U.S. Surgeon General’s Advisory: Marijuana Use and the Developing Brain

Steven Barto, B.S., Psych.

I am reposting this information from a link to the U.S. Department of Health and Human Services (HHS.gov) provided by the National Institute on Drug Abuse (NIDA) website.

I, Surgeon General Jerome Adams, am emphasizing the importance of protecting our Nation from the health risks of marijuana use in adolescence and during pregnancy. Recent increases in access to marijuana and in its potency, along with misperceptions of safety of marijuana endanger our most precious resource, our nation’s youth.

Background

Marijuana, or cannabis, is the most commonly used illicit drug in the United States. It acts by binding to cannabinoid receptors in the brain to produce a variety of effects, including euphoria, intoxication, and memory and motor impairments. These same cannabinoid receptors are also critical for brain development. They are part of the endocannabinoid system, which impacts the formation of brain circuits important for decision making, mood and responding to stress.

Marijuana and its related products are widely available in multiple forms. These products can be eaten, drunk, smoked, and vaped. Marijuana contains varying levels of delta-9-tetrahydrocannabinol (THC), the component responsible for euphoria and intoxication, and cannabidiol (CBD). While CBD is not intoxicating and does not lead to addiction, its long-term effects are largely unknown, and most CBD products are untested and of uncertain purity.

Marijuana has changed over time. The marijuana available today is much stronger than previous versions. The THC concentration in commonly cultivated marijuana plants has increased three-fold between 1995 and 2014 (4% and 12% respectively). Marijuana available in dispensaries in some states has average concentrations of THC between 17.7% and 23.2%. Concentrated products, commonly known as dabs or waxes, are far more widely available to recreational users today and may contain between 23.7% and 75.9% THC.

The risks of physical dependence, addiction, and other negative consequences increase with exposure to high concentrations of THC and the younger the age of initiation. Higher doses of THC are more likely to produce anxiety, agitation, paranoia, and psychosis. Edible marijuana takes time to absorb and to produce its effects, increasing the risk of unintentional overdose, as well as accidental ingestion by children and adolescents. In addition, chronic users of marijuana with a high THC content are at risk for developing a condition known as cannabinoid hyperemesis syndrome, which is marked by severe cycles of nausea and vomiting.

This advisory is intended to raise awareness of the known and potential harms to developing brains, posed by the increasing availability of highly potent marijuana in multiple, concentrated forms. These harms are costly to individuals and to our society, impacting mental health and educational achievement and raising the risks of addiction and misuse of other substances.  Additionally, marijuana use remains illegal for youth under state law in all states; normalization of its use raises the potential for criminal consequences in this population. In addition to the health risks posed by marijuana use, sale or possession of marijuana remains illegal under federal law notwithstanding some state laws to the contrary.

Marijuana Use during Pregnancy

Pregnant women use marijuana more than any other illicit drug. In a national survey, marijuana use in the past month among pregnant women doubled (3.4% to 7%) between 2002 and 2017. In a study conducted in a large health system, marijuana use rose by 69% (4.2% to 7.1%) between 2009 and 2016 among pregnant women. Alarmingly, many retail dispensaries recommend marijuana to pregnant women for morning sickness.

Marijuana use during pregnancy can affect the developing fetus.

  • THC can enter the fetal brain from the mother’s bloodstream.
  • It may disrupt the endocannabinoid system, which is important for a healthy pregnancy and fetal brain development.
  • Studies have shown that marijuana use in pregnancy is associated with adverse outcomes, including lower birth weight.
  • The Colorado Pregnancy Risk Assessment Monitoring System reported that maternal marijuana use was associated with a 50% increased risk of low birth weight regardless of maternal age, race, ethnicity, education, and tobacco use.

The American College of Obstetricians and Gynecologists holds that “[w]omen who are pregnant or contemplating pregnancy should be encouraged to discontinue marijuana use. Women reporting marijuana use should be counseled about concerns regarding potential adverse health consequences of continued use during pregnancy”. In 2018, the American Academy of Pediatrics recommended that “…it is important to advise all adolescents and young women that if they become pregnant, marijuana should not be used during pregnancy.”

Maternal marijuana use may still be dangerous to the baby after birth. THC has been found in breast milk for up to six days after the last recorded use. It may affect the newborn’s brain development and result in hyperactivity, poor cognitive function, and other long-term consequences. Additionally, marijuana smoke contains many of the same harmful components as tobacco smoke. No one should smoke marijuana or tobacco around a baby.

Marijuana Use during Adolescence

Marijuana is also commonly used by adolescents, second only to alcohol. In 2017, approximately 9.2 million youth aged 12 to 25 reported marijuana use in the past month and 29% more young adults aged 18-25 started using marijuana. In addition, high school students’ perception of the harm from regular marijuana use has been steadily declining over the last decade. During this same period, a number of states have legalized adult use of marijuana for medicinal or recreational purposes, while it remains illegal under federal law. The legalization movement may be impacting youth perception of harm from marijuana. 

The human brain continues to develop from before birth into the mid-20s and is vulnerable to the effects of addictive substances. Frequent marijuana use during adolescence is associated with:

  • Changes in the areas of the brain involved in attention, memory, decision-making, and motivation. Deficits in attention and memory have been detected in marijuana-using teens even after a month of abstinence.
  • Impaired learning in adolescents. Chronic use is linked to declines in IQ, school performance that jeopardizes professional and social achievements, and life satisfaction.
  • Increased rates of school absence and drop-out, as well as suicide attempts.

Risk for and early onset of psychotic disorders, such as schizophrenia. The risk for psychotic disorders increases with frequency of use, potency of the marijuana product, and as the age at first use decreases. 

  • Other substance use. In 2017, teens 12-17 reporting frequent use of marijuana showed a 130% greater likelihood of misusing opioids.

Marijuana’s increasingly widespread availability in multiple and highly potent forms, coupled with a false and dangerous perception of safety among youth, merits a nationwide call to action. 

You Can Take Action

No amount of marijuana use during pregnancy or adolescence is known to be safe. Until and unless more is known about the long-term impact, the safest choice for pregnant women and adolescents is not to use marijuana.  Pregnant women and youth–and those who love them–need the facts and resources to support healthy decisions. It is critical to educate women and youth, as well as family members, school officials, state and local leaders, and health professionals, about the risks of marijuana, particularly as more states contemplate legalization.

Science-based messaging campaigns and targeted prevention programming are urgently needed to ensure that risks are clearly communicated and amplified by local, state, and national organizations. Clinicians can help by asking about marijuana use, informing mothers-to-be, new mothers, young people, and those vulnerable to psychotic disorders, of the risks. Clinicians can also prescribe safe, effective, and FDA-approved treatments for nausea, depression, and pain during pregnancy. Further research is needed to understand all the impacts of THC on the developing brain, but we know enough now to warrant concern and action. Everyone has a role in protecting our young people from the risks of marijuana.

Overcoming Temptation (The Jesus Way)

“Let no one say when he is tempted, ‘I am tempted by God;’ for God cannot be tempted with evil and he himself tempts no one; but 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” (James 1:13-15, RSV).

By Steven Barto, B.S. Psych.

PERHAPS YOU’VE HEARD IT SAID “sow a thought, reap an action; sow an action, reap a habit; sow a habit, reap a character; sow a character, reap a destiny.” There is a basic concept at work here which involves obsession and compulsion. Watchman Nee (1903-1972) was a Christian leader and teacher who worked in China during the 20th century, helping to establish numerous churches in that region of the world. Nee wrote, “It is a pitiful and tragic thing to be obsessed. Those who are obsessed are in a very abnormal condition.” He said obsession encompasses lying and deception. The obsessed Christian lies to himself, pretending there is no problem with his behavior. This self-deception becomes thick like fog, making it nearly impossible to see beyond obsessive thought and habitual action.

What is Obsession?

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I have been prone to obsessions throughout my life. Psychology teaches us that obsessions are “recurring thoughts, urges, or images that are experienced as intrusive and unwanted and, for most people, cause anxiety or distress. The individual tries to ignore them, suppress them, or neutralize them with a different thought or action.” The specific details of obsessions can vary widely. For example, they might include thoughts about contamination, a desire for order, taboo thoughts related to sex or religion, or a compulsion to harm oneself or others. Obsessions can revolve around activities that provide pleasure or escape, especially relative to alcohol, drugs, gambling, shopping, watching pornography, or eating.

At this stage, the brain is typically focused on the so-called benefits of a particular action or habit rather than the negative consequences. One hallmark of an obsession involves what some addictions counselors refer to as euphoric recall. At first blush, this might sound “warm and fuzzy.” Relative to substance abuse, however, this is associated with remembering past drinking and drugging experiences in a positive light, while overlooking negative experiences associated with it. I heard someone at a 12-step meeting say, “Play the tape all the way through.” Huh? He expounded: “Look past the high and the fun and the escape, seeing the eventual consequences of taking that first drink or drug.” In other words, remember the ugly results. 

What is Compulsion?

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Compulsions are “repetitive behaviors or mental acts that one feels compelled to do in response to an obsession or based on strict rules.” Typically, such behaviors are meant to counter anxiety or distress or to prevent a feared event or situation, but they are not realistically connected to these outcomes, or they are excessive. Although rare, obsessive thoughts and compulsive actions can lead to Obsessive-Compulsive Disorder (OCD), as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). A person suffering from OCD is often plagued by obsessions or compulsions that take up more than one hour a day or cause clinically significant distress or impairment for the individual. In order for this diagnosis to stand, all other potential disorders involving similar symptoms must be ruled out. Psychiatrists and psychologists call this procedure differential diagnosis.

The Book of James

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James 1:13-15 explains the process of obsessive thoughts in the believer that lead to temptation and sin. The apostle gives us a few key points to think about.  We must remember that James said when we’re tempted, not if we’re tempted. It is inevitable that we’ll be coaxed or seduced (essentially “baited”) to disobey God’s Word. The foundation of such temptation can be demonic or fleshly. It can have physical or psychological roots, or, frankly, both. For example, the enticement to take a drug or to watch pornography has a physical component of pleasure and escape, but it might also have an emotional or psychological component. Depending on your circumstances, such as severe physical pain, the enticement can be nearly impossible to resist. From a psychological viewpoint, the inducement can be pride, anxiety, depression, or boredom. In my experience, both physical and psychological enticement can be equally compelling. The perfect storm, especially for me, is when both mechanisms are at play!

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James is quick to tell us that temptation is a solicitation from the devil to do wrong, and is never directed by God (1:13). Satan doesn’t want us to think about the how of our temptation. Instead, he wants us to obsess over the temporary pleasure to be gained when we give in to what is baiting us. The devil will deceive us about the results of taking the bait. Perhaps we’ll buy into this action as having some type of relief or benefit. That’s why deception is his “go-to” device. Our habitual sin is rooted in automatic (compulsive) behavior, focused only on temporary pleasure or escape. Hand-in-hand with the thought that God does not tempt us to sin is the fact that temptation is strictly an individual matter (1:14).

Eugene Peterson places verses 2 through 18 under the heading “Faith Under Pressure.” In his translation The Message, he writes, “Don’t let anyone under pressure to give in to evil say, ‘God is trying to trip me up.’ God is impervious to evil, and puts evil in no one’s way. The temptation to give in to evil comes from us and only us. We have no one to blame but the leering, seducing flare-up of our own lust. Lust gets us pregnant, and has a baby: sin! Sin grows up to adulthood, and becomes a real killer.” It’s critical that we see what James is teaching us on temptation. He is saying we are lured away from God in the midst of trials by our own desires. It is my experience that temptation is specific to that which I personally find pleasurable. Not everyone is prone to finding relief at the bottom of a bottle or from a handful of opiate painkillers, as I have been. Not all men or women are enticed by pornography. These wiles are specific to each of us, which makes them harder to resist.

On one level, we simply want to sin. Paul taught us this in the seventh chapter of Romans. He says, “But sin, seizing the opportunity afforded by the commandment, produced in me every kind of coveting. For apart from the law, sin was dead” (7:8, NIV) [italics mine]. He reminds us that the law is spiritual, but at our core, that is in the flesh, we are not spiritual. We’re sold as a slave to sin (7:14). Prior to giving his life to the Way of Jesus, Paul was a “Pharisee among Pharisees,” well-educated at the feet of the renowned rabbi Gamaliel. He knew the Law front-to-back. He felt justified in persecuting and murdering Christians as members of a heretical sect of Judaism. No doubt he believed he was helping to protect Israel from the wrath of God.

It is important to note that Paul, a highly-educated Jew who was called to preach the Good News to the Gentiles, and had undergone spiritual conversion on the road to Damascus, still recognized his struggle in the flesh. Exasperated, he said, “I do not understand what I do. For what I want to do I do not do, but what I hate I do. And if I do what I do not want to do, I agree that the law is good. As it is, it is no longer I myself who do it, but it is sin living in me. 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” (7:15-18, NIV).

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Be careful, though, for it is possible to allow Paul’s struggle to become a loophole with which you will excuse your own wilful sin. I’ve been there, thinking, If even Paul can’t resist the flesh, then how can I? (See my blog article Do You Look for Loopholes as a Christian?) Wilful sin, however, is anathema to repentance, which literally means “to turn away from.” To repent is to do a 180 and never look back.

So Now What?

Repentance involves having the will to change; to never be the same again. If temptation is so difficult to resist, then what is its purpose in the life of the Christian? We know that sin occurs when we yield to enticement and make a wrong decision regarding our behavior. The dynamics of that mental and emotional process is complex. Although we’ve been freed from being a slave to sin (see Romans 6), we haven’t completely lost our taste for sin. Desires will remain in our flesh for as long as we live in a physical body. What we cannot excuse, however, is the practice of sin. Paul notes this problem in Romans 1:32, using the Greek word prasso to describe wilful sin. This refers to performing sin repeatedly or habitually. One definition specifically states, “to exercise, practice, to be busy with, carry on.”

If we are aware of a particular desire personal to us that entices or lures us into sinful behavior, we are responsible for addressing that behavior. Instead, many of us (me included) agree to be tempted, and we get on with practicing the sin. Looking at it this closely truly exposes the mechanism (the “come-on” if you will) and the chronic, repeated behavior associated with that temptation. Let’s be real: We simply “give in” once again and fail to resist the devil.

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Temptation that leads to sin always follows the same process.  There are four steps involved in giving in to temptation:  (1) the bait is dropped, (2) our inner desire is attracted to the bait, (3) sin occurs when we yield to temptation, and (4) sin results in tragic consequences.  To be aware of these principles is to be armed in the face of struggling with temptation. But can a true Christian habitually sin? Many believers wrestle with this question, and often give up and give in, thinking they must not be saved if they cannot stop sinning. Some will even teach that if you have habitual sin in your life you are not really a Christian. One pastor put it to me this way a few years ago: “You don’t have God in your heart.” Ouch! But unfortunately we can have head knowledge about God and Jesus, yet not have the required heart knowledge needed to act according to our beliefs or our intention to do that which is right.

Thankfully, the Bible takes no steps in hiding the sins of key Old Testament figures. Abraham, Isaac, Moses, and David were not super heroes. They were normal men who sinned as Adam did. There is no question that David is one of the Bible’s more prominent figures. Jesus Christ came from the House of David. We are easily inspired by his youthful willingness to fight Goliath, his tender friendship with Jonathan, his worshipful Psalms, and his enduring patience under wicked King Saul. It’s almost hard to believe that this beloved character who’s spoken so highly of in more than half of the Bible’s books would also be guilty of breaking half of God’s commandments. David coveted Uriah’s wife, Bathsheba (2 Samuel 11:2-3), committed adultery with her (11:4) effectively stealing her from Uriah (12:9), lying to him (11:12–13), and eventually having him murdered (12:9).

Others come to mind as well. Noah was a drunk (Genesis 9:20-21). Sarah doubted God and allowed Abraham to have sex with her maidservant in order to help fulfill God’s promise of a son (Genesis 16). Jacob was a pathological liar (Genesis 25, 27, 30). Moses had a bad temper (Exodus 2, 32:19; Numbers 20:11) and killed an Egyptian. Solomon was said to be the wisest man in the world, but he was a sex addict who took over 1,000 sexual partners (1 Kings 11). The prophets, even as they spoke for God, struggled with impurity, depression, unfaithful spouses and broken families. Looking to the New Testament men of God, we see Peter’s denial of Christ (John 18:13-27). Paul persecuted Christians, often sending them to death, before God chose him to lead the Gentile world to Christ (Acts 22:1-5).

Handling Temptation the Jesus Way

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Paul said God intends for us to work out our salvation daily with fear and trembling (Philippians 2:12). Unfortunately, the importance of this verse is lost on many Christians today. It is often used by certain teachers and preachers to instill fear into people, wrongly warning them that they can lose their salvation. (I am working on a blog article on this subject, which will be based on diligent exegesis, to be published at a later date.) Paul was certainly not encouraging believers to live in a continuous condition of nervousness and anxiety. That would contradict his many other exhortations of peace of mind, courage, and confidence in Jesus, the author of our salvation. The answer lies in the Greek word phobou (from phebomai) which Paul uses for the word fear, meaning “to be put to flight.” Paul was likely telling the believers at Philippi to work out their deliverance (salvation) from sin by fleeing from it or, in the alternative, by telling it to flee. This dovetails nicely with James’s admonition, “Submit yourselves, then, to God. Resist the devil, and he will flee from you” (James 4:7, NIV).

The Greek verb for “work out” (katergazesthe) refers to continually working to bring something to completion or fruition. This sounds a lot like the ongoing process of sanctification by which we are “set apart” from our sinful nature for God. Paul describes himself as straining and pressing on toward the goal of becoming like Christ (Philippians 3:13-14).  He teaches that the very essence of salvation is holiness—what he calls sanctification of the spirit. He says good works find their only root in salvation and sanctification. In other words, we are not saved by our good works, but rather we are saved for our good works. It is true that genuine Christians are identified by their fruits. Jesus reminds us that He is the Vine, and God is the Vinedresser (John 15:1). The Vinedresser cuts off every branch that bears no fruit, while pruning the ones that do, making them more fruitful (15:2). This is a great description of the process of sanctification through being pruned and made fruitful.

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The means by which we are able to work out our salvation and resist temptation is grounded in Jesus. If we want to participate in the salvation and restoration of the world, we must live in a manner that works toward that end. We follow Jesus. This includes coming to understand the power in the Name of Jesus: power to break chains, heal minds and bodies, build the Body of Christ, and rely on the Holy Spirit to clarify the truth of the Gospel. Accordingly, we must not cherry-pick the Gospel. We cannot decide to follow Jesus in some aspects of our lives, but go our own way (or, worse, the way of the devil) in others. If we are going to follow Jesus, we must learn the ways in which He leads. Moreover, we need to examine His relationship with the Father. We have to lock on to these methods and follow them with consistency and completeness. Paul reminds us that this is not easy, and James tells us it can only be accomplished by resisting Satan.

Concluding Remarks

The ways and the means promoted and carried out in the world today are designed to take God completely out of the equation. It is no coincidence that America is suffering at the hands of gun violence, murder, terrorism, hatred, bigotry, increased rates of abortion, brokenness (especially regarding the home), addiction, deception, selfishness, illness, and heartache. Surely, wars are fought and won, wealth is accumulated, elections are won, diseases are cured, and victories are posted, but at what cost? The means by which these ends are achieved leaves a hole in the soul of our country. Many people are killed, others are impoverished, marriages are failing apart, addicts are dying at an alarming rate, our schools and other venues have become soft targets for violence, children are being abandoned and neglected, and worldly churches are hawking their watered-down message in the name of Christ. As a result, we’re not moving toward spiritual maturity.

Simply stated, Jesus said, “I am.” He is the way, the truth, and the life. He is the Word in the flesh. The salvation of the world. The Head of the Body of Christ. He said we must repent, believe, and follow Him. We repent by making a decision to turn away from everything we were in the flesh and walk toward Jesus. This must include a change of heart and mind, which is the first step in becoming a new creation in Him. This requires a personal, trusting participation in the reordering of our reality. Lastly, we must follow the Way of Jesus. This involves every aspect of our daily lives, including what we think, how we speak, the manner in which we behave, and how we pray and interact with Christ. To follow the Way of Jesus implies that we enter into a brand new reality that necessarily shapes our character. We cannot separate what Jesus says from what Jesus does and the manner by which He does it, nor can we fail to walk in that same manner.

References

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA: American Psychiatric Publishing, 2013.

Nee, Watchman. The Holy Spirit and Reality. Hatfield, South Africa: Van Schaik Publishers, 2001.

Peterson, Eugene. The Jesus Way: A Conversation on the Ways That Jesus is the Way. Grand Rapids, MI: Wm. B. Eeardmans Publishing, 2007.

 

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.

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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.

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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.

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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.

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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

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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.