumstances or the person, the Word of God will be presented in pure doctrine and not with some illusory or mistaken element to it.

I believe all three approaches (Historical, Philosophical, and Practical) must be applied to systematic Christian Theology in order to determine a “solidarity” relative to doctrine, without which the church may fall into legalism and become a battleground for competing dogmas.

On Monday I started my second class in pursuit of my Master’s in Theology at Colorado Christian University. This class is the first of three courses in Systematic Theology. Please join me Monday, October 21, 2019 as I discuss the lesson from the first week of Systematic Theology I.

References

Barth, K. Church Dogmatics, 1/2. (Edinburgh: T&T Clark), 1956).  

Schleiermacher, Friedrich. Brief Outline of the Study of Theology, translated by William Farrer, (Edinburgh; London; Dublin: T. & T. Clark; Hamilton, Adams, & Co.; J. Robertson), 1850.

Troeltsch, E. “Historical and Dogmatic Method in Theology,” in Religion in History (Minneapolis, MN: Fortress, 1991.

Let’s Go to Theology Class! Week Four

Summary of the fourth week of class in pursuit of my Master’s in Theology at Colorado Christian University.

Written by Steven Barto, B.S. Psych.

IT’S ONE THING TO pick up a book and read about theology. And that’s okay. It’s how I got interested in taking the subject on as a graduate student. It all starts with contemplation. We “think” about what it means to be alive, to have purpose. We wonder how we might make a difference in society. We question the “logic” of believing in God. Armed with such a burning desire to know, I enrolled in a master’s program in theology and started out on what so far has proved to be an amazing, breathtaking journey.

In week four of my theology class we considered the proper relationship between theological study, sanctification, contemplation, prayer, and action. Further, we discussed the type of character most conducive to theological insight, and how the systematic study of theology should impact one’s character. Generic “theological” study does not necessarily require any degree of sanctification. Many people choose to study theology or philosophy without any sense of what is meant by redemption or sanctification. These concepts are, however, imperative in Christian theology.

What is the proper relationship between theological study, sanctification, contemplation, prayer, and action?

I was amazed how little I understood about sanctification over the years. I thought it “just happened” when I “got saved.” Considering the decades of sinful behavior and active addiction I went through after accepting Christ (at age 13), I was far from sanctified. Of course, it does start with salvation. When we become redeemed, we are expected to “repent” of our old life. Then sanctification can begin. According to R.E.O. White, sanctification means “to make holy.” [1] It’s not uncommon for a new Christian to think this means he or she is made holy (shazam!) all at once. White further explains that to be sanctified is to be “set apart” from common or secular use.

First Corinthians 1:2 says we are sanctified in Christ Jesus, called to be saints. R.E.O. White writes that sanctification is not merely justification’s endgame; rather, it is justifying faith at work. The new believer is declared to be acquitted and clothed in the righteousness of Christ. Through sanctification, God begins to accomplish His will in us. This is often called becoming spiritually mature. We are not saved by good works, but there is little hope of sanctification without submitting to the will of God.

Thomas Aquinas says in the Summa Theologiae [2] that four of the gifts of the Spirit of the Lord are wisdom, understanding, knowledge, and counsel, and that these gifts have a direct impact on the intellect. Isaiah 11:2 says. “And the Spirit of the LORD shall rest upon him, the spirit of wisdom and understanding, the spirit of counsel and might, the spirit of knowledge and the fear of the LORD” (RSV). David Jeremiah explains that the coming king “will be endowed with the Spirit of the Lord, who provides the wisdom, ability, and allegiance to God that are necessary to accomplish a challenging task.” [3] Proverbs 2:6 says, “For the LORD gives wisdom; from his mouth come knowledge and understanding.” James reminds us that if we lack wisdom in any circumstance, we are to ask God and He will give it (James 1:5). Thomas Aquinas said any discourse of reason always begins from an understanding. It is critical, therefore, that we never attempt theology while lacking understanding. Although the work of the Spirit is already completed relative to the compiling of Scripture, His work regarding “illumination” is ongoing.

Prayer is the means by which we gain access to God. Just as we speak to the Father, and call upon Jesus, we must request from the Holy Spirit the guidance, understanding, knowledge, illumination, and discernment needed to effectively and accurately undertake systematic theology. It is equally important to pray for guidance regarding God’s call on our lives. When I decided to change my major from the master’s in counseling program to the master’s in theology, I spent weeks in prayer. I consulted with my pastor, several lay ministry friends, family members, my CCU student advisor, two professors, and several elders at my church. I cannot fathom undertaking a systematic study of Christian theology without prayer.

What type of character is most conducive to theological insight, and how should it change as the result of undertaking theological study?

In any theological undertaking, one would expect there to be a change of character. I think of Nabeel Qureshi (1983-2017), author, speaker, lecturer, and apologist, who converted to Christianity from Islam after spending nearly two years conducting an exegetical study of the Holy Bible. His character, if you will, was that of a loving, dedicated, well-behaved young man who had been raised in a religious home. In fact, no one in his immediate or extended family were extremists or jihadists. He loved the Qur’an, Allah, and his messenger Muhammad. This “character” coupled with a sharp intellect likely contributed to his willingness to examine the theology of Islam, and, ultimately, compare it to Christianity.

Tradition injects a lot into character, and, when that character matures, one becomes curious about tradition, religion, politics, culture, the meaning of life, and so on. Qureshi said one of the greatest hardships he faced was having to inform his parents he had become a Christian. He was, after all, part of a “community of believers” that were bonded together by solid theological principles and deep-seated tradition. He believed in Islam. He revered Muhammad. Regardless, once he met Jesus Christ, he could no longer reject Him than he could make himself stop breathing. This is precisely the type of character it requires to begin a theological study.

Insight comes from honest, rigorous, open-minded, and thorough study. We’ve been told that theology is in its simplest form “the study of God.” For me, the desire to know God stems from my burning desire to know why my earthly father seemed to hate me so much and, more frighteningly, whether my Heavenly Father was as mean-spirited, vindictive, nasty, judging, and punishing. (Incidentally, I eventually learned that my dad did not hate me, and he did the best he could to keep me from running off the rails and into the gutter.)

If God were to be “the same as” my dad, I would have no time for Him. Regardless, somewhere deep inside, I wanted to know several things. First, exactly who or what was this Christian God I’d heard of at church? Second, was He authoritative—leading from a position of authority and strength, love and longsuffering—or authoritarian—ruling over everyone with a heavenly despotic fist, ready to accuse and condemn? Third, was it true, as my father said many times, that I was worthless, or was there hope that my life had some greater meaning?

As to what type of character should result from theological study, Trevor Hart said, “Faith is not a natural progression from knowledge or experiences available to all, but results from a special dispensation which sets us in the perspective from which the truth may be seen, and demands a response” [4] [italics mine]. In other words, deciding to systematically study Christian theology is both a soulful drive or ambition and a rigorous discipline. I have gone through numerous personal changes as an undergraduate student of psychology at Colorado Christian University. I believe those changes set the stage for my choosing to take on a master’s level study of theology. There is a progression at play. Had I not first chosen to return to college, I would not have discovered CCU; had I not enrolled at CCU, I would not be the Christian I am today; and, had I not grown more mature in Christ as an undergraduate, I would not have undergone the requisite changes conducive to undertaking a master’s degree in theology.

This is the fourth week of my first theology class, and already I feel tectonic shifts within me. My personality has brightened, and my mind has cleared. I am ravenous for information about theology, Christology, eschatology, and apologetics. I see people as God sees them, and I’ve begun to feel a heartache for those who will never see the truth about the life, love, ministry, death, and resurrection of Jesus Christ. I have started to keep my promises more consistently than I used to, and I exercise greater control over my tongue (which was no easy task!). I even noticed a major change in the amount of television I watch. All of that notwithstanding, I find myself asking God every morning to put a task before me; to lead me where He needs me to go; to break my heart for what breaks His.

Footnotes

[1] R.E.O. White. “Sanctification.” Evangelical Dictionary of Theology. (Grand Rapids: Baker Academic, 2017), 770

[2] Thomas Aquinas. Summa Theologiae, I.II, q. 68, a1

[3] David Jeremiah. The Jeremiah Study Bible. (Nashville: Thomas Nelson, Inc., 2013), 893-94.

[4] Trevor Hart. Faith Thinking. (Eugene:Wipf & Stock Publishers, 1995), 75.

 

 

Let’s Go to Theology Class! Week Three

Summary of the third week of class in pursuit of my Master’s in Theology at Colorado Christian University.

Written by Steven Barto, B.S. Psych.

AS WE FOCUS ON the lessons covered to date in my initial theology class, we become familiar with how to understand faith as an object onto itself and its place in today’s world. Trevor Hart (1995) calls this type of study faith thinking. Theology is typically undertaken as part of a higher education, whether on the undergraduate, master’s or doctoral level; however, the activity known as “Christian Theology” must become (at least to some degree) an inevitable consequence of life as a thinking Christian. Why do we believe what we believe? How do we think about what we’re thinking about? What weight do we give it in our everyday Christian life?

Admittedly, I am behind in a few lessons from my first theology class. I was hit with an illness that put me behind in week three, and this had an unexpected domino effect. Not to worry. We are going to spend the next few days getting caught up. This will allow me to focus on the first lesson of my second theology class: Systematic Theology, Part 1 by Monday, October 14th.

In the third week of my initial class Major Approaches to Theology we discussed how to effectively read Scripture.

Certainly, reading is a two-way street regardless of its subject matter. When we read Scripture, we interact with information of paramount importance, on multiple levels, each having the potential to change how we see ourselves, our fellow man, and the material world. When reading the Bible, we are embroiled in a written medium that is alive. The New Atheists of today, such as Christopher Hitchens (1949-2011), are adamant about one thing: religion poisons everything. In his seminal book God is Not Great he wrote, “God did not make us; we made God.” In attempting to discredit the Bible, Hitchens used the tactic of lumping it in with the Qur’an, Homer’s Iliad, Salman Rushdie’s Satanic Verses, the red herring of “apocryphal” verses “canon,” and many other inter-related, if not unrelated, textual concerns.

Mesmerized by its reverence, power, emotion, history, and Almighty God, it is only natural for man to hold competing opinions on how best to respond to Scripture We are rightly overcome by a wide range of emotions when reading the Bible: conviction, elation, guilt, fear, boredom, hope, love and the like. Because Scripture is universally applicable, we don’t always know on an individual level how to categorize what we’re reading, let alone how to apply it to our situation. What is worth our immediate attention? What can wait until tomorrow? This is why systematic theology and the “community of believers” are critical to reading, understanding, and applying God’s Word.

Regarding Karl Barth, a Swiss theologian who penned such books as Church Dogmatics, Faith Thinking, and The Humanity of God, referred to Mark D.J. Smith’s quote, “The guiding principle of this strategy is Barth’s conviction that the Bible ought to be treated as testimony to God’s self-revelation in history.” Karl Barth believed Scripture must be regarded as God’s own words and nothing less. I recently read an attribute given to Barth. It says that, other than John Calvin, Barth is possibly the most important Protestant theologian of the twentieth century. Barth gave credence to a quote from N.T. Wright: “The tide of literary theory has at last reached the point on the beach where the theologians have been playing, and, having filled their sandcastle moats with water, is now almost in danger of forcing them to retreat, unless they dig deeper and build more strongly.”

Thankfully, grace is a key ingredient in any discussion regarding matters of the Word of God. Barth believed faith to be “awe in presence of the divine incognito.” Further, he understood full-well that faith (the faith each believer holds in his or her heart) cannot hold a candle to the amazing quality of love bestowed upon us through the written Word of God. Scripture is a living thing, yet it is at the same time both amazingly knowable and incomprehensible. Whenever an author writes a book explaining mercy or grace—and when those topics are the essence of the book itself—the writer risks having the subject matter missed entirely. Thankfully, as Christians, we know the “language” of the Bible in our hearts. We see its virtue and we know of its healing properties. Of course, this creates a great atmosphere for systematic theology and honest, open communication among the community of believers in order to best understand and apply the  accuracy and full meaning of Scripture. Barth equates Scripture with God speaking, as did Augustine. For both men, Scripture is in fact Scripture.

Of course, Scripture is not “just another holy book” or a canonical history of the Christian church. Nor, as Christopher Hitchens would claim, a book that can even remotely be categorized with the Qur’an or Homer’s Iliad! It is not merely a volume to be taken down from the shelf and studied. Hebrews 4:12 tells us, “For the word of God is living and active, sharper than any two-edged sword, piercing to the division of soul and spirit, of joints and marrow, and discerning the thoughts and intentions of the heart” (RSV). The Interlinear Greek transliteration says the Bible “[is] living… and operative and sharper beyond every sword two-mouthed and passing through as far as division of soul and of spirit, of joints both and of marrow and able to judge of thoughts and intentions of a heart.” (Excuse the cumbersome wording, but it is a literal rendition of the original Greek text.)

The writer of Hebrews adds, “And before him no creature is hidden, but all are open and laid bare to the eyes of him with whom we have to do (4:13, NIV). Eugene Peterson boldly says, “God means what he says. What he says goes. His powerful Word is sharp as a surgeon’s scalpel, cutting through everything, whether doubt or defense, laying us open to listen and obey. Nothing and no one is impervious to God’s Word. We can’t get away from it—no matter what” (4:12-13, MSG). It seems Barth had a rather “controversial” interpretation of Scripture. Although he approached the Bible with an orientation of sola scriptura (Scripture alone), many of his detractors tried to place him in one of the many –ism camps of his time: Platonism, Kantianism, intellectualism, biblicism, pessimism, universalism, or even modernism. Barth had one focus. The authority of the Word of God.

In the interest if keeping the momentum flowing, I intend to present a synopsis of my studies from weeks four and five of my first theology class in the next day or two. Thanks for stopping by. I encourage any comments, questions, or feedback.

For This Very Reason

For this very reason, make every effort to add to your faith goodness; and to goodness, knowledge; and to knowledge, self-control; and to self-control, perseverance; and to perseverance, godliness; and to godliness, mutual affection; and to mutual affection, love. For if you possess these qualities in increasing measure, they will keep you from being ineffective and unproductive in your knowledge of our Lord Jesus Christ” (2 Peter 1:5-8).

By Steven Barto, B.S., Psych.

THE APOSTLE PETER CONFIRMS our calling and election as members of the Body of Christ. He tells us that faith unites the weaker believer to Christ in the same manner that it does the stronger and mature believer. Every sincere believer is by his or her faith justified in the sight of God. This is the only means by which each of us are justified. There are no “favorites.” Upon belief in the life, sacrificial death, and resurrection of Jesus Christ as the Messiah, we all become clothed in the righteousness of Christ. As we grow in Him, our faith must work toward godliness—if you prefer, toward becoming more like Christ.

satan-in-silhouette-e1569902468622.jpg

Satan tries daily to pull us away from Christ, dragging us back to a life of sinfulness and self-centeredness. He attachs detritus and filthiness to our spirits in an attempt to blot out the righteousness of Christ with which we have been clothed. This is theologically impossible, of course, but we must remember to choose right thinking and proper acting every day—walking in a manner that truly demonstrates our repentance and exemplifies the new creation we have become in Christ. If we’ve truly done a 180, as they say, we will be less likely to habitually practice sin and unrighteousness. We cannot willfully choose disobedience. At the very least, when we are pulled back toward our old sinful ways, we must go kicking and screaming, fighting the tide of regression. Truly, we should resist the devil at every turn. When we do, he will flee.

James 4:7-10 says, “So let God work his will in you. Yell a loud no to the Devil and watch him scamper. Say a quiet yes to God and he’ll be there in no time. Quit dabbling in sin. Purify your inner life. Quit playing the field. Hit bottom, and cry your eyes out. The fun and games are over. Get serious, really serious. Get down on your knees before the Master; it’s the only way you’ll get on your feet” [MSG]. I am amazed by the number of Christians who don’t seem to grasp the power we have in Christ to stand against the wiles of Satan. Our authority over the devil is established by the work done by Christ on the cross.

Ephesians 2:20 says, “I have been crucified with Christ; it is no longer I who live, but Christ who lives in me; and the life I now live in the flesh I live by faith in the Son of God, who loved me and gave himself for me” (RSV). The same power that created the universe resides within us. Accordingly, Satan has no true power over us. He cannot force us to sin, nor can he possess us. This is not to say that he cannot oppress us, deceive us, or draw us away from the presence of God. That would be remarkable, but it would fly in the face of God’s primary gift to us other than our very salvation—He has given us free will.

The Building Blocks

As my friend Wally Fry wrote in his blog Truth in Palmyra,

We add these things Peter lists to our faith. Faith is always the starting point; however, it is not the endpoint. Faith never marks the end of our Christian lives, but only the beginning. Another thing to note is that this list Peter provides is not some sequential check-off list of Christian to-dos; it is to illustrate the totality with which we are to apply ourselves to progress in maturity.

Thank you Wally for providing this very profound truth we must all grasp as believers in Jesus Christ. Peter tells us that Jesus has given us everything we need for a godly life through our knowledge of Him who called us by His own glory and goodness. He says, “For this very reason add goodness, knowledge, self-control, perseverance, godliness, mutual affection, and love. There is a necessary progression here. Each attribute on Peter’s list is fully dependent on the prerequisite quality that precedes the new one. Peter adds, “The more you grow like this, the more you will become productive and useful in your knowledge of our Lord Jesus Christ” (2 Peter 1:8, NLT).

In his commentary on 2 Peter 1:5-8, Matthew Henry (1997) writes,

Faith work[s] godliness, and produces effects which no other grace in the soul can do. In Christ all fullness dwells, and pardon, peace, grace, and knowledge, and new principles, are thus given through the Holy Spirit. The promises to those who are partakers of the Divine nature, will cause us to inquire whether we are really renewed in the spirit or our minds; let us turn all these promises into prayers for the transforming and purifying grace of the Holy Spirit (p. 1240).

The New Living Translation expresses 2 Peter 1:5-8 thusly: “In view of all this, make every effort to respond to God’s promises. Supplement your faith with a generous provision of moral excellence, and moral excellence with knowledge, and knowledge with self-control, and self-control with patient endurance, and patient endurance with godliness, and godliness with brotherly affection, and brotherly affection with love for everyone. The more you grow like this, the more productive and useful you will be in your knowledge of our Lord Jesus Christ.” Please note, the more we grow in this fashion, the more likely we will have genuine unconditional love for everyone. Faith has to be more than mere belief—head knowledge, a mere collection of intellectual concepts or, if you prefer, mere “information.”

Belief, Faith, Behavior

Christian theology consists of three pertinent parts: belief (the cognitive decision-making that underlies our granting intellectual acceptance to its doctrines); faith (the inner state whereby we accept with complete trust and confidence—in our hearts rather than in our heads—the symbolic efficacy of those doctrines, grounded in spiritual apprehension rather than empirical evidence); and outward living or behavior (or, if you prefer, works). Religion provides us with a set of mental, symbolic, practical, and behavioral tools with which to approach the task of interpreting and living in our world according to our individual worldview. Christianity grounds this concept in the deity of Jesus Christ.

Faith Black and White Image

Our faith must be more than mere belief in a set of principles or doctrines. That’s just the jumping-off point. It must ultimately result in action; growth in Christ-likeness (character); and the practice of moral discipline—again, belief, faith, works. James 2:14-17 says, “What good is it, my brothers and sisters, if someone claims to have faith but has no deeds? Can such faith save them? Suppose a brother or a sister is without clothes and daily food. If one of you says to them, ‘Go in peace; keep warm and well fed,’ but does nothing about their physical needs, what good is it? In the same way, faith by itself, if it is not accompanied by action, is dead” (NIV). This supports the comment that we are saved for our good works. Indeed, the world should be able to recognize Christ in us. Jesus told the disciples “by their fruit you will recognize them” (Matthew 7:20, NIV) [italics mine].

Accordingly, a true life of faith leads to knowing God better, an increase in self-control, patient endurance in all things, godliness, and an abiding love of others under all circumstances. First Corinthians 13, often referred to as “the love chapter,” defines God’s unconditional love (from the Greek word agape), which we must all strive to attain:

Love is patient, love is kind. It does not envy, it does not boast, it is not proud. It does not dishonor others, it is not self-seeking, it is not easily angered, it keeps no record of wrongs. Love does not delight in evil but rejoices with the truth. It always protects, always trusts, always hopes, always perseveres. Love never fails (v. 4-8a, NIV).

We simply cannot express this depth of love without first seeking from God the power it requires to do so.

When Peter wrote for this reason, he was saying “along with this,” or “by the side of your obtaining precious faith.” His remark regarding what is added to our faith amounts to a kind of spiritual arithmetic. According to the Dake’s Annotated Reference Bible, there are seven steps in spiritual mathematics. You should note from this list that we cannot have a virtue without first being well-grounded in its prerequisite:

  1. Add to your faith virtue
  2. Add to virtue knowledge
  3. Add to knowledge temperance [self-control]
  4. Add to temperance patience
  5. Add to patience godliness
  6. Add to godliness brotherly kindness
  7. Add to brotherly kindness love.

Eugene Peterson, in The Message, translates 2 Peter 1:5-8 this way, “So don’t lose a minute in building on what you’ve been given, complementing your basic faith with good character, spiritual understanding, alert discipline, passionate patience, reverent wonder, warm friendliness, and generous love, each dimension fitting into and developing the others. With these qualities active and growing in your lives, no grass will grow under your feet, no day will pass without its reward as you mature in your experience of our Master Jesus. Without these qualities you can’t see what’s right before you, oblivious that your old sinful life has been wiped off the books” [emphasis added]. Let me repeat that last sentiment: that your old sinful life has been wiped off the books!

A closer examination of the blessings Peter speaks of in 2 Peter 1:1-4 indicate the following:

  • precious faith (Greek, isotimos), meaning equal honor purchased at a great price
  • righteousness
  • grace
  • peace
  • all things that pertain to life and godliness
  • glory
  • virtue
  • divine nature
  • escape from corruption and lust

Saved For Good Works

Paul tells us in Ephesians 2:10 that we are saved unto good works. Eugene Peterson puts it this way: “He creates each of us by Christ Jesus to join him in the work he does, the good work he has gotten ready for us to do, work we had better be doing” [emphasis added]. The Greek word for “ordained” Paul uses in verse ten is proetoimazo, which refers to preparing us for good works through regeneration. Remember, we do not possess the capacity under our own power to love unconditionally as described by Paul in 1 Corinthians 13. Our only hope is that through regeneration and progressive spiritual maturity we can build upon our virtue one step at a time, thereby increasing our ability—indeed, our likelihood—to begin imitating the agape love of Jesus.

It is Paul’s contention that we become Christians through God’s unmerited favor, not as the result of any effort, ability, intelligent choice, or act of service on our part. We will never be able to do enough good to overcome the pervasive sin nature that dwells in our flesh. We cannot do enough penance to secure the remission of our sins. Accordingly, out of gratitude for this free gift of redemption, we must reach out to serve others with kindness, love, and gentleness—not merely to make ourselves look good. God intends for our salvation to lead to spiritual maturity, which should include acts of service. After all, we are God’s masterpiece. Our salvation is something only God can accomplish, and even then it required the death of His Son Jesus Christ. All of us, no matter who we are or what we’ve done, are God’s masterpiece. Whenever we reach out and feed the hungry, clothe those who don’t have adequate clothing, heal the sick, or visit those who are in prison, it is as if we do these things unto Jesus (see Matthew 25:35-40).

For this very reason, we are called onto good works through progressive growth in Christian virtue and love.

References

Dake, Finis. Dake’s Annotated Reference Bible. Lawrenceville, GA: Dake Publishing, Inc., 2008.

Grudem, Wayne. Systematic Theology. Grand Rapids, MI: Zondervan, 2000.

Henry, Matthew. Matthew Henry’s Concise Commentary on the Whole Bible. Nashville, TN: Thomas Nelson, Inc., 1997.

Disturber of the Peace

Written by Steven Barto, B.S. Psych.

Lucifer Cast Down.jpg

WE HAVE HEARD OF many names for Satan. He started as Lucifer—his name is derived from the Hebrew word (helel), which means “brightness.” In Latin, it means “shining one, light-bearer.” This is also the Latin name for the planet Venus, the morning star in the ancient Roman era, often used for mythological and religious figures associated with the planet. The name “Satan” is derived from Hebrew, meaning “adversary.” He has been called Beelzebub, Belial, the tempter, god of this world, prince of the power of the air, and the father of lies. I’d like to propose one more: disturber of the peace.

The following is the legal definition of the term disturbance of the peace:

Disturbing the peace, also known as breach of the peace, is a criminal offense that occurs when a person engages in some form of unruly public behavior, such as fighting or causing excessively loud noise. When a person’s words or conduct jeopardizes another person’s right to peace and tranquility, he or she may be charged with disturbing the peace.

When I think of peace in a generic sense, I tend to scratch my head and wonder from where does this lovely ideal come? Why, if it exists, why do we failed to find “peace?” Why, instead, do we find conflict, turmoil, frustration, agitation, disharmony, distress, fighting, and a deep sense of personal angst? In Psalm , David cries out to the LORD seeking the opposite of turmoil, persecution, anxiety, and fear he sometimes felt. He previously stated in Psalm 3:1, “LORD, how many are my foes! How many rise up against me” (NIV). He said this after fleeing from the murderous intent of his own son! He makes this wonderful proclamation in Psalm 4:8: “In peace I will lie down and sleep, for you alone, LORD, make me dwell in safety.”

Jesus With Open Arms

With the peace of Christ, we feel a sense of quietness come over us. Its meaning in Hebrew (sâlôm) is quite comprehensive in its meaning: “wholeness, completeness, soundness, health, safety and prosperity.” It is a favorite biblical greeting, is used as a dismissal to or cessation of war, relationship between friends, and man’s relationship with God. The prophet Isaiah describes the fruit of righteousness as peace, stating “its effect will be quietness and confidence forever” and that God’s people will “will live in peaceful dwelling places, in secure homes, in undisturbed places of rest” (Isaiah 32:17-18). The prophet also wrote, “‘There is no peace,’ says the LORD, ‘for the wicked'” (48:22).

Jesus said, “Peace I leave with you; my peace I give to you; not as the world gives do I give to you. Let not your hearts be troubled, neither let them be afraid” (John 14:27, RSV). The Greek word used in this verse is eirênê, which refers to the peace that is the gift of Christ. It is also used many times in the New Testament to express Christ’s mission, character, and gospel. The purpose of the incarnation of Jesus was to bring spiritual peace with God through reconciliation. Luke 1:79 says, “to shine on those living in darkness and in the shadow of death, to guide our feet into the path of peace” (NIV). Christ’s life depicted in the Gospels is one of majestic serenity (Matthew 11:28; John 14:27). The very essence of the gospel can be expressed in “peace” (Acts 10:36; Ephesians 6:15). As Christians, we have countless blessings that are grounded in peace.

The mystical writings of the Zohar (a mixture of the mystical aspects of the Torah, secular mysticism and psychology) teach that God is peace, His name is peace and all is bound together in peace. In post-Talmudic Jewish thought, Isaac Arama paraphrased this idea by saying:

Peace is a positive thing, the essential means by which men of differing temperaments and opinions can work together for the common good. Pearls of individual virtue would be dim in isolation were it not for the string of peace that binds them together and so increases their luster. That is why peace is a name of God for it is He who gives unity to the whole of creation.

The Opposite of Peace

Paul wrote, “Let the peace of Christ rule in your hearts, since as members of one body you were called to peace. And be thankful. Let the message of Christ dwell among you richly as you teach and admonish one another with all wisdom through psalms, hymns, and songs from the Spirit, singing to God with gratitude in your hearts. And whatever you do, whether in word or deed, do it all in the name of the Lord Jesus, giving thanks to God the Father through him” (Colossians 3:15-17). Perhaps the opposite of peace is rooted in our failure to adhere to Paul’s admonition?

Anxiety 01.jpg

Truly, anxiety is antithetical to peace. The American Psychological Association defines anxiety (in a general sense) as an emotion characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure. In clinical terms, anxiety may become quite pronounced. People with anxiety disorders usually have recurring intrusive thoughts or concerns. They may avoid certain situations out of worry. They may also have physical symptoms such as sweating, trembling, dizziness or a rapid heartbeat.

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), anxiety disorders include those that share features of excessive fear and anxiety and related behavioral disturbances. Fear is the emotional response to real or perceived imminent danger, whereas anxiety is anticipation of future peril. Panic attacks feature prominently within the anxiety disorders as a particular type of fear response. A few decades ago, I began to experience overwhelming anxiety. It seemed no matter what I did, I could not escape the thought that something drastic was about to happen. This unfortunately led to panic attacks. On one occasion, I was nearly done shopping for groceries when I became overwhelmed with debilitating panic and fear. It was so pervasive that I left everything in my cart (milk, ice cream, cheeses, meats, and all) and ran from the store. 

So what are the deciding criteria for panic disorder? According to the DSM-5, a panic attack is an abrupt surge of intense fear or discomfort that reaches a peak within minutes, and during which time four (or more) of the following symptoms occur:

  1. Palpitations, pounding heart, or accelerated heart rate.
  2. Sweating.
  3. Trembling or shaking.
  4. Sensations of shortness of breath or smothering.
  5. Feelings of choking.
  6. Chest pain or discomfort.
  7. Nausea or abdominal distress.
  8. Feeling dizzy, unsteady, light-headed, or faint.
  9. Chills or heat sensations
  10. Paresthesias (numbness or tingling sensations).
  11. Derealization (feelings of unreality) or depersonalization (being detached from oneself).
  12. Fear of losing control or “going crazy.”
  13. Fear of dying.

If a panic attack is followed by one month (or more) of the following: persistent concern or worry about additional panic attacks or their consequences (e.g., losing control, having a heart attack, “going crazy;” a significant maladaptive change in behavior related to the attacks (e.g., behaviors designed to avoid having panic attacks, especially avoidance of exercise or unfamiliar situations). Not surprisingly, many people who are in the throes of a panic attack believe they are actually having a heart attack.

The Story of Satan

Satan Attributes

In Ezekiel 28:14-15 we hear God speaking of the fall of Lucifer: “You were anointed as a guardian cherub, for so I ordained you. You were on the holy mount of God; you walked among the fiery stones. You were blameless in your ways from the day you were created till wickedness was found in you” (NIV). Isaiah writes, “How you have fallen from heaven, morning star, son of the dawn! You have been cast down to the earth, you who once laid low the nations! You said in your heart, ‘I will ascend to the heavens; I will raise my throne above the stars of God; I will sit enthroned on the mount of assembly, on the utmost heights of Mount Zaphon.’ I will ascend above the tops of the clouds; I will make myself like the Most High'” (Isaiah 14:12-14, NIV).

Some theologians have refused to apply the prophesies of Isaiah 14:12-14 and Ezekiel 28:12-15 to Satan under the contention that these passages are addressed solely to the king of Babylon (in Isaiah) and the king of Tyre (in Ezekiel). Others believe these scripture passages refer to Lucifer for two important reasons: first, these prophecies far transcend any earthly ruler, and, second, Satan has a close connection in Scripture with the world system. Ephesians 6:12 says, “For we are not contending against flesh and blood, but against the principalities, against the powers, against the world rulers of this present darkness, against the spiritual hosts of wickedness in the heavenly places” (RSV).

Revelation 12 describes the casting down of Lucifer: 

Then war broke out in heaven. Michael and his angels fought against the dragon, and the dragon and his angels fought back. But he was not strong enough, and they lost their place in heaven. The great dragon was hurled down—that ancient serpent called the devil, or Satan, who leads the whole world astray. He was hurled to the earth, and his angels with him… Therefore rejoice, you heavens and you who dwell in them! But woe to the earth and the sea, because the devil has gone down to you! He is filled with fury, because he knows that his time is short (12:7-9, 12, NIV).

Tempted (Apple)

Satan, as the “serpent,” caused the fall of the human race (Genesis 3). His judgment was predicted in Eden (3:15) and accomplished at the cross (John 12:31-33). It’s been said by theologians that the number of demons who roam the earth in service to Satan is so great as to make them practically ubiquitous. Satan, although adjudicated “guilty” at Calvary, continues to usurp authority. Second Corinthians 4:4 tells us, “In their case the god of this world has blinded the minds of the unbelievers, to keep them from seeing the light of the gospel of the glory of Christ, who is the likeness of God” (RSV). Satan tempts and accuses us daily, intending to steal our peace and destroy our relationship with Christ. Believers are reminded of this in Ephesians 6:11-18, which contains specific and powerful instructions for how to defeat him.

Loss of Meaning or Purpose

One of the main reasons I have decided to follow my undergraduate degree in psychology with a master’s degree in theology is because I see a tremendous loss of meaning or purpose today. Especially in Western society, we tend to seek definition for our lives—what makes us joyous or happy or believewe have a sense of worth—through “things.” From a materialistic standpoint, this can be anything from the car we drive to the type of cell phone we carry conspicuously as we walk through the supermarket. For others, it is determined by the size of their bank accounts or the overall accumulation of wealth. We seem to have forgotten that none of these things will provide a true sense of worth, purpose, or peace. In the extreme, this approach becomes a form of idolatry.

Ravi Speaking.jpg

I have been following the ministry of Ravi Zacharias for several years, and enjoy watching his lectures and debates. I’ve read several of his books, including The End of Reason: A Response to the New Atheists and Beyond Opinion: Living the Faith We Defend. I highly recommend both books. (For further information concerning Ravi’s ministry please click here.) 

Ravi Zacharias says questioning life’s meaning and our purpose is quite normal. We are, after all, sentient beings. Unlike any other animal in God’s universe, we have capacity for morality, justice, beauty, meaning, love, and hatred. We’re hardwired to ask, debate, challenge, and search. He notes four great questions for which we seek answers: origin, meaning, morality, and destiny. Where did I come from? Why am I here? How should I live? Where am I going? I honestly know no one over my years that has not contemplated these questions. The result of a sense of meaninglessness in America and across the world has caused a myriad of social and personal consequences, ranging from addiction and other excesses to mental illness and conflict. Pluralism and moral relativism have led to a loss of any sense of “the vertical” view between heaven and earth, God and man, right and wrong. The great lie being taught today is there are no absolutes—that everyone’s worldview is correct. This is simply not true.

According to Zacharias, there is an immense difference between a worldview that is not able to answer every question to complete satisfaction (the Christian worldview) and one whose answers are consistently contradictory or arbitrary. There is an even greater difference between answers that contain paradoxes and those that are systemically irreconcilable. The Christian faith stands out as unique in this test, both as a system of thought and in the answers it provides. Christianity does not promise that you will have every question fully answered to your satisfaction before you die, but the answers it gives are consistently consistent. There may be paradoxes within Christian teaching and belief, but they are not irreconcilable.

Emmanuel Kant said, “Thought without faith is empty. Faith without thought is blind.” A genuinely critical Christian theology will be firmly rooted in the tradition of faith while open to the inevitable and necessary reforming of its traditional thought through critical reflection and interaction with new sources of knowledge, new ways of seeing things. A great example is the adjustment made in Christian thought when it was demonstrated through empirical evidence that the sun does not revolve around the earth (geocentric), but that the earth revolves around the sun (heliocentric).

The fact that truth is never available to us in any direct or absolute manner does not mean that we may not pursue it, or that we are unable to lay hold of it at all. The realization that our knowledge is inevitably mediated by some perspective or other does not lead automatically to the despairing conclusion that all points of view are equally useful in answering the question of truth.  Believing that there is something real out there to be known, therefore—that there is a truth to be laid hold of—yet recognizing nonetheless that our particular viewpoint is precisely that, and that the “view from nowhere” is unavailable to us, our concern will be to ensure that we stand in the place which offers the best view available.

Concluding Remarks

Not since the end of World War II has mankind felt afloat on menacing seas. The events of 9/11 (this generation’s Pearl Harbor) plunged us headlong into constant fear and loathing. Hatred, especially as it pertains to racism and violent terrorism, has created a tremendous loss of the sense of safety and security, and has given rise to ever-increasing claims that there is no God; or, if there is, that He is a violent heavenly despot. We see things from “left to right” with little-to-no concern for the middle. We are turning on one another in the name of ideology.

God wants us to be still and know that He is God; that He will be exalted in all the earth (Psalm 46:10). The Hebrew word for still comes from a word meaning to “let go” or “release.” He will make wars cease to the ends of the earth. He will break the bow and shatter the spear. Be still is a call for us to stop fighting and be quiet in Him. It comes from the Hebrew word rapa, meaning “to slacken, let down, or cease.” In some instances, the word carries the idea of “to drop, be weak, or faint.” It connotes two people fighting until someone separates them and makes them drop their weapons. It is only after the fighting has stopped that the warriors can acknowledge their trust in God.

We will find no true sense of meaning or purpose until we let go of the reigns, stop trying to be “right” (especially through might), and return to a vertical orientation (up-and-down.) We are all made in God’s image. We’re expected to look toward Him for the answers to Ravi Zacharias’ four great questions. Where did I come from? Why am I here? How should I live? Where am I going? Further, as Christians, we are commanded to give an answer for the reason for our faith, and to do so with “gentleness and reverence” (1 Peter 3:15, RSV). The true path to finding the meaning of life lies in the “community” of believers. Without first putting down our weapons and taming our tongues, we will not discover a comprehensive, cohesive worldview, nor will we be able to come against the true disturber of the peace: Satan.

 

 

 

 

Let’s Go to Theology Class! Week Two

Summary of the second week of class in pursuit of my Master’s in Theology at Colorado Christian University.

Written by Steven Barto, B.S. Psych.

WE HAVE LEARNED SO far that theology is an attempt by faith to understand itself, its object, and its place in today’s world. Trevor Hart (1995) calls this exercise faith thinking. Although theology is typically undertaken as part of a higher education endeavor, the activity known as “Christian Theology” should be an inevitable consequence of life as a thinking Christian. Systematic Theology is defined as “an integrating discipline that studies how the church may bear enduring, timely, and truthful witness to God as revealed in Jesus Christ.”

This week’s lesson focused on understanding religious faith. In Trevor Hart’s Faith Thinking, he expounds on contemporary approaches to theology through examination of objectivism and relativism, saying these are the only available intellectual options a “theologian can use. The Church Covenant at my home church indicates, “We covenant that we will not forsake the assembling of ourselves together, but will regularly attend the services of this Church. We will strive for its advance in knowledge, holiness, and fellowship, and sustain its ordinances, discipline and doctrines” (see Hebrews 10:25 for scriptural authority).

Further, the Covenant states that spreading of the Gospel must be built upon the truth, which can only be attained through being reconciled to God and being the very ambassadors through which God may work in the same manner He worked through Christ (see 2 Cor. 5:19-21). In other words our church members are expected to walk carefully in the world, being just in their dealings, faithful in their responsibilities and exemplary in their conduct, as well as understanding [having accurate knowledge of] what the Lord’s will might be. This directive is based upon Ephesians 5:15, 17.

Wolfhart Pannenberg

Clearly, faith evaluated through an objective view must focus on reason, purpose, and the individual self. This stems from the basic approach of objectivism as relating to or being comprised of only that which can be observed, negating the importance (if not existence) of that which cannot be observed. According to Trevor Hart, this is considered “public” versus “private” theology. This is specific to the manner in which we discuss or hold our underlying belief and should not to be interpreted as being double-minded or hypocritical.

Pannenberg believes the theologian’s first responsibility is to aid people in experiencing as reality whatever they are expected to build upon as their true theology or faith. He says this must be accomplished prior to the theologian asking individuals to take an initial step of faith. The basic platform on which such faith is built must be firm, thereby promoting confidence in the platform. Hart indicates some individuals will step out further in faith than others. Regardless, the Christian theologian cannot expect a potential believer (skepticism often hindering absolute conviction) to take that first step without his giving them a “good reason for doing so and pointing to something firm to place their foot on.”

What is this objective approach to faith? It’s been said that in order for faith to operate properly—that is, to provide an adequate window through which we can contemplate truth—we must grasp a meaning in our soul which is intrinsic and built upon knowledge we’ve come to accept as so. If it is based on internal, subjective truth, we may become fearful of investigation, asking What will become of believers if they dare challenge the very doctrine they are invested in as ontological? Under this system of thought, we might feel less of a believer whenever we question any tenet of our faith. Pannenberg says the reasonableness of responding to the Gospel and committing oneself to Jesus must be demonstrable to those who are not yet Christians—those who lack faith from the start. Pannenberg seems to take an apologetics view as he addresses the ruminations of the modern world concerning God and Christology. He believes theology must clearly demonstrate the credibility of its claims. As such, Pennenberg took an objective approach to theology.

Paul Althaus

Paul Althaus says the “truth” of the Christian gospel is not necessarily apparent to those who cannot see it. There’s a sense of predisposition here: The gospel cannot be grasped by those without the “eyes to see” or the “ears to here.” It is, therefore, not objective. Instead, Althaus said the study of systematic theology was relative to what each individual intrinsically believes to be true. There is a troublesome dilemma here: This type of God knowledge is unknowable in any straightforward way by the masses—it is not given in the public arena. Instead, it is merely discerned by the eye of faith specific to the individual.

There is a slight hint of Gnosticism with Althaus in that, as Hart puts it, Althaus argues “the true significance of those facts remains hidden or obscured to unbelief and is only recognized from the particular perspective of faith.” Althaus notes the many outward (public) examples of the signs and miracles performed by Jesus as proof of His claim to be the Messiah. He says, “There is nothing about them which, when viewed by the public at large, compels such recognition.” He thinks faith is not based on progressive accumulation of knowledge or experiences available to all; rather, it amounts to a special dispensation setting some believers apart, revealing truth and demanding an appropriate response, which seems to speak of an internal, relative and subjective belief system. Althaus seems to mix a bit of Calvinism or predestination in with this belief.

Pannenberg disagrees. He says if we accept that the meaning of gospel realities are only knowable based on a “prior decision of faith… then two things seem to follow.” First, we will be forced to embrace relativism, indicating there is no intrinsic truth or value “for its own sake,” only that which we choose to invest in it. Second, Althaus says there is a crude logical gap between public perspective and faith’s perspective. He believes faith to be some “absurd character” lacking any support from the perspective of what is commonly observed. It seems the best point of view for deducing the existence and meaning of God must come from without: As Augustine puts it, knowledge of God must be sought from God. Moreover, Pannenberg says, “Faith is not a blind leap, but a carefully considered and reasoned judgement; not a state of ‘blissful gullibility’ but a venture in which the Christian ‘risks trust, life and future on the fact of God’s having been revealed in the fate of Jesus.”

John Macquarrie

John Macquarrie tended to mix orthodox Christianity and existentialism. He saw faith not as a mechanism or demand as a prerequisite to finding the knowledge of faith and of God—an external, objective approach. Instead, he saw it as “a critical and reflective activity to which faith eventually leads.” Theology for Macquarrie is an activity of faith, but not in the sense that it requires or demands compilation of information through a prerequisite or a priori approach. Instead, he does see theology as a reflective and highly critical undertaking to which faith naturally leads. This writer is not sure how helpful it is to divorce faith from theology, especially when Macquarrie requires that it be set aside during the actual practice of theology. No doubt this is a side-effect of his existential approach to knowing.

Without a firm foundation (faith) on which to build, there remains the chance (with each individual search) to end up down some tangential path that will only serve to confuse and frustrate the search for truth. It is important that believers recognize their individual biases, preconceptions and assumptions about theology (public or private), and, knowing such exist, subject their conclusions to the scrutiny of the community of believers. This permits side-by-side evaluation of prescribed canons of truth, whether rational, historical, experiential, or whatever the focus. Hart says, “Theology, we are given to understand, must play the intellectual game together with everyone else on a level playing-field.”       

Bibliography

Hart, Trevor. Faith Thinking: The Dynamics of Christian Theology. Eugene, OR: Wipf & Stock Publishers, 1995.

 

Emergency Departments Can Help Prevent Opioid Overdoses

From the Blog of Dr. Nora Volkow
Executive Director, National Institute on Drug Abuse

Additional Writings by Steven Barto, B.S., Psych.

nida-banner-science-of-abuse-and-addiction

Originally Posted at the NIDA Website on August 26, 2019

One of the biggest risk factors for overdose death from opioids is having had a previous overdose. Common sense and a growing body of research suggest that patients with Opioid Use Disorder who receive acute care in an emergency department will be at reduced risk for later overdose if they are initiated on medications to treat their Opioid Use Disorder. Unfortunately, too few Emergency Departments are making this a standard practice, and lives are being lost as a result.

According to a new report published by the Delaware Drug Overdose Fatality Review Commission, half of the people in the state of Delaware who died of an overdose in the second half of 2018 had suffered a previous nonfatal overdose, and more than half (52%) of the overdose deaths occurred within three months of a visit to the emergency room. Even when visits were not for overdose, signs of Opioid Use Disorder were apparent during the visit in most cases. The report thus recommended that patients who visit emergency rooms with obvious signs of Opioid Use Disorder should be immediately referred to rehabilitation treatment. Optimally, the initiation of medication for Opioid Use Disorder should be started before patients are discharged. This will improve their clinical outcomes.

girl-overdose.jpg

Even without a waiver, Emergency Department providers are permitted to administer Subcutex (buprenorphine) or methadone a limited number of times to patients under their care. In fact, several studies have now shown the benefit of initiating Subcutex in the Emergency Department rather than just referring the patient to drug treatment—it is called an “emergency” department for a reason! A recent NIDA-funded study by Yale researchers published in JAMA in 2015 showed that Subcutex treatment initiated by Emergency Department physicians was associated with decreased opioid use and improved treatment engagement in the 30-day period following discharge.

There is significant evidence that medications for Opioid Use Disorder prevent overdoses. For example, a prospective cohort study of 17,568 opioid overdose survivors in Massachusetts published last year in Annals of Internal Medicine found significant reductions in the risk of subsequent overdoses over the next 12 months in those who received treatment with methadone or Subcutex. Yet, only 30 percent of those who had overdosed received medication for Opioid Use Disorder. This statistic is extremely alarming, because the sample of patients was clearly at high risk for overdosing.

Bottles of Opiate Prescriptions

More alarmingly, 34 percent of those who had been treated for overdose received additional opioid pain prescriptions during the subsequent 12 months, despite their overdose history, and 26 percent received benzodiazepines, which as respiratory depressants further increase risk of overdose in those who misuse opioid drugs or who are being treated with high doses of opioid medications for pain management. [From my personal experience, benzodiazepines were hightly addictive and I tended to abuse them along with oxycodone. Family members noted my complete lack of sadness or empathy during my father’s funeral in December 2014. I stared at the floor and did not shed a tear. This is solely based on the fact that I was high on oxycodone and benzodiazepines at that time.]

It is crucial that acute care physicians, and the health care systems in which they practice, become aware of the importance of ensuring that patients be screened for Opioid Use Disorder and, if same is detected, that they receive treatment, ideally by initiating them on Subcutex before they are released.  Additionally, patients who visit an Emergency Department because of an overdose, or who otherwise show signs of Opioid Use Disorder, should be sent home with Narcan (naloxone)  and given instructions on how to use it to reverse an opioid-induced overdose. This was another recommendation of the Delaware report.

Naloxone kit

Four out of five fatal overdoses reviewed by the Delaware state commission occurred in a private residence were Narcan was unavailable in nearly 93% of the cases. Abundant research has shown the life-saving benefits of distributing Narcan not only to people who are addicted to opioids or misusing them but also to pain patients being treated with high doses of opioid medications and their families and friends. After all, patients taking opiates for severe chronic pain are at risk of becoming dependent on the narcotic, and could suffer an accidental opiate overdose. It is simply a matter of brain neurochemistry that has no true moral component, and can impact patients of any socioeconomic class.

Making Emergency Department physicians more responsive to the opioid epidemic often means educating colleagues and changing hospital culture. Many emergency physicians do not feel adequately prepared to treat with Subcutex—there are real or perceived logistical impediments like obtaining prior authorization from insurers. Emergency physicians should be encouraged to complete the training necessary to get a waiver to prescribe Subcutext, which greatly enhances their confidence and ability to respond to patients with Opioid Use Disorder.

The NIDA-MED website includes firsthand stories from physicians implementing emergency department overdose treatment with buphrenorphine and prescribed Suboxone to patients suffering from Opioid Use Disorder. Gail D’Onofrio, the lead researcher of the 2015 JAMA study, translated the study findings into practical videos for Emergency Room clinicians now posted on NIDA-MED. NIDA has also developed a companion, comprehensive set of resources to help emergency physicians initiate buprenorphine. In fact, initiating buprenorphine treatment in the emergency room includes step-by-step guidance on buprenorphine treatment, discharge instructions, instructional videos for clinicians on interacting with Opioid Use Disorder patients, and other useful materials.

[PLEASE NOTE: I have added the following sections to Dr. Volkow’s blog post.

Let’s Take a Look at Opioid Use Disorder

DSM 5

The American Psychiatric Association¹ included a comprehensive explanation of Opioid Use Disorder in their Diagnostic and Statistical Manual of Mental Disorders, Fifth Ed. (DSM-5), beginning at page 541. Essentially, Opioid Use Disorder (OUD) is a problematic pattern of opioid use leading to clinically-significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period:

  1. Opioids are often taken in larger amounts or over a longer period than was intended [by the prescribing physician].
  2. There is a persistent desire or unsuccessful effort to cut down or control opioid use.
  3. A great deal of time is spent in activities necessary to obtain the opioid, use the opioid, or recover from its effects.
  4. Craving or a strong desire or urge to use opioids.
  5. Recurrent opioid use resulting in a failure to fulfill major role obligations at work, school, or home.
  6. Continued opioid use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of opioids.
  7. Important social, occupational, or recreational activities are given up or reduced because of opioid use.
  8. Recurrent opioid use in situations in which it is physically hazardous.
  9. Continued opioid use despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance.
  10. Tolerance, as defined by either of the following: (a) a need for markedly increased amounts of opioids to achieve intoxication or desired effect; (b) a markedly diminished effect with continued use of the same amount of an opioid. NOTE: This criterion is not considered to be met for those taking opioids solely under appropriate medical supervision.
  11. Withdrawal, as manifested by either of the following: (a) the characteristic opioid withdrawal syndrome (refer to Criteria A and B of the criteria set for opioid withdraw in the DMS-5, p. 547-548; (b) opioids (or a closely-related substance) are taken to relieve or avoid withdrawal symptoms. NOTE: This criterion is not considered to be met for those individuals taking opioids solely under appropriate medical supervision.

Healthcare is not yet doing enough to avail itself of an effective referral system in the opioid crisis: using visits to emergency rooms to get patients with Opioid Use Disrder on medication and provide them with Naloxone. Intervening in these simple ways would greatly help reduce the shocking numbers of deaths from opioids in this country.

Are You Struggling?

I was obsessed with alcohol and drugs for nearly four decades of my life, which caused horrific and lasting consequences. I ended up serving three years in a state prison around the time I turned 20 years old. My history of using had started in early summer of 1977 shortly after graduating high school. I enjoyed the escape these mind-altering (numbing?) substances provided. Admittedly, it was quite fun at first. Within months, I became dependent on drugs and alcohol in order to function and to feel any degree of release from the demons of my past and the obsessive thoughts in my brain. I couldn’t laugh, relax, enjoy sex or food, or sleep unless I first got high or drunk. Sadly, I struggled with active addiction from shortly after my 18th birthday in 1977 to June 8, 2019.

I had started smoking cannabis and popping oxycodone pills during early Spring of 2018 in an attempt to self-medicate my depression, anxiety, and severe back pain secondary to a construction-related injury several years ago. Looking at the above description of Opioid Use Disorder established by the DSM-5, when in active opiate addiction I exhibit ten out of eleven of the criteria needed for a definitive diagnosis! I am sixty years old now, and I am finally looking at who I am in Christ. I am clean from opiates and cannabis for nearly 120 days, and I no longer dwell on the decades of constant failure. I should mention that I nearly took my own life several times during  my long history of active addiction. My struggle with opiates is fairly recent, and has taken me to places that I did not wish to go. Thankfully, I am confronting this issue with confidence in the power of the Name of Jesus and my unmitigated committment to change, never to be the same.

I work extensively today with a drug and alcohol counselor who is a believer in Christ. The ability to focus on Christ in therapy sessions provides an opportunity to examine the “spiritual malady” of addiction. I am constantly in contact with several elders at my home church who have become mentors. I am “coachable” today. I have started speaking regularly with Duche Bradley on the phone. He has a nationwide ministry of speaking in prisons and high schools about addiction and who we are in Christ Jesus. You can hear his “white chair” testimony here. He has led me through renouncing pharmacia and all nature of flesh-bound habits and addictions, and has encouraged my growth in Christ in order to move forward with my own ministry. Duche said to me, “Brother, if you do these things, you will be blown away about the many permanent changes in your character and your life.”

Nowadays, after having submited to Jesus Christ as my “higher power”—indeed, as my Savior and my Lord and Teacher—the obsession to use chemicals is gone. Likewise, the physical compulsion or craving has been defeated. I could never accomplish this under my own power. The Big Book of Alcoholics Anonymous tells us that alcohol is cunning, baffling, and powerful! No human power can relieve our alcoholism, but God can and will if we seek Him. The same applies to drug addiction. After all, a drug is a drug whether you drink it, snort it, or shoot it into your veins.

It is only through admitting my weaknesses and deciding to work with those who have risen above the evil and failure in their lives that I can get on with my life: studying theology on the master’s degree level, teaching weekly Bible study lessons at a local homeless shelter, and reaching out to newcomers at 12-Step meetings that are presently on a rapid decent into the living hell of active addiction. By accepting God’s “call” on my life, I can move toward a ministry of evangelism, applied apologetics, and lecturing, writing about, and teaching about Christianity and the release we all can have through Jesus. This is my life (as it was always meant to be), and I am happy to finally get on with living it!

call-911-in-an-emergency_fi.png

Given the near impossibility of quitting a mind-altering substance on your own, I highly suggest you reach out to someone who’s been there. Check your local government phone number pages in the phone book or, better, yet, do a Google search for A.A. or N.A. If, however, you are in the middle of a psychological or physical life-threatening crisis secondary to substance abuse, Please Call 911.

With suicides on the rise, the federal government wants to make the National Crisis Hotline easier and quicker to use. A proposed three-digit number — 988 — could replace the National Suicide Prevention Lifeline, 1-800-273-TALK (8255). The FCC presented the idea to Congress in a report earlier this month and is expected to release more information and seek public comment about the proposal in the coming months. PLEASE REMEMBER: You are not alone.

______________________________
¹ American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, fifth ed. (DSM-5). Arlington, VA: American Psychiatric Publishing (2013), pp. 547-548.