The Nature of Man; The Nature of Sin

I do not understand my own actions. For I do not do what I want, but I do the very thing I hate. For I do not do the good I want, but the evil I do not want is what I do. Now if I do what I do not want, it is no longer I that do it, but sin which dwells within me. For I delight in the law of God, in my inmost self, but I see in my members another law at war with the law of my mind and making me captive to the law of sin which dwells in my members” (Romans 7:15, 19, 20, 22-23, RSV).

“Among these we all once lived in the passions of our flesh, following the desires of body and mind, and so we were by nature children of wrath, like the rest of mankind” (Ephesians 2:3, RSV).

By Steven Barto, B.S. Psych.

THE DOCTRINE OF SIN has become increasingly controversial in recent years. In fact, it is often stated by those of a liberal philosophy that conservative concepts and values concerning man and his sinful nature are archaic. Today’s New Atheists typically accuse Christians of being narrow-minded, backward, or elitist. How can Christianity claim unequivocally that man is (by his very nature) sinful? Or that the only means by which man can be “saved” is through faith alone in Christ Jesus alone? The above Scriptures indicate that as human beings we are prone to follow the desires and passions of our flesh and our minds.

Paul is presenting us with a description of an ongoing struggle with sin in Romans 7:14-25. He describes himself as a “prisoner” of sin, doing the evil he does not want to do, and not doing the good he does want to do. This is what is meant by being in bondage to sin. Paul sees himself as a “wretched” man crying out for deliverance. His self-portrayal in this passage demonstrates a man who is captive to sin in two aspects: in both his conscious choices and decisions, and also in his unconscious reactions to people and circumstances. It has been said that habitual sin is lodged somewhere in our unconscious responses to stimuli.

It would appear that Paul finds himself settling on options he does not want to choose, and responding habitually to situations and people in ways which he does not want to act. From a psychological perspective, these unconscious choices qualify as habitual sins. The accepted psychological definition of habit is a conditioned, automatic response to a stimulus, performed apart from conscious thought or choice. That may sound simple and innocent on the surface, but when it comes to unconscious behavior we are talking about compulsion. The average person wishing to discontinue a habit deemed to be unhealthy or, in the present application, sinful, sees a gradual or (sometimes) immediate decrease in said behavior. But what of those individuals who are not able to change their behavior? Psychiatry would have us believe there is a neurotic or psychological component to the habitual practice of that behavior.

Compulsion is a state of mind in which an individual feels an irresistible urge to perform an action. The word also connotes the action itself. In such a state, the individual feels compelled to say, think or do something they are unable to resist which, even at that very moment, appears to him or her to be harmful, absurd, pointless, or unhealthy. Of course, this is the very root of addiction. The command to perform the action comes from within and is contrary to the conscious will. We can now see the dilemma of defining the type of behavior Paul describes in Romans 7.

The conflicts underlying habitual performance of sinful acts are (according to Paul) unconscious. Such conflicts are varied and involve difficulties like fear, hostility, hatred, rejection, persistent self-doubt, despair, and self-destruction—all of which run contrary to the instinct to act in such a manner as to assure continued health, safety, and life. Of course, Paul’s argument is that once a Christian becomes aware of his or her tendency to sin (while in the flesh), the nature of sin and its concomitant consequences should provide some degree of strength or ability to decrease sinful acts in order to promote spiritual growth. He realizes that his sinful nature (that which resides in his flesh) seeks instant gratification regardless of the consequences of giving in to temptation. In other words, he does not see a “human” remedy for this problem; only a spiritual one.

“Wretched man that I am! Who will deliver me from this body of death? Thanks be to God through Jesus Christ our Lord! So then, I of myself serve the law of God with my mind, but with my flesh I serve the law of sin” (Romans 7:24-25, RSV).

THE NATURE OF MAN

Psychological Aspect

Most of us realize that human nature consists of a myriad of characteristics, including how we think, feel, and act. These characteristics are said to occur naturally. Perhaps one of the oldest debates in human history is whether man is basically good or essentially bad. Certainly, this speaks to our overall tendencies. Accordingly, man is both inherently good and inherently bad. We all have the capacity to love and care for others (to one degree or another) on a sliding continuum. Additionally, we have the capacity for being bad: mean-spirited, selfish, hateful, prejudice, deceptive (even murderous under the right circumstances). The extent to which we lean toward one extreme or the other is deeply rooted in a number of factors: childhood experience, personality, culture, geography, demographics, and the like.

You likely remember the tales of Dr. Jekyll and Mr. Hyde and Frankenstein. Each story gives us a particular viewpoint on the nature of man. Robert Louis Stevenson showcased the capacity within man to turn to the left or to the right—to do good or do evil. Dr. Jekyll was a member of the privileged class—a wealthy physician of public renown. He possessed an underlying evil nature which he could not control. When this sinister side took over, he said, “It was the curse of mankind that these incongruous personalities—the good and the bad were thus bound together—that in the agonized womb of consciousness, these polar twins should be continuously struggling.”  Mary Shelley painted a different picture. The monster Frankenstein said, “I was benevolent and good; misery made me a fiend. Make me happy, and I shall again be virtuous.”

When discussing the nature of man, we are examining whether man is a product of his environment (nature) or the result of an amalgam of his interpersonal experiences (nurture). I believe we are impacted by both. We’re speaking of “temperament,” which is a term we typically see in theories of personality development. I have found in my undergraduate studies in psychology that there are both empirical and theoretical links between childhood experience and adult personality traits. Personality seems to have an unavoidable influence on behavior. Temperament is often seen as a constitutional predisposition, observable in pre-verbal infants and animals, and tied, at least theoretically, to basic psychological processes. Personality traits are assumed to be acquired patterns of thought and behavior that might be found only in organisms with sophisticated cognitive systems.

I subscribe to Albert Bandura’s Social Learning Theory. He agreed with behaviorists relative to classical and operant conditioning, but added two additional criteria: (1) mediating processes occur between stimulus and response; and (2) behavior is learned from the environment through the process of observational learning vis-a-vis modeling behavior of primary caregivers and other significant individuals in our world during childhood and adolescence. I also support cognitive behavioral therapy to help clients address and defeat their “irrational” beliefs regarding the world and and their own sense of worth. This can be effective with people struggling with addiction and (what used to be labeled) neurotic views of the world. Further, it dovetails nicely with basic Christian doctrine: We must come to see ourselves not as we see ourselves, nor bound to the sum of all our past mistakes; rather, we must see ourselves as God sees us as believers—a new creation, clothed in the righteousness of Christ.

Spiritual Aspect

Scripture sees unregenerate man as enslaved to sin and possessing a corrupt nature. In this regard, man is in need of transformation through rebirth. When a person chooses to believe the Gospel, he or she identifies with the death, burial, and resurrection of Jesus Christ. Accordingly, the old nature is crucified with Christ. Paul says of the regenerate Christian, “So we do not lose heart. Though our outer nature is wasting away, our inner nature is being renewed every day” (2 Corinthians 4:16, RSV). The “old man” or the “old nature,” as expressed by Paul, is man as he was before he was reborn and sanctified by the grace of the Spirit. Don Steward of blueletterbible.org says, “The natural man may be defined as an individual who operates entirely on human wisdom.”

Although not everyone believes in an all-powerful Creator, both atheists and theists are tasked with explaining the innately fallen nature of humans. Mankind is capable of showing kindness and love and sacrifice on one hand,  and cold, calculating selfishness, hatred, deception, and murder on the other. I don’t believe these extremes are present to the same extent in every human being. I do, however, believe there is an underlying sinful and evil nature in mankind. In other words, the potential to be both good and bad exists within us all to varying degrees. Admittedly, many people have difficulty buying into the idea that from the moment of birth we are not innocent and inclined toward goodness. Instead, we are inclined toward sin.

“Therefore as sin came into the world through one man and death through sin, and so death spread to all men because all men sinned” (Romans 5:12, RSV).

Dr. Werner Gitt of Answers in Genesis believes it is impossible to understand human nature apart from biblical revelation. Despite my becoming a “born-again” Christian at age 13, I struggled for decades with the concept that I was less than what I have the potential to be. It’s been said to me recently that I don’t give myself enough credit for my accomplishments. Ten years ago, I would have been in complete agreement. But when I undertake an honest and thorough moral examination of myself, I see glaring character defects, repeated selfish and mean-spirited acts, forty-plus years of active addiction, numerous incidents of lying, cheating, and stealing, and the tendency to want “maximum results with minimum effort.” This is beyond laziness. It is akin to the sense of “absolute entitlement.”

Frankly, I am okay with this assessment. It finally makes perfect sense to me, and, accordingly, provides the opportunity for lasting change. I’ve said many times that no “human effort” (neither mine nor the relentless intervention of others) could rescue me from active addiction. Moreover, I have come to recognize (anew) the spiritual battle we all face daily, whether Christian, Muslim, Jewish, Buddhist, Native American, or atheist. I see how I’ve been a pawn in the struggle between flesh and blood, good and evil. There are powers of darkness that want to recruit us to go to war against God and Jesus Christ; against goodness and honesty, kindness and selfless service. Paul was well-aware of this concept, and he made it an integral part of his ministry.

A Personal Example

It is with some trepidation that I confess to a particular habit I have found hard to stop. I am quite fond of sex and enjoy feeling the nearly-euphoric closeness one experiences during sexual relations. For me, there is unfortunately a dark underside to this stimulus. At some point it became a form of escape. The physical sensation of achieving orgasm served as a perfect way to mask depression, anxiety, even physical pain. In this regard, these sensations became yet another form of “self-medication.” Naturally, this is not what sex is meant for. At least not when it becomes a compulsion. Moreover, the act of masturbation became yet another addiction. In fact, I was told years ago by a psychologist who specializes in addictive behaviors that because I tended to mix masturbation with the use of addictive substances that enhance the physical sensations of sex, I needed to address both issues. He said, “If you don’t, it’s like having two broken legs but only having a doctor set one of them.”

In its excessive form, masturbation becomes a compulsive (perhaps neurotic) act. When it is found in this form, it serves the purpose of allaying anxiety or other uncomfortable emotions. The root of this (and I don’t mean to sound Freudian here) may stem from a number of causes. A neglected or rejected child, who early in childhood may have learned to resolve the fear of isolation or insecurity by indulging in earlier infantile pleasures, will resort to masturbation as a satisfactory relief or consolation. The obvious downside to the persistent habit of masturbation, especially while viewing pornographic images, tends to cause the individual to objectify or sexualize women. This flies in the face of establishing meaningful relationships with a member of the opposite sex.

I am happy to report that by seeing pornography and masturbation as yet another addiction, I have applied the same methods to this compulsive behavior that I have been able to apply to my struggle with substance abuse. I could admit here that I have only recently become drug-free after yet another relapse, but I would rather focus on the fact that I am clean and sober today. I finally grasp the paramount importance of taking it “one day at a time.”

THE NATURE OF SIN

David said, “I have hidden your word in my heart that I might not sin against you” (Psalm 199:11, NIV). This is truly the only means by which we can hope to defeat habitual sin. Much like physical exercise—which strengthens our calves or our core muscles over time—the continual practice of sin will serve to strengthen our bad habits. It is true that Christians are often tempted to sin. It’s impossible to completely avoid temptation while we exist in the flesh. Sadly, many end up giving in to such enticement on a regular basis.

It is one thing to recognize our vulnerability while clothed in a fleshly body, but it is a completely different matter to give up and give in to the same sin time and time again. Although I don’t believe recurrence of habitual sin will nullify the saving grace and power of Jesus’s sacrifice, I think habitual sin tends to fill us with guilt, shame, and regret. It can cut us off from fellowship with God. Once this separation occurs, we become increasingly vulnerable to the practice of sin. Indeed, this becomes a vicious circle. Moreover, it taints our testimony, causing us to look like a testiphony

For me, I tend to fall into habitual sin when I fail to believe that holiness can result in a happier, healthier, successful life. In addition, I think the root of habitual sin is not necessarily a battle for self-control. Paul was clear about this in Romans 7. Instead, the root of habitual sin can be found in the need to “feel good.” We have a difficult time quitting a behavior for which we gain something—a sense of euphoria, peace, or happiness. In this manner, said habitual actions are a form of self-medication. Or, worse, an attempt at assuaging the pangs of guilt and the sense of failure we might be experiencing. Regarding chronic use of pornographic images, for example, those who use it to feel good are actually creating a false reality.

John said, “All wrongdoing is sin” (1 John 5:17a, RSV). But it is also more complicated than that. Although sin is simple by its nature, it can create complex illusions that are very difficult to identify and deny. Urges and motivations are quite complicated, often causing a tangled mess in our soul and spirit. In his epistle, James wrote, “each person is tempted when he is lured and enticed by his own desire… Then desire, when it has conceived, gives birth to sin; and sin when it is full-grown brings forth death” (1:14, RSV). James had never taken a course in psychology, but he thoroughly understood two things: what sin is in its basic form; and the concept that each of us is pulled in directions specific to our own desire. This is precisely why not everyone who drinks alcohol will become an alcoholic. It also explains why not every man or woman is enticed or drawn in by viewing pornographic images.

I believe every sin is, to a great degree, a repeat of the original sin when our first parents decided to eat the forbidden fruit to fulfill their desire to be “like God.” They were not ignorant of God’s instructions. They possessed enough information to make an informed decision to obey or disobey. In fact, God told them that eating the fruit would be wrong and that they would be far happier if they refrained from eating it (see Genesis 2:16-17). Satan misrepresented the truth and told them they would be far happier if they ate the forbidden fruit. In fact, he said to Eve, “For God knows that when you eat of it your eyes will be opened, and you will be like God, knowing good and evil” (Genesis 3:5, RSV). This sounded good to Eve.

We become enslaved according to what we believe. Accordingly, it becomes quite difficult to give up that which we’ve embraced as a means to escape an uncomfortable situation or alleviate a troublesome emotion. This makes habitual sin impossible to defeat through the power of self-denial. While in the grips of a habit that produces in us a great sense of relief or euphoria (consider the brain chemistry of dopamine, oxytocin, seratonin, and endorphins), we are powerless to stop the rewarding behavior. We can only defeat such a habit through the power of a greater desire. Sure, self-denial is necessary, but self-denial is only possible (especially over the long-haul) when it is fueled by desire for a greater joy than what we have decided to deny ourselves. One way to express this is the common phrase, “Change happens when the pain of staying the same is greater than the pain of change.”

In other words, when we desire a closer relationship with the LORD more than we desire continued physical pleasure, we are better equipped to extinguish habitual sin. This is achievable only by walking in the Spirit and not according to the flesh. We must renounce the lies we have believed, repent for having persistently believed them, and begin to exercise faith in God’s promises through obedience to Him. Until we believe we will experience the abundant life Jesus talked about, we will remain in bondage to our flesh, our neurotic or irrational beliefs about how best to achieve peace, joy and happiness. We will continue applying a bandage to our wounds rather than seek to have them healed.

Hazelden Betty Ford Foundation Recovery Advocacy Update

Startling data recently made public show the details of how pharmaceutical companies saturated the country with opioids. In the seven years from 2006 to 2012, America’s biggest drug companies shipped 76 billion oxycodone and hydrocodone pain pills in the United States. The result? Opioid-related deaths soared in communities where the pills flowed most. These new revelations come from the Washington Post, which spent a year in court to gain access to a DEA database that tracks the path of every single pain pill sold in the United States.

Opioid Epidemic Pic of Vidodin

The database reveals what each company knew about the number of pills it was shipping and dispensing and precisely when they were aware of those volumes, year-by-year, town-by-town. The data will be valuable to the attorneys litigating cases to hold manufacturers accountable, including a huge multi-district case in Ohio, where thousands of documents were filed last Friday. The data show that opioid manufacturers and distributors knowingly flooded the market as the overdose crisis raged and red flags were everywhere.

The Post has also published the data at county and state levels in order to help the public understand the impact of years of prescription pill shipments has had on their communities. Hazelden Betty Ford Foundation says to expect many reports from local journalists using the data to explain the causes and impact of the opioid crisis in their communities. The Post did its own local deep-dive, taking a close look this weekend at two Ohio counties that soon will be at the center of the bug multi-district litigation. Barring a settlement, the two counties are scheduled to go to trial in October as the first case among the consolidated lawsuits brought by about 2,000 cities, counties, Native American tribes and other plaintiffs.

Meanwhile, the CDC posted preliminary data suggesting that the number of Americans who died from drug overdoses finally fell 5% in 2018 after years of significant increases. This new data, while still preliminary, covers all of 2018, so it is firmer. And it is a rare positive sign. But it’s only one year and no cause for celebration or complacency—especially with continued funding for opioid crisis grants are uncertain and the decline in deaths anything but uniform across the states. For example, 18 states still saw increases in 2018. Policymakers must be reminded that we’re still very much in the midst of the nation’s worst-ever addiction crisis—one from which it will take years to recover. Federal funding remains essential, as advocate Ryan Hampton points out in his latest piece making the case for the CARE Act, a Congressional bill that would invest $100 billion over the next 10 years.

Chris-Herren

If you missed the premiere of  “The First Day,” a powerful, one-hour documentary that shows the evolved talk of former NBA-player-turned-recovery advocate Chris Herren, you can catch it again July 30 at 10:00 p.m. Eastern on ESPN. It is also now available for sale as a download. Herren has spoken to more than a million young people, and the film follows him on a dozen or so speaking engagements up and down the East Coast.

Delta Air Lines announced that naloxone, the medication used to treat (reverse) an opioid overdose, will be available in all emergency medical kits on flights beginning this Fall.

Delta’s decision comes after a passenger tweeted that a man died aboard a Delta flight last weekend from an opioid overdose. It’s unfathomable why naloxone isn’t already on all flights for all airlines. Last year, Hazelden Betty Ford Foundation joined the Association of Flight Attendants in urging the FAA to require it. No one should have to die before airlines take this common-sense step.

Oklahoma’s lawsuit against Johnson & Johnson went to the judge, who will decide later this summer whether to hold the drugmaker accountable for the state’s opioid epidemic. Oklahoma is seeking more than $17.5 billion to abate the costs of opioid addiction. Purdue Pharma and Teva Pharmaceutical settled their part of the Oklahoma case. But they and other drugmakers and distributors face some 2,000 similar lawsuits by states and local municipalities.

Bottles of Opiate Prescriptions.jpg

Purdue Pharma, a pharmaceutical company owned by the Sackler family, invented the so-called non-addictive drug OxyContin. The company was found to have falsified the addiction rate at less than 1% when in fact it was over 10%. Raymond Sackler had a personal net worth of $13 billion in 2016. He passed away on July 17, 2017. The Louvre in Paris has removed the Sackler family name from its walls, becoming the first major museum to erase its public association with the philanthropist family linked with the opioid crisis in the United States.

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

Dr. Nora Volkow, director of the National Institute on Drug Abuse, has written and spoken extensively about the importance of prevention in addressing the opioid crisis. NIDA studies have shown that teens who misuse prescription opioids are more likely to initiate heroin use. You can visit NIDA’s site by clicking here.

 

 

There’s A Kind of Love

Bible Pages in Shape of Heart Love.jpg

By Steven Barto, B.S. Psych.

LOVE. IT’S MORE THAN A four-letter word. At its basic, love is a noun meaning “strong affection for another arising out of kinship or personal ties,” such as a mother’s love for her child. Of course, it also means “attraction based on sexual desire: affection and tenderness felt by lovers.” It can mean admiration, benevolence, warm attachment, devotion, a term of endearment. However, love is not merely a noun.

Love is also an action verb. In other words, it’s not about something, it’s about doing something. Something selfless at the very least. The Merriam-Webster Dictionary indicates it is a transitive verb that means “to hold dear: cherish.” It can also implicate a lover’s passion, tenderness, amorous caress, copulation. Its etymology is from the Old English word lufu, which includes, “feeling of love; romantic sexual attraction; affection; friendliness; the love of God.” The Germanic word is from the Proto-Indo-European (PIE) root leubh, meaning “to care, desire, love.” It is “the love of God” I wish to talk about here.

There are seven types of love in Greek:

  • Eros—sexual or passionate love; the type most akin to our modern construct of romantic love.
  • Phileo—brotherly love; friendship; shared good will.
  • Storge—familial love; natural or instinctual affection, such as the love of a parent for his or her child.
  • Agape—a Greco-Christian term referring to “the highest form of love; charity; the unconditional love of God for man.”
  • Ludus—this form of love includes game-playing, manipulation, lying; the purveyor of ludic love has “conquests” but no commitments.
  • Pragmaalso known as “pragmatic” love, it is the most practical type; convenient love that involves “being of service” to another out a sense of duty.
  • Philautia—this type of love is within oneself; essential for any relationship because we can only love others if we truly love ourselves. One of the key lessons on a spiritual journey is learning to love unconditionally. In many ways, this type of love is a stepping stone to grasping agape love.

WHAT OF THIS THING CALLED “UNCONDITIONAL LOVE?”

I’ve heard it said that unconditional love is easy. You probably find that hard to believe. I did. There would be no boundaries to loving someone unconditionally. No matter what they’ve done or not done. One blogger posted an article titled “Unconditional Love: Is it Real or Just a Romantic Illusion?” The post analyzes relationship love. It notes that when love is unconditional nothing can tear it asunder. This is the “we are one in our new relationship” love that is ageless, timeless, and infallible. The writer states, “But here’s what you have to know: unconditional love is a romantic illusion, and one that reflects love that is immature.”

In the introduction to his book, Real Love, Greg Baer, M.D. describes his struggle with emotional problems and addiction to tranquilizers and other narcotics. One evening he took a handgun and went into the woods intending to end his life. He put the barrel against his head, ready to die. Instead, he realized something had to change. He sought treatment at a rehab, but said when he returned home clean and sober he was still at the same place that took him down the dark path of addiction: alone and empty. He was missing the profound happiness he’d been longing for his entire life. Reading Baer’s introduction, I saw myself on the pages.

Life for me has always been an emotional roller coaster. I was a little hellion who could not behave no matter what my father tried. His go-to answer seemed to be corporal punishment. This made me hate him and despise myself. I came to fear his very presence; to feel unloved and unlovable. In my heart, I wanted to please him and make him proud. But in my flesh, I wanted nothing but numbness and escape. As each year passed, I became increasingly sullen and doubted I’d ever amount to anything. Why couldn’t I stop lying, stealing, cursing, trashing my room, getting sent to the principal’s office? As my anger grew, I started hating everything and everyone. I got good at deception. After all, who wants to be in trouble all the time? This was the perfect breeding-ground for alcohol and drug abuse. Finally, I could feel euphoric, happy, invincible. I could escape.

As you can imagine, this was not a very sound solution. I ended up right back at the same place every time. Clean and sober for a short time, but lost and alone. Empty. Without friends. Estranged from my family. So I went back out there, drinking and drugging. Numbing the pain and hiding from the world. Withdrawing behind drawn curtains. I was convinced that I was one of those that Jesus couldn’t save. I drifted further from my Christian roots. My high school friends all left for college. I stayed home and hung out with the party crowd. Out until three, sleeping until noon. Just like the shampoo bottle says, “lather, rinse repeat.” I no longer believed God cared about me. It wasn’t long before I doubted the existence of God.

After four decades of active addiction and numerous relapses in my forties and fifties, I found my way back to the church. I started teaching Bible study at two local prisons and did a lot of studying and writing. You’d think my life improved, right? That I finally reached my happy ending. That there was nothing left but to love and be loved; to be clean and sober and help others find their path to sobriety. Sadly, that was not the case. Chronic and ever-increasing pain from a back injury, degenerative disc disease, severe arthritis, and fibromyalgia taunted me and drove me to opiate addiction. I knew better. I just couldn’t decide better. I was letting my physical pain dictate my behavior.

Even after returning to the church of my youth where I accepted Jesus as my savior; despite attending a Christian university and graduating with a bachelor’s degree in Psychology; regardless of years of research, writing, and blogging about addiction and spirituality, I continued to mess up and kept helping myself to narcotic painkillers of family members. Again, I was shunned. They were back to believing I will never change. I’d work my way back into their lives to only repeat my selfish and deceptive behavior.

So what is this all about?

It might sound too simple, but I’m wrestling not against flesh and blood, but against powers and principalities, against the rulers of the darkness of this world, against spiritual wickedness in high places (Ephesians 6:12). But it’s true. This is exactly what Paul means in Romans 7 when he says, “For I know that good itself does not dwell in me, that is, in my sinful nature. For I have the desire to do what is good, but I cannot carry it out. For I do not do the good I want to do, but the evil I do not want to do—this I keep on doing. Now if I do what I do not want to do, it is no longer I who do it, but it is sin living in me that does it” (verses 18-20, NIV). Although this is instrumental in helping me learn to crucify my flesh and walk instead in the Spirit, it does not alleviate the hurt, disappointment, and anger my family feels toward me. Their utter disgust and inability to trust me.

THE KIND OF LOVE ONLY GOD KNOWS

I recently discovered an incredible song by the Christian group For King and Country, called “God Only Knows.” Although the entire song cuts me to the core, several lines really stand out. Wide awake while the world is sound asleepin’, too afraid of what might show up while you’re dreamin’… Every day you try to pick up all the pieces, all the memories, they somehow never leave you. God only knows what you’ve been through, God only knows what they say about you… You keep a cover over every single secret, So afraid if someone saw them they would leave. God only knows where to find you, God only knows how to break through, God only knows the real you…

LOVE FROM GOD’S PERSPECTIVE

What happens when we look at love from God’s perspective?

The love of God is central to His relationship to the world. We cannot grasp His kind of love through our own intellect. Certainly, there are many paradigms, worldviews, and theological interpretations for God’s kind of love. Theologians consider divine love to be an overriding component of God’s character, if not the very essence of God. Conceptions of divine love vary widely. This is due, in part, because man has a tendency to split hairs over metaphysical matters. The result is theories and definitions which are often cemented in denominational, doctrinal, or other theological differences.

But here are some basic features of God’s love:

  • We can trust in God’s love. First Corinthians 13:4-8 provides an excellent description of God’s (agape) love. It is patient, kind, does not envy, does not boast, is not proud, does not dishonor others, is not self-seeking, is not easily angered, keeps no record of wrongs, does not delight in evil (but rejoices with the truth), always protects, always trusts, always hopes, always perseveres. Love never fails. Clearly, there is a powerful and unrelenting component to God’s love. We see evidence of this in His covenant relationship with His people. Even in our sinfulness, He demonstrates patience, showering us with unmerited grace and mercy.
  • Our salvation is an expression of God’s love. God loves us enough to have established a plan for our redemption before the foundation of the world; before man’s first sin of disobedience. He provides access to that redemption through His Son, Jesus Christ, who died in our place (see John 3:16). God did not send Christ as a reward for those of us who can keep the Law; rather, He provided Jesus as a solution to the sin problem by making Jesus a ransom for our disobedience. Although we were bought (redeemed) with a price, redemption is much more than being set free from the wages of sin. The crucifixion of Christ restores our fallen status by making peace between us and God. It takes away our shame. It provides for our physical healing. It provides for our spiritual rebirth and restoration.
  • God’s love serves as an exemplar for us. Truly, God has restored us to Him through Jesus Christ. It is up to us to work at restoring our relationships with others. We can only do this by being rooted in God’s love—striving to understand its depth and implications. God asks us to emulate this behavior.
  • The Holy Spirit produces love in us for others. The link between Christ’s love for us and our love for each other is found through the Holy Spirit. We see Christ’s love for us to the point of obedience unto death.

Paul writes, “…that Christ may dwell in your hearts through faith; that you, being rooted and grounded in love, may be able to comprehend with all the saints what is the width and length and depth and height—to know the love of Christ which passes knowledge; that you may be filled with all the fullness of God” (Ephesians 3:17-19, NKJV). By accepting the full measure of God’s love, we are able to begin practicing unconditional love toward others. We will by no means measure up to this divine attribute. This “no limits” love cannot be achieved through human endeavor. We become able to love this way only through yielding to the Holy Spirit. We can only accomplish it because God first loved us. What connects us with Jesus is faith—trusting His forgiveness; banking on His promises; cherishing His fellowship; desiring to fulfill His Greatest Commandment: to  love the Lord God with all our heart and with all our soul and with all our mind; and to love our neighbor as ourselves (see Matthew 22:36-40).

LOVE—PART OF THE FRUIT OF THE SPIRIT

Galatians 5:22-23 reminds us of what is achieved in us through the Fruit of the Spirit. Eugene Peterson translates it like this: “But what happens when we live God’s way? He brings gifts into our lives, much the same way that fruit appears in an orchard—things like affection for others, exuberance about life, serenity. We develop a willingness to stick with things, a sense of compassion in the heart, and a conviction that a basic holiness permeates things and people. We find ourselves involved in loyal commitments, not needing to force our way in life, able to marshal and direct our energies wisely” (MSG).

The late Billy Graham said, “This cluster of fruit should characterize the life of every Christ-born child of God. We’re to be filled with love, we’re to have joy, we’re to have peace, we’re to have patience, we’re to be gentle and kind, we’re to be filled with goodness, we’re to have faith, we’re to have meekness, and we’re to have temperance. But what do we find? In the average so-called Christian today we find the opposite.”

True love—the unconditional agape love of God—always protects, always trusts, always hopes, always perseveres (1 Corinthians 13:7). Jesus tells us in John 15:12, “My command is this: Love each other as I have loved you” (NIV). Paul reminds us in Romans 12:9-10, “Love must be sincere. Hate what is evil; cling to what is good. Be devoted to one another in love. Honor one another above yourselves” (NIV). When we expect this kind of undying love from our friends or family, we set ourselves up for disappointment. Further, as in my case, we’re at risk of living in the sin of offense because we become unforgiving of their unforgiveness. Rather, we must look to God for this kind of love. A love that culminated in the crucifixion of Jesus Christ.

CONCLUDING REMARKS

Each of us, before coming to Christ, is dominated by one nature—the “old man.” We’re controlled by our ego, our self. We are selfish at best; deceitful at worst. No one likes to be wrong. That’s human nature. Repeated mistakes—especially the ones that continue to break the hearts and spirits of those we love—are the hardest for us to let go. I loath myself when I cannot seem to do that which I want to do, and keep doing that which I wish not to do. I have to remember I am in good company, as the apostle Paul wrote of this very struggle in his life. 

The moment we receive Christ as our Savior, self is put down. We identify with His death, burial, and resurrection through backward-looking faith. Accordingly, we are to crucify our flesh daily. No amount of human power can relieve us of our habits, hangups, or addictions. But when we walk in the Spirit and not in the flesh, we put Christ on the throne in our lives. We dethrone ourselves. The Spirit of God is in control. It is only through realizing this and living it every day that we can ever hope to love unconditionally.

References

Baer, G., M.D. (2003). Real Love: The Truth About Finding Unconditional Love in Fulfilling Relationships. New York, NY: Avery.

Peterson, E. (2003). The Message//Remix: The Bible in Contemporary Language. Colorado Springs, CO: NavPress.

Skinner, K. (December 16, 2013). “Unconditional Love: Is It Real or Just a Romantic Illusion?” Retrieved from: https://www.yourtango.com/experts/kathe-skinner/unconditional-love-it-real-or-just-romantic-illusion

 

 

AT-121: A Promising Alternative to Opioid Pain Medications

By Eric Sarlin, M.Ed., M.A.
NIDA Notes Contributing Writer
National Institute on Drug Abuse

Dr. Eric Sarlin’s recent research reveals an experimental compound with a dual action at two opioid receptors which may provide powerful pain relief without many of the usual harmful opioid side effects. The compound may also have potential as a treatment for opioid addiction.

The reason AT-121 is promising is because it provides pain relief without producing the side-effect of euphoria.

This is a novel compound representing potential advancement toward the goal of non-addictive pain medications that are at least as effective as opioids but without typical opioid liabilities. The new compound—called AT-121—may also have potential as a treatment alternative for opioid addiction. Most of the potent analgesics currently in use act through mu-opioid receptors. AT-121 seems to relieve pain in monkeys without causing physical dependence. Most pain medications work by activating a receptor in the neurons the mu-opiate receptor. Mei-Chuan Ko, a professor of physiology and pharmacology at the Wake Forest School of Medicine, says “Oxycodone, morphine, fentanyl, heroin—they all work through the mu-receptor.” Ko is one of the authors of the study.

Dr. Nurulain Zaveri and colleages at Astraea Therapeutics, manufacturer of AT-121, used medicinal chemistry, computer modeling, and structure-based drug design to create and develop AT-121. Like opioids—such as morphine and oxycodone—AT-121 also binds to the mu-opioid receptor. Unlike those opioids, AT-121 also binds to another opioid receptor called the nociceptin/orphanin FQ peptide receptor. According to Dr. Zaveri, this interaction with the NOP receptor enhances AT-121’s analgesic effect and blocks unwanted side effects often seen with current opioid medications.

References

NIDA. (February 12, 2019). “A Promising Alternative to Opioid Pain Medications.”

Prenatal and Early Childhood Brain Development in Mom’s Using Drugs

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From the blog of Dr. Nora Volkow
Director, National Institute on Drug Abuse
March 11, 2019

The National Institutes of Health HEAL (Helping to End Addiction Long-Term) Initiative, which was launched last April, will support a wide range of studies aimed at improving prevention and treatment strategies for opioid use disorder and pain, including efforts to enhance treatments for infants born with Neonatal Abstinence Syndrome/Neonatal Opioid Withdrawal Syndrome. Specifically, HEAL funds will help support an ambitious longitudinal study—The HEALthy Brain and Child Development (HBCD) Study—co-funded by NIDA and several other NIH institutes and offices, to better understand the impact of early exposure to opioids, other substances, and social stressors on brain development in children.

The HBCD study will follow a large population of children from the prenatal period to age 10 and utilize some of the same assessment methods and imaging technologies used in the 10-year Adolescent Brain Cognitive Behavior (ABCD) study. HBCD is expected to enroll women during their second trimester of pregnancy or after birth of their baby. The study will gather data on potentially important factors about their environment, including drug and alcohol use, and follow them and their children over the subsequent decade.

The potential fruits of a longitudinal cohort study of this magnitude will include much new knowledge about the effects of opioids and other substance exposures during fetal development.  It will also yield a better understanding of the effects of genes that are driving brain development. The study additionally will look at many other exposures, including social interactions, environmental toxins, nutrition, and physical activity. Medicine has thus far lacked detailed baseline standards of normative brain development in childhood, and HBCD will help produce such standards. The information gained from the study will create an invaluable reference for pediatricians, pediatric neurologists, and psychiatrists.

The ABCD study recently accomplished its baseline recruitment of close to 12,000 nine- and ten-year-olds, and already the data gathered from the initial neuro-imaging is yielding interesting findings, such as associations between neuro-development and screen time. Likewise, the HBCD study will gather a rich data set that will be freely available to the wider research community to answer a wide range of research questions. For example, researchers can use the data to investigate how the human brain develops and characteristics that might be associated with the early manifestations of brain diseases, as well as those [with an] underlying resilience to adverse environments. As the data are being collected, they will be released so that discoveries can start well before the completion of these 10-year prospective studies. 

As with ABCD, the HBCD study will have multiple research sites across the country to ensure the study population is representative of the larger population, including all ethnic groups and demographics and even including women who use opioids. Exposure to many substances in the womb or through breast milk may have significant developmental consequences, and a study of this magnitude will greatly clarify the effects of prenatal and early opioid exposure on children. It will also greatly increase our understanding of the developmental consequences of environmental stressors like neglect, abuse, economic uncertainty, and the influence of parental opioid and other drug use during the post-natal period.

As you might imagine, there are many potential challenges to conducting regular brain imaging on young children—being able to remain still in MRI scanners is just one of them. There are also special legal and ethical challenges involved in recruiting and studying opioid-using mothers. In September and October of last year, NIDA in partnership with other NIH Institutes and Centers, hosted two expert panel meetings to discuss, respectively, the methodological challenges of studying neuro-development in children and recruitment and retention of high-risk populations in the study, including bio-ethical questions.

Based on input received during these expert panel meeting, it was determined that before soliciting grant proposals for the HBCD study per se, an initial planning period would be necessary. Thus, NIDA along with the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute of Child Health and Human Development (NICHD), the National Institute of Environmental Health Sciences (NIEHS), the National Institute of Mental Health (NIMH), the National Institute of Neurological Disorders and Stroke (NINDS), the National Institute on Minority Health and Health Disparities (NIMHD), the Office of Research on Women’s Health (ORWH), and the Office of Behavioral and Social Sciences Research (OBSSR) issued two funding opportunity announcements, one for individual research sites and one for linked, collaborative applications.

The planning grants will be awarded for a period of 18 months, during which time we expect to determine many critical facets of the experimental design. These include how to conduct neuro-imaging in prenatal and early postnatal stages, how to address the legal challenges associated with recruiting opioid- (and other drug-) using participants (which vary by state), how to form partnerships with state agencies and substance use treatment programs, how to retain the mothers in the study, and other practical and ethical issues. Applications are due in the last week of March, 2019. Researchers interested in applying for one of these grants can find more information on RFA-DA-19-029 and RFA-DA-19-036 from grants.nih.gov.

It is a very exciting time for all the sciences that study child health, human development, and the roots of mental health and psychiatric and neurological illnesses. We now have the tools to characterize human brain development in the transition from infancy into adulthood, a time when many of the medical conditions that afflict us later in life originate. The data from the HBCD study will ultimately lead to scientific solutions to addiction, pointing the way to new prevention and treatment interventions and thereby reducing the impact of opioid and other substance use disorders on American families.

Supporting Our Physicians in Addressing the Opioid Crisis

From the blog of Dr. Lora Volkow dated August 31, 2018

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A recurring theme among addiction researchers and professionals is the so-called treatment gap: under-utilization of effective treatments that could make a serious dent in the opioid crisis and overdose epidemic. Ample evidence shows that when used according to guidelines, the agonist medications methadone and buprenorphine reduce overdose deaths, prevent the spread of diseases like HIV, and enable people to take back their lives. Evidence supporting the effectiveness of extended-release naltrexone is also growing; but whereas naltrexone, an opioid antagonist, can be prescribed by any provider, there are restrictions on who can prescribe methadone and buprenorphine.

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A series of editorials in the July 5, 2018 issue of the New England Journal of Medicine made a strong case for lessening these restrictions on opioid agonists and thereby widening access to treatment with these medications. For historical reasons, methadone can only be obtained in licensed opioid treatment programs, but experimental U.S. programs delivering it through primary care docs have been quite successful, as have other countries’ experiences doing the same thing. Although buprenorphine can be prescribed by primary care physicians, they must first take 8 hours of training and obtain a DEA waiver, and are then only allowed to treat a limited number of patients. Some physicians argue that these restrictions are out of proportion to the real risks of buprenorphine and should be lessened so more people can benefit from this medication.

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Stigma contributes to reluctance to use evidence-supported treatment—both stigma against addicted individuals and stigma against agonist medications, due to the persistent myth that they just substitute a new addiction for an old. This idea reflects a poor understanding of dependence and addiction. Dependence is the body’s normal adaptive response to long-term exposure to a drug. Although people on maintenance treatment are dependent on their medication, so are patients with other chronic illnesses being managed medically, from diabetes to depression to pain to asthma. Addiction, in contrast, involves additional brain changes contributing to the loss of control that causes people to lose their most valued relationships and accomplishments. Opioid-dependent individuals do not get high on therapeutic doses of methadone or buprenorphine, but they are able to function without experiencing debilitating withdrawal symptoms and cravings while the imbalances in their brain circuits gradually normalize.

Treating patients with addiction may be uniquely complex and demanding for several reasons. Patients may have co-morbid medical conditions, including mental illness; thus they may need more time than doctors are reimbursed for by insurers. They may also have pain, and while pain management guidelines have changed to respond to the opioid crisis, those changes have not necessarily made a doctor’s job any easier, since there are currently no alternative medications to treat severe pain that are devoid of dangerous side effects.

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Because of the complexity of Opioid Use Disorder (OUD), providers may find that it is not sufficient to simply dispense a new prescription after a quick consultation. These patients often need ancillary services provided by nurses or other treatment specialists; and in the absence of these extra layers of support, treatment is less likely to be successful, reinforcing physicians’ reluctance to treat these patients at all. In short, physicians are being blamed for causing the opioid epidemic, but thus far they have not been aided in becoming part of the solution.

Medical schools are starting to respond to the opioid crisis by increasing their training in both addiction and pain. For example, as part of its training in adolescent medicine, the University of Massachusetts Medical School has begun providing pediatric residents with the 8-hour training required to obtain a buprenorphine waiver—an idea that is winning increasingly wide support. Physicians in some emergency departments are also initiating overdose survivors on buprenorphine instead of just referring them to treatment. And through its NIDA MedPortal, NIDA provides access to science-based information and resources on OUD and pain to enable physicians to better address these conditions and their interactions, including easy-to-use screening tools to help physicians identify substance misuse or those at risk.

But if physicians are going to assume a bigger role in solving the opioid crisis, healthcare systems must also support them in delivering the kind of care and attention that patients need. Physicians need the tools to treat addiction effectively as well as the added resources (and time) for patients who need more than just a quick consultation and a prescription.

The Opioid Issue: Part 4

Part Four: Taking It to the Streets

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The opioid epidemic doesn’t stay behind closed doors. It’s spilling into public life, spurring crime and homelessness.

The opioid crisis has hit hard in Macomb County, Michigan. Composed of 27 Detroit suburbs, the county has the state’s second-highest opioid-related overdose death rate, more than double the national average. District Court Judge Linda Davis has been on the bench 17 years. She sees the consequences pretty much every day. “When I look at the docket I handle, I’d say 70 percent is addiction-related,” she says, not counting low-level traffic offenses like driving on a suspended license. “We’ve definitely seen a rise in thefts with this opioid surge.”

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Although opioid addiction often starts out legally, recent years have seen a shift toward illegal opioids. It’s an all-to-familiar story: People get hooked on prescription painkillers, often moving on to heroin, which can be cheaper on the street. Since 2011, as prescription opioid overdose deaths leveled off, heroin overdoses started rising. Starting in 2014, illicit fentanyl deaths began spiking upward. Whatever the substance, the cost mounts up fast. So many users resort to theft. They’ll steal from family, friends, acquaintances or strangers. They’ll shoplift, commit fraud, rob pharmacies, break into homes or cars. Even commit armed robbery. And whether or not they’re committing those crimes themselves, their desperate dependency can feed some even worse ones.

Lethal Combination

In 2015, the nation’s homicide rate rose sharply (11 percent) after decades of decline. The uptrend continued in 2016, climbing another 8 percent. Some observers looked for racial reasons for it. There could be one, says Richard Rosenfeld, an emeritus professor of criminology and criminal justice at the University of Missouri-St. Louis. But he thinks there’s more to the story. When Rosenfeld looked into the data, he quickly saw homicides had jumped among several ethnicities—and it was very pronounced among whites.

“The increase is quite abrupt, quite recent and quite large, at levels we hadn’t seen since the early 1990s outside of 9/11,” Rosenfeld says. “The ‘Ferguson Effect’ doesn’t explain that. So what might explain it? The opioid epidemic, for one thing—which crosses racial lines, but is most concentrated among whites. Drug-related homicides rose more than 21 percent in 2015, a rate far higher than other common categories of homicide, which rose between 3 and 5 percent. Rosenfeld said it stands to reason that there’d be a connection between the spikes in opioid use and lethal violence.

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“It’s not opioid use per se that sparks violence, but the markets,” Rosenfeld says. “When disputes arise between sellers or buyers, they can’t be settled by police or courts or the Better Business Bureau. As the number of buyers expands, so does the number of disputes that turn deadly will also go up.”

Just how big a role do opioids play in driving the rise in homicides? That calls for more research, Rosenfeld says. But he sees ample evidence to sound the warning and to call for addressing the root causes. “Policymakers and law enforcement are framing this as a public-health crisis more than as a criminal-justice crisis, and I’m very much in favor of that,” he says. “The bottom line is: If we reduce demand, we reduce crime.”

“We Don’t Want Those People Here!”

Reducing demand for opioids would likely reduce other social pathologies too. Like homelessness. “For those of us who’ve been providing health care to people who are homeless, this is not a new problem,” says Barbara DiPietro, senior policy director for the National Health Care for the Homeless Council. “We’ve been seeing opioid addiction and overdoses for decades.

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“When people are in a spiral and aren’t getting the help they need, oftentimes they lose their jobs and their ability to pay rent. Before you know it, you cycle through family and friends, and you’re in a shelter or on the street.” Of course, not all people who are homeless have addiction issues, but those that do have a harder time getting into treatment once the stability of housing is gone. Living on the street could easily drive anyone to substance abuse. Maybe you started with alcohol, but once you were on the street, you found other things. It’s very hard to get well when you’re homeless.

Federally-qualified health centers provide care to 1.2 million people a year, and the Council provides technical assistance to help improve quality and access. DiPietro says homeless service providers often see clients who never expected to be in this situation. “We see a lot of clients who come from construction work or other hard-physical-labor jobs, who got hurt and got prescriptions for legitimate reasons,” she says. “We see a lot of people who’ve experienced trauma in their lives—child abuse, domestic violence, sexual assault. So they self-medicate to deal with the pain.” And on the street, their problems are much more visible than those of people who engage in their addictive behavior behind closed doors.

“They’re living their private lives in a public space,” DiPietro says. “They’re subject to public scrutiny, arrest and incarceration at a much higher rate. And once you have an incarceration history, it’s hard to get housing assistance or a job again.”

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While more medical facilities and first responders are being equipped with opioid-overdose medications like naloxone (Narcan), that’s just an emergency measure, not a solution. DiPietro says what people struggling with addiction and homelessness need most is stable housing where they can get effective treatment. Health care providers the Council works with can help, but not enough to meet the scale of the problem.

Right now, communities don’t have the capacity desperately needed to get people into treatment. Another big obstacle is the attitude known as NIMBY—Not in My Back Yard. “Everyone believes treatment is important, but no one wants the services near them,” DiPietro says. “When that’s proposed, they rise up in community meetings and say, “We don’t want those people here.”

We’ve simply got to get beyond that attitude.

A Parting Thought

I spent forty years in active addiction. It started simple enough: A case of beer and an ounce of Colombian Gold. Eighteen months later I was serving 3 to 10 in state prison. Drug and alcohol abuse continued throughout parole and into my thirties, forties and early fifties. My drug use ran the gamut, from weed to cocaine to crack to opiates. When I couldn’t get enough oxycodone through doctors, I began stealing it from friends and family. My addiction cost me plenty, yes, but it also cost my children, my two ex wives, my brothers, my sister, and my parents. I lost jobs, cars, apartments, friends and family. I blew every penny I made, bounced checks, embezzeled, fenced stolen goods. I was enslaved to addiction. Not only did my family disown me for nearly two years, my youngest son didn’t talk to me for five years.

It’s not only the family of addicts that can become fed up and turn their backs on their loved ones struggling with addiction; society has become rather fed up and impatient. One of our local television stations airs a nightly feature called “Talkback 16,” where viewers call to voice their grievances, pet peeves, and, yes, an occasional compliment. Several days after a news story aired about plans to build a drug and alcohol treatment center in the Pocono Mountains (Pennsylvania), a viewer called to complain about the plan, adding, “Not in my neighborhood. [Addicts and alcoholics] can’t be trusted. Besides, they did it to themselves.”

Truly, this attitude must change.