Mental Health and Addiction

The first section of this post is taken from the blog of Sophia Majlessi,
National Council for Behavioral Health
Released January 8, 2020

Voters More Likely to Support a Candidate Who Promises to Address Mental Health and Addiction, According to New Polling from the National Council for Behavioral Health Released Ahead of December 16 New Hampshire 2020 Presidential Candidate Forum

WASHINGTON, D.C. (December 11, 2019)—New polling released today by the National Council for Behavioral Health shows strong bipartisan agreement among registered voters in New Hampshire that the federal government is not doing enough to address mental health (84% of Democrats and 72% of Republicans) and addiction (77% of Democrats and 53% of Republicans) in America. The National Council released the new polling in advance of the Unite for Mental Health: New Hampshire Town Hall, a public forum for 2020 presidential candidates to discuss mental health and addiction policies. The National Council for Behavioral Health, Mental Health for US and the NH Community Behavioral Health Association will host Unite for Mental Health: New Hampshire Town Hall on December 16 at the Dana Center at Saint Anselm College in Manchester, N.H.

“The message is clear: candidates who want to win New Hampshire need to tell voters they have a plan to address the mental health and addiction crisis, one of the most important health issues facing the nation,” said Chuck Ingoglia, president and CEO of the National Council for Behavioral Health. “The Unite for Mental Health: New Hampshire Town Hall will provide an important opportunity for presidential candidates to engage with New Hampshire families, mental health professionals and local policymakers to discuss the issues and share solutions voters—and the nationare eager to support.”

This statewide poll comes on the heels of new national data from the U.S. Centers for Disease Control and Prevention (CDC) confirming that suicide is the second leading cause of death among teenagers in the U.S. The suicide rate among people ages 10 to 24 years old climbed 56% from 2007 to 2017, according to the CDC report. These findings, compared with high rates of death nationwide from drug overdose, are leading to calls for the 2020 presidential candidates to engage communities across the country in order to better meet the needs of millions of Americans.

“Mental health and addiction continuously poll as key issues for many Americans, yet our leaders rarely prioritize prevention, treatment, and recovery strategies,” said former U.S. Rep. Patrick J. Kennedy, founder of The Kennedy Forum and Mental Health for US co-chair. “This new polling data from New Hampshire is the catalyst we need for change. The Mental Health for US coalition is proud to stand with the National Council and the NH Community Behavioral Health Association as we call on policymakers and candidates to walk the walk for the those with mental health and addiction challenges.” “The results of this poll are compelling. The need to invest in caring for those with mental illness is clear, and the voters want to see candidates for public office at all levels address these important issues,” said Roland Lamy, executive director of the NH Community Behavioral Health Association.

Results from the full survey have a margin of error of +/-6%. Click here for full polling results.

My Thoughts

The struggle to break free from active addiction is among the hardest undertakings a person can face in his or her lifetime. Putting the drug down is more difficult depending on the substance, amount used, and duration of use. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), published by the American Psychiatric Association, has sequestered substance abuse under the new heading Substance Use Disorder (SUD). The substance-related disorders encompass 10 separate classes of drugs: alcohol; caffeine; cannabis; hallucinogens; inhalants; cocaine (powder or rock); opioids; sedatives and hypnotics; stimulants (amphetamine-type, cocaine, and other stimulants; tobacco; and other (or unknown) substances. It is important to note that all drugs (when taken in excess) have a common direct activation of the brain reward system, typically leading to dependency and addiction.

Mental health issues can become a complicating factor; this is often referred to as dual-diagnosis, or, in the vernacular, “double-trouble.” Moreover, individuals with poor self-control may be particularly vulnerable to substance abuse. Accordingly, the roots of substance abuse for some individuals can be seen in behaviors long before the onset of actual substance use itself. It is also important to note that substance-related disorders are divided into two groups: substance use disorders and substance-induced disorders. These secondary issues can include intoxication, withdrawal, psychotic disorders, bipolar and related disorders, depressive disorders, anxiety disorders, obsessive-compulsive and related disorders, sleep disorders, sexual dysfunctions, delirium, and neurocognitive disorders.

Features of substance use disorders include a rather important element: change in brain circuits that may persist beyond detoxification, particularly in individuals with severe disorders. The behavioral results of such changes may manifest in repeated relapses and intense craving for the individual’s favorite drug. This craving is often set in motion through a mere drug-related stimuli, which is referred to in the addictions field as a trigger. Typically, the longer an addict remains clean the easier it is to recognize and defeat such cravings. A craving is likely rooted in classical conditioning, and is associated with activation of specific reward structures in the brain. These structures are rather individualized; not every addict is triggered by the same thought or stimulus. Instead, triggers are established by what the individual is agitated or distressed by, and inversely related to the ability to properly handle such stimuli.

Not surprisingly, treating co-occurring substance abuse and mental illness calls for simultaneously addressing two critical and sometimes confounding problems. In fact, double-trouble can often complicate differential diagnosis—the comparison of symptoms from multiple likely mental or physical conditions. From a personal perspective, it was quite difficult for me to clearly determine what was “wrong” with me. Severe anxiety, constant ruminations, insomia, and underlying depression crippled me for decades. In addition, I felt powerless and helpless, unable to relax or sleep. This is likely what initially led to my substance abuse. I started drinking alcohol and smoking marijuana the summer following my high school graduation. My use was extensive from the beginning, but I was able to calm down, stop my thoughts from racing, and finally get some sleep. Unfortunately, I was not “sleeping” as much as I was passing out. It did not take long for my substance use to become excessive, leading to a decades-long season of poor choices and serious consequences.

Reasons for drug and alcohol abuse by individuals with mental illness varies by individual. Substance abuse could be primary or secondary to psychiatric issues, or may even in some cases be independent of mental illness. The association between mental disorders and substance abuse is complex. The relationship of substance abuse to onset, course, and severity of mental issues, and problems in the evaluation of dual-diagnosis patients, is often complex. Adding to this difficulty is the likelihood that the individual often engages in self-medication to alleviate troublesome symptoms for which they have no explanation. This psychodynamic perspective must also include neurochemical considerations. Affective disorders (those impacting mood, often including depression, bipolar disorder, anxiety disorder) are particularly difficult to manage. I found welcome relief through drug and alcohol us—albeit only temporarily.

Unfortunately, chronic substance abuse can also lead to the development of organic conditions, such as psychosis, mania, and mental confusion. Other disorders can include chronic apathy and dysphoria, and personality disorders such as Antisocial Personality Disorder and Borderline Personality Disorder. Again, there is often confusion regarding co-morbity. For example, addicts quite frequently use, abuse, manipulate, and disrespect friends, family, and other acquaintances in order to get what they need, whether it be money, shelter, or (at times) the drug itself. These traits are also typical of several key personality disorders.

As these traits become routine, the addict often slides down the slippery slope to criminal behavior—theft, embezzlement, forgery, kiting checks, burglary, armed robbery. A serious, unfortunate end-result for the dually-diagnosed addict can lead to suicide. I have personally considered taking my own life on many occasions during active addiction. I would become remorseful for the way I treated family and friends. The disconnect between my Christian worldview and my behavior haunted me. It seemed suicide was the only option. As my uncle once told me, I was unable to see the horizon. Truly, I have not faced a more difficult situation in my life than suffering from mental illness while in active addiction.

In my review of the diagnostic criteria for Borderline Personality Disorder, I determined I’ve displayed eight of the nine criteria for making such a diagnosis. I’ve demonstrated a pervasive pattern of instability in my interpersonal relationships, self-image, affect (mood swings), impulsivity (sexual behavior, drug and alcohol abuse, risk-taking, excessive impulse spending, reckless driving), recurring thoughts of suicide, chronic feelings of emptiness, and recurrent anger. Thankfully, I have seen a vast improvement in the lion’s share of these symptoms. However, I still deal with poor self-image at times, tend to “sanitize” the truth, occasionally manipulate others, and remain rather impulsive in areas such as impulsive spending.

Given the pervasive nature of dual-diagnosis, it is critical to identify when you are suffering from mental or emotional symptoms, and more importantly to recognize if you are using or abusing drugs or alcohol to dampen or defeat uncomfortable thoughts or feelings. Depression, anxiety, and insomnia tend to “respond” initially to substance use. However, the need for one’s drug of choice to “treat” these types of symptoms increases as use leads to abuse; abuse leads to tolerance; and tolerance leads to dependency. Consequently, self-medication of emotional or psychiatric difficulties by consuming drugs or alcohol is doomed to fail—often with quite devastating results. If you, or someone you know, is caught in the vicious cycle of addiction (with or without a co- occurring mental condition), it is vitally important to seek professional intervention.

It is impossible to “go it alone” and achieve anything like helpful results. In fact, it is likely your situation will deteriorate. I was told years ago by an addictions counselor that because I had an underlying mental illness, treating my addiction without addressing my psychiatric problem is like having two broken legs but only putting a cast on one of them.

If you or someone you know is struggling with substance use disorder and want more information or help quitting, please contact your local AA or NA chapter, or click here to visit the National Institute on Drug Abuse official website. You can also scroll back to the top of this post and click on the COMMENT bar to open an dialog with me. I will be glad to speak with you any time.

References

American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 5th edition (Washington, DC: American Psychiatric Publishing), 2013.

 

Recovery 2019: The Year in Review

From the Recovery Advocacy Update blog of the Hazelden Betty Ford Foundation originally posted on January 7, 2020.

Hazelden Betty Ford Banner with Woods Background.jpg

As Americans reflect on the past decade, the much more defining story, of course, was the opioid crisis, which fueled an unprecedented overdose epidemic that has barely begun to abate. Drug overdoses claimed a mind-boggling half-million lives in the 2010s and devastated countless others, while exposing the inadequacy of our nation’s overall approach and commitment to preventing and treating addiction, and supporting long-term recovery.

Amid the tragedy, we saw the beginning of positive change in addiction-related public attitudes, perceptions, policies, practices and systems. Hazelden Betty Ford has helped lead the way with many changes of its own. They began using opioid-addiction-treatment medications in 2012, and became a strong advocate for comprehensive care that includes medication options, psychosocial therapies and peer support. They emerged as a leading voice for breaking down barriers between the medical and Twelve Step communities.

Hazelden Betty Ford also transitioned to an insurance model so more people could access care; evolved away from the 28-day residential standard to a more individualized approach that enables people to stay engaged longer over multiple levels of care; launched a new era of aggressive collaboration with the broader healthcare field; made the evidence-based therapy “motivational interviewing” core to a more patient-centered clinical approach; initiated a new, innovative system for capturing and acting upon patient feedback throughout the treatment experience; developed new recovery coaching options; and much more. In addition, the foundation spoke up vigorously about the need for ethical and quality standards in recovery, and continued to support related industry reform efforts. It was a decade of big change for them, and they will likely evolve a great deal more in the 2020s, as they have consistently done since 1949.

Broader changes to the many systems that affect people with addiction are coming more slowly, but things seem to be pointed in the direction of progress. Indeed, most addiction specialists want addiction prevented and treated, rather than stigmatized and criminalized. The question arises, though: Does that mean it is wise to fully legalize and commercialize more addictive substances? Or are there policies and approaches in between that promote public health better than either extreme?

In the new decade, marijuana will be a case study and likely a defining story. The experiment with full legalization looks troubling so far. State-level data from the National Survey on Drug Use and Health finds that marijuana use in “legal” states among youth, young adults, and the general population continued its multi-year upward trend in several categories. New data and studies come in weekly, it seems—consistently showing cause for greater public health concerns. One of the foundation’s 2020 resolutions is to help ensure the facts about marijuana and the risks of expanded use get more attention.

One big concern, for example, is that marijuana vaping by teens surged in 2019, signaling that more adolescents are using the drug and consuming highly potent vape oils, according to new government data and drug-use researchers. Federal regulators are paying attention. They shut down 44 websites advertising illicit THC vaping cartridges, part of a crackdown on suppliers amid a nationwide spate of lung injuries tied to black-market cannabis vaping products.

The outbreak of severe lung injuries may have peaked, but cases are still surfacing, and the agency is urging doctors to monitor people closely after hospitalization, due to the risk of continued vaping. One Harvard graduate student writes, “I nearly died from vaping THC, and you could too.” Marijuana and vaping are both among the issues coming up on the campaign trail, and recent polling released by the National Council for Behavioral Health shows strong bipartisan agreement among registered voters in New Hampshire that the federal government is not doing enough to address mental health and addiction in America. Mental Health for US, a coalition trying to raise more awareness in the campaign, held a recent forum in New Hampshire. Watch the livestream replay here.

In Washington, the White House hosted a summit of its own on efforts to deliver mental health treatment to people experiencing homelessness, violence and substance use disorder. Watch Part 1 of the event, Part 2, and the President’s remarks. The Administration also issued its long-awaited vaping policy last week, with the FDA banning fruit, mint and dessert-flavored vaping cartridges but continuing to allow menthol- and tobacco-flavored cartridges as well as all flavored e-cigarette liquids. Many worry the guidelines don’t go far enough.

Since the foundation’s last update, the President also signed a $1.4 trillion spending package passed by Congress, averting a government shutdown. The package maintains funding levels for most areas relevant to the field of addiction counseling, with modest increases in a few SAMHSA grants as well as at the CDC and at the National Institutes of Health. Most notably, the legislation gives states more flexibility in spending State Opioid Response (SOR) grant funds; specifically, they’ll now be able to use the money to also address the growing problems associated with addiction to meth, cocaine and other stimulants. Here’s a thorough overview from our friends at the National Association of State Alcohol and Drug Abuse Directors.

If you are interested in more information about these topics or the Hazelden Betty Ford Foundation, please visit their website by clicking here.

If you or someone you know is struggling with substance use disorder and want more information or help quitting, please contact your local AA or NA chapter, or click here to visit the National Institute on Drug Abuse official website. You can also scroll back to the top of this post and click on the COMMENT bar to open an dialog with me. I will be glad to speak with you any time.

Do You Look for Loopholes as a Christian?

Written by Steven Barto, B.S. Psych.

The standard definition of a loophole is an ambiguity or inadequacy in a system, such as a law or a set of rules, which can be used to circumvent or otherwise avoid the purpose, implied or explicitly stated, of the system. It is basically a small mistake which allows people to do something that would otherwise be illegal. Generally, the cause of a loophole is a divergence between the text of the law (how it is written) and the meaning of the law (its intended effect).

Loophole Graphics

PHARISEES AND THEIR THEOLOGICAL LOOPHOLES

Pharisee Pointing

It’s no secret that the Pharisees of Jesus’ days were typically angry over infractions of the Sabaath. This was a huge issue between them and the Lord. Interestingly, the Pharisees created a loophole that allowed them to break their own rules regarding the Sabbath whenever convenient. According to Rabbinic teaching, a Jew could take no more than 3,000 steps on the Sabbath, nor carry more weight than half a dried fig. To circumvent this law, the Rabbis designed a small wearable tent. The tent had poles that rested upon their shoulders, lifting it from the ground. A chair was fastened to their rump Accordingly, they were not technically carrying anything. They would walk 3,000 steps, sit on the stool, then stand and walk 3,000 more steps, repeating the process over and over until they arrived at their intended destination. They declared the tent to be their home each time they sat down. Their “theology” gave them a loophole for travel and manual labor on the Sabbath if they found it necessary. Technically, they were in the clear. That’s what loopholes do for us—permit us to be “technically” right while breaking the rules.

CHRISTIANS AND THEIR LOOPHOLES

When Christians look for loopholes, they change Scripture to fit their circumstances. A believer with this mindset is not concerned with what Scripture dictates; rather, they are concerned about making Scripture say what they need it to say. Individuals who are Christian “in name only” look for loopholes. True followers of Christ don’t look for an out. Unfortunately, many believers today claim certain doctrines, proscriptions, or edicts in Scripture for “back in ancient times” rather than the modern church. This is basically a form of “progressive” Christianity, which flies in the face of God’s unchanging Word. Jesus is the same yesterday, today, and forever. Second Timothy 3:16 says, “All scripture is given by inspiration of God, and is profitable for doctrine, for reproof, for correction, for instruction in righteousness” (NIV). Ecclesiastes 3:14 says, “I know that whatever God does, It shall be forever. Nothing can be added to it, And nothing taken from it. God does it, that men should fear before Him” (NKJV).

PAUL

The Apostle Paul 001

Romans 7:19-21 says, “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. So I find this law at work: Although I want to do good, evil is right there with me” (NIV). It is important to note that Paul was not speaking about a non-believer, nor was he describing a carnal Christian. He was talking about a victorious disciple still at risk for sinful behavior. Admittedly, Paul is not speaking of the practice of sin by a believer—willfully sinning despite knowing the consequences.

Paul was leading a crucified life, putting on the righteousness of Christ (see verse 25). He delighted in the Law of God in the inward man (see verse 22). That means he was gratified by love, goodness, righteousness, and mercy. The part of his mind that was focused on serving God no longer practiced sin. His thoughts were on Jesus. He told the Christians at Corinth, “I resolved to know nothing while I was with you except Jesus Christ and him crucified” (1 Corinthians 2:2).

There were several aspects of Paul’s life where he had not yet received light. In such instances, he was taken captive by the law of sin in his flesh, causing him to do things he hated (see verse 23). Someone who is willfully committing sin is not doing what he hates. His mind approves of it. When desire is conceived, it gives birth to sin. We actually consent to the desire in our mind and sin is born. James 1:14-15 says, “But each person is tempted when they are dragged away by their own evil desire and enticed” (NIV). Such Christians are serving the law of sin with his or her mind.

THE LOOPHOLES OF ADDICTIVE BEHAVIOR

Addicts frequently use denial, rationalization, and loopholes to hide or downplay their abuse of drugs or alcohol. Heavy or chronic alcohol use leads to psychological and physical dependence and possible addiction. The Diagnostic and Statistics Manual of Psychiatric Disorders, Fifth Edition (DSM-5) says substance abuse related disorders encompass separate classes of drugs: alcohol; caffeine; cannabis; hallucinogens; inhalants; opioids; sedatives; hypnotics; and stimulants. 

Here are four common loopholes used by alcoholics and addicts:

  1. I’ve already ruined everything. Addicts try to avoid or not acknowledge the consequences of their actions—at least until these consequences are severely compounded. Whether it’s losing a job, legal trouble, homelessness, dysfunction in the household, or all of the above, addiction progressively destroys lives. Although hitting “rock bottom” causes some to seek treatment, others justify continued addiction because they focus on the perceived irreparable damage they’ve caused. 
  2. I don’t deserve a happy, healthy life. According to the Journal of the American Medical Association, roughly half of all individuals diagnosed with a mental health disorder are also affected by substance abuse. Although this is a co-occurring diagnosis (often referred to in 12-step parlance as “double trouble”), it is not a loophole for addiction. Admittedly, feeling undeserving of a happy, healthy life due to mental health symptoms can be a trap. This often leads to drinking or drugging to self-medicate for chronic anxiety or depression. Accordingly, a loophole is created for continued use. 
  3. Now I can finally handle it. This justification is a loophole for relapse, as well as active addiction. When someone feels that their life is now more manageable—perhaps, due to a period of sobriety or fixing certain problems while in active addiction—they may justify drinking or taking drugs again or continuing to use. Unfortunately, the progressive nature of addiction quickly disproves this rationale. This loophole often rears its ugly head following inpatient treatment at a rehab. The individual feels he or she is “armed with” enough information to finally use safely.
  4. For me, it’s just normal life. For some, addiction is a solitary issue. For others, however, addiction may be shared with friends, family members, or partners. These individuals tend to justify their actions because they feel their behavior is part of the fabric of a relationship or social agenda. Even if someone believes their own addiction may be a problem, they can justify their dependency by referring to getting drunk or high as part of the “norms” of social life. 

MY FAVORITE LOOPHOLE

Unfortunately, I have often looked at certain habitual sins in the light of Paul’s own struggle, saying to myself, If the apostle Paul failed to resist the flesh and do what’s right, then how can I ever hope to do so? I am sure you see the hypocrisy of this conclusion. Basically, I have allowed this part of Paul’s teaching to serve as an excuse for what amounts to the “practice” of sin. Worse, the type of habitual sin that has been prevalent in my life involved deception, lying, and stealing narcotic painkillers from family members.

THE ADDICTED CHRISTIAN

Morgan Lee edited and published a provocative article in Christianity Today, called “Why a Drug Addict Wrote a Christianity Today Cover Story.” The article was written by Timothy King, a Christian who contracted very painful acute necrotizing pancreatitis. He was discharged on IV medication and given opiates for pain. Eventually, King’s doctor realized King’s reliance on narcotic painkillers was impeding his ability to eat and to recover from pancreatitis. Despite being a believer, King had become addicted to opiates.

Here is an excerpt from King’s article:

I use the term addicted. There are some medical professionals who use the word dependent because I didn’t go out and engage in behaviors typically associated with addiction. I chose to use the word addicted because it accurately describes my situation. It is a term I hope other people feel less stigma about in the future to describe their own situation. When we give the right name to something that is going on in our life, it kills its power over us. Naming something is incredibly important. Opioid addict is now tied to my name. I’ve had to think through that, but once again I have had a great community of support to encourage me about this story.

Whether deserved or not, believers struggling with an addiction are often shamed by the church rather than being provided an atmosphere for healing. Believers and non-believers alike are dying every day because of drug overdose. This should be cause for concern and a great opportunity for the church to be the church (the Body of Christ). After all, Christians are called to be a loving community of grace and healing. The church should not choose to see active addiction as a moral issue, ignoring the physical and psychological elements of the disorder. This only serves to ignore or sidestep this crisis, evidenced by believers (and some church leaders) who choose to sit on the sidelines, judging and ostracizing those who are suffering.

THE MINDSET OF A DISCIPLE

Paul answers his own question regarding his—indeed, our—struggle with sin that dwells within us. In Romans 7:25, Paul writes, “Thanks be to God through Jesus Christ our Lord! So then, on the one hand I myself with my mind am serving the law of God, but on the other, with my flesh the law of sin” (NASB). Before Jesus overcame the power of sin and darkness, leaving us with an example to follow, it was impossible to completely overcome all sin in the flesh. But Jesus sent the Holy Spirit Who can show us our sin (convict us) and teach us the way through it. Like Paul, when we repent and begin to serve God, we have a new mindset—it is no longer our conscious, daily choice to serve sin. What comes from our flesh is not necessarily done willfully.

When we are in Christ Jesus and choose to serve God with our mind and our spirit, there is no condemnation if we absentmindedly do the things we hate (see Romans 8:1). We aren’t condemned for being tempted (thoughts or feelings that entice us to sin), nor for actions we do which haven’t passed our conscious mind first, allowing us to make a conscious choice. But in order to accomplish this, we need to walk in the Spirit, which means acting according to the light that we receive. This comes only from allowing that light to illuminate our habitual sins. We will then be able to recognize the desires of the flesh—the body of sin that is to be crucified daily through Christ. How do we accomplish this? We count ourselves dead to sin. We can then be disciples of Jesus, denying ourselves and taking up our cross daily (see Luke 9:23-24).

Disciple is another word for a follower of Christ; one who is learning to be like his Master. originally meant pupil or apprentice. Too many Christians believe they became disciples of Jesus when they accepted His death, burial, and resurrection for forgiveness of their sins. We were certainly dead in our trespasses. Thankfully, we are forgiven through Christ. He made us alive together with Him (see Colossians 2:13). However, forgiveness of sin is not discipleship. Once we have received atonement for our sins and are reconciled with God through the crucifixion of Christ, we come to the beginning of a new us. We are now instructed to start following Jesus. Emulating the examples He provided to us during His life and ministry.

CONCLUDING REMARKS

If you or someone you love is struggling with addiction, closing the loopholes of active addiction may be imperative before seeking treatment. In reality, we can rebuild our lives. But this involves realizing that addiction is progressively destructive. Further, it is important to believe we deserved to be happy and healthy, and that active addiction is not a normal, fulfilling human existence. Jesus said, “The thief does not come except to steal, and to kill, and to destroy. I have come that they may have life, and that they may have it more abundantly” (John 10:10, NKJV). Eugene Peterson translates this verse as follows: “A thief is only there to steal and kill and destroy. I came so they can have real and eternal life, more and better life than they ever dreamed of” (MSG). Living life in bondage to addiction is certainly not an abundant life.  

Second Corinthians 5:17 talks about new life in Christ: “Therefore, if anyone is in Christ, the new creation has come: The old has gone, the new is here” (NIV). When we recognize that old things have passed away, we stand a better chance of living life without resorting to loopholes. Frankly, making decisions based upon loopholes is the hallmark of an unrepentant carnal Christian. When we are truly “in Christ,” we are a new creation. Old things have passed away. This is the “abundant” life we read about in John 10:10. We cannot hope to have an abundant and glorious new life in Christ if we excuse our occasion to sin as something not even the apostle Paul could avoid.